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.


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.


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


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.


SFTT News: Week Ending December 30, 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 SFTT readers to click on the embedded links to read more on subjects that may be of interest to them.

This will be Stand For The Troops last military news summary for 2016.  We wish all readers, Veterans and men and women in uniform a Happy New Year and safe 2017.

Top 15 Military Stories in 2016 from Checkpoint
The stories span from tales of misdeeds at home to analysis of weapons used on the battlefield in Iraq and Syria. They also include inspiring stories about Americans who used their training to help others, and assessments of what the future U.S. military might look like.Here are the Top 15 stories on Checkpoint in 2016. A footnote: Several significant stories about the military were published on other parts of The Washington Post’s website, and thus are not counted here. They include breaking news early in December that retired Marine Gen. James Mattis has been nominated to be Trump’s secretary of defense, and a long-form story that explored Trump’s popularity among rank-and-file veterans.  Read more . . .

Veterans with PTSD - War in Afghanistan

Iraq Makes Renewed Assault on Mosul to Dislodge ISIS
Iraq’s special forces continued to push back Islamic State militants in the eastern sector of Mosul on Friday in intense fighting that forced scores of people to flee their homes. The fighting in the Quds neighborhood came a day after Iraqi forces broke a two-week lull in fighting to stage a multi-pronged offensive in eastern Mosul east of the Tigris River. The latest push, aided by airstrikes and artillery from a U.S.-led coalition, is taking place under clear and sunny skies and, if the weather holds, was expected to continue until all forces in the eastern sector reach the Tigris River.  Read more . . .

China’s Military Advances in 2016
China’s military advanced along several fronts in 2016 in its concerted program to develop new asymmetric and conventional warfare capabilities while continuing to challenge the United States for military control of key waterways in Asia. As 2016 drew to a close, China flexed its military muscle with the high-profile dispatch of its lone aircraft carrier, the Liaoning, to an area of the western Pacific in a carrier battle group formation. Seven warships accompanied the carrier – three destroyers, three frigates and a supply ship. Contrary to many western China analysts’ who said the Chinese carrier would take many years to deploy, Chinese state media trumpeted naval drills as a sign the the carrier will ready for combat operation sooner than expected.  Read more . . .

New DoD Outreach on Military Discharges
The Defense Department today announced a renewed effort to ensure veterans are aware of the opportunity to have their discharges and military records reviewed, according to a DoD news release. Through enhanced public outreach; engagement with veterans’ service organizations, military service organizations, and other outside groups; as well as direct outreach to individual veterans, the department encourages all veterans who believe they have experienced an error or injustice to request relief from their service’s Board for Correction of Military/Naval Records or Discharge Review Board, the release said.  Read more. . .

Russian Military Unit Reportedly Behind DNC Hacking
A cybersecurity firm has uncovered strong proof of the tie between the group that hacked the Democratic National Committee and Russia’s military intelligence arm — the primary agency behind the Kremlin’s interference in the 2016 election. The firm CrowdStrike linked malware used in the DNC intrusion to malware used to hack and track an Android phone app used by the Ukrainian army in its battle against pro-Russia separatists in eastern Ukraine from late 2014 through 2016. While CrowdStrike, which was hired by the DNC to investigate the intrusions and whose findings are described in a new report, had always suspected that one of the two hacker groups that struck the DNC was the GRU, Russia’s military intelligence agency, it had only medium confidence.  Read more . . .

Prescription Drugs Targeted by PTSD

The VA hooked Veterans on Opioids and Then Failed Them Again
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.   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 becoming a member of Stand For The Troops


Virtual Reality Better Than Opioids for Veterans

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Although the technology is not new, video games may be more effective than opioids in treating PTSD.

According to Nicholas Kardaras, Ph.D and Clinical Assistant Professor at Stony Brook University, playing virtual games may be more effective than narcotic drugs in treating pain.

In an article published in Psychology Today, the author interviewed researchers and made the following observations:

In my interview with the Navy’s head of Addiction Research Commander Dr. Andrew Doan, a Johns Hopkins MD and Ph.D. in neuroscience, he stated that he believes that there is indeed an endorphin-increasing mechanism that’s not entirely understood; he embraces the notion of screens acting as “digital pharmakeia” (Greek for pharmaceuticals), a term that he coined to explain the neurobiological effects produced by video technologies.

Brain imaging would eventually confirm that the burn patients treated with Snow World Virtual Reality (VR) were indeed experiencing less pain in the parts of their brain associated with processing pain. (See Figure Below) All of these stunning findings have led the military to further pursue the use of Virtual Reality and video games as a quasi-digital drug in order to help treat pain.

