HBOT for Veterans: Infrastructure Largely in Place

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As SFTT reported earlier, the VA will soon be providing a limited number of Veterans with access to hyperbaric oxygen therapy or “HBOT” at the VA’s Center for Compassionate Innovation (“CCI”) facilities in Texas and Oklahoma.

SFTT has yet to learn when these programs will begin or how many Veterans will be enrolled in these initial programs.  As important, SFTT and the HBOT community at-large is interested in learning how “test protocols,” “metrics,” and “clinical trials” will be set by the VA and DoD to determine the benefits of HBOT.

As one sorts through the often nasty exchanges between proponents of HBOT and the VA gatekeepers like Dr. David Cifu, one cannot be oblivious to the fact that the VA does not want to encourage the adoption of HBOT in treating Veterans with PTSD and TBI.

The VA’s claim is that “patient outcomes’ using HBOT are inconclusive based on VA and DoD trials.

Could it be – as many have suggested – that the test protocols were flawed to produce “inconclusive” test results?   From SFTT’s experience in monitoring the DoD, it would NOT BE THE FIRST TIME that test procedures have been deliberately modified to produce outcomes more to the liking of current military dogma.

Since the VA has no experience in using HBOTin treating Veterans with PTSD, it seems to make sense to use established experts in the industry like Dr. Paul Harch, members of the International Hyperbarics Association or The Sagol Center for Hyperbaric Medicine and Research in Israel which provides HBOT treatment to 120 patients a day and to the Israeli Defense Force (“IDF”) to agree on standardized test protocols and monitor results.

Many will argue that further HBOT tests are not required given the wealth research currently available.  In fact, found below is an extract from a Jan, 2017 report:

Xavier A. Figueroa, PhD and James K. Wright, MD (Col Ret), USAF Hyperbaric Oxygen: B-Level Evidence in Mild Traumatic Brain Injury Clinical Trials. Neurology® 2016;87:1–7 “There is sufficient evidence for the safety and preliminary efficacy data from clinical studies to support the use of HBOT in mild traumatic brain injury/ persistent post concussive syndrome (mTBI/PPCS). The reported positive outcomes and the durability of those outcomes has been demonstrated at 6 months post HBOT treatment. Given the current policy by Tricare and the VA to allow physicians to prescribe drugs or therapies in an off-label manner for mTBI/PPCS management and reimburse for the treatment, it is past time that HBOT be given the same opportunity. This is now an issue of policy modification and reimbursement, not an issue of scientific proof or preliminary clinical efficacy.”

While Secretary Shulkin is wise to proceed slowly, he must exercise extreme caution in allowing the naysayers within the VA any authority over the initial CCI HBOT trial programs.

HBOT Infrastructure in Place to Help Veterans

Assuming the VA leadership can get beyond the hurdles they largely created, Veterans with “mild TBI” and “persistent” PTSD should be able to quickly access hundreds of HBOT facilities across the United States.  With equipment already in place around the country in hospitals and private health clinics, there is no need to hold up treatment for Veterans to wait for the VA to outfit its facilities.

Follow this link to see a directory of currently active HBOT treatment centers around the country.

Clear treatment protocols and directives need to be established for each private clinic providing HBOT to Veterans.  HBOT is administered in a series of dives or sessions (usually between 28 and 40) over a 6 week to 2 month time frame.  Supervision by a trained clinician is required at each dive.  Clearly, a larger “dive chamber” capable of offering therapy to a number of Veterans at the same will help bring down the costs of HBOT.

Costs “per dive” or “session” vary significantly around the country.    Some hospitals charge $1,800 per session, but most private clinics offer this service at a cost of between $250 and $350 per dive.  Given the bargaining power of the VA, it seems most likely that a series of battery of dives can be accomplished for well under $10,000, which is less than half of what the VA currently spends on Veterans with TBI/PTSD.

As SFTT has stated on many occasions, HBOT is not the “silver bullet” to eradicate this silent wound of war, but many more Veterans with brain trauma will begin to be able to reclaim their lives with less reliance on VA prescription drugs that simply mask symptoms rather than provide any lasting improvement in brain functionality.

This could be a BIG DEAL for ailing Veterans and family members who provide our Veterans such caring support.

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VA Reluctantly Agrees to Provide HBOT to Veterans with PTSD

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In a carefully crafted message, “The Department of Veterans Affairs announced this week that it would begin offering hyperbaric oxygen therapy (“HBOT”) to some veterans with post-traumatic stress disorder, despite a lack of evidence that it works or being approved by the Food and Drug Administration as a treatment for PTSD.”

