WOUNDED VET TOUTS MARIJUANA

AUGUSTA -- Ryan Begin was checking a report of an improvised
explosive device in Iskandariya, Iraq., on Aug. 1, 2004.

Then the U.S. Marine Corps corporal saw one. It detonated, blowing
apart his right arm.

More than 30 surgeries later, Begin said he has regained some use of
his arm. But the psychological damage has taken a harsher toll,
including drug addiction and violence.

Begin told doctors in federal health centers high-grade medical
marijuana was his only hope for tamping down the innumerable
nightmares, flashbacks and fears that followed him from the battlefield.

"My mood's stable now -- no peaks and valleys, just stable ups and
downs," he said.

His mother, Anna -- "a little bit apprehensive" about medical
marijuana at first -- is a believer.

"When he started the marijuana, it was like having my son back," she said.

Doctors in the federal veterans' health care system aren't as
convinced. The substance remains illegal under federal law, and
guidelines for federal health centers don't support medical marijuana,

That ended Begin's relationship with the federal health system.

Battle scars

Today, Begin is unemployed, and one of 1,807 patients registered with
the state to use marijuana medicinally.

He entered the Marines in November 2001, and served two tours in
Iraq, from March to June 2003, then from July to August 2004.

Begin, 31, of Jackman, was given an early look at war.

He said his first day in Iraq, March 23, 2003, was the battle of
Nasiriyah -- one of the Iraq invasion's first large battles. Six
soldiers, including Pfc. Jessica Lynch, whose capture and rescue were
well-documented, were taken prisoner. More were killed.

"Every day, someone new would die," Begin said.

When civilian families attempted to leave by running military
checkpoints, they were often blown up and killed. Begin said there
were times he had to clear charred bodies.

"At the time, I was taught to not let emotion get involved," he said.
"You just do it."

He was honorably discharged in 2007 with the rank of sergeant, and
returned home to Jackman.

What followed was a string of reckless behavior Begin attributes, in
part, to his treatment.

"I was a mess," he said. "I had so much anger. I just couldn't cope with it."

On a cocktail of medications, he also drank heavily. One day in July
2007, he said he had two bottles of whiskey, took 90 valium pills and
took to the roads in his truck. He got pulled over and tried to
assault the officer.

He was sentenced in 2010 to 43 days in Somerset County Jail after
being found guilty of assault for that incident.

Begin also was arrested on a charge of violating bail conditions in
November 2007.

He said it was for possession of marijuana, which he was using to
illegally self-medicate.

Then, Begin was sentenced to 180 days, all suspended, with two years
of probation for an incident involving aggravated criminal trespass
on Jan. 13, 2008.

According to records, his wife got a protection-from-abuse order
against him after he threw an ashtray that struck her.

Seeking relief

Meanwhile, Begin was being treated for battle injuries both physical
and psychological.

He provided medical records to the Kennebec Journal that detail
treatment at Northampton VA Medical Center in Massachusetts and Togus
VA Medical Center.

The records detail military history, mental health narratives and
medications. Begin was being treated for post-traumatic stress
disorder in addition to physical injuries.

Begin said he was harmed by the drugs he was prescribed and the
psychological treatment he was offered.

In addition to opiates such as morphine for pain, Begin was
prescribed dextroamphetamine "for concentration, attention and mood."

"They focused on improving your memory," he said. "Why would you
improve someone's memory who has bad memories?"

In the records, he is quoted as saying he was addicted to prescribed
opiates from 2004 to 2007.

After years struggling with violent behavior and ineffective
treatment, Begin in March got a state license to use medical
marijuana after seeing Dustin Sulak, a Hallowell-based doctor known
statewide as an advocate for medical marijuana.

While records show Begin's federal doctors had known about his past
recreational marijuana use, Begin admitted he set up the appointment
with Sulak without notifying his VA doctors.

And Sulak wrote Begin's recommendation for chronic pain in his right
arm, not for PTSD.

That's because PTSD isn't on Maine's list of qualifying conditions
for the medical marijuana program.

"I knew (marijuana) would work for PTSD because it worked for me in
the past," Begin said.

When he finally told VA doctors he had registered as a medical
marijuana user, Begin said they gave him a choice.

"'If you're pot-positive, we're not writing you any prescriptions for
anything,'" he said they told him. "They told me, 'Prescription pills
or medical marijuana.'"

