Congress Passes Drug Abuse Bill

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With broad bipartisan support, the Senate passed a compromise legislative bill aimed at curbing prescription drug abuse.

While this comes as relief to many, one must simply scratch their head and wonder why it has taken so long to curb prescription drug abuse.  This horrible addiction problem didn’t emerge yesterday.

Could it have anything to do with lobbyists?

Drug Abuse

Not surprisingly, one political party blamed the other for a lack of action on a bill to curb prescription drug abuse:

White House press secretary Josh Earnest said in a statement Wednesday night that President Obama will sign the bill even though it “falls far short.”

“Every day that Republicans stand in the way of action to fund opioid treatment means more missed opportunities to save lives: 78 Americans die every day from opioid overdose,” Earnest said.

The spokesman said Mr. Obama “won’t stop fighting to secure the resources this public health crisis demands. Congressional Republicans have not done their jobs until they provide the funding for treatment that communities need to combat this epidemic.”

Taking money from pharmaceutical lobbyists continues to enjoy wide bipartisan support, so to blame one party or the other for Congressional inaction is simply outrageous hypocrisy.

You need to look no further than the Department of Veteran Affairs, (the “VA”) to see the widespread abuse of using prescription drugs in treating PTSD and other ailments.   Masking pain has been Standard Operation Procedure (“SOP”) at the VA for many years rather than providing curative treatments.

Will more government funding in addition to their $180 billion a year budget help the VA do the right thing?  I think not. 

Veterans have long been aware of the dangerous side-effects of the drugs commonly prescribed by the VA.  One military Drug Abuse specialist informed me that some Veterans would often sell Purdue Pharma’s wildly successful OxyContin on the black market to supplement their income or – in many cases – to simply make ends meet.

Purdue Pharma:  A Description of Hell?

In a recent investigation into Purdue Pharma,  Los Angeles Times authors Harriet Ryan, Lisa Girion and Scott Glover suggest that the company’s shameless promotion of “OxyContin’s 12 Hour Problem” is little more than a “description of hell.”

After reviewing thousands of confidential internal documents, the LA Times reporters concluded that:

√ Purdue has known about the problem for decades. Even before OxyContin went on the market, clinical trials showed many patients weren’t getting 12 hours of relief. Since the drug’s debut in 1996, the company has been confronted with additional evidence, including complaints from doctors, reports from its own sales reps and independent research.

√ The company has held fast to the claim of 12-hour relief, in part to protect its revenue. OxyContin’s  market dominance and its high price — up to hundreds of dollars per bottle — hinge on its 12-hour duration. Without that, it offers little advantage over less expensive painkillers.

√ When many doctors began prescribing OxyContin at shorter intervals in the late 1990s, Purdue executives mobilized hundreds of sales reps to “refocus” physicians on 12-hour dosing. Anything shorter “needs to be nipped in the bud. NOW!!” one manager wrote to her staff.

√ Purdue tells doctors to prescribe stronger doses, not more frequent ones, when patients complain that OxyContin doesn’t last 12 hours. That approach creates risks of its own. Research shows that the more potent the dose of an opioid such as OxyContin, the greater the possibility of overdose and death.

More than half of long-term OxyContin users are on doses that public health officials consider dangerously high, according to an analysis of nationwide prescription data conducted for The Times.

Needless to say, a spokesperson for Purdue Pharma vigorously disputes the allegations in the LA Times investigation, but others suggest that  . . .

. . . more Americans die from opioid overdose than from car accidents. And this (sic LA Times) article gives only a partial tally of Purdue Pharma’s predatory conduct. The drugmaker targeted overly-busy, not very well trained general practitioners in communities which were likely to have high incidence of pain (think communities with a lot of jobs that involved manual labor). In other words, it’s no accident that OxyContin has become a plague in rural America.

Sadly, this bipartisan Congressional bill comes far too late for many Veterans and others who have been deceived by the predatory practices of Big Pharma and their enablers in the FDA and VA.  Is it asking too much for those in a position “to know” the effects of potentially lethal drugs to take action far sooner to protect the safety of our brave warriors and our citizens?

While some Senators are urging an investigation into Purdue Pharma’s predatory practices, it is unlikely that much will come of it.   Big money trumps ethics and common sense.

