The VA and Opioids: Finger-pointing Begins

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SFTT has been reporting for a number of years the abuse at the Department of Veterans Affairs (“the VA”) for prescribing addictive prescription drugs to Veterans suffering from PTSD and TBI.

Despite repeated messaging by VA officials that it applies “science-based evidence” to prescribe treatment for Veterans, it would appear that the VA has been sadly duped into believing that painkilling opioids is a “science-based” solution to treat Veterans with PTSD.

The Washington Post reports tonight (Oct 15, 2017), that 60 Minutes will provide an expose on how the drug industry triumphed over the DEA.   While I have no idea how CBS will spin the narrative,  it has been evident for many years that the pharmaceutical industry “owned” Congress and government authorities who “regulated” their business practices.

Opioids for Veterans with PTSD

The fact that we have an opioid epidemic in the United States should be of no surprise to anyone who has watched this tragedy unfold.    What is a surprise, is that the same groups who enabled this tragedy are now sounding the alarm bells to curb the excesses they themselves created.

In an earlier blog, SFTT cited a few organizations that should have the decency to admit that their “science-based evidence” completely underestimated the effect that easy prescription practices would contribute to addiction.

I do not doubt that corporate greed has played a large role in this terrible prescription drug epidemic, but let’s not forget their important enablers:

More to the point, politicians of both parties deserve a large measure of culpability in providing pharmaceutical companies with the breathing space and easy access to peddle their lethal drugs to the medical profession and naive end users.

How the VA Fueled the Opioid Crisis

Just this last week, Newsweek describes in detail how the VA fueled the opioid crisis by prescribing potent prescription drugs to Veterans suffering from the effects of PTSD and TBI.

In 2011, veterans were twice as likely to die from accidental opioid overdoses as non-veterans. One reason, as an exhaustive Newsweek investigation—based on this reporter’s book, Mental Health, Inc.—found, is that for over a decade, the VA recklessly overprescribed opiates and psychiatric medications. Since mid-2012, though, it has swung dangerously in the other direction, ordering a drastic cutback of opioids for chronic pain patients, but it is bungling that program and again putting veterans at risk. (It has also left untouched one of the riskiest classes of medications, antipsychotics—prescribed overwhelmingly for uses that aren’t approved by the Food and Drug Administration (FDA), such as with post-traumatic stress disorder.)

The Newsweek article, written by Art Levine, goes into great detail how the VA let our Veterans down by prescribing prescription drugs to Veterans with PTSD with little – if any – required approvals from the FDA.

Like most other pseudo-science arguments spun by VA spokespeople, our brave Veterans did not receive proper therapy for PTSD and TBI but rather were served a concoction of addictive drugs that simply mask the symptoms rather treat the problem.

The VA then felt the need to discredit any other therapy programs for Veterans that might conflict with the limited “approved” VA treatment options.

While there does seem to be a strong effort to curb the use of prescription pain drugs, Art Levine points out that this has forced addicted Veterans to seek other alternatives:

Equally troubling, the crackdown on opiate prescribing—a swing from one dangerous extreme to another—may be contributing to an increase in heroin and illegal opiate medication use among veterans, as well as suicides from pain-wracked veterans going through poorly monitored withdrawal. (Even with new opioid guidelines, the number of veterans with opioid-use disorders increased 55 percent from 2010 to 2015.)

While recognizing the heart-wrenching impact of this epidemic is certainly an important first step, it seems ludicrous to suggest that the same cast of characters who created the problem should be the ones empowered to solve it.

Veterans, Veteran organizations and our political leaders have known for years that the VA is broken.   How many more needless Veteran deaths and suicides do we need to confirm the undeniable fact Veterans are not receiving proper care and treatment at VA facilities?

While 60 Minutes will no doubt cast a dark shadow on the pharmaceutical industry, shouldn’t their partners in crime stand up and admit their undeniable culpability?

Our Veterans deserve far better than the shady dealings between unethical drug companies and their no less reprehensible political benefactors.

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Veterans with PTSD: The VA Way or the Highway

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It is easy to find fault with the Department of Veterans Affairs (“the VA”), particularly when it comes to Veterans with PTSD.

Department of Veterans Affairs

Secretary of Defense, Robert McNamara, tried to employ body count statistics to assess our progress in the war in Vietnam.  Similarly, the VA has erected a statistical house-of-cards to deceive Veterans and their loved that the VA has the answers for Veterans coping with PTSD and TBI.

Like McNamara, the VA “knows what is best for Veterans” and has erected insurmountable statistical barriers to prop up their failed strategies.  In effect, the VA is telling Veterans:  “It is my way or the highway!