He chose the latter, and said he hasn't been to Togus since.

Stress factor

A fact sheet from the Vietnam Veterans of America and Veterans of
Modern Warfare said 300,000 veterans of the Iraq and Afghanistan wars
are expected to suffer from PTSD or major depression.

Charles Wynott, executive director of the Westbrook-based Maine
Medical Marijuana Patients Center, said he gets calls from veterans
with PTSD "all the time," lamenting its exclusion from Maine's condition list.

"I sympathize with them and tell them I'm doing everything I can to
get (the list of qualifying conditions) changed," he said. "It's
definitely at the top of our list."

Gordon Smith, executive vice president of the Maine Medical
Association, said his group would likely support expansion of the law
into PTSD and mental health conditions -- provided experts agree.

Recent proposals would allow doctors to recommend marijuana for any
condition they see fit.

"I think there's a feeling that that puts the law into a whole new
realm," Smith said. "I could see us getting involved if there was science."

Wynott said, "We have a lot of PTSD. We have a lot of veterans. And
it's only going to get worse as they're taking troops out."

And Sulak said, "A lot of people outside my profession don't realize
how prevalent PTSD is."

Sulak said he has seen approximately 400 patients with PTSD
accompanying pain come through his office.

He calls PTSD "the second-most common condition people want marijuana
to treat."

Pain is why Sulak says he can recommend a PTSD patient get marijuana.

"Half of the people who come in with pain have it for traumatic
reasons," Sulak said. "We often think of remembering as important to
health. Forgetting is just as important."

Tolerated, not allowed

As a federal hospital, the Togus VA center is at a crossroads between
state and federal law when it treats Maine veterans.

Though patients who go there may be state-authorized to use medicinal
marijuana, state law doesn't apply there.

Marijuana is an illegal drug in the eyes of the feds -- protected by
state law or not. And possessing medical marijuana on VA property is
a criminal offense.

Furthermore, a January directive from Undersecretary for Health Dr.
Robert Petzel said the Veterans Administration believes marijuana has
no currently accepted medical use.

In a statement issued Friday, VA spokesman Josh Taylor said "the
Department of Veterans Affairs understands the importance of
alternative treatments," but that VA personnel are not allowed to
authorize or recommend medical marijuana."

Still, "VA patients will not be denied service because of their
participation in a state-approved medical marijuana program," the
statement said.

The 2011 directive says that any prescriptions for chronic pain must
be managed under the auspices of the VA's "stepped-care" model, and
that VA doctors make no recommendation for medical marijuana.

That model, outlined in 2009, outlines a three-step program that
includes development of a network of primary caregivers, timely
access to specialists and "advanced pain medicine diagnostics."
Opioids are listed as one of the main pharamacological interventions.

"The use of addictive pain medication, particularly opioid pain
medication, has been the primary means of pain management for a
significant period of time," according to a VA slideshow presentation.

Begin asks, "Do they actually want people to get better, or do they
just want them in a pill haze?"

Sulak said he had been receiving referrals from Togus -- not for
marijuana, but for other integrative medical services his offices provide.

Then he said he received an "opinionated" letter from the hospital
saying it wouldn't route patients that way.

"Someone in the referral office decided marijuana was bad," he said.
He said he stopped getting referrals from Togus this past winter.

Benefits of bud?

Begin buys his marijuana from a caregiver. For $235 an ounce, he gets
a high-grade product from which he says he gets real relief from PTSD.

And he isn't bashful about it. At a recent meeting, standing well
outside his truck with his 4-year-old daughter leaning out the
window, he lit up a marijuana cigarette in a parking lot and showed a
reporter jars of pot and a tincture bottle.

It's a normal occurrence. He said he even smokes while driving, and
claims marijuana doesn't adversely affect him.

"It puts memories in a safe in your mind. You can access that safe,
but it isn't tormenting you every minute," he said. "It's not
pounding away at the back of your eyeballs."

Begin said he devotes his time to advocating wider use of medical
marijuana. He wants PTSD added to that qualifying list of conditions
and also calls for alternative pain treatment -- not the prescription
medication he said impeded his progress.

He said he knows many veterans who use black-market marijuana to
treat various ailments.

When he tells them to register, they bristle.

"They're scared. They don't want to tell their doctors," Begin said.
"They don't want to lose what they have."