Indeed, the game used to help soldiers cope with burn pain was called Snow World and first used in 2008.

Recent studies indicate that brain scans of patients who used virtual reality programs showed significant improvement in cognitive functions.

With further study, this form of treatment could help curb opioid addiction.


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.


Hyperbaric Oxygen: What the VA Doesn’t Want You To Know

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The gatekeepers at the Department of Veteran Affairs (the “VA”) remain intransigent in providing urgently need care to Veterans suffering from PTSD and/or TBI. Standard Operating Procedure (“SOP”) at the VA is to argue that FDA-approved clinical studies are needed to sanction treatment methods – regardless if these treatment alternatives have been used with success in many other countries for decades and, in some cases, hundreds of years.  

hyperbaric oxygen and the VA

Instead, the VA serves our Veterans a cocktail of potentially lethal prescription drugs that do carry the FDA’s “Good Housekeeping Seal of Approval.”   How is this possible when the Centers for Disease Control and Prevention (“CDC”) reports  an epidemic in addiction to prescription drugs?

Unfortunately, the VA’s SOP in prescribing these opioids to Veterans with PTSD and TBI hasn’t changed in many years.   Why?  Could it be that the benefits to Big Pharma outweigh the benefits of providing our Veterans with the treatment they merit?   I am most hesitant to ask this question, but I can think of no other explanation.

For instance, treating head injuries with Hyperbaric Oxygen Therapy (“HBOT”) has been around for decades.  It is the standard procedure provided to wounded soldiers and civilians with head injuries by the Israeli medical profession for decades.

This short video below is in Hebrew with English subtitles, but it provides a very compelling argument why our Veterans should have access NOW to HBOT while the bureaucrats and FDA twiddle their thumbs and continue to ingratiate themselves with Big Pharma lobbyists.

Gordon Brown  of Team Veteran argues that  “We need this type treatment in our VA and military hospitals instead of the DRUG therapy they are now using. Most TBI cases have been misdiagnosed as PTSD and drug treatment cause further complications for our veterans.”   Gordon’s views reflect my own and those of hundreds if not thousands of Veterans.

In fact, some hospitals in the private sector are taking radical steps to curtail the use of opioids in treating pain.  In an recent New York Times article, St. Joe’s hospital is implementing wide-ranging changes to comply with CDC recommendations:

“St. Joe’s is on the leading edge,” said Dr. Lewis S. Nelson, a professor of emergency medicine at New York University School of Medicine, who sat on a panel that recommended recent opioid guidelines for the Centers for Disease Control and Prevention. “But that involved a commitment to changing their entire culture.”

In doing so, St. Joe’s is taking on a challenge that is even more daunting than teaching new protocols to 79 doctors and 150 nurses. It must shake loose a longstanding conviction that opioids are the fastest, most surefire response to pain, an attitude held tightly not only by emergency department personnel, but by patients, too.

Is it too much for that lumbering behemoth VA to show the same sense of urgency?

I suppose we can continue to get distracted with the many other “big” issues facing our country, but providing our Veterans with proper therapy is one issue where Americans can easily unite.  Let’s not let the bottom line of Big Pharma distract us from that mission.  The brave men and women who have served our country deserve no less.


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.


SFTT News: Week of May 13, 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.

New U.S. Commander in Afghanistan
After 18 months in command during a period of military and political conflict, General Campbell handed off on Wednesday to Gen. John W. Nicholson Jr. of the United States Army. The new commander, who leads a force of about 13,000, will oversee NATO’s reduced mission of training and assisting the Afghan forces at a time when the Taliban insurgency has spread wider than at any point since the group was removed from power in 2001.  Read more . . .


DoD buys Faulty Drones that Failed Testing
U.S. Special Operations Command bought dozens of hand-launched drones that failed military tests and may not be able to meet mission requirements in the harsh environments they were designed for, according to a newly released report from the Defense Department’s inspector general.  Read more . . .

Donald Trump Adviser Signals Change to Veteran Health Benefits
Donald Trump says the Department of Veterans Affairs’ health-care system is badly broken, and this week his campaign released some guidelines that would steer changes he would implement if he wins the presidency.  While short on details, the presumptive GOP presidential nominee would likely push VA health care toward privatization and might move for it to become more of an insurance provider like Medicare rather than an integrated hospital system, said Sam Clovis, Mr. Trump’s chief policy adviser, in an interview.  Read more . . .