HBOT Therapy

The news was released by “Stars and Stripes” on November 30 in an article titled “VA to offer unproven hyperbaric oxygen therapy to vets with PTSD.”

The article is hardly a ringing endorsement of HBOT.  More to the point, Secretary Shulkin reportedly said on Wednesday that “the VA must ‘explore every avenue’ and ‘be open to new ideas.’”

Well, HBOT may be “new” to the VA, but this therapy has been around for decades and is used successfully around the world to treat patients with brain trauma.  The VA stigma exists because Dr. David Cifu and many other bureaucrats within the VA continue to push a stale agenda of ineffective and often dangerous therapies that don’t work.

In fact, this is one of the major reasons that Veterans with PTSD and TBI have sought treatment outside the VA.   Talking heads at the VA would like Veterans and the public to believe that HBOT is “snake oil,” but there is a long and detailed clinical trail of evidence that suggests otherwise.

Arguing that HBOT is “not FDA or DoD approved” rings a bit hollow after the President’s Report on Fighting Drug Addiction and Opioid Abuse states that “the modern opioid crisis originated within the healthcare system.”   

Let’s face it:  What do you do when evidence-based medicine is proved wrong?   Well, in this case, the Federal government will provide “the healthcare system” with billions of taxpayer dollars to fix the mess they largely created.   Sounds absurd, but you don’t even have to read the small print.

While SFTT is thrilled that Dr. Shulkin has decided to part ways with the orthodoxy of failed VA therapies to treat Veterans with PTSD, it will be years before all Veterans will receive the lifesaving benefits of HBOT.   Furthermore, it is likely that the VA and DoD will again manipulate test protocols to produce treatment outcomes that produce inconclusive results.

Will HBOT work in all cases?   Of course not, but life-changing outcomes are far more likely with HBOT than the only two failed programs currently offered by the VA:

  • Prolonged Exposure Therapy (“PE”) and,
  • Cognitive Processing Therapy (“CPT”)

In any event, we hope that doctors within the VA system will not be so dismissive of HBOT that it leads to another Veteran suicide like Eric Bivins.  For those who want a first-hand look into the travesty of the VA system, follow this painful trail of systemic abuse by Eric’s widowed spouse, Kimi.

Our brave Veterans deserve more and SFTT would like to thank Secretary Shulkin for taking this important first step.

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Veteran Drug Courts Are Now Needed More than Ever

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Over five years ago, SFTT met with Judge John Schwartz,  one of the early pioneers in the Veteran Court system.  Discussing the rationale for Vet Courts, Judge Schwartz stated the following “We offer hope to these troubled veterans who have served our country so valiantly.  It’s simply common sense.”

Today, Vet Courts are needed more than ever to help Veterans recover their lives.   Indeed, when one reads that the “the modern opioid epidemic originated within the healthcare system,” one must be simply oblivious to the plight of Veterans if we choose to penalize them once again.

Homeless Veteran

Drug Courts began to emerge in the nineties to deal more effectively with a growing drug problem in the United States.  As SFTT wrote earlier,

“Since the mid-1990, the US judicial system has recognized the need to deal with drug-related criminal activity and have established some 2,600 Drug Treatment Courts in the United States.  Drug treatment courts are specialized community courts designed to help stop the abuse of drugs, alcohol, and related criminal activity. Non-violent offenders who have been charged with simple possession of drugs are given the option to receive treatment instead of a jail sentence.   These programs have proven to be remarkably successful for reducing the level of recidivism in our prison system.

Capitalizing on the infrastructure and success of the Drug Treatment Courts, some 50 or so Veteran Courts (now reportedly 300) have sprung up across the United States to deal with veterans who have committed a crime while suffering from substance abuse.  In many cases, these troubled vets have the support of other Vets (often from the Vietnam era) who “mentor” their military colleagues through the rehabilitation process.

This descriptive video from Justice for Vets provides a useful overview of why our Veterans deserves a better choice than incarceration:

Thanks to Judge Schwartz and other inspired leaders in our judicial and police system, Veteran Courts have expanded all across the United States.  Nevertheless, NPR reported earlier this year that many more Vet Courts are required.  Specifically, NPR noted that some states still do not have a Vet Court and that North Carolina has only 3 when the evidence suggests that we require 17.