Paraphrasing a joke: “The VA uses statistics as a drunk uses a lamppost — For support rather than illumination.”

Sadly, it is no laughing matter when we consider the thousands of combat Veterans suffering from PTSD and TBI.  More importantly, reflect on the often tragic consequences for their families and loved ones.

While Congress and the public continue to be seduced by the steady stream of assurances that the VA provides the best possible care to Veterans with PTSD and TBI, the FACTS tell a far different story.

FAKE NEWS from the VA on Veterans with PTSD

Found below is a video of Dr. David Cifu, Senior TBI Specialist at the VA, testifying before a Congressional Committee:

The VA continues to push a stale and failed agenda that states that the only two effective treatment therapies offered by the VA are:

– Cognitive Behavioral Therapy (“CBT”)and,

– Prolonged Exposure Therapy (“PET”).

As these “therapy” programs have failed miserably according to independent studies (see below), the VA has “coped” with the problem by prescribing a lethal concoction of prescription drugs which treat the symptoms of PTSD rather than deal with the underlying problem.

And we wonder why we have an opioid epidemic in this country?

REALITY CHECK at the VA

While Dr. David Cifu continues to entertain a Congressional Committee on the efficacy of the VA’s protocols, experience for yourself one woman’s harrowing experience with the VA which eventually led to husband’s suicide:

The story of Kimi Bivins is not the exception to the type of treatment Veterans with PTSD receive at the VA. Based on many similar stories, the VA is failing our Veterans and their loved ones.

I encourage readers to read Kimi’s harrowing description of what actually takes place at a VA facility.

While the folks at the VA casually dismiss anecdotal stories, VA claims that Veterans receive the best therapy possible is simply not supported by the evidence.

No less of an authority that the National Academies of Sciences (Medical Division) reported in a 2014 study entitled “Treatment for POSTTRAUMATIC STRESS DISORDER in Military and Veteran Populations,” that CBT and PET barely made a statistical dent in providing Veterans with PTSD any lasting improvement in their condition.

Consider Maj. Ben Richards‘ compelling evidence documenting the failed experiments at the VA in helping Veterans with PTSD.

Standing behind a well-entrenched bureaucracy of statistical inaccuracies and dogma, the VA goes out of its way to discredit other treatment alternatives. Consider this bitter “scientific” debate between Dr. Cifu and Dr. Paul Harch on the efficacy of hyperbaric oxygen therapy or HBOT in treating PTSD and TBI.

Finding a Middle Ground for Veterans with PTSD?

With so little known about the brain and how to treat trauma, it seems absurd for the VA to insist that they have all the answers.  The evidence clearly suggests that the VA doesn’t have a clue.

Nevertheless, the VA argues that “alternative therapies” that do not pass scientific scrutiny and FDA approval will not be endorsed by the VA.  As we have seen countless times – from body armor testing to hyperbaric oxygen studies – the DoD uses test protocols that deviate from accepted standards.

If the tests are flawed, one is likely to draw the wrong conclusions!

For the vast majority of Veterans with limited economic means, the VA is effectively making life and death decisions based on flawed testing and a reluctance to embrace other treatment alternatives.

This is probably done with the intent of protecting Veterans from charlatans and snake oil peddlers, but doesn’t it also block Veterans from receiving promising therapies from legitimate sources?

When dogma or “approved” therapies become the LAW, then it seems unlikely that much progress will be made to help our brave Veterans recover their lives.  The VA would do well to encourage Veterans to seek alternative therapies and provide an interactive sounding board for Veterans to voice their opinions on these programs.

Honesty and transparency and a willingness to accept mistakes is the sign of a responsive institution.   Today, the VA hides behind a dogma based on self-delusion and falsehood.

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SFTT Military News: Highlights for Week Ending Sep 29, 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.

Millions Allegedly Enlist in North Korean Military
Kim Jong Un’s media machine reported this week that 4.7 million people offered to enlist in the North Korean armed forces in the days after President Donald Trump promised to “totally destroy” the rogue state—and the new recruits would more than quadruple the size of the nation’s already mammoth military.  State-run newspaper Rodong Sinmun said the fresh recruits include students and veterans of all genders.  Read more . . .

General Named to Head Puerto Rico Relief Effort
The Pentagon named a senior general to command military relief operations in hurricane-ravaged Puerto Rico on Thursday and the Trump administration sent a Cabinet emissary to the island as U.S. lawmakers called for a more robust response to the crisis. The U.S. territory of 3.4 million people struggled through a ninth day with virtually no electricity, patchy communications and shortages of fuel, clean water and other essentials in the wake of Hurricane Maria, the most powerful storm to hit the island in nearly 90 years.    Read more . . .

