Kicking Opiate Crankiness

For one Vietnam Vet, Cannabis Relieves more than Pain

Rick Fabian’s wife Elaine is happy that her soul mate tokes. In her opinion, the earlier in the day that he partakes, the better. In fact, so effective is his med-

icine as a mood elevator, she’s taped a Wake & Bake! sign on his TV where he will see it as soon as he opens his eyes each morning.

“He tends to get busy and forget, and then I’ll walk in and say something, completely innocently, and he just about snaps my head off,” she said, as they both share a laugh. “Once he medicates, then he is like a normal person.”

Elaine has been though the ringer with her husband’s moods. A Vietnam veteran, he was prescribed morphine by a Veterans Affairs (V.A.) doctor for a war-related injury that had gotten worse over the years. He hated the uneasy, drugged-out feeling that morphine gave him, and she had reached her limit with his mood swings and surly attitude.

“Before the cannabis, he was a total jerk,” she said. “He was very forgetful, very sleepy and extremely irritable. Basically, I figured I’d wait until the point where he was well enough to maybe live in a ground-floor apartment by himself, and I’d get a divorce. I was not going to live with that crabby, crabby man.”

Fabian’s war story began four decades ago. In 1969 he joined the Marines and was trained to be a radio telegraph operator. A year later, at 19, he was sent to Vietnam and assigned to the Commanding General’s guard, an assign- ment that bored the bejesus out of him. He complained about being in a dud outfit, which resulted in a transfer to his next assignment, the Military Police (MP).

Fabian is a large man with a commanding presence. “They said that they were looking for large — I was 6- foot-4 — NCOs, non-commissioned officers,” he said. “They also felt that I was up to the challenge of being an MP because my grandfather was a city police officer, my mother was an office manager for a California Highway Patrol station, and I had other relatives in law enforce- ment. It was in my blood, they told me.”

The assignment, policing military personnel who were taking a break for a few days of rest and relaxation in a region outside of Da Nang, was stressful. He did not see active combat. Instead, he dealt with traffic accidents and thievery, someone stealing food or arms off of a truck stopped in traffic, for instance. In war-torn Vietnam, petty theft was often the catalyst for much more, and his job was to help keep order.

“PTSD is something that festers,” he said. “It might not show up for the first month, or even years, but I know that I kept getting progressively worse.”

As a cop in a war zone, one of his responsibilities was to try to prevent members in the U.S. military, who were dealing with their own personal traumas, from commit- ting crimes. “After being out in the bush for two or three months, doing all kinds of crazy, wonky things, they’d come back and want three things,” he explained. “They wanted to drink and get high, and they wanted to go to the house of ill repute. My job was to keep them from going in there, or, if we found them in there, to arrest them, and take them away from where everyone else said that they were blowing off steam. Nobody liked the MP. A cop in a war zone didn’t have many friends.”

One day he was chasing a Marine down an alley and up a hill into an empty building when he ran into what he knew to be a trip wire, possibly connected to a Claymore mine or a grenade. Thankfully, the wire was only connect- ed to a flare, but in awkwardly contorting his body to pull out and away from the wire, he ripped the muscles in his right knee, which resulted in an operation. The injury still causes him much pain.

In Vietnam, everyday moments were filled with crises. One morning in traffic, a boy ran up to a Jeep, pulled a wrist watch off of a soldier, and ran.

“The guy pulled out his pistol, and shot the kid down; blew about half of his head off,” he said. “We were the third vehicle behind that, and I was the one that got out and disarmed the guy. I asked him what had happened, and he said, “He stole my watch,” and I yelled, “That’s a reason to kill a kid?””

During this time, one of his fellow officers gave him a joint and told him to smoke it because this was the only way to survive what they referred to as “The Nam,” to get a bet- ter grip on reality, and focus on the task at hand. He did begin smoking daily. Decades later, that wartime advice would have application in civilian life.

Upon returning home to Oregon, he struggled through stormy relationships with his parents, several wives, and four children. Four years after his Vietnam knee injury, he was in a motorcycle accident and his right foot was ampu- tated. He self-medicated with drugs and alcohol, eventu- ally contacting Hepatitis-C. Miserable, he searched for stability, and eventually found life-saving support with 12- step programs. In 1990, with the help of doctors at the V.A., he was able to get off of drugs and alcohol.

His knee grew worse. His left leg was the support for his injured right leg, resulting in double injuries, and many operations on both knees. Walking with a double limp ruined his back.

Fabian was being treated at a V.A. hospital for his injuries and his pain. He talked to his doctors about anxiety and irritability. He did not know what was wrong, but he was not right. He was depressed and frustrated. He could not sleep. His days as an M.P. would return in a flash when he saw military personnel in uniform. He was diagnosed with post-traumatic stress disorder (PTSD).

