A sobering new report into suicide among Australia’s serving and veteran defence forces has sparked fresh appeals for the Department of Veterans Affairs (DVA) to end its hard line approach to subsidising medicinal cannabis as a treatment for mental health trauma.

As veteran advocates spoke of the need for individualised support, ex-serviceman Derek Pyrah again called on the DVA to adopt such an approach and re-think its attitudes to cannabis.

Never forgotten: a total of 1,273 serving personnel and veterans took their own lives between 2001 and 2019

The Iraq War survivor has long insisted that only medicinal cannabis has contained his suicide ideation and restored his quality of life. Yet still the DVA ignore his appeals and refuse to subsidise his treatment.

Many other veterans are believed to be in the same position.

Pyrah’s GP, Dr Matty Moore, also reiterated the urgent need for new, progressive thinking, describing conventional treatments as a “burden on our soldiers and on the system”.  

The renewed appeals follow the release of the fourth annual report into suicides among permanent, reserve and ex-servicemen and women.

The calls also coincided with the publication of a report by Bernadette Boss, the National Commissioner for Defence and Veterans Suicide Prevention, in which she called for further exploration of alternative therapies for veterans, including hallucinogens.

This year’s report into suicides, compiled by the Australian Institute of Health and Welfare (AIHW), expanded its scope to include those who served from 1985, doubling the size of the previous cohort which was limited to ADF members who served from 2001.

The report revealed that 1,273 men and women took their lives over the past 19 years, three times more than previously recorded.

The AIHW stressed, however, that while a larger number, the rates of suicide were broadly the same and the increase reflected the expanded scope of the research.

Speaking movingly at the release of the report, Gwen Cherne, Australia’s first veteran family advocate commissioner – who lost her husband Pete Cafe to suicide in 2017 – issued a poignant reminder that the data represented “real people”.

“These are sons and daughters, mothers and fathers,” she said.

Gwen Cherne: support for veterans is not a one-size-fits-all

Cherne also emphasised that it remained an ongoing mission to provide the right services and support, and to tailor that support to individual circumstances.

“We still need to keep doing the work we are doing, to better develop services and support when people do seek [it],” she said.

“We have to look at ways we can individualise the services and we all have different protective factors at play. It’s not a one-size-fits-all. Suicide, we all know, is incredibly complex.”

She added that what would have worked for her husband “would not work for someone else”.

Continuing fight

For Derek Pyrah, financial help for his medicinal cannabis would represent that individualised support. Yet he has twice been rejected by the DVA which, despite his positive health outcomes, continues to argue there is a lack of solid evidence to prove its worth.

Continuing the fight: Derek Pyrah is set to maintain pressure on the DVA

“I have not received any flexibility from the DVA regarding my applications for access to medicinal cannabis to successfully treat my PTSD condition,” he told Cannabiz. “This is despite showing overwhelming evidence that DVA-approved PTSD medications do not work for me and actually make my condition worse.”

Medicinal cannabis, he said, is the only medication that has successfully treated and managed his condition.

The DVA, Pyrah added, is out of touch with veterans and the struggles they face — and probably too conservative to change.

“The evidence shows that the DVA has zero flexibility when it comes to the health and wellbeing of Australian veterans.  

“While it is possible that reports like this may shift attitudes within the DVA, I believe it is too ultra-conservative to change its stance on medicinal cannabis for PTSD. 

“The DVA also says it uses an evidence-based approach in its decision making. But it clearly doesn’t because an evidence-based approach looks at studies, advice from specialist doctors and how the patient responds to treatment, all of which clearly show that, in my case at least, medicinal cannabis is the only medication which successfully treats my symptoms. 

“All this suggests the DVA is a government department out of touch with its ‘clients’, ordinary Australians who served and sometimes gave their all for the country.”

The sentiments were echoed by Dr Moore, who continues to fight his patient’s corner.

The WA-based practitioner said the sobering reality of the report should trigger a change of heart at the DVA.

Dr Matty Moore: veterans are caught in a bureaucratic sinkhole

“It makes sense to adopt another strategy if the current one isn’t working,” he said. “Being rigid to changing circumstances is a failed policy. I’m still optimistic for my veterans, but we’re currently caught in a bureaucratic sinkhole.

“Time is of the essence and unfortunately that’s run out already. Conventional treatments are a burden not only on our soldiers, but on the system itself financially. I would have expected them to at least listen to that argument.”

Royal Commission

Many veterans and their families are putting their faith in a Royal Commission, set up by the Government in July to examine suicide rates among veterans and serving personnel.

But that remains some way off, with an interim report not due until August next year before the tabling of a final report by June 2023.

Pyrah, who intends to tell his story to the Royal Commission, said action needs to be taken before then, with a meeting with veterans affairs minister Andrew Gee among the priorities for campaigners, who include United in Compassion and AMCA co-founder Lucy Haslam.

“Unfortunately it will be some years before this RC finishes and during that time we will lose more veterans to suicide and more families will be separated,” Pyrah said. “Lucy Haslam, Dr Matty Moore and myself will continue to fight until we are successful in changing the DVA’s outdated and unsuccessful medical treatment of Australian veterans who suffer daily with the numerous symptoms of PTSD.”

The campaign is backed by Entoura, which has supported Pyrah with subsidised cannabis. Even when faced with individual circumstances, the DVA refused to acknowledge the benefits of his treatment, general manager Clare Barker said.

Entoura general manager Clare Barker: time for a different approach

“Unfortunately the DVA is not being flexible in its approach to medicinal cannabis and veterans with PTSD,” she said. “I am an optimist and would like to believe that reports like this on veteran suicide can help shift attitudes within the DVA. It should highlight that the current administration of the system and framework is not working.

“At the very least I would hope that highlighting that the current interventions are not effective for all of its veterans could shift the DVAs thinking towards exploring other alternatives.”

One such alternative could see the DVA supporting a clinical trial to satisfy the level of evidence it is requesting, she said.

“Throughout the duration of the trial, veterans would benefit from the treatment with medicinal cannabis while being part of an ongoing solution for the wider veteran population,” Barker said.

The issue of the DVA and PTSD was further complicated earlier this year when a Freedom of Information request lodged by Cannabiz revealed the department had, in fact, approved funding for medicinal cannabis to treat an unspecified number of PTSD cases.

The DVA said such cases were “very rare” and only approved in exceptional clinical circumstances.

Prior to launching Cannabiz, Martin was co-founder and CEO of Asia-Pac’s leading B2B media and marketing information brand Mumbrella, overseeing its sale to Diversified Communications in 2017. A journalist...

Steve has reported for a number of consumer and B2B titles over a journalism career spanning more than three decades. He is a regulator contributor to health journal, The Medical Republic, writing on...