Russian Ends Zapad Military Exercises in Belarus
Russia finally concluded its quadrennial Zapad-2017 military exercises last week.  The exercises, which were held in Belarus and western Russia for six days, tested Russia’s defensive capabilities against the fictional country of Veishnoriya which had supposedly been infiltrated by western-backed militias. The games were not, as many eastern European leaders and even some US generals feared, used to occupy Belarus, invade Ukraine or for some other deceitful act.  Read more . . .

U.S. Drones Attack ISIS Militants in Libya
Six U.S. air strikes on an Islamic State desert camp in Libya killed 17 militants and destroyed three vehicles, the U.S. military said on Sunday, the first American strikes in Libya since President Donald Trump took office in January. U.S. Africa Command said in a statement that strikes on Friday targeted a camp 150 miles (240 km) southeast of Sirte, a city that was once the Islamic State stronghold in Libya. The camp was used to move fighters in and out of Libya, plot attacks and store weapons, the statement said.  Read more . . .

VA Cited in Controversial Experiments on Dogs
The Department of Veterans Affairs is tightening oversight of controversial medical experiments on dogs after an investigation found surgery failures and canine deaths in research projects at a VA facility in Virginia — findings that spurred a push in Congress to defund the experiments altogether. Nationwide, invasive experiments at three VA facilities are slated to include roughly 300 dogs, including 6-month-old Beagle puppies, and involve surgeries on their brains, spines and hearts by researchers seeking treatments for heart disease and other ailments. All the dogs will be killed when the research is complete.     Read more . . .

VA Report Suggests VA is Lax in Providing Veterans Medical Support
Internal Department of Veterans Affairs data provided by whistleblowers reveals the agency is only filling about half of its capacity to make medical appointments, even as veterans continue to wait an average of at least 30 days before a medical appointment can be scheduled. The VA documents show that between July and September of 2017, the agency only used 51.44 percent of the appointments available across its healthcare system.  Read more . . .

PTSD and Bacteria Link Suggested
There are several factors that influence whether or not people are more likely to develop PTSD. This includes genetics, epigenetics (factors that influence the way genes are expressed into proteins) and the environments that they are exposed to. Newer evidence is showing there may be another factor at play. Studies show that people who suffer from psychiatric disorders have high levels of inflammation in their bodies. Scientists are still unsure of how this inflammation comes about although some studies on animals have suggested the gut microbiome could play a role. They found that exposure to stress changed the gut microbiome of these animals and also resulted in increased levels of immune molecules and inflammation.  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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Veteran Suicides: The VA Releases “New” Statistics

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The Department of Veterans Affairs (“the VA”) recently released a report showing state-by-state disparities in suicide rates among Veterans.  Sadly, the data tracks Veteran suicides rates through 2014 leaving a significant time gap in determining whether the trend in 20+ veteran suicides a day is improving.

Veteran Suicides

(U.S. Army photo by Stephen Baker)

The news media has been quick to seize on some of the notable anomalies in the data, some of which is highlighted below from PBS news:

  • Suicide among military veterans is especially high in the western U.S. and rural areas;
  • Suicide rates in Montana, Utah, Nevada and New Mexico averaged 60 per 100,000 individuals compared to the national average of 38.4 (overall in the West was 45.5);
  • Women veterans had a suicide rate 2.5 time higher than for female civilians;
  • A VA study (last year) found that veterans who received the highest doses of opioid painkillers were more than twice as likely to die of suicides than those receiving the lowest doses;  
  • 65% of Veteran suicides were age 50 or older. 

It is difficult to generalize from this somewhat dated report other than to say that Veteran suicide rates are considerably higher than the national average.

Furthermore, it would appear that the VA’s propensity to dispense potent prescription drugs – primarily opioids – may have contributed to high suicide rates among Veterans.

Just who is to blame for the opioid epidemic sweeping the United States?  Finger-pointing suggests that many are to blame for the epidemic, but new candidates emerge daily.

For instance, the New York Times recently reported that insurance companies may need to shoulder part of the blame for opioid abuse.  Why?

“Opioid drugs are generally cheap while safer alternatives are often more expensive.

“Drugmakers, pharmaceutical distributors, pharmacies and doctors have come under intense scrutiny in recent years, but the role that insurers — and the pharmacy benefit managers that run their drug plans — have played in the opioid crisis has received less attention. “

Nevertheless, some institutions took measures far earlier to stem addictive drug treatment.   For instance, Mother Jones reports that: “Partnership HealthPlan, the main public insurance provider for Medi-Cal patients in rural Northern California, discovered an alarming trend: Many counties where Partnership operated had among the highest rates of opioid prescribing and overdose in the state. Hydro­codone was the top-prescribed medication among Partnership patients, who include more than 570,000 Medi-Cal recipients from the vineyards of Sonoma County to the redwoods on the Oregon border. In Lake County, a poor, rural area bordering Sonoma, enough opioid painkillers were prescribed in 2013 to medicate every man, woman, and child with opioids for five months, according to a report by the California Health Care Foundation.”