“PTSD is something that festers,” he said. “It might not show up for the first month, or even years, but I know that I kept getting progressively worse.”

His doctors invited him to attend a PTSD program at the American Lake Division of the Veteran Affairs Puget Sound Health Care System in Tacoma, Washington. There, he realized that he could identify with 19 of 23 recognized PTSD symptoms. He received counseling, and he talked to others who were going through the same hell on earth that he was. He learned coping mechanisms to reduce anxiety.

Five years after he stopped drinking and doing drugs, he met Elaine and they hit it off. After a year and a half together, they married. He was attending 12-step pro- grams, and the only drug he was taking was ibuprofen for pain. Unfortunately, he was suffering, gritting his teeth, and in constant pain. In 1998, three years after meeting his wife, Fabian’s doctor put him on morphine. The narcotic helped, but he really felt conflicted. While he was careful to take only the prescribed amount, he worried that he might become addicted. Another huge problem, morphine blocked some of his pain but it also turned him into a grouch.

“I was an ass,” he said. “I remember thinking, why does she put up with me?”

A friend suggested that he might like to try marijuana, which is legal for certain qualifying conditions in Oregon.

“I kept saying, “No. I’m clean and sober now; I can’t!,” he said. “She kept telling me that marijuana might be easier on my system than morphine. “ Every health professional he spoke with said that medical

marijuana was worth a try. He met with a doctor and received a recommendation. He visited MAMA, Mothers Against Misuse and Abuse, to learn about using marijua- na as a medicine. In existence since 1982, MAMA is focused on responsible drug decisions, and has been involved with Oregon’s medical marijuana program since its beginning in 1998.

“He was troubled by the possibility of substance abuse, and wanted to be honest with his 12-step commitments,” said Sandee Burbank, MAMA’s executive director. “It was the smoking that helped him at first. Now that he has learned more, he uses different types of preparations like the salves that he can rub into his joints and muscles for instant relief. He understands now that medical marijua- na is not about getting high.”

In Oregon, efforts to introduce PTSD as a qualifying con- dition in the state’s medical marijuana program have failed twice but advocates are not giving up. The state has a large veteran population, estimated at 300,000.

Not everyone suffering with PTSD is lucky enough to qualify for a cannabis recommendation with other quali- fying conditions. The list of conditions that qualify for an Oregon medical marijuana card are cancer; glaucoma; Alzheimer’s agitation; HIV/AIDS and related HIV/AIDS wasting syndrome; severe pain; severe nausea; seizures including but not limited to seizures caused by epilepsy; and persistent muscle spasms, including but not limited to spasms caused by multiple sclerosis.

Advocates recently participated in a new Rules Advisory Committee formal process to rewrite procedures for eval- uating health conditions with the aim of creating a fair, unbiased process in place of what has long been viewed as flawed and not focused on medicine, science or compas- sion for the sick. Since the program’s beginning 14 years ago, the only condition to be added is agitation due to Alzheimer’s disease. Burbank has been a member of many committees, including two four-year terms on the

Advisory Committee on Medical Marijuana, an 11-mem- ber, volunteer committee that is supposed to have an advi- sory role in the Oregon Medical Marijuana Program. Dysfunction within the Oregon Department of Human Resources, which oversees the Oregon Public Health Division, which oversees the Oregon Health Authority, which oversees the OMMP, leaves her jaded at times.

“If this had anything to do with logic, PTSD would have been added to the list a long time ago,” she said.

In addition to pain relief, Fabian found that cannabis was able to reduce anxiety and calm him down. He also tried acupuncture, and that seemed to help as well. He reduced his morphine dose from 180 to 120 milligrams a day. Within four weeks of starting cannabis therapy and acupuncture, he stopped using morphine altogether.

Fabian has been using a wheelchair for two years. He has used crutches for many years. With a brace on his left knee and a right foot prosthesis, he sometimes walks with a cane. He has found that a cannabis salve made with bees wax will alleviate pain when rubbed into his knees and hips.

Now 61, clean, sober, and content with his life, he starts each day with two teaspoons of medical marijuana glyc- erin tincture in his coffee. “The tincture seems to start my day off in a much more positive and peaceful manner, which pleases my wife,” he said.

When Fabian first told Elaine that he was considering medical marijuana, she was 100 percent in favor of a non- narcotic medicine. His cannabis therapy proved to be extremely beneficial for both of them.

“He had not smiled in three years on mor- phine, and now, here he is a happy camper again,” she said. “He is still pretty doggone salty in the morning before he medicates, but marijuana saved our marriage.”