Opioids: Unanimous Bipartisan Incompetence in DC

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Just when one was beginning to wonder whether politicians could agree on anything comes the CBS/Washington Post story that shows that the Senate unanimously passed H.R. 471 – Ensuring Patient Access and Effective Drug Enforcement Act of 2015, which stripped the DEA of any enforcement capability and greatly fueled the opioid epidemic in our country.

Senator Joe Manchin of West Virginia voices his outrage in an interview with MSNBC:

Sadly, the wake up moment for me occurs at about 4 minutes and 20 seconds into the video when Senator Manchin explains the “vetting” process used by Congressmen and Senators to approve legislation.

Basically, the take away from Senator Manchin’s interview (and several others he gave) are the following:

  • U.S. Legislation is written by lobbyists;
  • Politicians don’t read the legislation that is enacted into law unless one of their constituents or a government agency raises a “red flag;”
  • Complex laws are enacted by Congress and the Senate without anyone really understanding the consequences of the proposed legislation;
  • Government enforcement agencies are simply a training ground for future lobbyists who march to a different drummer.

Mind you, I doubt whether anyone (other than a paid lobbyist) has the tenacity to sit through 33,000 pages of regulations covered by the Affordable Care Act (aka Obamacare).

Without getting into the merits of which party has the moral high ground, I think it is fair conclude that our system of government is out of control.

Honesty, how can Congress unanimously pass flawed legislation which directly contributed to the deaths of over 60,000 Americans last year?

Stand for the Troops has long argued that the employment merry-go-round between government and lobbyists destroys the very foundations of our democracy.   Wasn’t it President Eisenhower who warned against the evil of the military industrial complex?

Nowhere is criminal collusion any more evident than the dreadful story which documents The Drug Industry’s Triumph Over the DEA.

Over the years, SFTT has highlighted this lethal yet symbiotic relationship between government officials and lobbyists in the following areas:

  • military body armor;
  • military helmets;
  • psychotic drug testing;
  • agent orange coverup;
  • the Department of Veterans Affairs’ (almost everywhere you turn);
  • opioids and PTSD/TBI programs by the VA

I could list another dozen or so conflictive programs, but the fact remains that no one is likely to be held accountable for his or her actions. Furthermore, our government will merrily provide the culprits that fueled the opioid crisis – or stood on the sidelines watching it evolve – with additional money to “fix the problem.”

This closed loop of collective incompetence and culpable negligence is a self-sustaining blight on the lives of so many brave men and women who have served our country so valiantly.   I would like to tell you that the public is fed up, but who do you turn to?

Most sad!

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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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SFTT Military News: Week Ending Aug 18, 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 Korea Kim

More Sabre-Rattling from North Korea
North Korea warned Sunday that the upcoming US-South Korea military exercises are “reckless behavior driving the situation into the uncontrollable phase of a nuclear war.” Pyongyang also declared that its army can target the United States anytime, and neither Guam, Hawaii nor the US mainland can “dodge the merciless strike.” The messages in Rodong Sinmun, the official government newspaper, come a day before the US starts the Ulchi Freedom Guardian military exercises with South Korea.  Read more . . .

Trump’s Military Options in Afghanistan
President Trump on Friday will huddle with his national security team at Camp David in Maryland to discuss the country’s strategy in Afghanistan. The president is being presented with a variety of options, including withdrawing all American troops or adding 3,900 more to the current 8,400 total. Here is a look at the options being considered by the Trump administration for what is now being called the South Asia strategy.  Read more . . .

Cyber Security Becomes More Important
President Donald Trump is boosting U.S. Cyber Command’s status in the sprawling military hierarchy in a move intended to bolster its role defending against hacking attacks and in fighting Islamic State militants in cyberspace. Trump elevated Cyber Command to a “unified combatant command” Friday and directed Defense Secretary Jim Mattis to recommend someone to lead the organization. The new command will “strengthen our cyberspace operations and create more opportunities to improve our nation’s defense,” the president said in a statement. The step helps “streamline command and control of time-sensitive cyberspace operations by consolidating them under a single commander” with the requisite authority, Trump said. It also will ensure cyber operations are “adequately funded,” he said.   Read more . . .

