By Sarah Ferreira
I came hobbling back into my office fresh from the ER with a little bag of 800mg of Motrin and a tube of biofreeze. My lumbar back is totally locked up and I have bouts of sciatica shooting down my left leg. About four hours earlier I herniated my L5-S1 disc doing heavy deadlifts (always a good reminder to keep your ego in check). My civilian co-worker who I share an office suite with, eager to help alleviate my pain, hands me a lotion and proceeds to tell me how she uses it all the time for joint and muscle pain that pops up from her days of collegiate gymnastics. I take a closer look at the label and I see that it’s actually CBD lotion.
Me: Does this stuff actually work?
Her: Oh yeah, I use it all the time. Really helps with inflammation.
Me: Does it get you high?
Her: No! It doesn’t contain any actual THC.
As I begin to open the bottle, eager to start slathering this stuff all over my back, I pause and wonder if I’m even allowed to use or take CBD as an active duty servicemember. I’ve been working an office job for the past 3 years and been out of the loop so to speak on the latest policies as it relates to these types of things. I open the discussion up to my other military officemates and ask them. “Hey-what’s the military policy on CBD products?” I get a wide variety of answers, quickly prompting me to head to the Google search. After a few minutes of searching there it was, plainly stated on the Uniformed Services University website- all CBD is off-limits to all military service members. I continued down a rabbit hole and after 30 minutes of internet searching, I had more questions than answers about CBD use and its benefits. I politely declined my coworker’s CBD lotion, but I couldn’t help but wonder if this stuff could actually work and get me back under the barbell.
Fast forward a few weeks and I’m catching up with some of my veteran friends who are out of the military. They openly share their struggles with PTSD, depression, and suicidal ideations. The conversation turns toward the unwanted side effects of the prescription meds they are on to help treat their mental health issues. Many of them openly use CBD as a part of their personal treatment plan. Again, I ask the question of “Does it get you high?” and the answer is always no.
So, if this stuff has potential benefits for a wide variety of ailments and conditions why does the military take such a hard stance against it?
What is CBD?
CBD is a cannabinoid found in the cannabis plant and is often confused with tetrahydrocannabinol (THC) which is the cannabinoid that is responsible for the “high” that comes from marijuana use. CBD does not cause a “high” sensation. CBD can be derived from hemp or from marijuana with the primary difference being that hemp plants contain no more than .3% of THC. Knowing the difference between hemp and marijuana is important because marijuana CBD products will contain enough THC to pop hot on a drug test. Hemp-based CBD products contain such small traces of THC, less than .3%, that it is highly unlikely to show up in a drug test, however, there is no absolute guarantee.
Despite the oftentimes confusing legality of CBD as the laws vary from state to state, the industry is booming right now. CBD is being added to drinks, gummies, food, and oils. The country’s most popular podcast host, Joe Rogan, who is also a very serious BJJ athlete, recently teamed up with Kill Cliff to launch a CBD infused drink with his full endorsement.
CBD is commonly advertised as providing relief for anxiety, stress, PTSD, sleep disorders, and pain. It’s easy to see why veterans and military members would be drawn to this type of product, as many are constantly seeking a way to alleviate mental and physical pain outside of prescription medication.
Herein lies the problem. The popularity of the product has outpaced the science. The current body of research on CBD and its potential benefits is lacking. The FDA has only approved one drug with CBD extract used to treat a rare seizure disorder in children. However, there is emerging evidence to suggest that CBD may be beneficial for anxiety, insomnia, and chronic pain (Masataka, 2019; Babson, 2017; Xiong, 2012).
Numerous smaller studies show promise that CBD can be used to help treat addiction, inflammation, and even side effects of chemotherapy (Xu, 2020; Hurd, 2019; Parker, 2011). The primary issue with many of these studies is that they have very small sample sizes and are not randomized, double-blind, placebo-controlled clinical studies which is the gold standard. Also, many studies with CBD are conducted with animals-not humans.
In an effort to better understand if CBD can be used to effectively treat PTSD, the Department of Veterans Affairs is funding its first study on CBD and pairing it with psychotherapy (https://clinicaltrials.gov/ct2/show/NCT03518801). From my perspective, it’s exciting to see the VA taking open-minded, proactive steps to help the vet community.