Unfortunately, the VA is largely unaccountable to anyone and Veterans have few affordable choices other than to rely on treatment options provided by the VA.  With a dismal track record in providing treatment for Veterans with PTSD, it is hard to see how any meaningful progress will be made by the VA in curbing VA suicides.

More disturbing is the thought that Veterans with PTSD incurred from the Gulf Wars and continued deployments in Afghanistan and Iraq will soon be approaching their 50th birthday.   If the VA statistics are credible that “65% of Veteran suicides are over the age of 50,” then we may actually see an uptick in suicide rates among Veterans.

Despite repeated assurances to Congressional Committees, Dr. David Cifu and his cronies at the VA don’t have a clue on how to treat PTSD.   Cocktails of lethal prescription drugs are clearly not the answer, but the VA’s blind insistence that Cognitive Behavioral Therapy and Prolonged Exposure Therapy are the only effective treatment programs is simply ludicrous.

Whatever the reasons, Veterans with PTSD and TBI may not really have a viable financial alternative outside the treatment barriers currently erected by the VA.

Even though the information is dated, the VA has done a good job illustrating the extent of the problem.  While one can draw many inferences from the data, it would be totally wrong to suggest that the VA has a handle on the problem and absurd to think that they have answers!

No wonder Veterans with PTSD and TBI have lost faith in the VA.

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How the VA Callously Treats Veterans: A National Disgrace

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As we reported earlier, Veteran Eric Bivins committed suicide after being unable to find the support and care he needed from the Department of Veterans Affairs (“the VA”).

Found below are a moving – AND MOST SAD – series of videos by Kimi Bivins, Eric’s spouse which describes her experiences with the VA in attempting to find the proper care for her husband.

Kimi’s experiences with the VA are not dissimilar from my own and countless of others who have sought care from the VA. I agree with Kimi that it is a “national disgrace,” yet the VA continues to remain largely unaccountable for their callousness and disdain in treating our brave warriors.

I would encourage readers to watch these powerful videos to understand the frustration and agony of a loved-one in dealing with the VA.

Kimi’s YouTube videos are presented in a more or less chronological order, with limited commentary by me other than to clarify certain expressions.

Published on March 23, 2016. Kimi’s Initial PRIVATE Appeal for Help.

Published on March 10, 2016. Kimi’s Frustration on Getting VA Paperwork

Published on March 18, 2016. Eric in a VA Facility

Published on March 23, 2016. Eric is Coping, but Life is Still Very Difficult

Published on April 13, 2016. Eric at Independent Treatment Facility.

Published on May 15, 2016. Eric is Better, But Seeks Therapy Outside the VA

Published July 11, 2017. After Eric’s Suicide

While many will be shocked by these series of videos, it is far too commonplace within the VA.

Before Eric’s suicide he had been accepted into a program to receive hyperbaric oxygen therapy or HBOT.  I credit HBOT with saving my life and enabling me to begin the long road to recover my life.

It is sad that some uninformed doctor at the VA would shatter Eric’s dream of life-changing therapy by parroting the VA’s institutional bias against HBOT.

Dr. David Cifu and his cronies at the VA and the DoD have done their upmost to discredit HBOT and other alternative therapies to support the failed VA programs of Cognitive Process Therapy (“CPT”) and Prolonged Exposure Therapy (“PE”).

Failed VA therapy programs to treat PTSD have been documented numerous times by credible independent studies.   And yet, VA spokespeople still parrot the same stale party line.  Veterans with PTSD and TBI are not deceived and have abandoned the VA in droves.

It sickens me to watch these tragic videos of Kimi documenting her fruitless attempt to navigate the uncaring bureaucracy of the VA.  In my estimation, Kimi’s videos should be mandatory training for all employees at the VA.

While the VA provides much needed comfort to thousands of Veterans, those Veterans with PTSD and TBI need to look elsewhere for REAL therapy.

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SFTT Military News: Week Ending Aug 25, 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.

US Military Collaborates with West Virginia University over Opioid Abuse
As the opioid epidemic continues to have a substantial impact on the state, leaders from WVU reached out to USU’s Defense and Veterans Center for Integrative Pain Management, aware of their efforts to successfully combat opioid misuse in the military over the last several years with the idea that lessons learned in the military would be applicable to their state’s current crisis. Earlier this year, leaders from both universities developed a cooperative research and development agreement allowing them to formally share pain management resources developed by DVCIPM.  Read more . . .