Veteran Health Care and Opioid Abuse
This veteran — one of 20 who kill themselves every day, a frightening figure — received medical care from the Department of Veterans Affairs (VA) and a non-VA doctor who prescribed opioids for his chronic pain. While psychological factors were the reasons and drugs were the tools, the suicide was facilitated by a hole in a system designed to give vets the choice, in same cases, to obtain outside medical care at government expense. With Patient 1, “there is no evidence in the medical record that any of his VA providers were aware of the new opioid prescriptions,” according to the inspector general.  Read more . . .

VA Study Recommend Tighter Control on Opioids
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 . . .

Yuval Neria

Equine Therapy for Veterans with PTSD
They are each wary and slow to trust others. They each scan their surroundings constantly. And each stays constantly alert for danger. But while horses depend on those characteristics for survival, veterans with post-traumatic stress disorder can find them debilitating — traits that interfere with family and work life and can result in disturbed sleep, depression and substance abuse.   Now, researchers are hoping that when man and beast find common ground, through a series of guided interactions such as grooming the horse and leading it around a ring, it will help treat PTSD.  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 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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Opioid Abuse, Veterans and Mea Culpa

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With 80 people dying each day from overdoses of opioids, it is not surprising that Federal, State and Local authorities are seeking emergency measures and money to treat opioid abuse.

OxyContin - Veteran Addiction

Less surprising is the moral outrage and lynch-mob mentality of those who seek vengeance against those they deem responsible for the epidemic.  Just today, I read in the New York Times that the McKesson Corporation, “the nation’s largest drug distributor . . . finds itself at the center of the nation’s opioid epidemic.”

According to New York Times editor Gretchen Morgenson, McKesson shareholders and investors are likely to question the lavish pay packages earned McKesson executives while promoting the sale of lethal opioids to an unsuspecting public.

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

I realize it is a lot easier to blame some Colombian or Mexican War Lord for our nationwide drug addiction, but it seems undeniable that the U.S. government and trusted private and public associations have colluded with drug companies to create this “semi-legal” drug epidemic.

The consequences are heart-wrenching for many families who have lost loved-ones to this terrible addiction. Large towns and cities across the country have been devastated. Communities can no longer support themselves due to drug addiction by large segments of their population.

Rather than seek villains from this terrible tragedy, it is an opportunity for all citizens to reflect on the dysfunctional medical and substance control and testing process that enabled privately-owned companies to “legally” hook so many Americans on prescription drugs.  The “mea culpa” has plenty of self-serving enablers who would do well not to point fingers.

Sure, Big Pharma may eventually pay the price, but political party operatives have had their hands out at every stage of the addiction process to accept  “political contributions” to keep the regulatory process well lubricated.

The Veterans and Opioids

As SFTT has reported on numerous occasions, the VA has regularly resorted to using opioids and other toxic prescription drugs to treat Veterans with PTSD and TBI.  The VA and the Department of Defense (the DoD) have long known of the side-effects of opioids, but both have cited the FDA and “clinical trials” as evidence that their treatment procedures have strong support from the medical community.

According to the VA (whose numbers are generally suspect), some 68,000 Veterans are addicted to opioids:

“The Center for Investigative Reporting, using data provided under the Freedom of Information Act, said prescriptions for four opioids (hydrocodone, oxycodone, methadone and morphine) surged by 270 percent between 2000 and 2012, leading to addictions and a fatal overdose rate that was twice the national average.

“In 2014, the VA said it issued 1.7 million prescriptions for opioids to 443,000 vets to be taken at home.

“Citing a VA Office of Inspector General’s report, the Center for Ethics and the Rule of Law (CERL) said: “Between 2010 and 2015, the number of veterans addicted to opioids rose 55 percent to a total of roughly 68,000. This figure represents about 13 percent of all veterans currently prescribed opioids.”

Even by the VA’s own admission, these numbers are staggering.  More to the point, the use of these opioids may have helped Veterans cope with their pain, but it has done little if anything to help treat Veterans suffering from PTSD and TBI.  In fact, many Veterans will argue that the use of these prescription opioids has led to deeper depression and anxiety and, in some cases, suicidal tendencies.

