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Ann M. Brum and Wayne Smith discuss their roles as cannabis advocates fighting for reform and veteran access to medical cannabis.
Ann M. Brum, founder and CEO of Joint Venture & Co., and Wayne Smith, veteran and veterans’ advocate, discuss their roles as cannabis advocates fighting for reform and veteran access to medical cannabis.
Post-traumatic stress disorder (PTSD) is defined by the American Psychiatric Association (1) as a psychiatric disorder that may occur in people who have experienced or witnessed a traumatic event such as a natural disaster, a serious accident, a terrorist act, war or combat, rape, or who have been threatened with death, sexual violence, or serious injury.
Although the American Psychiatric Association said PTSD affects approximately 3.5% of US adults every year, war veterans are more likely to experience symptoms of PTSD. As such, inside the US Department of Veterans Affairs (VA) is the National Center for PTSD, a research and educational center for PTSD and traumatic stress (2).
Many have heard the horror stories of soldiers returning from war with PTSD. According to an article published in Dialogues in Clinical Neuroscience, “The late and delayed effects of combat exposure in the form of PTSD were a significant source of suffering and disability among veterans in the United States. An estimated 700,000 Vietnam veterans—almost a quarter of all soldiers sent to Vietnam from 1964 to 1973—required some form of psychological help” (3).
However, hearing it from the point of view of Wayne Smith, a former combat medic in Vietnam and advocate for peace and justice, offers an intimate, raw, and vulnerable look at PTSD and his fight for veterans’ access to medicinal cannabis. In this article, Smith shares his personal journey with cannabis and his advocacy work. In addition, we spoke with Ann M. Brum, founder and CEO of Joint Venture & Co., to learn how she became interested in medicinal cannabis and her journey towards advocacy for veterans and medicinal cannabis access. Along the way, Brum and Smith joined forces to help educate their local communities, legislate laws in Washington, D.C., and fight for veteran access to medical cannabis.
A child of the 60s and the Civil Rights Movement, Smith was introduced to marijuana in high school. “The war in Vietnam was raging, and every young man was faced with the inevitability of do they go, or do they avoid service?” he explained. “Marijuana was introduced, and it was a period of young people shaking off the martini hours and the pattern of our parents who had a drink to get the same kind of relief that we got from marijuana.”
In 1969 in Vietnam, drugs like marijuana were popular, as alcohol wasn’t often used as a form of relief, relaxation, or even sociability. Smith and other soldiers would smoke marijuana after completing their assigned duties.
“We needed to wind down from the loss of friends and buddies; the horror of death was always with us—the stress was so enormous,” he said. “I never forgot how even in a combat zone, even in some of the greatest horrors that are indescribable to civilians, marijuana helped us feel more normal.”
But when Smith and other veterans arrived home from the war, it wasn’t a warm welcoming. PTSD wasn’t defined by the American Psychological Association until 1979, so Smith said veterans were left to their own devices to heal, treat, and process.
“Our country fully betrayed us,” Smith said. “The government sprayed carcinogenic toxins—Agent Orange—on us, so veterans were developing serious physiological health problems. There were high rates of depression among returning veterans, suicide was off the charts, and the VA was openly hostile to us.”
Veterans started forming self-help organizations in their neighborhoods and states. In Providence, Rhode Island, Smith and others formed a group called the Vietnam Era Veterans Association. And in 1977, Smith got his degree in psychology. Finally in 1979, the U.S. government created a series of programs called the Vietnam Era Veterans' Readjustment Assistance Act of 1979 with the VA to help returning veterans.
“I saw the kind of healing that was needed, and I was in the right place at the right time,” he said. “I was counseling veterans, and we were just helping one another, trying to come to terms with the trauma that we had experienced, trying to find meaning to life, and it was enormously difficult. But for those of us that used marijuana, it made a great difference.”
The problem was, men who used marijuana in the military and post-war were getting serious prison sentences. “They were sent to jail for having a couple joints, so marijuana wasn’t something we could openly talk about, but we used it very aggressively and copiously.”
Cannabis is still considered federally illegal in the United States, and it is listed as a Schedule I drug by the United States Drug Enforcement Administration (DEA). According to the DEA, a schedule I classification means that a drug has no currently accepted medical use and a high potential for abuse. This status for cannabis is highly disputed because of the medicinal benefits that have been well-documented and scientifically proven.