Opioids for Veterans with PTSD

Pot Advocate Argues that VA Cannabis Study for PTSD is Useless
Cannabis advocates are criticizing the Department of Veterans Affairs for wasting time and resources on recently published research that produced inconclusive results on the effects of medical marijuana in treating pain and post-traumatic stress disorder. “I find the funds spent on regurgitating these studies to be worthless,” said Sean Kiernan, a veteran and advocate for the Weed for Warriors Project. VA researchers last week published two studies that reviewed previous analyses and evaluations of the effects of marijuana on treating chronic pain and PTSD. Read more . . .

Telehealth May Help Thousands of Veterans
Imagine the day that you can see your medical provider from anywhere in the country, including from the comfort of your own home. You wouldn’t have to take a full day off of work, travel long distances or spend hours in a hospital waiting room. Thanks to the age of smart phones and other advanced technology, that day has come. And it couldn’t have come at a more critical moment. Across the nation, wait times in the private sector for new patient appointments have increased 30 percent in the last three years, including in major cities such as Seattle, Boston, Denver and Los Angeles, according to a recent survey. Telehealth technology is revolutionizing how Americans access health care.  Read more . . .

Parents of Veteran Who Died of Drug Overdose Cite VA Apathy
Standing in the crowd at a rally calling for a royal commission into the Department of Veterans’ Affairs were the parents of Jason Grant, a veteran of Afghanistan who died of a suspected drug overdose at his Ferny Creek home just a month ago. Ross Grant was a quiet but powerful presence at the rally on Tuesday, holding a placard reading “DVA Killed My Son” as well as photos of Jason in uniform, in recent years and also as a child.   Read more . . .

Canadian VA Service Dog Study for PTSD Doesn’t Please All
Some veterans advocates aren’t pleased with the results of the first phase of a federal study intended to assess the effectiveness and safety of psychiatric service dogs used by people who live with post-traumatic stress disorder. The study, commissioned by Veterans Affairs Canada through the Canadian Institute for Military and Veteran Health Research, found nine positive effects of service dogs on symptoms of PTSD and two “major undesirable effects.” The positive effects include the detection, prevention and control of crisis, improved sleep, reduction of nightmares, better concentration, improved self-confidence and increased social participation. The undesirable effects are difficulty accessing public spaces and knowing how to react when faced with that difficulty, and stigmatization.  Read more . . .

War of Words Continues over North Korea
North Korea had more harsh words for the US on Wednesday, strongly condemning US-South Korean joint military exercises and criticizing President Donald Trump’s “weird” and “ego-driven” social media posts just hours after Trump claimed the rogue nation’s leader is “starting to respect us.”  Read more . . .

(U.S. Army photo by Staff Sgt. Shane Hamann/Released)

Thousands of More Troops to Afghanistan
President Trump’s speech this week announcing his decision to extend the U.S. war in Afghanistan provided no detail on exactly what new American troops will do when deployed. Trump went out of his way during his announcement at Fort Myer, Va., to say, “we will not talk about numbers of troops or our plans for further military activities.” Trump’s decision not to telegraph his plans was in keeping with his frequent assertion on the campaign trail about the need to maintain battle plan secrecy — a stance that was intended as a rebuke of former president Barack Obama’s 2009 announcement in which he provided a timetable for withdrawal from Afghanistan.  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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Can Secretary David Shulkin Fix the VA?

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Can Secretary David Shulkin fix the Department of Veterans Affairs (“the VA”)?  The answer is an emphatic NO!

Department of Veterans Affairs

This is not a commentary on Dr. Shulkin’s inspired leadership or his vision for a vastly improved VA, but a consequence of competing ideologies and a dysfunctional institution.

As Stand for the Troops has stated several times over the past year: “THE VA IS SIMPLY TOO LARGE TO SUCCEED IN ITS MISSION.”

As suggested in last week’s article by Maj. Ben Richards, the care provided by the VA is far different than the “happy talk” its administrators disseminate to a gullible public and Congress.   The disturbing suicide of Veteran Eric Bivins can clearly be laid at the doors of the VA, but does anyone in authority really care?

Will the desperate pleas Eric’s spouse Kimi resonate in the corridors of power in DC?  Probably not.  And yet, Kimi’s description of the troubling treatment provided by the VA is far more accurate than the self-serving assurances that VA “change agents” dispense to the press.

Veterans are giving up hope daily and seeking treatment outside the VA.  If Congress truly wanted to know the extent of the problems in the VA, they would surely spend far more time seeking out the views of Veterans than blindly accept the assurances of its administrators.  Will this occur? Not likely – and even if it were to occur, not much is likely to change.