Veteran EMT Support Act Passes Congress
Today (May 12), the U.S. House of Representatives passed H.R. 1818, the Veterans EMT Support Act, by a vote of 415 to 1. The legislation assists military medic veterans to efficiently transition their military medical training into the civilian workforce and addresses the shortage of emergency medical technicians in states.  This has been a key legislative priority of the National Association of Emergency Medical Technicians (NAEMT), as well as other national and state EMS organizations. H.R. 1818 directs the Department of Health and Human Services to establish a demonstration program for states with a shortage of emergency medical technicians to develop a streamlined transition program for trained military medics to meet state EMT licensure requirements.   Read more . . .

A Brief History of Opioid Abuse:  Courtesy of CNN
The abuse of opioids, including prescription painkillers and drugs like heroin, is something the United States has struggled with since before the 1900s. But it’s a problem that keeps coming back.  Now, federal agencies are trying to tackle the problem in different ways. The Centers for Disease Control and Prevention recently issued guidelines for prescribing opioids for chronic pain, part of an effort to push doctors to prescribe pain medications responsibly. The U.S. Food and Drug Administration announced that immediate-release opioid painkillers such as oxycodone and fentanyl will now have to carry a “black box” warning about the risk of abuse, addiction, overdose and death.   Read more . . .

Memory Manipulation to Treat PTSD?
Imagine if memory could be tuned in such a way where good memories are enhanced for those suffering from dementia or bad memories are wiped away for individuals with post-traumatic stress disorder. A Stony Brook University research team has taken a step toward the possibility of tuning the strength of memory by manipulating one of the brain’s natural mechanisms for signaling involved in memory, a neurotransmitter called acetylcholine. Their findings are published in the journal Neuron.   Read more . . .

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Opiate Abuse Mounts: Veterans in Crossfire

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The tragic death of Prince appears to have been an overdose of opioids designed to relieve pain.  While we are still awaiting toxicology reports, it does appear the Prince has suffered from excruciating pain for quite some time and was taking ever-increasing amounts of pain-killers to deal with this problem.


At this stage, it is unclear that these drugs were prescribed or that he was self-medicating with drugs obtained illicitly.   In fact, some argue that Prince did not die from pain pills but from chronic pain.

Whatever is determined to be the final cause of Prince’s death, it is abundantly clear that Prince was in great pain and that he took a variety of addictive drugs to help him deal with this problem.

You don’t have to stray far to see that addiction to pain-killers has reached epidemic proportions in the United States.  In fact, in late March President Obama called attention to this growing problem by saying the following:

“When you look at the staggering statistics, in terms of lives lost, productivity impacted, costs to communities, but most importantly cost to families from this epidemic of opioid abuse, it has to be something that is right up there at the top of our radar screen,” Obama said at the National Rx Drug Abuse and Heroin Summit in Atlanta.

The epidemic is a rising issue in U.S. politics that has found its way into the presidential campaign. Both of the front-running candidates, Democrat Hillary Clinton and Republican Donald Trump, have been confronted on the campaign trail by ordinary people affected by drug abuse, and have responded with widely disparate strategies to confront the problem. The Obama administration has meanwhile proposed a dramatic increase in federal spending, to about $1.5 billion in fiscal 2017, for addiction treatment and other measures to stem the epidemic.

“Today, we are seeing more people killed because of opioid overdose than traffic accidents,” Obama said.

“We’re taking a number of steps, but frankly we’re still under-resourced,” Obama added. “I think the public doesn’t fully appreciate yet the scope of the problem.”

While the general public may not be aware of the problem, Veterans and our military leaders are well aware of the devastating consequences of taking prescription drugs to deal with PTSD and other brain-related traumas.

veterans with ptsd opioids

Stand For The Troops has been reporting for years on the effects of prescribing potentially lethal combinations to Veterans with PTSD.    Even the FDA is concerned as evidenced by their recent initiative to seek tighter controls on the use of prescription drugs.

Clearly, prescription drugs can play an important role in helping Veterans cope with the symptoms of PTSD, but it should now be obvious that prolonged use of opioids or other addictive pain-killers is not a long-term solution that will benefit Veterans.

Nevertheless, the Department of Veteran Affairs (the “VA”) continues to drag their feet on providing Veterans with access to other less dangerous treatment alternatives.

The VA can continue to stonewall this problem claiming “lack of resources,” or “lack of clinical evidence” for alternative treatments, but the continued use of haze-inducing opiates is certainly not the answer our Veterans expect nor deserve.

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