Prescription Drug Abuse Hits Center Stage

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

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

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

Homeless Veteran with PTSD

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

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

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

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

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

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

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

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

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

Just Say No

Veterans with PTSD and Treatment Alternatives

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

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

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

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

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

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

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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.

Prince

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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Drugs and Super Soldiers

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The Atlantic just published a lengthy article entitled “The Drugs That Built a Super Soldier” describing how Vietnam military personnel were provided drugs to enhance performance or mask pain and injury.    The author, Lukasz Kamienski, reports that:

The conflict was distinct in another way, too—over time, it came to be known as the first “pharmacological war,” so called because the level of consumption of psychoactive substances by military personnel was unprecedented in American history. The British philosopher Nick Land aptly described the Vietnam War as “a decisive point of intersection between pharmacology and the technology of violence.”

In 1971, a report by the House Select Committee on Crime revealed that from 1966 to 1969, the armed forces had used 225 million tablets of stimulants, mostly Dexedrine (dextroamphetamine), an amphetamine derivative that is nearly twice as strong as the Benzedrine used in the Second World War. The annual consumption of Dexedrine per person was 21.1 pills in the navy, 17.5 in the air force, and 13.8 in the army.

Research has found that 3.2 percent of soldiers arriving in Vietnam were heavy amphetamine users; however, after one year of deployment, this rate rose to 5.2 percent. In short, the administration of stimulants by the military contributed to the spread of drug habits that sometimes had tragic consequences—because amphetamine, as many veterans claimed, increased aggression as well as alertness. Some remembered that when the effect of speed faded away, they were so irritated that they felt like shooting “children in the streets.”

military drugs

Sadly, drugs have long been in the arsenal of the military to keep warriors alert and focused on the mission at hand or, more recently, over-medicating warriors with prescription drugs to cope with the symptoms of PTSD.

Mind you, drugs alone are not enough for the military brass and its lobbyist buddies to maximize the performance of our warriors.   The U.S. Army is now experimenting with the Comprehensive Soldier Fitness program.  This $125 million experimental program is designed to improve “Soldier performance and readiness. Build confidence to lead, courage to stand up for one’s beliefs and compassion to help others. Comprehensive Soldier Fitness is about maximizing one’s potential.”

Comprehensive Soldier FitnessWhile is seems sacrilegious to criticize our military leadership, there are simply far too many examples of Ill-advised programs and the promotion of sycophant officers who endorse shoddy equipment procurement practices, yet deny our brave fighting men and women the equipment and support they require to accomplish their mission and receive the medical treatment they deserve following deployment.

The Government Accountability Office (“GAO”) repeatedly takes to task the VA on how it treats Veterans.    Recently, the GAO cited that 63% of the cases of Veteran suicides were “inaccurately processed.”

One suspects that this situation –  and many other heart-wrenching reports from the GAO on the incompetence of the VA – would trigger outrage by the public and Congressional leaders.  If so, it is difficult to discern the noise of this outrage.  The media seems more preoccupied with “topical crises” largely of their own making.   Perhaps, “real outrage” doesn’t sell much advertisement to trigger an overhaul of the VA.

Fortunately, many concerned individuals and charitable organizations have stepped in to privately provide the support our Veterans deserve.   While this “private” support may not be as comprehensive as the services available at the VA, it does provide Veterans with caring and inclusive therapy.

SFTT remains hopeful that the VA will seize the opportunity to reform itself.  There are far too many well-intentioned employees within the VA to allow our Veterans to dangle perilously because of incompetent leadership.

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Veterans Turn to Pot to Treat PTSD

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According to various press releases, Veterans are turning to pot or marijuana or cannabis to self-medicate against the symptoms of PTSD.   According to Ben Finley of the Associated Press and published recently on ABC:

While the research has been contradictory and limited, some former members of the military say pot helps them manage their anxiety, insomnia and nightmares. Prescription drugs such as Klonopin and Zoloft weren’t effective or left them feeling like zombies, some say.