“There are no cases of suicide or overdose from cannabis,” Smith said. “Instead, there is a wealth of first-person accounts and science on cannabis’ ability to enhance and help one's ability to cope, relax, and enjoy life versus the lethal effects of alcohol.”
California was the first state pushing for change and legislation to legalize marijuana and make it accessible, and many Vietnam veterans were involved in pushing for legislation. “My involvement with the Iraq and Afghanistan Veterans of America has been one of the most rewarding ventures because this is a generation that understands the struggles Vietnam veterans had to go through—we had to kick in doors, demonstrate, and fight to have a hearing on alternatives to the powerful psychotropic drugs the VA gives out like candy.”
It’s not only taken a lot to change the country’s views on cannabis, it’s taken a lot to change how Vietnam veterans are viewed too. Smith and other veterans have worked hard to change people’s perspectives, which is something he’s very proud of. “Americans were able to finally separate the war from the warrior,” he said. “They looked at the individual soldiers and saw that after the shooting stopped, they came home and had real struggles to be like they used to be, and that meant getting help and treatment.”
Brum was first exposed to medicinal cannabis while working in hospice and end-of-life care. The agency used complementary therapies for veterans such as Reiki therapy, massage therapy, aromatherapy, singing therapy, and pet therapy—she was amazed by the patients’ relief. And one of her last patients was a former nurse who talked about how cannabis had helped her.
Fast forward to late 2015, through a vertically integrated medical operator, Brum was able to meet patients in the Medical Use of Marijuana Program in Massachusetts, which registers qualifying patients, personal caregivers, registered marijuana dispensaries (RMD), and RMD agents.
“Veterans were part of that patient population,” she said. “I received a lot of feedback from veterans on different types of products, dosing, their preferred method of administration, titration, and different cultivars that provided relief.”
A few years later, Brum was recruited to a medical patient provider that hosted, Honor Those Who Serve. During the event, cannabis leaders and professionals educated attendees on cannabis. The patient card provider gave qualifying veterans complimentary patient cards for the state cannabis program. From there, Brum launched a boutique growth agency, Joint Venture and Co., an organization dedicated to leaders who create industry movements with their teams and within the market.
Through various mediums, Brum connected with Tracey Gregory, an RN, and Stephen Mandile, an Iraqi war veteran and cannabis advocate, and the three of them presented at the Hospice and Palliative Care Federation of Massachusetts (2018 HPC FM) annual education conference on PTSD at end of life with veterans.
From there, Brum was introduced to Dr. Marion McNabb, DrPH, MPH—the CEO and co-founder of the Cannabis Community Care and Research Network (C3RN), a Massachusetts-based cannabis research company—who was eager to gather data on cannabis and veterans to present to legislators, industry, and the public. Shortly after, the Veterans Health and Medical Cannabis Study was born in collaboration with Brum, Mandile, and Dr. McNabb. The Veterans Health and Medical Cannabis Study is a comprehensive study, funded by various industry and media partners, that surveyed 565 veterans, both nationally and in Massachusetts, about various factors including age, wars served, military branch, symptoms, PTSD, treatments, medications, cannabis use, and more.
“It was the first time I was involved in an extensive study,” Brum said. “I’ve done surveys before but never at this scale in partnership with UMass Dartmouth for Institutional Review Board approval and future academic publications.”
In order to get the attention of legislatures, industry, consumers, veteran organizations, academics, regulators, and more, they founded the Cannabis Advancement Series as an awareness channel for the study in which the data was presented at curated community education development events.
“It was an incredible experience to collaborate with the founders Steven and Marion and curate important content, share veterans’ stories, and see their participation in the community, advocacy in cannabis, and entrepreneurship,” Brum said.
Smith was asked to be a keynote at the fourth installment of the Cannabis Advancement Series. The two met while Smith was presenting on a panel at the New England Cannabis Convention.
Both Smith and Brum continue to advocate for cannabis reform.