Frankly, the use of opioids in treating PTSD and TBI has been largely unsuccessful.  There are many less invasive treatment alternatives for PTSD and TBI, but the VA seems reluctant to pursue them.

Why?  Has the insatiable greed of corporations and their government enablers blocked the pursuit of new treatment alternatives?

I certainly hope not, but I remain sceptical.

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Did the VA Hook Veterans on Opioids?

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Recent information suggests that 68,000 Veterans are addicted to some form of opioid (hydrocodone, oxycodone, methadone and morphine).  The VA argues that “more than 50 percent of all veterans enrolled and receiving care at the Veterans Health Administration are affected by chronic pain, which is a much higher rate than in the general population.”

Oxycontin and PTSD

According to the Center for Investigative Reporting obtained under the Freedom of Information Act,

. . . prescriptions for opioids surged by 270 percent between 2000 and 2012, leading to addictions and a fatal overdose rate that was twice the national average.

Citing a VA Office of Inspector General’s report, the Center for Ethics and the Rule of Law (CERL) said: “Between 2010 and 2015, the number of veterans addicted to opioids rose 55 percent to a total of roughly 68,000. This figure represents about 13 percent of all veterans currently prescribed opioids.”

The American Society for Addiction Medicine reports these startling facts on the opioid epidemic currently sweeping the U.S.

– Drug overdose is the leading cause of accidental death in the US, with 52,404 lethal drug overdoses in 2015. Opioid addiction is driving this epidemic, with 20,101 overdose deaths related to prescription pain relievers, and 12,990 overdose deaths related to heroin in 2015.

– From 1999 to 2008, overdose death rates, sales and substance use disorder treatment admissions related to prescription pain relievers increased in parallel. The overdose death rate in 2008 was nearly four times the 1999 rate; sales of prescription pain relievers in 2010 were four times those in 1999; and the substance use disorder treatment admission rate in 2009 was six times the 1999 rate.

While evidence provided by the Center for Controlled Disease and Prevention (CDC) suggests that the use prescription opioid painkillers has fallen some 41% since its peak in 2010, some 33,000 Americans died last year from addiction to opioids.  The addiction to prescription painkillers like Vicodin (hydrocodone) and Percocet (oxycodone) are rampant in the U.S.

The VA and Prescription Drugs for PTSD

For well over 5 years, Stand for the Troops (“SFTT”) has been reporting on the Department of Veterans Affairs (“the VA”) fascination with potent prescription drugs to treat Veterans with PTSD.

Despite the VA’s dismal record in effecting any meaningful change in patient outcomes, a cocktail of prescription drugs (generally opioids) are often the last resort since the VA’s Prolonged Exposure (PE) and Cognitive Processing Therapy (CPT) treatment programs have proved largely unsuccessful.

In what continues to be standard SOP, the VA perseveres in treating the symptoms of PTSD without offering any compelling life-changing treatment alternatives.  In effect, the VA is tacitly admitting “we don’t have a clue,” while arguing that they are providing the best therapy available and to seek funding for new “clinical” studies that address symptoms and not causes (i.e. cannabis, for instance) of PTSD and TBI.

In our research (mostly anecdotal but with those “in the know”), SFTT discovered that many Veterans treated with prescription opioids for PTSD would become violent and often suicidal.  In fact, they would often either discard these potent drugs (“flush them down the toilet”) or sell them on the black market to civilians.

One former Veteran explained that his colleagues would often grind up oxycontin pills into a powder and sell it on the black market for approximately $500 a month.  So prevalent was this behavior, that the government forced a large pharmaceutical company to produce oxycontin only in gel.  The result:  sales at the pharmaceutical company dropped 60% once the black market disappeared.

Personally, I think the FDA and the pharmaceutical industry effectively colluded into turning many Veterans and a large percentage of our population into junkies.

The Rationale?:  The level of addiction in the U.S. and easy access by the public to potent prescription drugs is simply unprecedented if compared to other countries.