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SFTT News: Week Ending July 8, 2016

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

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

President Obama Says 8400 Troops to Remain in Afghanistan
President Barack Obama gave up Wednesday on ending the war in Afghanistan during his term in office and said that at least 8.400 U.S. troops will still be on the ground for the next occupant of the White House to command.  With the Taliban resurgent under a new leader, and the Afghan army struggling to make headway, Obama bowed to the recommendations of his generals to shore up the Kabul government with a continuing U.S. and NATO presence along with billions in additional funding.  Read more . . .

President Barack Obama

 Veteran Daily Suicide Rate Now at 20
On average, 20 veterans a day committed suicide in 2014, a slight decrease from the previous government estimate, but federal health officials are cautious about concluding the suicide problem is getting better.  Rather, they say the Department of Veterans Affairs is relying on a more comprehensive database than ever before, making comparisons to prior studies difficult and possibly offering a truer snapshot than what was captured in the past.  Read more . . .

VA Secretary Corrects Statement on VA Wait Times
Veteran Affairs Secretary Bob McDonald on Tuesday took an “opportunity to correct” a comparison he made of the long wait for medical care at his agency’s facilities to lines at Disneyland. “If I was misunderstood, if I said the wrong thing, I’m glad that I have the opportunity to correct it,” he told MSNBC’s Andrea Mitchell. “I’m only focused on one thing, and that’s better caring for veterans. That’s my job, that’s why I’m here.”  Read more . . .

Nato Repercussions from Brexit
The dominant vibe in Warsaw is all about unity. The results are mostly pre-cooked. And there should be few surprises. With little dissent to speak of, in the next couple days NATO is expected to beef up its forces in its vulnerable frontline states in the east; forge closer ties with traditionally neutral Finland and Sweden; and upgrade the importance of cyber defense.  Read more . . .

Anemia Negatively Affects TBI Recovery
Approximately half of patients hospitalized with traumatic brain injuries are anemic, according to recent studies, but anemia’s effects on the recovery of these patients is not clear. Now, researchers from the University of Missouri School of Medicine have found evidence that anemia can negatively influence the outcomes of patients with traumatic brain injuries.  Read more . . .

Genetic Factors for Treating PTSD?
Individuals with trauma- and stress-related disorders can manifest symptoms of these conditions in a variety of ways. Genetic risk factors for these and other psychiatric disorders have been established but do not explain the diversity of symptoms seen in the clinic — why are some individuals affected more severely than others and why do some respond better than others to the same treatment?

DNA Research

“People often experience stress and anxiety symptoms, yet they don’t usually manifest to the degree that results in a clinical diagnosis,” says Allison T. Knoll, PhD, post-doctoral fellow at The Saban Research Institute of Children’s Hospital Los Angeles. “We felt that if we could understand differences in the severity of symptoms in a typical population, it might provide clues about clinical heterogeneity in patients.”   Read more . . .

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

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PTSD: More Drugs on the Way?

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In yet another example of how the Department of Veteran Affairs (“VA”) and DoD try to reinvent the wheel in search of a miracle drug to treat PTSD, Fox News reports that “TNX-102 SL, which contains the same chemical property as Flexeril” may soon be used in treating Veterans with PTSD:

An already-approved muscle relaxant may offer relief for U.S. military veterans and first responders suffering from combat-related post-traumatic stress disorder (PTSD). The Phase 2 trials of the drug, TNX-102 SL, which contains the same chemical property as Flexeril, identified a dose and administration method that statistically improved participants’ PTSD symptoms among several mental health indices.

The findings were announced this month at the American Society of Clinical Psychopharmacology Annual Meeting (ASCP), and could eventually lead doctors to unroll the first PTSD drug in more than a decade, said Dr. Harry Croft, Chief of CNS Studies at Clinical Trials of Texas. Croft, who has also headed the investigation of 60 similar clinical trials over the last 25 years, said current PTSD treatments either don’t address every individual’s range of PTSD symptoms, pose unwanted side effects, or have poor adherence rates. Thus, scientists have continued searching for new PTSD treatments.

According to the article, “no new PTSD drug has been approved by the Food and Drug Administration (FDA) since Paxil in 2001, and before that, Zoloft in 1999.”

the VA and drugs

While the VA has been dismissive of other proven old-fashioned therapy programs such as Hyperbaric Oxygen (“HBOT”), it appears that the VA has an unlimited research budget for new experimental drugs.  The pharmaceutical companies must be thrilled.