Indeed, the use of cannabis by Veterans has increased despite the fact that it “remains illegal in most states and is unapproved by the Department of Veterans Affairs (“VA”) because major studies have yet to show it is effective against PTSD.”

cannabis to treat ptsd

Image Source: https://cannabisincanada.ca/

Indeed, SFTT has been reporting for months that the VA seems to have lost its way in providing meaningful therapy for Veterans with PTSD.   The cocktail of prescription drugs continues to be the standard treatment recommended by the VA in treating PTSD, despite overwhelming evidence that Veterans mistrust these prescription drugs.   Furthermore, even the FDA and DoD believe that these prescription drugs are toxic.

Is Cannabis to Treat PTSD Effective?

There are many conflicting reports on whether or not “pot” is effective in treating the symptoms of PTSD.  Anecdotal evidence, as argued in the video below, suggests that cannabis or medicianl marijuana allows Veterans a few moments of peace or the ability to cope with their PTSD symptoms better than the psychotic drugs often prescribed by the VA.  Perhaps, alcohol or other recreational or “hard” drugs may provide the same benefits in treating they symptoms of PTSD as pot.

Treating the symptoms of PTSD and providing long-term solutions to help Veterans reclaim their lives are two very different goals.  Sure, any number of forms of self-medication or prescription drugs can mask the symptoms of PTSD temporarily, but this chemically-induced temporary “release from pain” hardly allows the Veteran – or any other person – to recover from a traumatic event.

In the opinion of SFTT, meaningful solutions are needed to allow Veterans suffering from the invisible wounds of war to reclaim their lives without the dependency of drugs or other prescription pharmaceuticals.  In fact, our dependency on drugs has become a national epidemic.

Earlier this week the Center for Disease Control and Prevention (“CDC”) issued guidelines to curb the use of prescription drugs.    Why?   As Lloyd Sederer of US News and World Report suggests:

The CDC guidelines are a needed and valuable public health step towards changing the deadly opioid epidemic in this country. We can prevent addiction for many, reduce overdoses and death for tens of thousands each year, improve functioning in countless people and introduce means other than pills to manage the inescapable pains of living.

Indeed, whether it is marijuana or prescribed opioids, as individuals and as a society, we need to ask whether it is better to seek solutions to materially improve the quality of our life or are we simply prepared to continue to live a life in a haze of smoke that simply masks the symptoms of the pains we have acquired through life’s journey.  This is the question that each Veteran must ask themselves.   There is no easy answer.

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The VA and Veteran Suicides: Sleeping Beauty Wakes Up

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Only a cynical person could look with amusement on the recent self-serving announcement by the Department of Veterans Affairs (“VA”) that it is taking “additional steps” to address Veteran suicides.   I realize that it is somewhat difficult to get a $180 billion a year bureaucratic behemoth to focus on an issue that has been front-page of every major media outlet, the DoD and even the VA for well over 10 years.

In fact, many legislators and many grieving families are simply scratching their heads and asking the question that most any sane American would ask:   Hasn’t the VA been focused on Veteran suicides all along?   I guess the simple conclusion is this:  Yes, the VA is aware that approximately 22 Veterans commit suicide each day, but our management believes that these “additional steps” will help stem the tide:

Several changes and initiatives are being announced that strengthen VA’s approach to Suicide Prevention. They include:

  • Elevating VA’s Suicide Prevention Program with additional resources to manage and strengthen current programs and initiatives;
  • Meeting urgent mental health needs by providing Veterans with the goal of  same-day evaluations and access by the end of calendar year 2016;
  • Establishing a new standard of care by using measures of Veteran-reported symptoms to tailor mental health treatments to individual needs;
  • Launching a new study, “Coming Home from Afghanistan and Iraq,” to look at the impact of deployment and combat as it relates to suicide, mental health and well-being;
  • Using predictive modeling to guide early interventions for suicide prevention;
  • Using data on suicide attempts and overdoses for surveillance to guide strategies to prevent suicide;
  • Increasing the availability of naloxone rescue kits throughout VA to prevent deaths from opioid overdoses;
  • Enhancing Veteran Mental Health access by establishing three regional tele-mental health hubs; and
  • Continuing to partner with the Department of Defense on suicide prevention and other efforts for a seamless transition from military service to civilian life.