How to Fix the VA’s Opioid Credibility Problem

It is sad to read the daily stories of spouses and loved ones deal with ravages of PTSD.  A few days of reading the Facebook page of “Wives of PTSD Vets and Military” will give you some idea of the ravages of the silent wounds of war.

Sure, we can continue to medicate these Veterans and military personnel with prescription drugs to deal with the symptoms, but I would far rather see an attempt to reverse the causes of debilitating brain injury rather than mask the symptoms.

There are several noninvasive solutions used by other countries.  First and foremost is hyperbaric oxygen therapy or HBOT that is widely used by the IDF.  For reasons that seem incomprehensible, the DoD claims that there is no scientific evidence to suggest that HBOT is effective.

Gosh, there doesn’t seem to be much evidence that suggests that prescription opioids, Prolonged Exposure (PE), and Cognitive Processing Therapy (CPT) are effective either.  Yet, the VA continues to push it’s stale and misleading agenda that it is providing our Veterans with the best available treatment programs.

Surely, we can do better than “talk the talk.”  Let’s look for real solutions.  If it can’t be found in the VA, let’s give the private sector an opportunity to help our brave Veterans.

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Veterans with PTSD Knew that VA Opioid Prescriptions Were Wrong

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After many lives of many brave Veterans with PTSD have been lost, the State of Ohio has finally taken action against pharmaceutical drug companies for hyping opioids.

Opioids

According to the New York Times reporter,  

The State of Ohio filed a lawsuit on Wednesday against the pharmaceutical industry over the opioid epidemic, accusing several drug companies of conducting marketing campaigns that misled doctors and patients about the danger of addiction and overdose.

Defendants in the case include Purdue Pharma, Teva Pharmaceutical Industries, Johnson & Johnson, Endo Pharmaceuticals, Allergan and others.

Purdue, the maker of OxyContin, a time-release opioid, released a statement saying, “We share the attorney general’s concerns about the opioid crisis and we are committed to working collaboratively to find solutions,” and calling the company “an industry leader in the development of abuse-deterrent technology.”

As most Veterans treated by the Department of Veterans Affairs (“the VA”) are aware, opioids were the prescription of choice for Veterans suffering from PTSD.

Despite overwhelming evidence available to the VA and the Department of Defense (the DOD) that this was probably not a wise course of action, the VA persisted in treating the symptoms of PTSD with dangerous prescription drugs.

It is only now with opioid and drug addiction ravishing communities across the United States that some local and State governments are beginning to take action.  In the interim, thousands of Veterans with PTSD have suffered through over-medication with opioids by doctors at the VA.

More to the point, the VA continues to insist on dated and ineffective treatment programs for Veterans with PTSD and TBI.   Under the inept counsel of Dr. David Cifu, these same treatment therapies continue at the VA today.

It is difficult to predict when this tragic saga will end, but clearly there are no indications that the VA plans to make any substantial changes to current programs.  As such our brave Veterans will continue to receive the same flawed therapy and, most likely, a healthy supply of prescription drugs to mask the symptoms.

Where are our leaders in Congress and leaders within the VA to put an end to this tragedy?  Cynical though I am, I have a difficult time believing that Big Pharma political campaign donations would be the reason.

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Opioid Abuse: Department of Veterans Affairs Culpability?

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While many families will be celebrating Easter today, I am quite sure that their thoughts will turn to a family member or friend who were among the 52,000 that died of a drug overdose last year.

By comparison, there were only 33,000 traffic fatalities over the same period.  These statistics suggest that substance abuse plays a far greater threat to our society than careless driving.

In an excellent 5-part series by FOX News entitled “Drugged, Inside the Opioid Crisis,” the network explores the devastating impact of opioid abuse in towns across the United States.

In fact, the FOX network claims that 4 out of 5 overdose fatalities can be traced to the initial use of prescription drugs for pain medication.   It is clear that prescription painkillers have caused many innocent victims to become dependent on more lethal drugs like heroin.

Temazepam_10mg_tablets-1

As Stand for The Troops (“SFTT”) has been reporting for several years, Veterans suffering from PTSD have been regularly over-served with a concoction of drugs – primarily opioids – to allow them to cope with pain and other issues.

