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.

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

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

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

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

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

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

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

– Cognitive Behavioral Therapy and,

– Prolonged Exposure Therapy.

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

Conversation with a Veteran Drug Abuse Specialist

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

What he told me shocked me.

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

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

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

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

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

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

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

Opioid Abuse in the United States

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

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

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

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

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

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

Opioids for Veterans: Deja Vu All Over Again

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

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

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

Easter Advice from Veteran Wives Who Care

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

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

Just A FEW of mine would be:

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

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

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

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

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PTSD Treatments

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As the VA struggles to deal with the overwhelming number of cases of Veterans suffering from PTS, new approaches are beginning to manifest themselves.  From Equine therapy to Transcendental Meditation, no approach is being dismissed lightly given the clear evidence that prescription drugs have not proven to be successful in providing a long term cure.

SFTT is thrilled to count on the assistance of Yuval Neria (see below) is a Special Advisor to SFTT’s Medical Task Force.    We welcome his active collaboration.

Yuval Neria

Medical Center (CUMC Director of Trauma and PTSD Program, and a Research Scientist at the New York State Psychiatric Institute (NYSPI) …

While SFTT often focuses on the men and women suffering from PTS, it is clear that their spouses, children and immediate families are not immune to the terrible side-effects.

Study: PTSD affects veterans’ spouses, too – ksl.com

PTSD generic paxil 20 mg tablet affects veterans’ spouses, tooksl.comResearchers have know for some time that PTSD places relationships at risk, but this new research raises red flags for health risks for a spouse or partner. “It’s having an effect beyond the vet …

Military May Be Turning to Meditation for PTSD – PsychCentral.com

Military May Be Turning to Meditation for PTSD.  Military May Be Turning to Meditation for PTSD With its emphasis on developing tranquility, meditation may seem an odd fit for the military. But recent studies have shown that mindfulness …

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Are drugs the right solution to treat PTSD?

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It’s hard to know what what works best when dealing with military Vets with symptoms of PTSD or TBI. For certain, we have learned that there is no “silver bullet” solution and that drugs tend to address symptoms rather than provide any “real” long term improvement, let alone cure. In fact, anecdotal evidence and SFTT’s research suggests that most current “treatment” programs often over prescribe drugs and this will often lead to drug dependency with explosive consequences.

Earlier, SFTT reported that OxyContin or “Hillbilly Heroin” was regularly prescribed to Veterans by the VA. The side effects were devastating and some independent researchers have suggested that the prescription of OxyContin actually led to more self-destructive behavior in Vets rather than provide any real cure.

SFTT Medical Advisory Board is examining all recommended PTSD treatment options. Your generous contribution help insure that our brave warriors get proper information on treatment modalities and where possible discover treatment options that may be better suited to their particular circumstances.

The articles below illustrate the ongoing debate about various drug treatment modalities and their repercussions. Please note that the articles below describe the complexity of dealing with PTSD and neither SFTT nor or Medical Advisory Board necessarily recommends any of treatment modalities discussed below:

PSTD vets given drugs against guidelines – Big News Network.com

PSTD vets given drugs against guidelines.  The study, published in Psychiatric Services, found in 2009, among all veterans with PTSD who had continuous VA medication use, 65.7 percent were prescribed elective serotonin-norepinephrine …

The Deadly Rise of Prescription Drug Abuse in the Military – MyABC50.com

The Deadly Rise of Prescription Drug Abuse in the Military.  Over the past decade, the military has spent $1.6 billion on painkillers (opioids) such as Oxycontin and Hydrocodone. $2.7 billion has been spent on anti-depressants and …

Military turns to meditation for PTSD – Fort Wayne Journal Gazette

Military turns to meditation for PTSD. PTSD is usually treated with drugs, behavioral therapy and other approaches. But for many, these methods don’t work. Now, researchers are looking at a new method that might limit future c …

A Potential Therapy for PTSD? – TIME

Potential Therapy for PTSD? My research focuses on the harmful effects of a class of drugs called quinolines, most notably the antimalarial drug mefloquine (or Lariam), which has been widely prescribed to deployed troops in Somalia, Iraq, an …

Drug Free PTSD Treatment & Cure for Soldiers & Military

The website is patriot outreach.org, I have nothing to do with this organization other than I know it has changed lives. It’s very simple and powerful.

Clearly, the symptoms of PTSD can be traumatic for the veteran and loved ones.  Many organizations promise support, but very few deliver a replicable and comprehensive treatment program that allows veterans a better than average chance of reclaiming their lives.  Claims of successe in dealing with this terrible affliction need to be carefully evaluated.

 

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