For many, especially Veterans seeking to reclaim their lives, it is difficult to fathom the “logic” of the folks at the VA, but it is hard to argue with a program administrator who places his or her interest ahead of the Veterans they should be serving.  It is difficult – read impossible – to have a discussion with someone who has all the answers.  Particularly so, if they are the wrong answers.

At a time when Congress is trying to determine whether the monolithic VA is the best way to provide help to Veterans,  it would appear that VA bureaucrats will continue to determine what drugs or therapy works best for Veterans.

In effect, Veterans – particularly those suffering from PTSD and/or TBI – will be denied access to alternative therapies in the private sector because the VA gatekeepers “know best.”

How many more Veteran suicides and disrupted lives do we need to say that this may not be the right approach?

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Latest Developments on Treating PTSD

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Much has been written about the terrible long-term consequences of Post Traumatic Stress or “PTSD,” but there appears to be no clear way of treating PTSD.  Some argue that PTSD is best treated using “psychological” methods to treat the trauma while others argue that certain war-related events (i.e. IEDs) cause physiological changes in the brain.

treating ptsd

This dilemma makes diagnosing and treating PTSD so difficult.  Based on SFTT’s experiences, we have found that Veterans with symptoms of PTSD respond differently to various forms of therapy.   In short, there seems to be no definitive solution to a very serious problem which is now reaching epidemic proportions.

In a recent article published in the New York Times, medical scientists now believe that traumatic war-related events may actually cause physiological changes in the brain.

Quoting Dr. Daniel P. Perl, a neuropathologist who led a study for Lancent Neurology, evidence now exists that changes brain patterns:

Less understood is how the blast wave — the pulse of compressed air that shoots in all directions faster than the speed of sound and arrives before the wind — affects brain tissue after crashing through the helmet and skull. Blasts are also believed to compress the sternum and send shock waves through the body’s blood vessels and up into the brain. . .

The researchers examined the brains of the five veterans who had been exposed to blasts, and compared samples with those of 16 other veterans and civilians with and without brain injuries from military service or other activities. Scar tissue in specific locations of the cerebral cortex, which regulates emotional and cognitive functioning, was found only in the blast-injury cases.

Dr Perl and fellow researchers discovered the following changes in the brain following concussion like events:

Perl and his lab colleagues recognized that the injury that they were looking at was nothing like concussion. The hallmark of C.T.E. is an abnormal protein called tau, which builds up, usually over years, throughout the cerebral cortex but especially in the temporal lobes, visible across the stained tissue like brown mold. What they found in these traumatic-brain-injury cases was totally different: a dust-like scarring, often at the border between gray matter (where synapses reside) and the white matter that interconnects it. Over the following months, Perl and his team examined several more brains of service members who died well after their blast exposure, including a highly decorated Special Operations Forces soldier who committed suicide. All of them had the same pattern of scarring in the same places, which appeared to correspond to the brain’s centers for sleep, cognition and other classic brain-injury trouble spots.

Then came an even more surprising discovery. They examined the brains of two veterans who died just days after their blast exposure and found embryonic versions of the same injury, in the same areas, and the development of the injuries seemed to match the time elapsed since the blast event. Perl and his team then compared the damaged brains with those of people who suffered ordinary concussions and others who had drug addictions (which can also cause visible brain changes) and a final group with no injuries at all. No one in these post-mortem control groups had the brown-dust pattern.

Dr. Perl on Treating PTSD

While it will takes years of analysis and research to determine whether these neurological changes can be reversed, many Veterans will continue to suffer the “invisible wounds of war.”  Dr. Perl is justifiably worried:

 After five years of working with the military, he (Dr. Perl) feels sure, he told me (author Robert Worth), that many blast injuries have not been identified. “We could be talking many thousands,” he (Perl) said. “And what scares me is that what we’re seeing now might just be the first round. If they survive the initial injuries, many of them may develop C.T.E. years or decades later.”

This is not hopeful news, but at least we as a society are beginning to take PTSD seriously.  Hopefully, we will not try and bury the research in the way the NFL has sought to hide the effects of CTE on NFL players and downplay its significance to football fans who seem addicted to the violence of the spectacle.

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Veteran Charities in Context

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Active Duty military personnel that I know generally despise being used as “poster-boys (or girls)” for political campaigns.  In fact, anyone who has served in the Armed Forces is well aware of DoD Directive 1344.10 which prohibits members of the Armed Forces from engaging in “partisan political” fundraising or actively campaigning on behalf of a political party, candidate or political cause.

