Marijuana and Veterans with TBI

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Thomas Brennan, a former sergeant in the Marine Corps, is the founder of The War Horse, a veterans’ news site, and a co-author of “Shooting Ghosts: A U.S. Marine, a Combat Photographer, and Their Journey Back from War,”  makes an impassioned plea to “make pot legal for Veterans with TBI.”

Cannabis for Veterans with PTSD and TBI

In an “Opinion” piece for the New York Times of September 1, Mr. Brennan states to following:

“Most of the major veterans groups, including the American Legion, Iraq and Afghanistan Veterans of America, Veterans of Foreign Wars and Disabled American Veterans, support regulated research into the medical uses of cannabis . . .

“What I know is that it works for me. If I hadn’t begun self-medicating with it, I would have killed myself. The relief isn’t immediate. It doesn’t make the pain disappear. But it’s the only thing that takes the sharpest edges off my symptoms. Because of cannabis, I’m more hopeful, less woeful. My relationship with my wife is improving. My daughter and I are growing closer. My past is easier to remember and talk about. My mind is less clouded. More than anything, it feels good to feel again. My migraines and depression don’t control my life. Neither do pills.

“But I live in fear that I will be arrested purchasing an illegal drug. I want safe, regulated medical cannabis to be a treatment option. Just like the sedatives and amphetamines the V.A. used to send me by mail. And the opioids they still send to my friends.”

Personally, I am delighted that Mr. Brennan feels better and is recovering his life, but one man’s (or woman’s) experience with “alternative medication” hardly makes a compelling argument to justify universal endorsement.

Superficially, one could argue that pot is far less “addictive” than opium and the opioid variants currently endorsed by the FDA and the AMA, but I suggest that Mr. Brennan compelling argument touches on a far more important issue:

Officially sanctioned / LEGAL therapies to treat Veterans with PTSD and TBI are not working! 

No one should be surprised that Mr. Brennan and many other brave warriors are seeking alternative therapies – either not sanctioned or “illegal” – because the limited treatment options provided by the Department of Veterans Affairs (“the VA”) are tragically failing the needs of our heroes and their families.

Last week, Maj. Ben Richard’s commented on a disturbing series of videos that trace a widow’s tragic quest to seek help from the VA for her husband who committed suicide when denied alternative therapy.

The tragic suicide of Veteran Eric Bivins is just another example of the abuse of power at the VA that literally makes “life and death” decisions based on a long history of failed treatment programs:  Cognitive Process Therapy (“CPT”) and Prolonged Exposure Therapy (“PE”).

If the only choice for Veterans with PTSD and TBI is institutional abuse and lethal prescription drugs, why not run the risk (illegal or unsanctioned) and seek help that works?  In the case of Mr. Brennan, cannabis might be the answer, but SFTT seeks out programs that may offer life-changing therapies rather than medication that simply deals with the symptoms.

Personally, I don’t think that potentially addictive drugs are the long term answer for PTSD and TBI, but I can certainly understand why many Veterans seek relief outside the limited number of options and callous disregard currently shown by the VA.

Perhaps Secretary David Shulkin can bring about much needed reform at the VA, but the odds are firmly stacked against him.

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How the VA Callously Treats Veterans: A National Disgrace

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As we reported earlier, Veteran Eric Bivins committed suicide after being unable to find the support and care he needed from the Department of Veterans Affairs (“the VA”).

Found below are a moving – AND MOST SAD – series of videos by Kimi Bivins, Eric’s spouse which describes her experiences with the VA in attempting to find the proper care for her husband.

Kimi’s experiences with the VA are not dissimilar from my own and countless of others who have sought care from the VA. I agree with Kimi that it is a “national disgrace,” yet the VA continues to remain largely unaccountable for their callousness and disdain in treating our brave warriors.

I would encourage readers to watch these powerful videos to understand the frustration and agony of a loved-one in dealing with the VA.

Kimi’s YouTube videos are presented in a more or less chronological order, with limited commentary by me other than to clarify certain expressions.

Published on March 23, 2016. Kimi’s Initial PRIVATE Appeal for Help.

