Veteran prescribed 'ghastly' amount of cannabis by for-profit health company

Steve Johnstone says he trusted his doctors, but wondered why he was being sent so much cannabis. (Four Corners: Amy Donaldson)

When doctors heard how much medicinal cannabis Steve Johnstone was being prescribed, they were shocked. 

"They just couldn't understand how I was functioning."

He was barely functioning. In April this year, Steve was admitted to a psychiatric ward for veterans. He was paranoid, suicidal and wasn't sleeping.

He never should have gotten so unwell, because at the time, the Department of Veterans' Affairs (DVA) was paying thousands of dollars so two for-profit companies would provide him with the very best care.

Instead, for nearly two years he was sent huge quantities of high-THC cannabis prescribed by doctors he never spoke to.

A Four Corners investigation has found some for-profit providers are aggressively targeting veterans through advertising and phone calls, spruiking "free" services and treatments funded by DVA.

In Steve's case, one of those treatments put his life at risk.

When Steve returned from serving as an army medic in Afghanistan in 2012, the most mundane daily activities unleashed a torrent of trauma.

Steve was an army medic. (Supplied)

Kids crying at the shops reminded him of the children with burns and the babies he couldn't save.

He drank to cope and abused cannabis and other drugs to numb his racing mind.

The Department of Veterans' Affairs (DVA) accepted his PTSD, chronic pain and substance abuse was linked to his service, allowing him to access compensation and DVA-funded treatment.

By 2024, Steve was doing well under the care of a psychiatrist and a local GP. But he was plagued by chronic back pain.

Steve's mental health had improved, but like many veterans he suffered from back pain. (Four Corners: Amy Donaldson)

"I was just scrolling my phone one day and I saw this ad pop up from VeteranCann, and it basically said, 'free natural health'."

Soon Steve was on the phone to a VeteranCann nurse who went through all his DVA accepted conditions.

"We're pretty much getting to the fun part where we get to talk about cannabis," the nurse can be heard saying in a recording of the call.

Steve told the nurse he had a history of substance abuse but downplayed that cannabis was a problem.

She said the next step would be a quick DVA-funded phone call with a pain specialist so the company could apply for him to access high-strength THC products.

That pain specialist was the only doctor he spoke to.

Less than a month later, his prescribing doctor applied to DVA for funding to increase Steve's dose straight from 25mg THC per day to 1,220mg without ever talking to him.

Three experienced medicinal cannabis prescribers told Four Corners 1,220mg a day was unacceptable and far beyond what they'd ever seen prescribed.

Vicki Kotsirilos, a Melbourne-based GP and associate professor, described it as "ghastly".

"These are unacceptably high doses of THC and there's a real concern with looking after patients with histories of substance abuse and chronic pain without seeing the patient," she said.

After one chat with a pain specialist Steve started getting sent cannabis. (Supplied)

As Steve's high-strength cannabis continued arriving in 5kg postage bags, the only monthly check-ins he had were with a nurse.

"The nurse would say to me, 'How much have you got left?' And if I had some left, I'd say, 'Look, just send me my allocated dose,'" he said.

"They basically had a shopping cart for me … I'd say, 'Give us the highest dose you have.'

"The pain that I've sort of suffered, from being overseas, I just wanted to numb that."

Companies like VeteranCann are generally paid more by DVA when prescribing more products or higher doses of THC.

High-strength THC has less evidence of efficacy and greater risks of dependence and psychosis.

Steve was sent cannabis flower and gummies. (Supplied)

Steve says by the end of last year he was addicted, taking more than recommended and consuming huge quantities of gummy pastilles prescribed to him — each containing 40mg of THC.

"[I] started getting real paranoid," he said.

"I just would see things on the news of different attacks and think someone's gonna come and attack me.

"Being a medic, you trust your doctor … but I just started to question it, going, 'Why am I getting sent so much? Like, how do I get out of this?'"

The rapid rise in for-profit companies for veterans began not long after the royal commission into veteran suicides found slow claims processing had put their mental health at risk.

The government responded by investing more than half a billion dollars in funding to better support veterans and help clear the backlog.

The increase in funds attracted private providers keen to help veterans apply for compensation and access care. Last year DVA spent a record $10 billion on compensation and another $5 billion on care.

In the last three years, the amount the department has spent on medicinal cannabis more than tripled to $125 million.

Daryl and Andrea Duckett both got calls offering them a ketamine treatment. (Four Corners: Amy Donaldson)

East Timor veterans Andrea and Daryl Duckett were prescribed medicinal cannabis for chronic pain too, through a company called Valentius they saw on Facebook.

Andrea said for a while she found cannabis oil helped immensely. But after experiencing a suicidal episode when her supply was interrupted, she took herself off it and left Valentius.

She was surprised when a few weeks later she got a call about another drug — esketamine — a nasal spray form of ketamine used for treatment-resistant depression.

Andrea, who trained as a nurse, was unimpressed.

"I know the rules around an S8 (schedule 8) drug. You're not supposed to be cold-calling someone about this drug," she said.

A few days later, her husband Daryl said he got a similar call from a woman offering the same thing.

"[She said as] I'd been on the CBD oil, would I be interested in esketamine?" he said.

He was shocked. "My doctor and I have never spoken about this."

Daryl and Andrea served in East Timor. (Supplied)

A few weeks later Andrea got another call. This time, it was a mental health nurse who told her he was also the CEO of GoodMind Therapeutics, the company offering the ketamine treatment.