While these regulations do not apply to Veterans, it has been my experience that most Veterans tend to avoid the limelight of partisan politics and, instead, pursue causes to support fellow Veterans that do not tend to attract much media attention.   Like Active Duty personnel, Veterans tend to avoid serving as “props” for political campaigns.

Donald Trump Veterans

As SFTT and others reported earlier when a Donald Trump fundraising event was announced during the Republican primaries:

. . .several Veteran groups accused Donald Trump of using Veterans like political pawns in his dispute with Fox News over the moderators of the last debate.    In many respects, I agree with Veterans that don’t want to be used as pawns in contentious posturing by politicians.  Sadly, every four years or so, most politicians tend to embrace Veteran causes as they might disingenuously cuddle a puppy dog to encourage voters to look favorably on them.

While it is completely understandable that some, many or all Veterans may not wish to be seen to embrace the policies of Donald Trump, it is most disingenuous – read dishonest – for the media to skew fund-raising efforts by anyone (including Donald Trump) to support Veterans.  

Yet, that is precisely what happened.  In a ridiculous article published on June 2 in the New Times entitled “Putting Donald Trump’s $1 Million to Veterans in Context,”  the author, Peter Eavis, argues that Mr. Trump’s contribution “to veterans’ charities is small compared with those of some fellow billionaires . . .” and that, “Mr. Trump’s $1 million gift to veterans not only came later than some expected, but it is also small for the plutocrat class.”

How silly to judge the merit of candidates on the amount of money they donate to charitable causes, but this is the insane world of partisan politics that dominates media channels rather than constructive solutions to the many issues faced by Veterans.

Last week, I noted Sebastian Junger‘s hope that we have a more united country to deal with  this nation’s many problems.   Even though SFTT has no political affiliation, it is very discouraging to see both the media and our politicians engage is such polarizing propaganda.  Mr. Junger clearly has his finger on the pulse of a huge adjustment problem facing returning Veterans when they see such a dysfunctional society.  It is certainly not comforting.

ZVets

Should the VA be Privatized?

With its colossal $180 billion annual budget, the Department of Veteran Affairs (the “VA”) is in the focus of those who say this giant institution should be privatized.  Everyone knows the VA is not functioning properly and there have been countless GAO studies suggesting that something be done to address these problems.

When issues like the privatization of the VA surface during an election year, it immediately becomes politicized.  SFTT doesn’t have an answer let alone a position on this issue; however, SFTT has seen enough to know that the VA does not provide adequate care to a large number of its constituents on a timely basis.

The Libertarian Party and several others are suggesting that the VA should be privatized.    Why not take off our partisan political armbands and have a look at the implications.  Maybe some elements now administered by the VA could be handled more competently in the private sector.  If so, it could be a major benefit for underserved Veterans?

If charitable contributions to Veterans can become politicized, imagine the outcry in entrenched political sectors when the VA comes under serious scrutiny.   From the perspective of the SFTT, if it ain’t working properly we might as well look at different approaches; however unappealing they may be to certain entrenched interests.  After all, it is the Veteran who is the focus of our attention and these brave warriors deserve better than what they are receiving

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Equine-Assisted PTSD Therapy Study Seeks Veteran Volunteers

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The New York Presbyterian Military Family Wellness Center at the Columbia Veterans Research Center is currently conducting a Trauma-Focused Equine-Assisted Therapy for Veterans with PTSD study.  See details below:

equine2

Through the NYP Military Family Wellness Center we offer veterans and family members evidence-based treatments at no cost in the context of a research study. Essentially, patients are periodically assessed during and after treatment so that we can learn more about the needs of the veteran population.

Equine Therapy Program

In the equine study we’re investigating the efficacy of an alternative treatment for PTSD that has not been thoroughly studied in the past. The treatment does not involve riding horses, but instead focuses on ground activities such as grooming and leading horses.

It is a group treatment with each group consisting of 4-6 veterans. Treatment sessions will take place at the Bergen Equestrian Center in Leonia, NJ (about 15 minutes away from our office in Washington Heights).

Veterans or their loved ones who seek more information, please contact Anne Hillburn at (646) 774-8042.

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Veterans with PTSD: Can We Unite As a Society?

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As one who watched a largely unappreciative nation heap scorn on returning Veterans from our war in Vietnam, I am struck by the contrived efforts to celebrate Veterans who have now served in the Afghanistan and Iraq wars.   In particular, I shed a tear for Veterans with PTSD who have difficulty coping with an unsympathetic society that seems far different from the camaraderie they experienced while serving in a war zone.