As SFTT and others have reported in the past, Veterans with PTSD and TBI have been largely neglected by the Department of Veterans Affairs (“the VA”).  Veterans suffering from brain trauma often resort to substance abuse to curb pain and many resort to crime to support their habits.  Should we penalize these brave Veterans for our collective failings to provide our Veterans with the support they deserve?

SFTT would like to thank the many Veterans and volunteers in the legal profession who give of their time to support our Veterans through an often confusing legal system.

When communities reach out to help these brave warriors, our society is enriched. From our perspective, it’s simply a matter of doing the right thing!  We owe these brave young men and women big time!

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SFTT Offer “Thanks” to our Brave Military on Thanksgiving

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SFTT joins millions of Americans in offering our thanks this Thanksgiving to the Veterans and active duty personnel who valiantly defend our freedoms.

US military Thanksgiving

As we all sit down to enjoy the traditional Thanksgiving turkey, SFTT is reminded of those who have sacrificed their lives for our country and the many Veterans who continue to suffer from the silent wounds of war.

While the battlefield war may be over, tens of thousands of Veterans suffer the effects of brain trauma.  The effect of this debilitating injury not only affects the Veteran, but their family and loved ones who act as caregivers.  While one would like to think that we are close to finding a life-changing solution for Veterans who suffer from PTSD and TBI, no credible solution appears imminent.

Some promising new therapies have surfaced in recent years, but the Department of Veterans Affairs (“the VA”) seems stuck in a time-warp defending outdated and failed programs.  SFTT remains hopeful that the VA will come to its senses and begin adopting some successful third-party programs that have worked wonders for Veterans.

Hiding behind the mantra of “evidence-based medicine” sounds good, but loses its luster when the evidence strongly suggests that the VA programs have failed.

Our Veterans and their loved ones need solutions now!

As 2017 draws to a close, SFTT would like to thank a few people and organizations that have made a difference in the lives of Veterans this year.  By no means is this an all-inclusive list, but one that offers our Veterans a path to recovering their lives:

Paul Harch and Hyperbaric Oxygen Therapy

Dr. Paul Harch is one of the leading practitioners of Hyperbaric Oxygen Therapy or “HBOT.”  HBOT is a commonly used therapy provide patients with oxygen administered under pressure in a series of “dives” in an HBOT chamber.  Used widely around the world for decades, HBOT has been shown to stimulate brain cells and help reverse the symptoms of PTSD and TBI.   While many Veterans have found dramatic improvement in their condition, HBOT is not recommended by the VA to treat Veterans with PTSD and TBI.

Colin and Karen Archipley of Archi’s Acres

Thanks to combat-decorated Marine Sergeant Colin Archipley and his wife, Karen, a successful fashion industry entrepreneur in her own right, Archi’s Acres provides dedicated Veterans with the skills necessary to run a successful organic farming business  in their community. With meaningful jobs in short supply for Veterans returning from multiple deployments to Iraq and Afghanistan, Archi’s Acres gives Veterans a lifeline to become entrepreneurs in a rapidly growing and eco-friendly business.

Yuval Neria and Equine Assisted Therapy

Dr. Neria is Professor of Medical Psychology at the Columbia University Medical Center and “Scientific Advisor” to Stand for the Troops (“SFTT”).  He is now deeply involved in the Man O’War Project which is the first-ever clinical research study to determine the effectiveness of equine-assisted therapy (“EAT”) and establish guidelines for the treatment of military veterans who suffer from Post-Traumatic Stress Disorder (“PTSD”).

Maj. Ben Richards and Service Dog Bronco

Maj. Ben Richards is the Director of Veterans Operations at SFTT.  Over a year ago, Maj. Richards acquired a service dog, Bronco, which has brought much needed comfort, safety and stability to his life. Sadly, the VA is “studying” the efficacy of service dogs in helping other Veterans with PTSD.  This study will not be available until 2019.

service dogs for Veterans

Dr. Henry Grayson and Neuro Pathways

 Dr. Grayson is co-chairman of SFTT’s Medical Task Force and has provided several day-long training programs to caregivers and clinical psychologists  dealing with veterans suffering from Post Traumatic Stress (“PTSD”).  The author of Use Your Body to Heal Your Mind,  Dr. Grayson presents a radical view of health and healing based on an equally radical world view that we are all intrinsically connected rather than separate and that our belief in our separateness is a causal source of emotional and physical illness. Positing the body as the recipient of our beliefs, he shows that reading and responding to the body is a reliable path to emotional and physical healing. This is a challenging read with practical help for all willing to explore beyond the borders of traditional beliefs.”

