What Veterans with PTSD Should Know About Alternative Drugs

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Most every day there is a provocative news report suggesting that some “miracle drug” may help treat Veterans with PtSD and TBI.  If it is not a new drug, cannabis or ecstacy are often cited as “new” drugs that can help Veterans cope with  the debilitating symptoms of PTSD.

While many Veterans with brain injury and their caregivers hope that prescription medicine relief is on the way, the Department of Veterans Affairs (“the VA”) has a very poor track record in providing Veterans with the care that they deserve.  More to the point, prominent spokespeople for the VA – like Dr. David Cifu – give misleading information when they claim that the VA provides the best available treatment programs for PTSD and TBI.  This is simply not the case.

In fact, there are hundreds of stories documenting the frustration of Veterans with the staff of the VA.   The suicide of Veteran Eric Bivins as told by his wife is just one of many horrific stories of how doctors at the VA callously treat Veterans.

When all else fails (as it normally does), the VA prescribed drugs – in many cases, opioids.  Mind-altering drugs was to “go-to” choice for overworked VA medical personnel who still don’t know how to deal with, let alone treat brain injury.

While we all remain hopeful that drug relief is just around the corner, it seems likely that the new “miracle” drug will only deal with the symptoms of behavioral changes caused by PTSD and TBI.  Veterans consulted by SFTT  seek a permanent or semi-permanent solution that avoids invasive drugs.  Found below are questions Veterans and their caregivers should consider when thinking about using “alternative” drugs.

What Veterans Should Know About “Alternative” Drugs

There is much “buzz” in social media channels and even authoritative medical websites on important new breakthroughs on “drugs” to help Veterans with with PTSD and TBI.   Given the wide disparity in treating brain injury, it seems unlikely that marijuana, MDMA or others in clinical trial will provide a long term solution.

There is a vast difference between providing therapy that permits Veterans with PTSD and TBI to recover their lives than supplying prescription drugs which treats the symptoms.  As the public has painfully learned from the opioid epidemic, prescription drugs that treat only the symptoms can have detrimental side-effects.

VA’s Research on Alternative Drugs

The VA continues to help fund initiatives to identify less addictive drugs that help Veterans cope with chronic pain, depression and anxiety.  Clinical trials take several years to complete and there is a lengthy regulatory and review process to obtain FDA approval.

Selected SFTT Posts on Alternative Drugs

Opioids:  Bi-Partisan Incompetence in D.C.

The VA and Opioids:  The Finger-Pointing Begins

Marijuana and Veterans with PTSD

Genetics to Cannabis:  Implications for Treating PTSD

Veterans with PTSD Knew that VA Opioid Prescriptions Were Wrong

SFTT’s Position on “Alternative” Drugs

SFTT sincerely hopes that researchers and the medical profession will hopefully create a variety of new – and less addictive – drugs to treat Veterans with PTSD and TBI.  Nevertheless, members of the medical profession must clearly distinguish between drugs that treat “symptoms” and those that may offer long term remission from brain injury.  For reasons that are not entirely obvious, the VA does not make that distinction public. Sadly, the VA’s track record is not good in dispensing prescription drugs to Veterans with brain injury.  

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FAQ on Service Dogs for Veterans

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For some inexplicable reason, the Department of Veterans Affairs (“the VA”) has a “thing” about service dogs.  Despite an overwhelming amount of evidence that service or companion dogs help Veterans, the VA insists on studying this issue still further.  SFTT wishes the VA had taken the same level of precaution in prescribing OxyContin for Veterans with PTSD.

DoD photo by Erin A. Kirk-Cuomo (Released)

Service Dogs for Veterans with PTSD and/or TBI

A companion service dog program appears to provide comfort and support to Veterans with the symptoms of PTSD, including depression, nightmares and social anxiety. Service dogs are trained to anticipate anxiety attacks and nightmares.

How Does it Work?

After the dogs reach maturity – normally 6 months – they begin an intensive 5 month training program designed to familiarize the service dog with elements of supporting a human being. For instance, the dog has to learn to navigate elevators and escalators and to respond to potential danger signals which could cause panic in the dog’s human companion.

A well-trained service dog is not distracted by peripheral events like the presence of other dogs or animals and will avoid eating food that has been dropped on the floor.

After the service dog has successfully completed his training, the certified service dog is then introduced to his/her human companion.  In general, Veterans will spend seven weeks in intensive – about 4 hours of training a day (generally in the morning) and a few weekend sessions.

How Much Does a Service Dog Cost?

While many Veterans obtain a service dog free thanks to the generous contributions of others, a properly trained service dog costs approximately $10,000.  To that cost must be added the opportunity cost of training with the service dog as well as upkeep and veterinary bills.

What is the VA’s Position on Service Dogs?