While I do not doubt that many Americans genuinely honor the sacrifices of young men and women who have served in these wars;  the American flag pin in one’s lapel or tributes to Veterans at major sporting events fall well short of the support these brave heroes deserve.

This point was made abundantly clear by Sebastian Junger in a recent MSNBC interview. Sebastian Junger, an acclaimed war-correspondent and author, has just published Tribe: On Homecoming and Belonging. In his book, Mr. Junger suggests that Veterans returning from Iraq and Afghanistan find a deeply divided and “alienated society” and argues passionately that our society may be as much to blame for Veteran suicides and depression as a Veteran’s war experience.

Mr. Junger articulates his views in a very moving Ted Talk that was filmed late last year.


As an anthropologist, Mr. Junger’s arguments are quite persuasive. It is hard to argue with his premise that the incidence of “suicides and depression” tends to decrease during periods of great stress: he cites 911, the bombing of London in WWII and many other similar situations. Junger suggests that people’s behavior tends to become “more tribal” during periods of great stress and that this provides a level of support and comfort that many returning Veterans do not presently encounter when they return home to our “alienating society.”

Mr. Junger concludes that many problems for Veterans with PTSD would be greatly diminished if we “can unite as a society.”

640px-Politics

As we watch an increasingly hostile and bitter presidential race unfold, it is not hard to understand Mr. Junger’s premise.  Imagine a young man or woman serving their country in a hostile and dangerous environment returning home to see a dysfunctional society at war with itself. How discouraging.

Indeed, if the Department of Veteran Affairs (the “VA”) doesn’t have your back, who does?

In an unfortunate analogy, Veterans Affairs Secretary Robert McDonald stated “‘When you get to Disney, do they measure the number of hours you wait in line? Or what’s important? What’s important is, what’s your satisfaction with the experience?'” McDonald said Monday during a Christian Science Monitor breakfast with reporters. ‘And what I would like to move to, eventually, is that kind of measure.'”

This is not the first time, Secretary McDonald has been embroiled in a controversy, but I am quite sure that Secretary McDonald wished he hadn’t been quite so candid.  Nevertheless, his “misspeak” provided plenty of fuel to other politicians.

House Majority leader Paul Ryan correctly pointed out that Veterans had lost their lives while waiting in line for someone at the VA to pickup the phone.

This is precisely the type of dysfunctional dialogue engaged in by “tribal leaders” that Veterans – and many others – find so frustrating and largely disingenuous.

Most everyone knows that the VA is not functioning properly.  Rather than simply point fingers to gain personal political leverage, let’s harness our efforts and begin solving the many problems faced by the VA.

One man or woman’s political advantage pales in comparison to the suffering of the many brave men and women who have placed their lives at risk for a society that seems hellbent on tearing itself apart.  How tragic.

Mr. Junger, your heartfelt appeal is noted and I sincerely hope that we as a nation can embrace the challenge.  I pray that our tribal leaders will unite to provide our country with the inspirational leadership that our brave men and women in the military service deserve.  Anything less is tragic.

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SFTT News: Week of May 27, 2016

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

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

Military Suicides:  Most Appear Before Combat
“We found the highest rates of suicide attempts were among never-deployed soldiers and those in their first years of service,” Ursano’s team (Dr. Robert Ursano of the Uniformed Services University of the Health Sciences in Bethesda) wrote in their report, published in the Journal of the American Medical Association’s JAMA Psychiatry. Six months into a deployment is often when they get their first break. “That six-month time is usually the time most soldiers are taking a visit home,” Ursano said. “They are transitioning home and back again.”  It’s not precisely clear why suicide attempts — as opposed to completed suicides — go up at these times. Other research shows the risk for a completed suicide has little to do with whether someone has been in actual combat.  Read more . . .

VA Restores Benefits to Veterans Wrongly Declared Dead
A Florida congressman says the Department of Veterans Affairs cut off the benefits of more 4,200 people nationwide after they were wrongly declared dead.  Rep. David Jolly says these people were “very much alive” and their benefits were resumed after the VA looked into their cases, which happened between 2011 and 2015.  Read more . . .