The VA is like an old automobile that is falling apart.  Sure, we can try fixing it with the same failed strategies that have been used in the past OR how about trying a different approach? Scrap the dysfunctional VA and build a responsive institution that truly attends to the needs of most Veterans?

How Can the VA be Fixed?

With an annual budget of over $180 billion and nearly 350,000 employees, things can easily get off-track.  More to the point, impassioned administrator can run about putting their fingers in the holes of a leaking dyke, but another leak will surface almost immediately.

As I stated previously,

NO AMOUNT OF MONEY or CHANGE IN LEADERSHIP or ENACTMENT OF NEW LEGISLATION will bring about A MORE RESPONSIVE VA.

The VA has become a bureaucracy that answers only to itself and is not responsive to the needs of Veterans.  Frankly, the VA has lost its way and very little will change unless the VA is broken down into far smaller manageable components.

While smaller components of the VA will invariably fail, A SMALLER AND LESS CENTRALIZED VA WON’T COMPROMISE THE FULL MISSION.  

The public seems relieved that Veterans now have a choice of service providers because the Choice Program has been extended by Congress, but for many thousands of Veterans like Eric Bivins and his family, there really is NO CHOICE!

Where the VA is Today

Personally, I believe that Dr. Shulkin has done a remarkable job in addressing some of the more urgent problems at the VA.  While one can argue whether he has done enough, the task he has been given is like being assigned to captain the Titanic after it has hit the iceberg.

The speed with which the VA will sink further into disrepute may be slowed, but SINK it will.

How many more reports do we need from the Office of the Inspector General (the “IG”) that the VA lacks effective governance and oversight?

How many more times to we have to fire ineffective VA employees when the Labor Union intercedes to protect  employee “rights”?

How many more infection risks do Veterans need to overcome at VA facilities?

These are just the latest “issues” that Dr. Shulkin and his staff need to deal with.  Despite evidence of much needed progress to overhaul the VA, these problems are likely to persist.

In fact, every local incidence of inefficiency or incompetence becomes magnified into a matter of national concern and raises further doubts about the VA’s ability to reform itself from within.  Frankly, there are far too many competing mandates for it to do so.

Sadly, our Veterans and their loved ones will continue to suffer until we stop posturing and enact real reform.

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SFTT Military Highlights: Week Ending Aug 11, 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.

Tensions High over North Korea
“Military solutions are now fully in place, locked and loaded, should North Korea act unwisely,” President Trump said on Friday, in his latest salvo in the exchange of rhetoric with the isolated regime. “Hopefully Kim Jong Un will find another path!”  The statement, made via Twitter, comes one day after Trump wondered whether he had been stern enough in talking about North Korea earlier this week, when he promised to meet Pyongyang’s threats with “fire and fury.”  Read more . . .

Military Food Rations Amazon

Food Rations May Become a Military Profit Center
Amazon is using everything at its disposal to take on the grocery and food delivery business. The online retailer purchased Whole Foods Market in June for $13.7 billion, announced new meal-prep boxes that challenge Blue Apron in July, and now it’s turning to the military for its next move. According to a CNBC report, Amazon wants to use military food technology to create prepared meals that don’t need to be refrigerated. This would allow the company to store and ship more food more efficiently and to offer ready-to-eat, (hopefully) tasty meals at a lower price.  Read more . .

Is the VA Planning to Close Incomplete Healthcare Applications?
A well-known whistleblower in the Department of Veterans Affairs warned Wednesday that the VA appears to be getting ready to close tens of thousands of incomplete healthcare applications, even though it’s been clear for more than a year that the VA was failing to give veterans a chance to complete these applications. Scott Davis is a public affairs officer for the VA’s Member Services in Atlanta who has testified before Congress about problems within the VA.  Read more . . .

Deja Vu All Over Again at the VA
The Department of Veterans Affairs (VA) has been forced to employ the former Washington, D.C., medical center director for the time being after the employee was fired for failing “to provide effective leadership at the medical center.” Brian Hawkins was fired in July after it was revealed he had sent sensitive information to his wife’s personal email account. However, Hawkins appealed the termination and the federal Merit Systems Protection Board issued a stay on the decision on Aug. 2, allowing Hawkins to build a defense that he was wrongfully let go. VA Secretary David Shulkin pushed back against the stay and has prohibited Hawkins from working around patients.   Read more . . .