 

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You Can’t Handle the Truth!: Spies and Damn Lies

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I suppose that most everyone recalls Col. Jessup’s (Jack Nicholson) impassioned defense of a “Code Red” in the film A Few Good Men:  “You can’t handle the truth!

For Col. Jessup and many others, the “truth” is an absolute certainty. Every time I hear some “talking head” or “politician” state that “the American public deserves to know,” I can’t help but recall Col. Jessup’s staunch defense of his own “personal” truth or value system.

Many are beginning to realize that discovering the “truth” is – at best – a personal quest. Just when you think you have found that elusive kernel of “truth,” new revelations create additional uncertainties.

For reasons that are not entirely clear (personally, I think it may be intellectual laziness), many of our citizens have created a very simple coping mechanism which I call “tribal politics”. Instead of wearing tribal colors or a tattoo, we simply register for one political party or the other and then cheer loudly to see which party can humiliate members of the other party more viciously.

Civil discourse is now little more than a shouting match, with party supporters cheering on their political gladiators in much the same way that “the mob” cheered on the lions at the Colosseum some 2,000 years ago.

Sadly, our search for the “truth” (even if it could be found) has given way to a whole host of silly slogans and tribal chants that prematurely end any reasonable quest for something close to the truth before it has started. Col. Jessup was probably correct in his assertion that we “can’t handle the truth.”

House of Straw: U.S. Election Meddling and Russia

I understand that people get rattled when they think that Russia meddled in the U.S. election.  While politicians and the media have been beating the “meddling” war drums loudly, I am entirely at ease with the thought that Kremlin spooks, lobbyists and hackers have been seeking to tamper with our election.  Gosh, I would be even more surprised if Russia hadn’t been doing everything possible to gain a political and military advantage over the U.S.

Why?  Well, U.S. clandestine agencies do exactly the same thing in other countries (friends and foes alike).  It is not unreasonable to expect that the U.S. would try to influence or manipulate results in other countries for our geo-political advantage.  I certainly hope that U.S. spies, hackers and “influencers” have been as active as Putin’s shady cast of characters.   In fact, anyone who has played the very popular Online game Sid Meier’s Civilization would attest to the value of spying to gain a competitive advantage over your competitors on the world stage.

It is just plain hypocrisy or stupidity to play the role of a “blushing” democracy when our spy agencies are doing exactly the same thing as Russian spies (or spies of most any other nationality).  

While Congressional Hearings are surely a “big thing,” you simply must laugh if you expect spies to tell the truth.  Spies are trained to lie and the best ones do a very good job of it.  In my estimation, Congress and the Senate and the “American People,” will not be any wiser after this silly political charade plays out in D.C.

Tribal Behavior

When politicians lack the courage to rise above their tribe’s silly rituals, representative democracy suffers.  With tribal behavior lurking behind the sanctimonious sound bites of most politicians, it is the American public that suffers.

It is impossible to determine how the “Special Counsel” charade will play for the electorate, but those who place their lives on the line every day to defend our freedoms must be genuinely disillusioned by politicians who argue that they will get to “the truth” for the benefit of the American people.   If you buy into this silly argument, there is a bridge in Brooklyn that many of these politicians will sell you.

While tribal leaders of both parties continue to posture with meaningless soundbites, real issues like the reform of the Department of Veterans Affairs and opioid abuse (among many serious issues) will continue to be pushed into the background as politicians position themselves at taxpayer expense for the next election.

Maybe Col. Jessup is right, “We can’t handle the truth!”

The views expressed here are those of the author and NOT necessarily those of the members of SFTT.

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Reflections on Veterans Day

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Maj. Ben RichardsYears ago when I was a young Army lieutenant, my reconnaissance platoon was preparing to conduct a night-time helicopter insertion far behind enemy lines to seek out intelligence critical for a large-scale operation to be conducted 48 hours later. The operation was high risk. That night as I back-briefed my Troop commander over the hood of a Humvee  in the German woods, I expressed my concern about the level of danger the platoon was facing.

My boss, an experienced cavalry scout himself who had served as an enlisted soldier and noncommissioned officer before earning an officer’s commission, replied directly: “If you get into trouble, we will roll this entire brigade to come and get you.”

At that time the war in Iraq was still over a year in the future, and the risk was largely hypothetical, but I wondered whether the Army would really risk a brigade of 3,000 to 4,000 soldiers and hundreds of armored vehicles to rescue a few men in a desperate situation. And then I didn’t think about it again.

