New Study Suggests that Blood Test Can Detect PTSD

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According to a recent Dutch study involving military personnel deployed to Afghanistan, there is evidence to suggest that blood-based miRNAs (Micro RiboNucleic Acids) may serve as “candidate biomarkers for symptoms of PTSD.”

Image from Biochemistry for Medics

A research group from the Netherlands collected blood samples Dutch soldiers before, as well as 6 months after deployment.

Author of the study, Dr. Laurence de Nijs (Maastricht University), states the following:

“We discovered that these small molecules, called miRNAs, are present in different amount in the blood of persons suffering from PTSD compared to trauma-exposed and control subjects without PTSD.

“We identified over 900 different types of these small molecules. 40 of them were regulated differently in people who developed PTSD, whereas there were differences in 27 of the miRNAs in trauma-exposed individuals who did not develop PTSD.

“Interestingly, previous studies have found circulating miRNA levels to be not only correlated with different types of cancer, but also with certain psychiatric disorders including major depressive disorders. These preliminary results of our pilot study suggest that miRNAs might indeed be candidates as predictive blood markers (biomarker) to distinguish between persons at high and low risk of developing PTSD. However, several steps need to be performed before such results can really have an impact on the larger field and in clinical practice. In addition to working towards biomarkers, the results may also provide novel information about the biological mechanisms underlying the development of PTSD”.

While more studies are required to confirm the results of this study, it does suggest that blood-testing could help identify risk factors for susceptibility to PTSD for troops scheduled for deployment.

It is difficult to generalize from such a limited test sample but clearly, evidence based markers seem to be a far better way to test the incidence of PTSD and brain trauma than the simplistic PTSD screening questionnaires currently employed by the Department of Veterans Affairs (“the VA”).

There continues to be much promising research into preventing and curing PTSD and TBI, but sadly the VA continues to insist on failed therapy programs while sponsoring research studies than focus on helping Veterans cope with the symptoms of brain trauma rather that provide meaningful solutions.  The cannabis and ecstasy studies suggest that the VA feels far more comfortable dispensing prescription drugs rather than provide Veterans with a meaningful path to full recovery.

While thousands of Veterans continue to suffer from combat-related brain trauma, the VA has done precious little to help these Veterans and their families cope with this debilitating problem.  While the VA insists that they are doing everything possible to help Veterans with PTSD and TBI, the story of Eric Bivins and countless other brave warriors paints a far different picture of what Veterans can really expect at the VA.

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SFTT Military News Highlights: Week Ending Sep 8, 2017

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Found below are a few military news items that caught my attention this past week. I am hopeful that the titles and short commentary will encourage SFTT readers to click on the embedded links to read more on subjects that may be of interest to them.

If you have subjects of topical interest, please do not hesitate to reach out. Contact SFTT at info@sftt.org.

China Sends Military Warning to North Korea
As tensions continue to mount following North Korea’s latest nuclear test, the Chinese military has conducted another drill near the Korean Peninsula. According to the South China Morning Post (SCMP), a Hong Kong-based publication, on Tuesday a Chinese ground unit practiced shooting down simulated low flying missiles over Bohai Bay. Bohai Bay is “ the innermost gulf of the Yellow Sea between China and North Korea,” the report noted. Although few details were given, including which defense systems were used, Chinese websites indicated the test sought to simulate a surprise attack in a realistic, warfighting scenario.  Read more . . .

U.S. “Military Options” for North Korea are all “Terrible”
Despite President Donald Trump’s continued talk of military options in the North Korean standoff, his national security chiefs told lawmakers that they are trying to tighten the diplomatic and economic noose around the Hermit Kingdom, because there are no good offensive military options—and the defensive measures are far from foolproof. “It was a sober discussion,” said one person briefed on the closed-door session of senators with Secretary of State Rex Tillerson, Defense chief Jim Mattis, Director of National Intelligence Daniel Coats, and Joint Chiefs Chairman Gen. Joseph Dunford. “Military options were just described as ‘terrible,’” he said.  Read more . . .

Department of Veterans Affairs

GAO Finds VA Insurance Enrollment Standards Lacking
The Department of Veterans Affairs is one of the largest healthcare organizations that provides health benefits, but their enrollment standards and processes lead to delays and errors, according to a new report from the Government Accountability Office (GAO). GAO analyzed veteran enrollment in VA medical centers (VAMCs) across the country and found that enrollment staff frequently did not process veterans’ enrollment applications within the timeliness standard of 5 business days. These issues were found both at VA’s Health Eligibility Center (HEC), the VA’s central enrollment processing center, and within local VAMCs that also process enrollment applications. The HEC experienced an enrollment error rate of 12 percent. The VAMCs analyzed in the report had a 27 percent error rate.  Read more . . .