Opioids for Veterans with PTSD

Tighter Controls Over Opioid Prescriptions at the VA?
The U.S. Department Veterans Affairs Office of the Inspector General released a report Aug. 1 that recommended non-VA health care providers being paid by the VA to provide services to veterans be required to submit opiate prescriptions directly to VA pharmacies. According to the report, veterans are one of the highest risk pools of people to become addicted to opiates and that veterans could receive treatment in the form of opiates from non-VA doctors without regard for the possibility of co-occurring mental health problems. “Veterans receiving opioid prescriptions from VA-referred clinical settings may be at greater risk for overdose and other harm because medication information is not being consistently shared,” said U.S. Department of Veterans Affairs Inspector General Michael J. Missal. “That has to change. Health care providers serving veterans should be following consistent guidelines for prescribing opioids and sharing information that ensures quality care for high-risk veterans.”  Read more . . .

Link Between PTSD and Alzheimer’s Disease and Dementia?
More and more evidence is suggesting that developing post-traumatic stress disorder early in life can raise the risk of dementia in old age. New research finds a molecular link between the two conditions, which paves the way for new therapies. An increasing number of epidemiological studies have suggested that people who develop a neuropsychiatric condition such as post-traumatic stress disorder (PTSD) in childhood are also likely to develop Alzheimer’s disease later in life.  Read more . . .

How Combat Vet’s PTSD Affects Families
Soldiers who experience the horror and terror of conflict often return home far different people than they were when they left. Many are angry, suffer from depression, harbour suicidal thoughts or attempt to isolate themselves from the world, hoping to avoid triggers that can instantly force them to relive their experiences. While increasing attention has been paid in recent years to helping armed forces members cope with post-traumatic stress syndrome (PTSD), not as much attention has been paid to the experience and grief of intimate partners and families who experience trauma in trying to deal with the changes a loved one, coping with PTSD, goes through.  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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SFTT Military News: Highlights for Week Ending August 4, 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.

With Eye on Russia, US Military Focuses on Global Exercises
The U.S. military is moving toward more global exercises to better prepare for a more assertive Russia and other worldwide threats, a senior officer said in an interview with Reuters. Air Force Brigadier General John Healy, who directs exercises for U.S. forces in Europe, said officials realized they needed to better prepare for increasingly complex threats across all domains of war – land, sea, air, space and cyber. Some smaller-scale war games with a global focus had already occurred, but the goal was to carry out more challenging exercises by fiscal year 2020 that involved forces from all nine U.S. combatant commands – instead of focusing on specific regions or one military service, such as the Marines.  Read more . . .

Secretary of State Tillerson Seeks Talks with North Korea
In the Trump administration’s first serious attempt at a diplomatic opening to North Korea, Secretary of State Rex W. Tillerson has offered to open negotiations with Pyongyang by assuring “the security they seek” and a new chance at economic prosperity if the North surrenders its nuclear weapons.Mr. Tillerson’s comments came just hours before the United States on Wednesday tested an unarmed Minuteman III intercontinental ballistic missile, sending it 4,200 miles to a target in the Marshall Islands. The Pentagon said the test was not intended as a response to the North’s launch on Friday of a missile that appeared capable of reaching Los Angeles and beyond.But military officials said the test demonstrated that the American nuclear arsenal was ready “to deter, detect and defend against attacks on the United States and its allies.”  Read more . . .

Telehealth for Veterans Rolls Out To General Acclaim
American Telemedicine Association (“ATA”) has long supported the VA’s vision of expanding veterans’ access to telehealth services, facilitating high-quality encounters between veterans and providers, and ensuring that veterans are equipped with the best tools to monitor their health. This includes innovative models that facilitate cross-state practice and enable consumer choice such as the VETS Act (S. 295 and H.R. 2123). “We applaud Dr. Shulkin for demonstrating the value of telehealth today at the White House.” said Gary Capistrant, Chief Policy Officer, ATA. “We encourage President Trump to issue an Executive Order to eliminate the state-by-state licensure model for all federal and private-sector health professional employees servicing federal government programs—notably agencies (such as the VA and the Department of Health and Human Services), health benefit programs (such as Medicare and TRICARE), federally-funded health sites (such as community health centers and rural clinics), and during federally-declared emergencies or disasters.  Read more . . .

Veteran Choice Options Expanded
Thank bipartisan support for helping veterans, or lingering anger over the previous scandals at the Department of Veterans Affairs, but whatever the reason, Congress is managing to get legislation passed addressing veterans’ needs. First, Congress finally worked out a deal on funding for Veterans Choice. If you believe that veterans should be able to seek out and get the best care wherever they prefer, whether it’s within the VA or from a private health care provider, Veterans Choice is a nice half-step, but hardly a sweeping change. (The booming demand for treatment through the program can be interpreted in veterans’ interest in exploring other treatment options.)  Read more . . .