If there was any doubt about the culpability of the Department of Veterans Affairs (“the VA”) in addicting our Veterans to painkillers rather than treat them, I suggest that you watch the video below:

With 20-20 hindsight most everyone can be on the “right side of history,”  but our Veterans, the VA and Congressional oversight committees have known that opioids was not the proper way to treat Veterans suffering from PTSD and TBI.

Dr. David Cifu:  A State of Denial at the VA

Unfortunately, VA protocols to treat PTSD as articulated by Dr. David Cifu, the senior TBI specialist in the Department of Veterans Affairs’ Veterans Health Administration, have resulted in few lasting benefits for Veterans with PTSD.  Paraphrasing Dr. David Cifu,  “the worse thing you can do for someone with PTSD is not to press them back into action as quickly as possible.  At the VA, we prescribe drugs for those in pain or suffering trauma.”

Indeed, there is no compelling evidence that the VA has improved the lives of Veterans suffering from PTSD or TBI.  

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

– Cognitive Behavioral Therapy and,

– Prolonged Exposure Therapy.

To see how badly the VA has failed our Veterans, one only needs to listen to a detailed explanation by Maj. Ben Richards citing his experience with the VA and a summary of failed patient outcomes at the VA. Watch the first two minutes to see Maj. Richards refute all VA claims that they are dealing with the problem effectively.

Conversation with a Veteran Drug Abuse Specialist

Several years ago, I had the opportunity to visit a Community Center in northern New York that was working with high-risk Veterans suffering from PTSD and TBI.  During this visit, I encountered a Drug Abuse Specialist, who had been rescued from addiction through the Veteran Court System.

What he told me shocked me.

– Well over 90% of Veterans returning from Iraq and Afghanistan suffer from substance abuse issues;

– Veterans are well aware that opioids don’t work and have major side-effects (i.e. suicidal thoughts) when combined with other prescription drugs provided by the VA;

– Rather than flush prescription drugs down the toilet, the drug of choice, OxyContin, was pulverized into powder and sold on the black market to civilian drug users;

– A leading supplier of OxyContin to the VA had its sales of the drug fall by more than 60% when Congress forced them to repackage the pills in a gel composite so it couldn’t be sold as a powder on the black market;

– This same pharmaceutical company petitioned Congress to reinstate OxyContin in pill form citing that “it is more effective than gel;”

– VA prescribed drugs don’t provide Veterans with a meaningful road to full recovery.

Sadly, I don’t believe the situation has changed significantly in recent years.

Opioid Abuse in the United States

The magnitude of the addiction problem in the United States can’t be underestimated.  Consider these staggering statistics from the American Society for Addiction Medicine (ASAM):

– Drug overdose is the leading cause of accidental death in the US, with 52,404 lethal drug overdoses in 2015. Opioid addiction is driving this epidemic, with 20,101 overdose deaths related to prescription pain relievers, and 12,990 overdose deaths related to heroin in 2015.

–  The overdose death rate in 2008 was nearly four times the 1999 rate; sales of prescription pain relievers in 2010 were four times those in 1999; and the substance use disorder treatment admission rate in 2009 was six times the 1999 rate.

– In 2012, 259 million prescriptions were written for opioids, which is more than enough to give every American adult their own bottle of pills.

– Four in five new heroin users started out misusing prescription painkillers.

– 94% of respondents in a 2014 survey of people in treatment for opioid addiction said they chose to use heroin because prescription opioids were “far more expensive and harder to obtain.

Opioids for Veterans: Deja Vu All Over Again

It’s often said that the definition of insanity is doing the same thing over and over again and expecting a different outcome.  As previous articles from SFTT have argued, the VA is in a rut and will continue to pursue well-meaning but demonstrably ineffective procedures to help Veterans with PTSD.  Most tragic.

While one would think that there is compelling evidence for the VA to follow in a different tack, I read a few days ago that OxyContin is again being tested to treat PTSD and substance abuse.

How much longer to our Veterans need to suffer from the VA bureaucracy and autocratic controls that remains largely unresponsive to their very real needs?   Based on the evidence, it seems that the VA management philosophy of benign neglect will continue to persist.  How sad!