Published on March 10, 2016. Kimi’s Frustration on Getting VA Paperwork

Published on March 18, 2016. Eric in a VA Facility

Published on March 23, 2016. Eric is Coping, but Life is Still Very Difficult

Published on April 13, 2016. Eric at Independent Treatment Facility.

Published on May 15, 2016. Eric is Better, But Seeks Therapy Outside the VA

Published July 11, 2017. After Eric’s Suicide

While many will be shocked by these series of videos, it is far too commonplace within the VA.

Before Eric’s suicide he had been accepted into a program to receive hyperbaric oxygen therapy or HBOT.  I credit HBOT with saving my life and enabling me to begin the long road to recover my life.

It is sad that some uninformed doctor at the VA would shatter Eric’s dream of life-changing therapy by parroting the VA’s institutional bias against HBOT.

Dr. David Cifu and his cronies at the VA and the DoD have done their upmost to discredit HBOT and other alternative therapies to support the failed VA programs of Cognitive Process Therapy (“CPT”) and Prolonged Exposure Therapy (“PE”).

Failed VA therapy programs to treat PTSD have been documented numerous times by credible independent studies.   And yet, VA spokespeople still parrot the same stale party line.  Veterans with PTSD and TBI are not deceived and have abandoned the VA in droves.

It sickens me to watch these tragic videos of Kimi documenting her fruitless attempt to navigate the uncaring bureaucracy of the VA.  In my estimation, Kimi’s videos should be mandatory training for all employees at the VA.

While the VA provides much needed comfort to thousands of Veterans, those Veterans with PTSD and TBI need to look elsewhere for REAL therapy.

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Veterans Account for 20% of U.S. Suicides

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Military suicides, particularly among Veterans, show no signs of abating.  Despite recent efforts by Secretary of Shulkin of the Department of Veterans Affairs (“the VA”), the “silent wounds of war” follow our Veterans into civilian life.

Veteran Suicides

(U.S. Army photo by Stephen Baker)

In a most informative report published by CNN, Veteran suicides account for roughly 20% of all suicides in the United States.

SFTT has reported on this disturbing trend for several years, but little has been done to curb Veteran suicides. Our analysis of this dreadful situation – covered amply in previous articles – may be summarized as follows :

1. PTSD and TBI are the Smoking Guns of Veteran Suicide

Veterans with complex PTSD or PTSD and TBI are more than 25 times more likely to commit suicide than their veteran peers, according the National Center for Biotechnology Information (“NCBI”).

2.  The VA is Currently Not Able to Effectively Treat Veterans with PTSD

Like the NFL’s denial of culpability, the VA continues to insist that Cognitive Process Therapy (“CPT”) and Prolonged Exposure Therapy (“PE”) help reverse the trends of PTSD and TBI.  This is patently untrue as described in more detail below.

The VA’s top-tier Specialized Intensive PTSD treatment Programs (“SIPPs”) failed to achieve clinically significant improvement in PTSD symptoms after an average 46-day program of treatment at an average cost of $23,578 per veteran. Average change in PCL-M scores was 5.7 points and “most program graduates met the criteria for clinically significant PTSD after discharge….” according to Institute of Medicine of the National Academies or IOM 2014 study, p.100.

“However, the outcomes from RCTs suggest that only a minority of veterans can be expected to lose their PTSD diagnosis as a result of getting CPT or PE, arguable administered in an ideal fashion…” (p.49) 2/3s retain PTSD diagnosis.

“In the RCTs conducted to date, with one exception, mean symptom scores at the end of treatment or at the latest follow-up (when available) indicated that PTSD symptoms were still substantial .” (p.49)

“Attaining high end-state functioning may be the exception rather than the rule.” (p.49)

The VA continues to treat the symptoms of PTSD and TBI with potentially lethal prescription drugs rather than use other proven therapy programs.  In fact, many current programs (i.e. cannabis) funded by the VA focus on treating symptoms rather than the underlying causes of PTSD and TBI.

3. The VA has Shown Little Inclination to Understand the Causes of PTSD

The “evidence-based” treatments currently deployed by the VA and DOD have little actual evidence supporting their efficacy in treating combat trauma and the existing evidence shows these treatments are generally ineffective.