VA Secretary Compares Veteran Wait Times to Lines at Disneyworld 
Critics said Monday that Veterans Affairs Secretary Robert McDonald had trivialized the long-standing problem of lengthy wait times for appointments at California’s veterans medical centers by comparing them to waiting in long lines at Disneyland. His comments sparked an angry backlash from California lawmakers who felt that he had dismissed the angst and frustration of their constituents. McDonald made the comments Monday during a roundtable discussion with reporters hosted by The Christian Science Monitor.  Read more . . .

VA Secretary Robert McDonald

Five Things to Know about President Obama’s Trip to Vietnam
President Barack Obama is visiting Vietnam, the third U.S. president to do so, for a series of meetings with officials aimed at deepening U.S. ties with the country through new economic and security initiatives. The two governments are expected to announce a host of new agreements. Here are five things to know about Mr. Obama’s trip to the Asian nation.  Read more . . .

Dining with President Obama in Hanoi
Deep in the heart of Hanoi, US President Barack Obama sat down for a $6 meal with celebrity chef Anthony Bourdain on Tuesday. The chef, known for his love of adventurous street food, described the occasion in a series of tweets and an Instagram post.  Read more . . .

Obama Bourdain Hanoi

Former Navy Seal Sheds Light on PTSD
First Sgt. Clint Castro spent 15 months on the front line as a medic in Iraq. When he came home to East Meadow, he faced another kind of battle against post-traumatic stress disorder. He says it led him to drink and lose his temper, and he isolated himself from his family. Castro turned to Northwell Health’s Rosen Family Wellness Center for help. He admits it wasn’t easy initially to ask for assistance.   Read more . . .

Treating Ukranian Veterans with PTSD with Service Dogs

The Coming Changes to the War in Afghanistan
U.S. officials on Monday justified the weekend drone strike that killed Mullah Mohammed Akhtar Mansour by saying the Taliban leader planned to attack American or coalition forces in Afghanistan. But some observers believe the secretive operation that targeted the extremist at a southwest Pakistan hideout represents a shift in how the White House plans to execute the long-running war.  Read more . . .

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

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SFTT News: Week of May 20, 2016

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

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

Should women register for the military draft?
The Senate majority leader, Mitch McConnell said on Tuesday that he believed the role of women in the military had expanded so broadly in recent years that they should be required to register for the draft just as men do.  Mr. McConnell, Republican of Kentucky, was quick to stress that he did not envision any return to the use of the Selective Service and believed that the volunteer, professional military had been “very successful.”   Read more . . .

Military Draft Women

Can Congress save the U.S. Military?
This week the House of Representatives takes up the National Defense Authorization Act (NDAA) for fiscal year 2017. Much of the debate and media coverage will revolve around a handful of controversial provisions ranging from nuclear weapons to religious freedom. These debates are important, but the most important question that Americans should ask Congress is this: Will this bill begin to rebuild the U.S. military?   Read more . . .

The U.S. Needs to Revisit PTSD Treatment Guidelines
Organizations from the United Kingdom and Australia and the World Health Organization take the position that trauma-focused psychotherapies such as prolonged exposure, cognitive processing therapy, and eye movement desensitization and reprocessing are most effective when it comes to PTSD treatment. Basically, their stance is that the evidence for meds is just not as strong. A recent study carried out by military and VA researchers, and published in the journal Depression and Anxiety, supports this position.  Read more . . .

Size of Brain Region Associated with Response to PTSD Therapy
A study has found that PTSD patients with a larger hippocampus–a region of the brain key to distinguishing between safety and threat–are more likely to respond to exposure-based therapy for post-traumatic stress disorder (PTSD).  In this study, the researchers examined the relationship between hippocampus volume, measured with MRI, and response to treatment in 50 participants with PTSD and 36 trauma-exposed healthy controls. The participants were evaluated at baseline and after 10 weeks, during which time the PTSD group had prolonged exposure therapy, a type of cognitive behavioral therapy that has been shown to help patients with PTSD discriminate between real and imagined trauma.   Read more . . .

Brain size and PTSD Therapy

Worst Charity for Veterans Run by VA Employee
At first glance, the National Vietnam Veterans Foundation is a roaring success. According to its tax filings, the charity has received more than $29 million in donations from generous Americans from 2010 to 2014 for what it calls on its website “aiding, supporting and benefiting America’s veterans and their families.”  But look a little closer on those same filings and you can see that nearly all of those donations have been cycled back to telemarketers, leaving less than 2 percent for actual veterans and veterans’ charitable causes.   Read more . . .