Easter Advice from Veteran Wives Who Care

On Facebook, I recently came across this wonderful advice from Wives of PTSD Vets and Military.  I quote this useful advice below:

“If there is anything you have learned from your experience that you would tell those who are new to PTSD and the VA, what would it be?

Just A FEW of mine would be:

1. Staying on top of the VA and the veteran’s care is a full time job by itself. It is important to stay on top of it or they will fall through the cracks. Don’t wait for the VA to call. You call the VA.
2. Always research the severe side effects, and interactions of ALL medications including over the counter.
3. Always be aware of their moods, anniversaries (if possible), and seek help if you see them slipping downward.
4. Have a safety plan.
5. Find ways to communicate with your spouse. Use of code words, safety words etc are extremely helpful for us. Our new one is trust tree, which means either one of has something important to say, and the other one can’t judge, flip out, or start an argument. So far, it’s working. I’ll make a post later for it.

These are only a few off the top of my head. I have a lot more in depth ones that I will write about after while. What things have you learned or did you wish you knew when starting this roller coaster ride called PTSD?”

While one can only hope that this pragmatic spouse finds a sympathetic ear at the VA, “effective treatment” still seems out of reach.

In summary, may our brave Veterans and their families and friends get the HONEST SUPPORT THEY DESERVE.

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SFTT Military News: Week Ending Apr 14, 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.

Military Revamping Retirement System to Attract Millennials
In a bid to lure millennials, the U.S. military is making the most sweeping changes to its retirement program since World War II. Gone are the days when only a 20-year veteran leaves the service with a nest egg. Going forward, those who serve as little as two years will return to civilian life with retirement savings. The new system introduces 401(k)-type savings for military personnel while downsizing the traditional pension benefit—a trade the corporate world has been making for 35 years. The new design also comes with a stepped-up effort to provide service members with the education they will need to make the most of a system that demands more individual involvement.  Read more . . .

Expanded U.S. Military Push in Yemen?
Amid reports President Trump is considering more American military help for the Saudi-led fight in Yemen, U.S. lawmakers are urging caution, if not an about-face. Four U.S. senators have offered legislation to limit arms sales to Riyadh over its troubled Yemen campaign. Fifty-five members of the U.S. House called on Trump in a letter to end both U.S. refueling for Saudi coalition warplanes and logistical assistance for the Saudi-led bombings in Yemen — and they said Trump must seek congressional approval before he deepens U.S. military involvement.  Read more . . .

Department of Veterans Affairs

Another VA Hospital Criticized by the Inspector General
In a scathing report, the Inspector General for the Department of Veterans Affairs listed a range of overlooked and long-standing problems at the Washington, D.C., VA Medical Center “sufficient to potentially compromise patient safety.” The risk to the 98,000 vets served by medical center in the nation’s capital was so high that the office of Inspector General Michael Missal took the unusual step of issuing a preliminary report to alert new VA Secretary Dr. David Shulkin to the danger.  Read more . . .

Future of the US Military Health System
Three components are needed for a high-performing military. First, the health of military personnel affects “readiness and battlefield performance.” So, health is not only a personnel matter, but also a national security issue. Second, maintaining the health of service members requires “everything from nutritious meals to medical services.”  Third, health care benefits help to attract and retain men and women in the armed services.  Nevertheless, the Military Health System “is a major cost” to the federal government, and the growth of that system “threatens other defense priorities” and attracts “criticism and proposals to reform military health care.”  Read more . . .

Oxycontin and PTSD

Oxycontin Being Tested (Again) for Treatment of PTSD
Nightmares. Obsessive thoughts. Avoiding particular places. Sudden outbursts. Fearing you’re in danger. Survivor guilt. These experiences – manifestations of post-traumatic stress disorder (PTSD) – are part of life for up to 1 in 3 U.S. combat veterans and active military personnel. That’s more than triple the prevalence of PTSD in the population at large. About two-thirds of those with PTSD struggle with alcohol abuse. A new trial may hold new hope for these military personnel through treatment with oxytocin, sometimes referred to as the “love hormone.”  Read more . . .