The findings from the Veterans Health and Medical Cannabis Study paved the way for Brum and others to advocate and petition for Bill H4274 at the Massachusetts State House. Their bill included two additional qualifying medical conditions for veterans and the general public: opioid use disorder and PTSD. PTSD is not considered a qualifying condition for a medical cannabis patient card in Massachusetts. It is one of only seven states with a medical program that does not have it listed.
Using the data from the study, Brum and others testified in January 2020 about their project and advocated for veterans to have a streamlined process to become a patient in Massachusetts.
“In terms of reform, we are only at the beginning of seeing the systemic impact these findings will have to inform legislators and constituents,” she said. “My hope is that moving forward, by legislative mandate, medical cannabis programs have a compassionate-use program that covers the costs for veterans to pay for their entry into the program with a patient card and offer an allotment or allowance to cover the cost of product—the barrier of entry and the barrier of cost are two complementary findings from our research and study findings.”
And for those veterans who received prison sentences for marijuana use, Smith, as part of his role as membership director of Vietnam Veterans of America, lobbied Congress for mental-health treatment methods and reduced sentences for veterans incarcerated for marijuana.
But still, Smith said the biggest misconception among Americans is ignorance. “People just don't know. Those who tend to be opposed to cannabis legalization and especially medical cannabis don't know about its benefits,” he said. “The VA is one of the largest consumers and dispensers of pharmaceuticals because they have the largest healthcare system in the country, over 250 hospitals. The biggest challenge continues to be the groundwork we are doing in Massachusetts and informing the American people to not be afraid, but to understand that cannabis has medicinal value, and it has changed and saved people's lives.”
As veterans and non-veterans alike advocate together, progress and change are happening, and they are inspiring others to get involved.
“We have helped to inform and inspire larger veterans’ communities, and they have come around in a very big way,” Smith said. “Stephen and Dr. McNabb were in Massachusetts blazing trails. I can't tell you how proud I am, as are other guys like me, old guys, who’ve been in the trenches for a long time, to see this next generation of leaders informed and using science. Stephen put his body on the line to help the people of Massachusetts understand that there are alternatives to gaining better control over their mental health and over their lives, to provide support and meaningful happiness to their families.”
Brum said she is always looking for opportunities to support those who are actively engaged like Mandile and Smith. “I’ll do anything I can to help support and raise awareness for veterans to have the access and choice of medical cannabis,” she said. “I will also continue to advocate at the Massachusetts State House and provide public testimony for the veteran community and policy around medical cannabis, as well as show up and support veteran organization initiatives such as the Massachusetts Disabled American Veterans Chapter and vote in local and state elections.”
Informing local communities and educating politicians, business leaders, and educators helps to diminish the stigma and fear around cannabis. “We have work to do at the state and federal levels. We need to push state legislatures that are less progressive than Massachusetts to come into the 21st Century,” Smith said. “And we will continue to lobby Congress and the White House to support practical, safe, and affordable treatment.”
“Show up and care enough to check in with veteran organizations, veterans, caregivers, and families” Brum urged. “There are amazing local, regional, and state organizations, as well as at the national level to participate and support. It’s about walking the walk and talking the talk. Show up, listen, learn, support, advocate, and vote. You’ve got to vote.”
Smith said people can get involved by supporting the work they do. “Contact Stephen Mandile or Dr. Marion McNabb. But more importantly, I hope every person who reads this calls their senator, congressperson, or state representative and asks two simple questions: Are you a supporter of medical cannabis? If so, thank you. If not, why not? It’s our civic duty,” said Smith. “We are asking people to stand with us to change the ignorance and to help educate people on the facts. We want to change public policy at the local and state level and change the government's opposition to doing the right thing and making medical cannabis available to every citizen who needs it.”
Brum, Smith, and many others continue to empathize, advocate, and educate for cannabis reform in hopes that current and future veterans and the general public can have access to cannabis’ medicinal benefits.
“I know suffering sucks; I’ve seen way too much with the loss of my father who was a foreign veteran from Portugal, serving on the islands of Azores,” Brum said. “I wish I had known about access or the benefits of cannabis or hemp in 2002 for his comfort and care.”
And Smith agreed. “It makes me wish that when I came home from Vietnam, there was a Stephen Mandile and a Dr. Marion McNabb. I think of how much better my life and the lives of so many other veterans that I've worked with over the years would be.”