The IOD concluded in 2014 that “[N]either department [DoD and VA] knows whether it is providing effective, appropriate, or adequate care for PTSD.

The VA insists that this is not the case, but many other studies have reached similar conclusion regarding the standard therapies used by the VA.

Specifically, in randomized controlled trials of “evidence-based” treatments in military PTSD “. . . mean post-treatment scores for CPT and prolonged exposure therapy remained at or above clinical criteria for PTSD, and approximately two-thirds of patients receiving CPT or prolonged exposure retained their diagnosis after treatment.  Symptom remission was rare.”   (Steenkamp, et. al., p. 489)

4.  SFTT has Assembled a World Class Medical Task Force to Identify and Deploy Effective Treatment for TBI and PTSD

Despite overwhelming evidence to the contrary, the VA continues to march to a drummer of its own choice insisting that Veterans are receiving the best care possible.  As SFTT will demonstrate in the next couple of weeks, support for Veterans diagnosed with PTSD (and their supportive families) is abysmal.

Veterans recognize the limitations of the VA and are seeking alternative therapy programs.  SFTT has assembled a world class Medical Task Force to identify promising new technologies and recommend proven treatment programs.

While some of these therapy programs have been around for years with proven success stories, others are more experimental in nature.  There is no “silver bullet” and each Veteran may respond differently to a specific program.  Nevertheless, it seems far better than the hype rather than substance of VA programs.

Visit the SFTT website for more information on promising new therapies to treat PTSD and TBI and do consider supporting the SFTT mission through a kind DONATION.

Veterans and those who serve our country need a helping hand.

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GAO Hammers VA on Protocols for Veteran Suicides

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In yet another devastating report recently released by the Government Accountability Office (“GAO”), this government oversight agency calls into question the VA’s data records with the tragic conclusion that “63% of suicide cases were inaccurately processed.”   As readers of SFTT’s Blog, you are probably not surprised by these latest findings but many in the public may be scratching their heads since they thought these problems were addressed in the wake of the 2014 Phoenix, AZ Veterans Hospital Scandal.

WAKEUP CALL AMERICANS!:    Despite much “wailing and gnashing of teeth” by our elected leaders, at least 22 Veterans still commit suicide each day.

While SFTT and many others are doing their part to stem the “invisible wounds of war,” many veterans suffer from depression and anxiety caused by their wartime experiences.  Sure, giving to charities that support Veterans maybe one way to help, but Sgt. Tony Hogrefe has a far more practical and personal suggestion.   Let our veterans know that you care and extend that Lifeline to as many military service men and women in your community.  Who knows?: Your phone call just may help a veteran with severe depression get through another day and, perhaps, reclaim control of their life.

 Improper Processing of Suicides

Found below are the heart-wrenching results of a recent GAO report on the Department of Veteran Affairs (“VA”) protocols for treating Vets with depression.   As the report suggests,  “Patient data was flawed, inconsistent and incomplete.

Here is a brief breakdown of the stats based on the audited sample:

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

These numbers are terribly frightening to anyone with a conscious.    Please spare our Veterans the soundbites of political posturing.    While some may argue that we have a “crisis in Syria and Iraq with Islamic terrorists,” I would argue that the real crisis is much closer to home:  “How we treat our Veterans!”   Let’s get together and provide these brave heroes “more than lip service,” and insist that our military and civilian leaders do the same.

Depression and Suicidal Thoughts In Soldiers

Most studies of PTSD suggest that “major depression” or “severe depression” are the single strongest drivers of suicidal behavior.    In fact the somewhat dated Canadian study highlighted below highlights the gravity of the problem which persists today among Veterans of foreign wars.

“Current and former soldiers who seek treatment for post-traumatic stress disorder (PTSD) should be screened closely for major depression since the disorder is the single strongest driver of suicidal thinking, say authors of a new Canadian study.

“Researchers evaluated 250 active duty Canadian Forces, RCMP members and veterans.  The study comes at a time when record numbers of suicides are being reported among American troops returning from Afghanistan and Iraq, and the number of suicides reported among Canadian forces last year reached its highest point since 1995.