The general consensus among the medical community seems to be that initial research is promising, but much more needs to be done.
Current Military Policy
The challenge with CBD products is that they are not regulated by the FDA. Therefore, there is no way to guarantee that the CBD products are actually containing less than .3% THC, which could cause current servicemembers to test positive on a drug test. A 2017 study concluded that fewer than a third of 84 CBD products tested actually contained the amount of CBD on their labels (Bonn-Miller, 2017). However, there are reputable and safe CBD products and companies that utilize 3rd party verifiers and testers.
In order to safeguard troops from generally unregulated industry, and to protect the integrity of the drug testing process, the DoD issued a blanket ban on CBD products (Cannabidiol: Are products with CBD legal? opss.org). Service members can be punished under UCMJ for possession or use of CBD products.
But does an all-out blanket ban on CBD make sense? The military allows servicemembers to consume dietary and nutritional supplements; another multi-million-dollar industry not regulated by the FDA. The DoD Dietary Supplement Resource Operation Supplement Safety (OSS) website lists banned substances and ingredients that are off-limits to servicemembers. Many of the reasons listed for the banned ingredients include “synthetic substance that currently does not meet the definition of a dietary ingredient” or “new dietary ingredient lacking evidence of safe use”. Those reasons are logical and are in place in order to protect the health, safety, and wellbeing of servicemembers. CBD and hemp are also listed as banned on the OSS website. The reasons listed why CBD and hemp are not allowed simply states “new DoD Policy” or “service policy”- no actual safety reason to ban the substance outright.
Servicemembers can currently screen dietary and nutritional supplements for safety using the OSS website. This same safety screening tool could be modified and then applied to CBD products thus adding a layer of protection to servicemembers. The DoD could also easily help servicemembers identify reputable hemp and CBD companies. Would it really be that difficult to have a comprehensive policy in place that allows servicemembers to use CBD products containing less than .3% of THC? I don’t think so. Through consumer education, safety checks, and health care provider support, the DoD could implement a realistic solution to allow for responsible CBD use.
Why CBD should be authorized
We’ve all seen the staggering statistics and there is clearly a problem. The latest VA report published in NOV 2020 shows that on average, 17.6 Veterans commit suicide every single day. If you include active duty, reservists, and national guardsman that number increases to about 18 per day (Shane, 2020). Many factors such as PTSD, anxiety, sleep disorders, substance abuse/addiction, depression, chronic pain, and personal life stressors contribute to the high veteran and military suicide rate (USU, 2020). The military has made great progress in the past few years in terms of reducing mental health stigmas, increasing mental health screenings, and encouraging service members and vets to seek help from professional health providers, but more needs to be done. If CBD, which is non-habit forming, generally safe, and non-psychoactive, can help treat vets with mental health issues, the same opportunity should be afforded to current servicemembers.
While I don’t see a one for one swap of CBD for the traditionally prescribed 800mg of Motrin for normal aches and pains, I do think that military medicine should be advocating for the safe use of CBD for serious chronic pain issues and inflammation. We have too many Soldiers walking around with permanent profiles for pain injuries that they have given up on treating. Or worse, we have servicemembers who turn to alcohol, opioids, or illicit drugs to help deal with the pain. The DoD policy may be putting servicemembers in a no-win situation, almost forcing some to choose between the proverbial rock and hard place scenario. Servicemembers could be jeopardizing careers by taking CBD in order to manage pain, which is crucial in order to say fit for duty and continued service. So, do they risk violating the DoD policy in order to try and stay mission ready?
With all these considerations, it’s evident that the benefits of advocating for safe CBD use clearly outweigh the risks. The common side effects of CBD include dry mouth, fatigue, reduced appetite, and diarrhea- very low when compared to the potential advantages to thousands of servicemembers. It is absolutely necessary to take a holistic, open-minded, and maybe even experimental approach to combating veteran’s and current servicemembers suicide and health issues. CBD containing less than .3% of THC should be authorized for use for current servicemembers.
The military has a unique opportunity to shape the narrative and lead the charge by advocating for safe CBD use and funding research into new health treatments that include CBD. In the meantime, I’m stuck with 800mgs of Motrin and my heating pad for my sore and aching back
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