That is until I was leading men in a real war in Iraq. In November of 2006, my Cavalry Troop was in the process of moving from Tal ‘Afar in northwest Iraq to Taji, a large operating base just outside of Baghdad. The night before our movement, a special operations team had been conducting a raid deep in the al Qaeda-controlled hinterlands of the infamous Anbar province. The raid had run into trouble and a large force of al Qaeda fighters was closely engaged with the small special operations team.

A pair of Air Force F-16 fighters scrambled to provide air support for the troops, but because the fighting had moved to such close range, they could not use their normal load of bombs without risking the lives of the men they were trying to save. With no good options, one pilot, Major Troy Gilbert, volunteered to conduct a highly-dangerous low-level night-time strafing mission in order to employ his aircraft’s 20mm cannon which could be used much closer to friendly troops.  On completing the diving attack, his plane was unable to pull out in time and crash landed in the Anbar desert.

Although he had been unable to eject, the aircraft was largely intact and it was possible that MAJ Gilbert had survived. On that chance, my Troop and over two thousand other US combat troops—an entire Army Brigade’s worth – were quickly dispatched to rescue the pilot. We had just arrived in Taji and had not even unpacked, when we sortied into the desert.

The area had never been under US control and the roads were littered with large and deadly Improvised Explosive Devices (IEDs). The going was slow and occasionally punctuated by the ambush of al Qaeda fighters. We reached the crash site and then searched the surrounding desert and villages for four days until we were able to find forensic proof that MAJ Gilbert had not survived the crash. After an extended search other soldiers were able to locate and bring home his remains.

During those nights in the desert, I remembered another night in the German woods and realized that I was helping to fulfill a promise made not just by my commander, but by millions of American soldiers over hundreds of years. The risk MAJ Gilbert accepted was extraordinary. As an experienced pilot, he was fully aware of the danger and the cost he might have to pay to save the lives of a few Army soldiers.

Our mission to find MAJ Gilbert was the most dangerous we had conducted up to that point. As we rolled out into the desert, we also knew the risks and willingly accepted them—also at a cost. In my unit, Corporal Billy Farris, also a young father, was killed in an ambush during the operation.

What stands out about Troy Gilbert and the incredible men and women I had the privilege of serving with was their belief in the infinite value of the life of another soldier.

Unfortunately, after returning home from Iraq as an “invisibly wounded” veteran with Traumatic Brain Injury and Post Traumatic Stress Disorder, that was not the ethos I found at home, particularly in the very institutions created to care for nearly one million combat-disabled veterans like me. In 2012, Pulitzer Prize-winning journalist Nicholas Kristof observed in the New York Times, “if you want to understand how America is failing its soldiers and veterans, honoring them with lip service and ceremonies but breaking faith with them on all that matters most, listen to the story of Major Richards.”

What is exceptional about Kristof’s statement is that he made it after I had been provided the top level of care available within the DOD and VA medical systems—a level of care only a few hundred service members a year were given access to. However, these alleged best efforts were only a façade.

Suffering from daily, debilitating pain and unable to function in most facets of life including interacting with my wife and our four children, I began to seriously consider suicide. That was when Stand for the Troops came to my rescue and joined me in my personal battle against the invisible wounds of war. They arranged for me to receive several months of Hyperbaric Oxygen Therapy (HBOT) from one of the leading practitioners in the country, Dr. Paul Harch at Louisiana State University (who provided the treatments for me at his own expense).

It was the first genuinely effective medical care I had received since returning home, and it has restored much of my life. Today I am a productive and contributing member of society, with a loving family and a high quality of life.

As we reflect this Veterans Day on the blessings derived from the service and sacrifice of so many men and women and their families, we begin to realize the magnitude of the task before us in living up to legacy heroes like MAJ Troy Gilbert.

I am pleased to report that there remain many great Americans, both in and out of uniform, who share the belief in the infinite value of a soldier’s life. Please join me in supporting Stand for the Troops in making sure the nearly one million veterans disabled by TBI and PTSD finally get the genuinely effective care they deserve.

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Opioid Crisis: Contributors to the Current Crisis

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The opioid crisis is real.  It is hard to believe that people dying from drug overdoses each year now exceed the total number of brave warriors who lost their lives in Vietnam.

Homeless Veteran

Regardless of one’s political affiliation, this drug epidemic must be faced with determination to eradicate this awful plague.  Yet, in looking at The President’s Final Report on Fighting Drug Addiction and Opioid Abuse, I find myself wondering how we got to this sad state of affairs in the first place.

