The campaign to enable Iraq War veteran and Post Traumatic Stress Disorder (PTSD) sufferer Derek Pyrah to access subsidised medicinal cannabis received a body blow this week after the Department of Veterans’ Affairs (DVA) knocked back his GP’s submission for the second time.

After the DVA rejected Dr Matty Moore’s first submission in February, citing “insufficient high-quality evidence” supporting medicinal cannabis as a treatment for PTSD, the GP appealed the decision.

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His resubmission argued medicinal cannabis has been the only treatment that has worked since Pyrah was first hospitalised in 2006, three years after returning from Iraq. His psychiatrist has also backed the use of medicinal cannabis.

Iraq War veteran Derek Pyrah

While acknowledging the lack of gold standard clinical trials in the area of PTSD demanded by the DVA, the second application cited recent case studies and supporting data and urged the department to follow its own framework of “demonstrating empathy for individual circumstances” and dealing with applications on a case-by-case basis.

However, in a written response, DVA chief health officer Professor Jenny Firman reaffirmed the department’s view regarding the lack of evidence, citing three “recent high-quality studies” to back its decision: a 2017 report prepared for the DVA by Phoenix Australia Centre for Post Traumatic Mental Health; a 2019 review published in The Lancet Psychiatry journal; and another review published in the Journal of Dual Diagnosis in 2020.

It added: “Within DVA, evidence is assessed by qualified medical specialists according to the hierarchy of evidence, with systematic review and meta-analyses reaching the highest level of certainty of effect. The DVA framework for funding consideration requires that the treatment is supported by several high-quality scientific studies with very few or no credible opposing findings that it is effective in treating the condition.”

It did offer one olive branch, assuring Dr Moore that it would continue to monitor the developing research and published evidence “as research into medicinal cannabis as a treatment is rapidly evolving”.

Dr Matty Moore: not trying to set a precedent

A frustrated Dr Moore told Cannabiz he was not asking the DVA to set any precedents by considering Pyrah’s case on the evidence submitted.