Veteran Suicides

While I guess we should all take some solace from the fact that these “additional steps” may help reduce suicides among Veterans, many of us wonder why it has taken so long for the VA to recognize that its current treatment process has proved to be inadequate.  Indeed, the VA seems more intent on throwing cold water on alternative therapy programs than doing much at all to help get Veterans in help they need for PTSD and TBI.   More prescription drugs is not the answer according to the F.D.A., but I suppose it will be difficult for the VA to radically change its modus operandi.

Having been in business for many years, I am suspect when people tell me they are “taking steps.”   To paraphrase the late British columnist Bernard Levin, I have no idea whether these are “fast steps,” “double-time steps,” or as is often the case for bloated government bureaucracies: “marching in place and hoping for a better outcome.”

Judging from the VA’s record, I am not at all convinced that these “additional steps” – even if implemented – will improved the outcome so fervently desired by Veterans and their loved ones.  For the most part, these “additional steps” seem more like a public relations initiative rather than something will bring about a major change in the way PTSD and TBI are diagnosed and treated by the VA.  I hope I am wrong.

Accountability and responsibility is a theme well understood by the brave men and women who serve in our armed forces.  Sadly, accountability and responsibility seem to be in short supply at the VA.  We should all be outraged!

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News Highlights – Week of March 6, 2016

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Found below are few military news items that surfaced during the last week that caught my attention. 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 interest them.

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

Wounded Warrior Project (“WWP”) attracts attention of Doonesbury
It was only a matter of time before the scathing humor of Gary Trudeau captured the tragedy unfolding with Wounded Warrior Project which appears to place the financial interests of its administrators in front of the needs of Veterans.  Such a shame!   Read more . . .

Veterans with PTSD

Legislation would halt bad military discharges due to PTSD, TBI
Last week, a coalition of Republican and Democratic lawmakers who served in Iraq and Afghanistan introduced legislation to ensure that military discharge review boards must consider troops’ mental health issues, and must accept a PTSD or TBI diagnosis from a professional as an acceptable rebuttal to a dismissal.   Read more . . .

House approves bill to consider PTSD as circumstance when sentencing veterans
The Oklahoma House of Representatives has passed a bill that will “expand current law to enable judges to consider a diagnosis of PTSD as a mitigating circumstance when sentencing veterans who have been diagnosed with PTSD, prior to being charged with a crime”.  Would be nice to see this type of legislation in all states.  Read more . . .

Veterans with PTSD

Service dogs aid veterans with PTSD
The service dog is trained to wake Sergeant Petz from his nightmares. Bosko is the first service dog provided by the Paws Forces, a new program of the Maumee-based the Arms Forces that helps veterans with PTSD and traumatic brain injuries get services.  Read more . . .

Veterans Aware: PTSD primer
I work for the Department of Veteran Affairs, Readjustment Counseling Service at the St. George Vet Center. I work with veterans who have been deployed in areas of active American combat operations, veterans who have traumatic brain injuries, or TBI, people diagnosed with post-traumatic stress disorder and folks who have experienced any variety of service-connected traumatic experience that has left them disabled emotionally or physically.  Read more  . . .

Buprenorphine May Beat Opioids for Triad of Pain, PTSD, SUDs
In a retrospective cohort study, investigators found that twice as many veterans treated with the partial nociceptin opioid receptor agonist experienced improvement in PTSD symptoms, beginning at 8 months and increasing over time. In contrast, those treated with opioids experienced a worsening of symptoms.   SFTT is not a big fan of prescription drugs – be careful!  Read more . . .

Join SFTT in helping get our Veterans the support they deserve.

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