Despite having only 5% of the world population, the US consumes 80% of the world’s global opioid supply.  More to the point, these are not disreputable drug barons south of the border peddling addictive drugs, but licensed members of the medical profession encouraging the use of lethal and addictive prescription drugs.

There have been pharmaceutical companies like the Sackler’s firm of Purdue Pharma that used their considerable marketing skills to hype the benefits and hide the risks of opioids, but the most obvious revelation is that the very institutions that should have protected our backs may have been complicit in enabling them:  the Healthcare System.

Specifically, the President’s Final Report (pages 20 – 23 with just a few summarized below) argues “that the modern opioid crisis originated within the healthcare system and have been influenced by several factors:”

Unsubstantiated claims: High quality evidence demonstrating that opioids can be used safely for chronic non-terminal pain did not exist at that time. These reports eroded the historical evidence of iatrogenic addiction and aversion to opioids, with the poor-quality evidence that was unfortunately accepted by federal agencies and other oversight organizations.

Pain patient advocacy: Advocacy for pain management and/or the use of opioids by pain patients was promoted, not only by patients, but also by some physicians. One notable physician stated: “make pain ‘visible’… ensure patients a place in the communications loop… assess patient satisfaction; and work with narcotics control authorities to encourage therapeutic opiate use… therapeutic use of opiate analgesics rarely results in addiction.

The opioid pharmaceutical manufacturing and supply chain industry:   To this day, the opioid pharmaceutical industry influences the nation’s response to the crisis. For example, during the comment phase of the guideline developed by the Centers for Disease Control and Prevention (CDC) for pain management, opposition to the guideline was more common among organizations with funding from opioid manufacturers than those without funding from the life sciences industry.

Rogue pharmacies and unethical physician prescribing: The key contributors of the large number of diverted opioids were unrestrained distributors, rogue pharmacies, unethical physicians, and patients whose opioid medications were diverted, or other patients who sold and profited from legitimately prescribed opioids.

Inadequate oversight by the Food and Drug Administration (FDA):  The FDA provided inadequate regulatory oversight. Even when overdose deaths mounted and when evidence for safe use in chronic care was substantially lacking, prior to 2001, the FDA accepted claims that newly formulated opioids were not addictive, did not impose clinical trials of sufficient duration to detect addiction, or rigorous post-approval surveillance of adverse events, such as addiction. 

Reimbursement for prescription opioids by health care insurers: Sales of prescription opioids in the U.S. nearly quadrupled from 1999 to 2014, largely paid for by insurance carriers. It is estimated that 1 out of 5 patients with non-cancer pain or pain-related diagnoses are prescribed opioids in office-based settings.

Lack of foresight of unintended consequences: As prescription drugs came under tighter scrutiny and access became more limited (via abuse-deterrent formulations and more cautious prescribing), market forces responded by providing less expensive and more accessible illicit opioids.

Public demand evolves into reimbursement and physician quality ratings pegged to patient satisfaction scores:  Prior to this year, poor patient satisfaction with pain care could lead to reduced hospital reimbursement by Medicare through Value-Based Purchasing (VBP). There are often higher costs or no specific reimbursements for alternative pain management strategies, alternative pain intervention strategies, or spending time to educate patients about the risks of opioids.

Given the scope of the problem, there is no question that urgent action needs to be taken to address this epidemic.  Nevertheless, one must question why we should entrust leadership  of that initiative to the same institutions that enabled the epidemic in the first place.

As reported earlier by SFTT in Opioids:  Bipartisan Incompetence in DC and vividly documented in the joint Washington Post and 60 Minutes Report, there are entrenched political and business interests at play.    I find it highly unlikely that they will release their grip on the brass ring with so much money at stake.

To date, there is no price tag on resolving the drug overdose crisis.  Isn’t it ironic that the same cast of characters that profited from addicting our nation, now get a chance to monetize the painful withdrawal process?  In the corporate world, we refer to this as “double-dipping,” but in politics it is simply “business as usual.”

If you honestly believe that “big government” will get us out of the drug addiction and opioid abuse crisis the government and healthcare system colluded to create, P. T. Barnum has a bridge to sell you.

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SFTT Military News: Week Ending Nov 3, 2017

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Found below are a few military news items that caught my attention this past week. I am hopeful that the titles and short commentary will encourage SFTT readers to click on the embedded links to read more on subjects that may be of interest to them.