Tonix Drug PTSD Study Enters Phase 3
Tonix Pharmaceuticals Holding Corp. announced today that it has enrolled the first participant in the Phase 3 HONOR study of TNX-102 SL 5.6 mg, for the treatment of posttraumatic stress disorder (PTSD). “Enrolling the first participant in the HONOR study is an important event not only to Tonix, but potentially to millions who suffer worldwide from both civilian and military-related PTSD,” said Seth Lederman, M.D., Tonix’s president and chief executive officer. “The HONOR study is designed to confirm the clinical benefit of TNX-102 SL to improve PTSD symptoms across several measures as demonstrated in our Phase 2 AtEase study in military-related PTSD.”   Read more . . .

VA Launches New “Quality of Care” Website
The Department of Veterans Affairs unveiled a new website Wednesday aimed at providing information on the quality of care at VA medical centers, touting new accountability even as it grappled with fresh questions of patient safety in its beleaguered health system. The VA website, www.accesstocare.va.gov, is a work in progress. It provides preliminary data on the VA’s 1,700 health facilities, along with more than a dozen private-sector hospitals and national averages. Three years after a wait-time scandal at the Phoenix VA medical center, the website offers comparative data on wait times as well as veterans’ satisfaction ratings in getting timely appointments.  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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How the VA Hooked Veterans on Opioids

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In yet another example of well-researched reporting, the Washington Post details how the Department of Veterans Affairs (“the VA”) hooked Veterans on opioids and other powerful prescription drugs and then failed to provide these Veterans adequate treatment facilities.

The U.S. Department of Veterans Affairs acknowledges its role in creating a large population of opioid-addicted veterans by overprescribing painkillers for injuries and post-traumatic stress disorder. After the agency tightened prescribing practices in 2013, many veterans bought pain pills sold illicitly on the streets. When those became too expensive, they sought heroin and fentanyl, a potent synthetic narcotic.

The VA is now struggling to undo the damage. Hampered by budgetary and bureaucratic obstacles, it has failed to build a rehabilitation program robust enough to meet the overwhelming demand for treatment from the tens of thousands of veterans with opioid addiction, say analysts who have studied the issue. That has left many veterans to fend for themselves, tapping whatever resources they can find to battle a chronic, complex—and frequently fatal—condition.

While the number of toxic opioids prescribed by the VA began to decline after 2013, the damage had been done to many Veterans returning from our wars in Iraq and Afghanistan.  SFTT has long argued against the use of these addictive drugs, but the VA has been slow to respond to the evident abuse and potentially lethal consequences for Veterans suffering from PTSD.

Drug Abuse

While the much needed reform within the VA has received widespread bi-partisan Congressional support, labor leaders like David Cox have blocked any meaningful reform.  Clearly, the self-serving interests of VA employees appears to take preference over the needs of our Veterans.

The Commission on Care report on overhauling the VA was released on June 30th, 2016.  Sadly, political parties lined up on either side of the report to misrepresent the meaningful reforms sought by “disinterested” consultants seeking to improve treatment for Veterans.  It is difficult to speculate what – if any – of these reforms will be implemented by the new administration, but it appears that the labored search for a new VA Secretary suggests that it is a rather difficult position for the Trump administration to fill.

President Barack Obama

As the Obama administration gives way to a new one, President Obama would do well to heed the advice of John Rowan, President of the Vietnam Veterans of America, “to pardon all post 9/11 Veterans who received less-than-honorable discharges without the due process of a court-martial.”

Mr. Rowan argues that

The “misconduct” the military frequently cites to justify less-than-honorable discharges is often related to PTSD, traumatic brain injury or other service-related illnesses and injuries. Yet the military itself is culpable, having for years under diagnosed those problems. After service, things often get worse, since “bad paper” discharges can result in the denial of veterans benefits. Without proper care, and with the stigma of a less-than-honorable discharge, these veterans are often more likely to become substance abusers, homeless or incarcerated — or to die by suicide.

While some may be absolved by this sweeping policy, it could be a step forward to call attention to the plight suffered by many Veterans suffering from PTSD and TBI that have been ill-served by the medical community in treating this debilitating injury.

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