How Congress and the VA Left Many Veterans without a ‘Choice’
NPR — together with member stations from across the country — has been reporting on troubles with the Veterans Choice program, a $10 billion plan created by Congress two years ago to squash long wait times veterans were encountering when going to see a doctor. But as we reported in March, this fix needs a fix.  Around the nation, our joint reporting project — called Back at Base — has found examples of these problems. Emily Siner of Nashville Public Radio reported on troubles with overcrowding in Tennessee. And Monday, we reported on hospitals and doctors not getting paid in Montana and veterans getting snarled in the phone systems trying to make appointments in North Carolina.  Read more . . .

If you want to support our brave Veterans reclaim their lives, do consider a donation to SFTT

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Prescription Drug Abuse Hits Center Stage

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Veterans have known for quite some time that something was amiss at the Department of Veteran Affairs (the “VA’) with their “go-to” promotion of prescription pain-killers to treat PTSD.

There are countless well-documented stories of extreme behavior changes – including suicide – of “over-served” Veterans that were provided a lethal cocktail prescription drugs by VA doctors.

A number of Veterans interviewed by SFTT indicated that they simply “flushed the drugs down the toilet,” while many others reported that there was a thriving black market for pain medication.    In quite a few cases, Veterans were reported to sell VA-prescribed pain medication to others to feed other substance-abuse habits or simply to support their family.

Homeless Veteran with PTSD

Using US government statistics, CNN provides these alarming statistics on prescription drug abuse for the general public:

Death from prescription opioid overdose has quadrupled since 1999, according to the Centers for Disease Control and Prevention.

The Substance Abuse and Mental Health Services Administration estimates that in 2014, about 15 million people in the United States older than 12 were non-medical users of pain relievers. On the agency’s website, it offers a behavioral health treatment services locator where individuals can type in their ZIP code and get directions to treatment centers in their community.

In fact, the CNN article goes on to suggest that Veterans should call  the Veterans Crisis Line which directs veterans and their loved ones to “qualified, caring Department of Veterans Affairs responders through a confidential toll-free hot line”: 1-800-273-8255, option 1.

Stand for The Troops (“SFTT”) has featured this Veteran Hot Line number prominently on its website for quite some time as well as other useful treatment options that Veterans or their loved ones may wish to consider.

In fact, I found it somewhat surprising that the CDC (Center for Controlled Diseases) should announce that “medical errors are the third largest cause of death in the U.S.” after cancer and heart disease.    The timing of this release over the public uproar of prescription drug abuse seems suspicious.

If we add “medical errors” and deaths attributed to “prescription drugs” together, one could argue that visiting a doctor is hazardous to your health.

It would be totally unreasonable and a specious assault on the integrity of the medical profession to suggest that malpractice and an undo reliance on prescription pain-killers is evidence of a medical profession that is out of control.

Clearly, more “good” is being done by the medical profession than “bad,” but it seems clear that individuals need to take more responsibility for the drugs they are ingesting.    In fact, our school system seems to have it right with their “Just Say No” campaign to cut back on drug addiction and substance abuse in general.

Just Say No

Veterans with PTSD and Treatment Alternatives

While the VA has often been singled out by SFTT and others – most notably by the GAO – for chronic mismanagement of Veteran care, most would acknowledge that this huge organization does a reasonable job to support our Veterans.

Nevertheless, there is clear evidence that the VA has been over-reliant on prescription drugs to treat Veterans with PTSD and publicly dismissive on other alternative treatment therapies recommended by third-party providers that conflict with their own treatment methodologies.

With substance abuse now rampant throughout the United States and fueled by a lackadaisical approach by an unsuspecting public and unscrupulous medical practitioners, it seems high time that the VA begin to encourage Veterans to seek alternative treatments that seem to provide better patient outcomes.

Indeed, SFTT lists a number of alternative treatments under its Rescue Coalition that provides community-based programs to Veterans without the dependency on addictive pain-killers.  Isn’t this the way forward?

The VA should take the lead in both nurturing and encouraging the  growth of these programs rather than rely on dated and stale practices which continue to rely on prescription drugs.

Samples of alternative treatments abound.  In fact, in a recent New York Times report, Dr. Denzil Hawkinberry, an anesthesiologist and pain management consultant for Community Care in West Virginia, imposes very rigorous standards on who should be prescribed opioids.  Perhaps, the VA could take a page out of Dr. Hawkinberry’s book and dial back the use of prescription drugs in favor of other treatment methodologies.

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