If you have subjects of topical interest, please do not hesitate to reach out. Contact SFTT at info@sftt.org.

North Korean Defector Warns of “Massive” Military Counterstrike
North Korean military officers have been trained to trigger a devastating counterstrike if their country is attacked by the United States, according to a high-profile defector. Former North Korean diplomat Thae Yong Ho’s comments to U.S. lawmakers suggest that military action on the Korean peninsula — a course of action repeatedly raised by President Donald Trump — would almost certainly result in a catastrophic number of civilian casualties. “North Korean officers are trained to press the button without any further instructions from the general command if something happens on their side,” Thae said Wednesday. “So if there is any sound of fire or bombs or strikes from Americans, the [North Korean] artillery and short-range missiles will fire against South Korea.”  Read more . . .

Kim North Korea

First U.S. Airstrikes Reported Against ISIS in Somalia
The U.S. military for the first time has conducted two airstrikes against Islamic State group fighters in Somalia, where the group is a growing presence in a country long threatened by the al-Qaeda-linked extremist group al-Shabab. The U.S. Africa Command said the two drone strikes killed “several terrorists” in northeastern Somalia, with the first around midnight local time and the second later Friday morning. The U.S. said the strikes were carried out in coordination with Somalia’s government.   Read more . . .

Syria Claims that Last ISIS Outpost in Syria Falls
The Syrian government declared victory over Islamic State in the eastern city of Deir al-Zor on Friday, a big blow to the jihadists as their last stronghold in Syria crumbles. Deir al-Zor, on the west bank of the Euphrates River, is the largest and most important city in eastern Syria, and is the center of the country’s oil production. “The armed forces, in cooperation with allied forces, liberated the city of Deir al-Zor completely from the clutches of the Daesh terrorist organization,” the military source said, using an Arabic acronym for Islamic State.  Read more . . .

VA Plea for New Drugs to Treat PTSD
Reported cases of post-traumatic stress disorder are increasing, and trends indicate that growth will continue as more military men and women return from overseas service. But treatment help doesn’t appear to be coming quickly. So far in 2017, six dermatology drugs have been approved by the Food and Drug Administration, but no drug has been approved for treatment of PTSD since 2001. At this point, two drugs — Paxil and Zoloft — have been given FDA approval for PTSD. The Department of Veterans Affairs created a PTSD Psychopharmacology Working Group, which has issued an urgent plea for the development and approval of new drugs for PTSD as part of a national mental health priority.  Read more . . .

Ecstasy in the Loop to Treat PTSD?
In July, the Food and Drug Administration took the important step of approving two final-phase clinical trials to determine whether a party drug that has long been on the Drug Enforcement Administration’s Schedule I list of banned substances could be used to treat a psychiatric condition that afflicts millions. The drug is MDMA, a psychedelic commonly known as Ecstasy, previously deemed to have “no currently accepted medical use.” The trials aim to determine whether the drug is, as earlier trials have suggested, a safe and effective treatment for post-traumatic stress disorder, when combined with psychotherapy.  Read more . . .

Eye Movement Desensitization Reduces PTSD
In a meta-analysis of clinical trials published in PLoS One, eye movement desensitization and reprocessing was shown to reduce the symptoms of posttraumatic stress disorder (PTSD), with a longer duration of treatment correlating with better outcomes. The study authors evaluated 26 randomized controlled trials that evaluated the use of eye movement desensitization and reprocessing in patients with PTSD. Outcomes included the effects of treatment on PTSD symptoms, depression, anxiety, and subjective distress.  Read more . . .

Drop me an email at info@sftt.org if you believe that there are other subjects that are newsworthy.

Feel you should do more to help our brave men and women who wear the uniform or our Veterans? Consider donating to Stand For The Troops.

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Thank you Rachel Maddow

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I would like to thank Rachel Maddow not only for honoring my late husband Colonel David Hackworth, on October 17, but also for honoring all fallen soldiers past and present as well as their families.

As I watched the opening segment of Tuesday’s The Rachel Maddow Show on MSNBC, I was so deeply touched I had chills, then tears in my eyes. I didn’t know that Hack would be featured and I wasn’t prepared for Rachel’s heartfelt recounting of my beloved husband’s years of service to our country and his troops. He served in more wars than anyone his age should have and he did so brilliantly and proudly. And when he left the military, he never really left. His network of everyone from military brass to grunts was extensive, with new “recruits” calling him almost daily to find out how they could help him “stand for the truth” while supporting the troops – with more than lip service.