The VA provides service dogs for Veterans suffering from blindness and mental illness which limits their mobility.  Nevertheless, the VA “does not provide service dogs for physical or mental health conditions, including PTSD.”

The VA claims that “there is not enough research yet to know if dogs actually help treat PTSD and its symptoms.”   An independent study is being conducted to determine the benefit of service dogs, but the results of this study are several years off.

Selected SFTT Posts on Service Dogs

Veterans with Service Dogs:  Apparently not for Everyone

The Department of Veterans Affairs and Service Dogs

Service Dogs for Veterans:  The VA Still on the Fence

Maj. Ben Richards and Service Dog Bronco

Other Resources

Companions for Heroes (Promotional)

Patriot Paws (Promotional)

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Will the VA Expand HBOT Therapy for Veterans with PTSD and TBI?

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As reported earlier, the Department of Veterans Affairs (“the VA”) is now providing hyperbaric oxygen therapy of “HBOT” on a trial basis to Veterans with PTSD and TBI.  This marks an abrupt turnaround within the VA that has repeatedly claimed that there is insufficient clinical “evidence” to support the use of HBOT in treating Veterans with brain injuries.

HBOT Therapy

The VA’s position reportedly stems from some 32 “inconclusive” studies on the effectiveness of HBOT in treating TBI and PTSD. Most recently, the 2015 DoD trial of HBOT concluded that there was a “lack of evidence” that HBOT helped Veterans with PTSD or TBI.

Col. Miller, the DoD project manager, “didn’t see any value in moving forward with more studies.”  As SFTT reported earlier, Col. Miller is an infectious disease specialist and not a brain trauma specialist.  Fortunately, he now works for the Gates Foundation focusing on his specialty: infectious disease.

The VA and the DoD go to great lengths to discredit the use of HBOT in treating Veterans with brain injury. Nevertheless, their arguments seem rather spurious against the almost overwhelming scientific evidence that HBOT is effective in helping to improve brain functionality.

Some in the medical profession have questioned whether test protocols in the DoD 2015 study were manipulated to produce the “inconclusive” outcome.  More to the point, how is it possible for the VA to continue to defend its ONLY two non-invasive therapy programs: Prolonged Exposure Therapy (“PE”) and, Cognitive Processing Therapy (“CPT”)?   Patient outcomes for these two programs have been shown by independent studies to be next to useless.

In fact, so abysmal have been therapy results that the VA used highly addictive prescription drugs to treat the symptoms of PTSD and TBI rather than provide any long term cure.  Indeed, the VA has no small role to play in contributing to the opioid epidemic which is now ravaging America.

Hopefully, the lack of any meaningful success in treating PTSD and TBI has forced the VA to accelerate its exploration of alternative therapies.  Hopefully, HBOT will soon be incorporated into the treatment options currently provided to Veterans by the VA.

While Dr. David Cifu and his cronies at the VA may continue to put out disingenuous statements regarding HBOT, it is widely used all over the world to treat trauma.  Specifically, HBOT is the “go-to” option for the Israel Defense Forces (IDF).   As reported in an earlier SFTT article, Daniel Rona, who has fought with both the IDF and US military states that in Israel:

“In essence, our mental attitude is that we must take care of ourselves and through that process little Israel has become a blessing for the rest of the world…we treasure our soldiers, young and old. They are our only defenders….no one else will fight our battles. You can imagine that every concussive event will be treated with HBOT !” . . .“the policy of the IDF is that life has the highest value and they are committed to use any treatment, in any case, to save a life”.

Furthermore, as Dr. Paul Harch and others have pointed out, there are many independent scientific studies confirming the benefits of HBOT.  Specifically, Dr. Xavier Figueroa has written a compelling argument suggesting that the VA has dropped the ball on HBOT research.

There is plenty of anecdotal evidence to suggest that Veterans are seeking treatment centers all across the United States.  In many cases, clinics are opening their doors to Veterans to help them recover from the silent wounds of war.  Nevertheless, the treatment can be quite expensive as remains out of financial reach for most Veterans.

While Veterans and their support givers cope with this devastating war wound, SFTT remains hopeful that HBOT and other alternative therapy programs will soon be adopted by the VA to help these brave Veterans recover their lives.

Found below is an old (2012) but compelling video (caution, it takes a while to load) from a TV Station in Louisiana (WWL.com) which shows the remarkable recovery of Maj. Ben Richards mental and motor skills after having received treatment from Paul Harch:

While HBOT may not be “right” solutions for all Veterans suffering from brain injury, it does seem a far more compelling treatment alternative to the ineffective programs currently offered by the VA. More to the point, HBOT is non-invasive which suggests that we won’t have a new generation of addicts to contend with given failed VA programs.

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

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

OxyContin - Veteran Addiction

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

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

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

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

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

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

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

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