One combat veteran says that although marijuana is not a cure and not 100% effective, it does alleviate traumatic brain injury symptoms more effectively than the pills that the Veterans Administration prescribes.
Sergeant Thomas Brennan sustained a TBI in Afghanistan. Two years later, he received a medical discharge due to severe depression, persistent migraines, vertigo, and other symptoms. He began receiving a panoply of pills from the VA, a vast array of antidepressants, mood stabilizers, amphetamines, and sedatives. Initially, he says that these pills helped, but that effect wore off rather quickly, so his doctors kept increasing the dosage and kept prescribing more pills to counteract the side effects.
Finally, Sgt. Brennan tried marijuana. He said it helped him sleep through the night and also dramatically improved his mood during the day. “I thought I had found a miracle drug,” he recalled. But marijuana is still illegal for all purposes in 21 states, and the VA will not prescribe it even in places where its use is legal. That may change soon, as the VA has already embraced mindfulness and yoga as alternative therapies that can reduce dependence on opioid pain relievers. Current VA Secretary Dr. David Shulkin says he supports research into the medical use of cannabis.
There is only one VA-licensed medical cannabis research facility in the United States.
The Military and Brain Injuries
Combat-related brain injuries first emerged during World War I. By 1914, when the war broke out, almost all countries used high-explosive TNT in their ordnance as opposed to picric acid, which is basically the same active ingredient in fireworks. Furthermore, both sides used poison gas in this conflict, whether they were irritants like tear gas or lethal like chlorine gas. Such attacks actually did not cause many casualties, especially in the latter half of the war as countermeasures improved, but they were still horrifying events.
Such incidents — shockwaves due to explosions and exposure to combat stress — are the two most significant causes of combat-related brain injuries.
The first cause is not easy to understand. But in August 2017, reports surfaced that Cuban agents may have targeted Canadian diplomats with high-frequency sonic blasts which caused traumatic brain injuries and other wounds, as well, such as hearing loss. Sudden loud noises, such as explosions, probably have roughly the same effect, as they send out shock waves that somehow permanently disrupt brain function.
Furthermore, scientists now understand that exposure to combat stress erodes the prefrontal cortex and compromises its ability to control the amygdala. Essentially, the PFC and amygdala are like the brain’s horse and rider, in that the PFC controls logical and emotional processing and the amygdala governs base impulses, like desire and fear. If the rider cannot control the horse (the PFC cannot control the amygdala), the horse runs wild. That is why brain injury patients experience symptoms like heightened awareness, flashbacks, and nightmares.
Most scientists speculate that one or two extremely traumatic events may be sufficient to cause such erosion and therefore brain injuries.
The military does not have a good history with brain injuries. World War I victims were diagnosed with “shell shock,” although ignorance probably explains that misdiagnosis. Subsequently, in 1943, General George Patton slapped two soldiers who were hospitalized with brain injury-like wounds. The general called one of them, 18-year-old Pvt. Charles Kuhl, a “coward” and ordered him to leave the infirmary tent. To a considerable extent, this attitude persists even today.
Brain Injury Treatment
Although emerging therapies, such as ones that involve stem cells, may soon make brain injuries curable, that is impossible today because dead brain cells cannot self-regenerate.
So, treating the symptoms is the only alternative. Usually that involves a two-pronged approach of medication and physical therapy. The medication portion is well addressed in the above story. Physical therapy is usually for victims who have a physical loss of function, such as vision problems, digestive issues, or limited physical mobility. This treatment is designed to teach nearby and uninjured portions of the brain to assume any lost function.
In today’s military, regular servicemembers are not the only persons in combat zones that are at risk of injury, as private military contractors often serve alongside these men and women. Furthermore, private contractors often perform escort and guard duty, where there is considerable risk of a terrorist-style attack.
These interventions, especially long-term physical therapy, are quite expensive, and that is where the Defense Base Act comes in. It provides benefits that provide money for medical bills, lost wages, and other economic losses that result from an overseas injury in a combat zone.
These two phrases (overseas injury and combat zone) both have specific meanings and are both extremely broad. Moreover, DBA insurance covers a wide range of combat-related injuries, because the United States Supreme Court has specifically held that victims need only establish a nexus (some kind of relationship) between their injuries and their duties. Finally, victims need not be “on the clock” to qualify.
The bottom line is that it is difficult for the insurance company to challenge the underlying basis for the claim. But these companies nearly always challenge the amount of the medical bills, claiming that the procedures were not medically necessary. An aggressive attorney can refute these allegations, so victims get maximum compensation.
For more information about the specific kinds of available benefits under the DBA, contact Barnett, Lerner, Karsen & Frankel.