This number of veterans whose lives Hack touched still astounds me. At Stand for the Troops the foundation Hack and I founded, we receive emails, tweets, Facebook posts and letters from servicemen and women worldwide who remember Hack’s legacy of getting to the truth behind the “story,” whatever that narrative was and how that it was spun. From Rumsfeld to better armor for desert combatants, David made sure the media “got it right.”

While listening to Rachel, I was hearing a journalist with similar integrity and determination. A reporter who night after night, just as Hack did on Larry King post 9/11, has the same commitment to viewers: to ask difficult questions and demand answers. So it was last week when Rachel spoke about how we honor those who volunteer to die, sustain injuries or endure a lifetime of invisible battle wounds for all of us.

Every day at SFTT, we continue Hack’s desire to help living veterans suffering quietly from Traumatic Brain Injury, (TBI) and Post Traumatic Stress Disorder (PTSD) find help. We’ve partnered with various treatment providers to deliver therapies that veterans say work far better with less side effects than those offered by the VA.

If you’d like to honor Hack’s legacy of fearlessly ferreting out the truth and helping veterans improve their quality of life, please contact us.

And thank you, Rachel, for remembering my husband’s heroism with such accuracy, tenderness and respect.

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GAO to Investigate VA Over Treatment and Therapy of Veterans with PTSD

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At the request of Reps. Mike Coffman, R-CO., and Ann McLane Kuster, D-N.H., the Government Accountability Office (“the GAO”) agreed Sept. 27 that it “will review the way the Department of Veterans Affairs (“the VA”) treats patients who suffer from post-traumatic stress disorder (PTSD) and other combat-related conditions.”  In particular, the GAO will focus on “how heavily the VA relies on powerful psychotropic drugs to treat patients.”

OxyContin - Veteran Addiction

As reported in the Armed Forces News, “this decision is a victory for combat veterans everywhere who are suffering from PTSD and who have been prescribed a cocktail of very powerful drugs to mask their symptoms in lieu of other forms of interactive therapy that work to bring down the stress levels of PTSD to a point where they are no longer debilitating,” said Coffman.

While this new GAO study may come as a big relief to many Veterans with PTSD (and their families), the tragic findings will surprise few who monitor the shoddy treatment procedures provided to Veterans with PTSD at the VA .

For those expecting that this “new” GAO study will result in any improvements in the treatment our Veterans receive, I refer you to the December, 2014 GAO study of the VA with the title of “Improvements Needed in Monitoring Antidepressant Use for Major Depressive Disorder and in Increasing Accuracy of Suicide Data.”

Here is a brief summary of the conclusions reached in this GAO audit as reported by SFTT in March, 2015 in an article entitled GAO Hammers VA on Protocols for VA Suicides:

– 10% of vets treated by VA have major depressive disorder and 94% of those are prescribed anti-depressants
– 86% of audited files of vets on anti-depressants did not receive a follow up evaluation within the required 4-6 weeks
– 40% of the same group of veterans on anti-depressants did not receive follow up care within the recommended time frame
– 63% of suicide cases were inaccurately processed

This means 500,000 veterans have major depressive disorder and 470,000 of those are prescribed anti-depressants. This means it is possible that 404,200 veterans on anti-depressants are not receiving timely follow up assessments.

With data integrity breaches like this, it is no wonder GAO cited the suicide data VA relies on as “not always complete, accurate, or consistent.”
Credits: GAO Audit Shows 63% Of Suicide Cases Improperly Processed

If Representatives Coffman or McLane Kuster expect different patient outcomes, they are likely to be as disillusioned as Kimi Bivins, the wife of Veteran Eric who tragically committed suicide earlier this year.    There is little need to request a GAO study to find out how dysfunctional the VA has become.  Simply listen to Kimi describe how her husband was treated at VA facilities.
Even as far back as 2012, the VA knew that opioids were not appropriate for treating PTSD, and yet, the VA continued to provide Veterans with lethal prescription drugs knowing full well the consequences.
While SFTT could point out many similar government studies on inefficiencies at the VA, it seems to be far easier for politicians to request new studies, since they never bothered to read the existing studies or insist on much needed reforms.
Sadly, the VA has become a “law unto itself” and no amount of well-intentioned “studies” or GAO audits will do anything to turn the VA around unless politicians on both sides of the aisle take a sledgehammer to break up the VA into manageable components.   As of today, the VA is simply too large to succeed in its mission.
We can continue to study the problem, but for the sake of our brave Veterans and their families, it is time to take action!
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