This time she recorded it and complained.

"Unless I'm the one initiating it or my treating doctor is the one initiating it, how dare you do that?"

DVA spent more than $11 million on esketamine in the first eight months of this year, at a cost of almost $27,000 per patient.

Valentius has a referral relationship with GoodMind, but said it had no records of sharing their information.

GoodMind has a new CEO and said in a statement it did not cold call members of the public.

At the beginning of the year, Steve Johnstone was in a bad place.

After almost two years of taking high-THC medicinal cannabis with no contact from his prescribing doctors, he was paranoid, suicidal and had recently quit his job.

His wife Ashanti started desperately trying to contact doctors at a company called Total Veteran Healthcare (TVH), who were meant to be managing his care.

"It was just getting worse and worse … I was telling them, 'I don't know how to deal with a situation like this. I don't know how to deal with someone that's suicidal,'" she said.

Ashanti was desperate to get help for Steve. (Four Corners: Amy Donaldson)

Since mid-2024 doctors at TVH had been paid by DVA to care for Steve through what's called a Coordinated Veteran Care (CVC) plan.

It's meant to be an extra payment of more than $2,500 a year to the veteran's regular treating GP to coordinate complex care needs.

Instead, Four Corners' investigation has found multiple examples of for-profit companies signing up veterans for DVA-funded treatment and getting them to move their CVC plans away from their usual treating GP.

Steve's records show he had quarterly phone calls with a nurse but never spoke to or saw any of the TVH GPs who were billing DVA for his care, until his acute mental health crisis in March.

That's when he told a TVH nurse he wanted to stop medicinal cannabis, his mental health was deteriorating, he was engaging in risk-taking behaviours like driving at high speeds on back roads and was suicidal.

The nurse warned his prescribing doctors, one of whom called him for the very first time.

"We had a chat and he said, 'How's your pain level?' And I said, 'Mate, my pain level's fine. It sits at about a seven. It's been like that for ages, but my mental health, like… I've got a drug problem.'

"'I've been diagnosed with substance abuse before. I'm addicted to these gummies and to THC'.

"And he said, 'No worries, mate. We'll stop the gummies getting sent.'"

A few days later he received another shipment of high-strength cannabis flower to his door.

"WE need to contact VETCANN and tell them to STOP SUPPLYING HIM.

It is doing (and has done) REAL HARM.

But MAIN THING is to STOP GIVING HIM CANNABIS."

Steve finally had his first in-person appointment with a doctor at Total Veteran Healthcare on the first of April this year.

By that point he was so unwell he was sent to emergency before getting a bed in a specialist psychiatric ward for veterans.

He told the admissions staff, "You've literally saved my life".

"I really do believe that," he says.

"I was gonna commit suicide. I was done".

It wasn't until April this year that Steve had an in-person appointment with a TVH doctor. (Four Corners: Rob Hill)

He was heavily sedated for weeks and spent nearly three months in hospital.

The day Steve was admitted, VeteranCann lodged another application to DVA for a reduced amount of medicinal cannabis, stating his mental health "has been stable throughout treatment".

DVA funds clinical treatment but doesn't regulate companies and says it's up to doctors to appropriately prescribe drugs and decide what treatment is right for patients.

Earlier this year DVA tightened up medicinal cannabis rules. Veterans now need to see a specialist doctor or GP face-to-face and DVA will only pay for three products at once. It no longer funds THC gummies.

VeteranCann said in a statement that Total Veteran Healthcare was responsible for Steve's care through their platform and its clinical model now operates in accordance with the DVA's changes.

In a statement, Total Veteran Healthcare didn't answer questions about why the GPs billing for his care or writing his scripts had not spoken to him for almost two years.

When Steve recently looked at what had been billed to DVA under his name, he discovered TVH doctors had charged for the care plans done by nurses, as well as for two in-person consultations he says he never had.

The two consultations had been billed the day Ashanti was trying desperately to get help for Steve.

Steve is more matter-of-fact. "Someone's billed DVA money fraudulently in my opinion … claiming that I was at his consulting rooms when I wasn't."

Total Veteran Healthcare said it rejects "any suggestion of fraud" but "where Total Veteran Healthcare has identified CVC claims that did not meet DVA's requirements, it is working with DVA to correct any overpayment".

It claimed DVA's rules did not require GPs to see patients in person for CVC reviews until last year, something DVA said the company had been told multiple times was wrong.

"Total Veteran Healthcare has been advised that telehealth was never an option for the CVC Program on a number of occasions," a DVA spokesperson said in a statement.

"All claims for CVC items are required to be for in-person consultations with the participant's usual GP.

"It is extremely concerning to see commercial entities who advertise that they operate in the best interests of veterans spreading false information, which has the potential to cause distress to a vulnerable community."

The family has made a fresh start in Central Queensland. (Four Corners: Rob Hill)

While the couple are now rebuilding their lives, VeteranCann has been in touch again.

"I received a text message from VeteranCann basically saying that you're due for another appointment, would you like to set an appointment date?" Steve said.

VeteranCann said "that contact is about the patient's wellbeing, not about prescribing".

Steve's not against for-profit companies. He wants better regulation to ensure veterans get the care they need.

"It's targeting veterans for the wrong reasons. It's also just wasting taxpayer money."

Watch Four Corners' full investigation Defenceless from 8:30pm Monday on ABC TV and ABC iview.