Brain and PTSD Studies

No Surprise Here:  PTSD May Be More Physical than Psychological
The part of the brain that helps control emotion may be larger in people who develop post-traumatic stress disorder (PTSD) after brain injury compared to those with a brain injury without PTSD, according to a study released today that will be presented at the American Academy of Neurology’s Sports Concussion Conference in Jacksonville, Fla., July 14 to 16, 2017. “Many consider PTSD to be a psychological disorder, but our study found a key physical difference in the brains of military-trained individuals with brain injury and PTSD, specifically the size of the right amygdala,” said Joel Pieper, MD, MS, of University of California, San Diego. “These findings have the potential to change the way we approach PTSD diagnosis and treatment.” In the brain there is a right and left amygdala. Together, they help control emotion, memories, and behavior. Research suggests the right amygdala controls fear and aversion to unpleasant stimuli.  Read more . . .

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

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Military News Highlights: Week Ending Jul 21, 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.

Turkey Releases Secret Sites of US Troops in Syria
In the latest display of Turkish anger at U.S. policy in Syria, the state news agency has divulged the locations of 10 U.S. military bases and outposts in northern Syria where the U.S. is leading an operation to destroy the so-called Islamic State in its self-styled capital of Raqqa. The list published by the Anadolu news agency points to a U.S. presence from one end to the other of the Kurdish self-administration region—a distance of more than 200 miles. The Anadolu news agency even listed the number of U.S. troops in several locations and in two instances stipulated the presence of French special forces.  Read more . . .

South Korea Proposes Military Talks with the North
South Korea on Monday proposed holding military and humanitarian talks with North Korea, its first visible split with the Trump administration, which has said it will deal with North Korea’s continued missile tests by stepping up sanctions and military pressure on the country. If the talks take place, they will be the first military-to-military dialogue since 2014. It is an attempt to ease tensions along a heavily armed border, and perhaps to arrange the resumption of reunions of families divided decades ago by the Korean War. But North Korea did not immediately respond, and such conversations have a dismal history since military officials on both sides are usually not empowered to negotiate significant agreements.  Read more . . .

French Military Chief Resigns Over Defense Cuts
A public fight between President Emmanuel Macron and France’s chief military officer over proposed cuts in military spending led Wednesday to the first high-profile resignation of a public servant since Mr. Macron was elected in May. In an unusual move, the military chief, Gen. Pierre de Villiers, offered his resignation after Mr. Macron said publicly that he would be the one to determine military policy and implicitly criticized General de Villiers for questioning the government’s proposed budget cuts. The president’s seemingly unshakable confidence in his judgment, and his reluctance to brook any dissent, could signal potential difficulties ahead as Mr. Macron tries to shrink government spending.  Read more . . .

Major IT Contract at Department of Veterans Affairs in Danger of “Catastrophic Failure”
Internal documents obtained by the American-Statesman show that last year, even as government overseers were taking the VA to task for failures in other high-profile IT projects, VA officials worried that the department’s $543 million contract with Hewlett-Packard Enterprise Services to implement a real-time locating system, or RTLS, was careening off the rails. The system, which consists of tagging and wirelessly tracking everything from catheters to hospital beds, has been hailed as a way to potentially save millions of dollars in lost or misplaced equipment.  Read more . . .

PTSD Brain Details

New PTSD Study Points Way to Future Treatment
A study of post-traumatic stress disorder (PTSD)—conducted by the VA National Center for PTSD (NCPTSD), National PTSD Brain Bank, and Yale University—has identified a new potential mechanism contributing to the biology of the disorder that may be targeted by future treatments.  The study, led by NCPTSD and Yale psychiatrist Irina Esterlis, is the first to implicate a specific alteration in brain glutamate signaling in PTSD. Glutamate is a chemical messenger of brain signals, and alterations in glutamate levels in PTSD were described previously. The new study reports that positron emission tomography (PET) scans show increased levels of a subtype of glutamate receptor in the brain, metabotropic glutamate receptor-5 (mGluR5), in patients with PTSD. In animals, overstimulation of mGluR5 is associated with fear and stress-related behaviors; drugs that reduce mGluR5 function may reduce these symptoms. Thus, the current study may have implications for the treatment of PTSD, said the researchers.  Read more . . .

Welsh Study on Treating PTSD
Funded by the Forces in Mind Trust (FiMT) and supported by Health and Care Research Wales, the study is seeking to help veterans who have not responded to current PTSD treatments. The two-year study is investigating the effectiveness of a new therapy known as 3MDR, where patients walk on a treadmill whilst interacting with a series of self-selected images that are related to their trauma, and displayed on a large screen. The aim of this therapy is to help patients learn how to move through their avoidance by, literally, approaching their traumatic memories.   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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