In veterans suffering from post-traumatic stress disorder, about half also have symptoms of major depressive disorder during their lifetime, said the researchers.”
Credits: Depression Strongest Driver of Suicidal Thoughts in Soldiers, Vets

As Sgt. Hogrefe suggested above, we can all do our part and reach out to a Veteran to let him or her know that we care.  For those who want to play a more active role in channeling your energies into SFTT’s Rescue Coalition projects that help Veterans acquire new skills or receive better treatment, please contact SFTT.

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PTSD and Military Suicides

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Talking about the suicide  of a loved one is not easy.  There is always a sense of guilt that “I could have done more,” but this is generally not the case for military veterans suffering from PTSD or as SFTT prefers to call it:  PTS  (“Post Traumatic Stress”).  Let’s remove the “disorder” stigma for what is now the signature wound of  many warriors who have served our country so valiantly in Iraq and Afghanistan.

SFTT will continue to provide a synopsis of the latest news developments on PTS.  Some of these stories are heart-wrenching, but we do need to get these stories out in the open to raise the level of public awareness of this terrible social cancer.  This is not a military problem or the VA’s problem – PTS is our problem and we have an  obligation to help provide our Vets with a glimmer of hope that they can reclaim their lives.  Add your voice to others  at SFTT to bring about the change we need to help deal with PTS as adults.   Donations are accepted to help SFTT’s medical advisory board investigate new treatment methodologies.

PTSD and Suicide

This past weekend I lost a friend to suicide. She was a combat medic with the Army. She was “treated” by the Army for PTSD. Their treatment consisted of restricting her to base, having her check in daily with her supervisor, and meds. Then as

Charts: Suicide, PTSD and the Psychological Toll on America’s Vets

Charts: Suicide, PTSD and the Psychological Toll on America’s Vets Don’t miss Mac McClelland’s feature on the PTSD epidemic among returning vets, and how it’s spreading to their families. Additional reporting by Mac

PTSD Survivor: Suicide

It’s been a while…. It’s also been very rough. My son refusing to speak to me has me in a deep depression. He’s 600 miles away. A week ago, I was up by myself online and happened to look over and see my

Suicidal ideation

Ideation is a medical term for thoughts about or an unusual preoccupation with suicide . … Post-traumatic stress disorder (PTSD) …

Let’s mobilize our resources to help these brave young men and women reclaim their lives.  You can help.

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General Peter Chiarelli Speaks Out About PTSD

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To his credit, former Vice Chief of Staff General Peter Chiarelli has always been at the forefront of focusing the public’s attention on the “unintended consequences of war” facing our brave men and women when they return home from repeated deployments to Afghanistan and Iraq. His moving and pointed introduction to the 2010 report seeking to understand the increasing rates of suicides among military personnel demonstrates his resolve in supporting our men and women in uniform. The 350 page report entitled “Health Promotion Risk Reduction Suicide Prevention,” painted a rather disturbing picture of the terrible and ongoing “mental” costs faced by our military veterans and their families.  Sadly, two years later, the problems are compounding rather than diminishing.

General Chiarelli is currently CEO of One Mind For Research, a new-model non-profit dedicated to delivering accelerated new treatments and cures for all brain illness and injury within ten years time.

SFTT concurs with General Chiarelli grim assessment of the situation and has realigned its energies to focus on PTS (“Post Traumatic Stress”).  In fact, SFTT has formed a Medical Task Force to evaluate current and emerging treatment methodologies to provide long term treatment to veterans who suffer from this debilitating injury.

While General Chiarelli and others have raised public awareness of the ravages of these debilitating injuries, we have been lax as a society to accept the consequences of sending young men and women to war.   Make no mistake, PTS and TBI have terrifying social consequences that extend well beyond the individual who suffers these debilitating injuries.  Thanks to the generous support of   approach to dealing with trauma and many other concerned individuals, we are now beginning to mobilize the necessary resources to attack this problem head on.

SFTT welcomes General Chiarelli’s call to action to provide our military personnel with the best available treatment to help return them to wellness.

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