Top Military Officials Cite Troubling Problems in Dealing with TBI
Top current and former officials in the U.S. Military are raising the alarm over the disturbing combination of high rates of Traumatic Brain Injury in the armed forces and a lack of public policy solutions to adequately address the problem. Researchers are only now getting their arms around the magnitude of the class of injuries that are difficult to treat and have affected an estimated 400,000 service members since the September 11th attacks in 2001.  Read more . . .

Congress Debates “Exit Oath” to Curb Veteran Suicides
Congress is currently debating a bill that attempts to curb high rates of veteran suicide by giving military members the choice to take an “Oath of Exit.” In this oath, veterans would state that they won’t take their own lives after leaving their post. The Oath of Exit Act is a section of the proposed 2018 version of the National Defense Authorization Act, which has already passed through the House of Representatives. The oath is a voluntary pledge for exiting service members in which the veteran promises to “not bring harm to [themselves] without speaking to [their] fellow veterans first.” Mast believes that because integrity and honor are significant to servicemen and women, if they pledge to do something, they will follow through. However, suicide and military mental health experts like Craig Bryan, an assistant professor in clinical psychology at the University of Utah, think the bill could do just the opposite. In Bryan’s study, “Effect of crisis response planning vs. contracts for safety on suicide risk in U.S. Army Soldiers: A randomized clinical trial,” published in the January 2017 “Journal of Affective Disorders,” he found that “contracts for safety” do not lower suicide risk among U.S. soldiers, but “crisis response plans” do.  Read more . . .

Blood Test Suggests Combat-Related PTSD 
Individuals affected with PTSD (Post-Traumatic Stress Disorder) demonstrate changes in microRNA (miRNA) molecules associated with gene regulation. A controlled study, involving military personnel on deployment to a combat zone in Afghanistan, provided evidence for the role of blood-based miRNAs as candidate biomarkers for symptoms of PTSD. This may offer an approach towards screening for symptoms of PTSD, and holds promise for understanding other trauma-related psychiatric disorders. Limitations of the study are that this was a small pilot study, and the findings need to be validated, extended and confirmed. First results will be presented at the ECNP conference in Paris.  Read more . . .

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

Feel you should do more to help our brave men and women who wear the uniform or our Veterans? Consider donating to Stand For The Troops.

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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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SFTT Military News: Highlights for Week Ending August 4, 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.

With Eye on Russia, US Military Focuses on Global Exercises
The U.S. military is moving toward more global exercises to better prepare for a more assertive Russia and other worldwide threats, a senior officer said in an interview with Reuters. Air Force Brigadier General John Healy, who directs exercises for U.S. forces in Europe, said officials realized they needed to better prepare for increasingly complex threats across all domains of war – land, sea, air, space and cyber. Some smaller-scale war games with a global focus had already occurred, but the goal was to carry out more challenging exercises by fiscal year 2020 that involved forces from all nine U.S. combatant commands – instead of focusing on specific regions or one military service, such as the Marines.  Read more . . .

Secretary of State Tillerson Seeks Talks with North Korea
In the Trump administration’s first serious attempt at a diplomatic opening to North Korea, Secretary of State Rex W. Tillerson has offered to open negotiations with Pyongyang by assuring “the security they seek” and a new chance at economic prosperity if the North surrenders its nuclear weapons.Mr. Tillerson’s comments came just hours before the United States on Wednesday tested an unarmed Minuteman III intercontinental ballistic missile, sending it 4,200 miles to a target in the Marshall Islands. The Pentagon said the test was not intended as a response to the North’s launch on Friday of a missile that appeared capable of reaching Los Angeles and beyond.But military officials said the test demonstrated that the American nuclear arsenal was ready “to deter, detect and defend against attacks on the United States and its allies.”  Read more . . .

Telehealth for Veterans Rolls Out To General Acclaim
American Telemedicine Association (“ATA”) has long supported the VA’s vision of expanding veterans’ access to telehealth services, facilitating high-quality encounters between veterans and providers, and ensuring that veterans are equipped with the best tools to monitor their health. This includes innovative models that facilitate cross-state practice and enable consumer choice such as the VETS Act (S. 295 and H.R. 2123). “We applaud Dr. Shulkin for demonstrating the value of telehealth today at the White House.” said Gary Capistrant, Chief Policy Officer, ATA. “We encourage President Trump to issue an Executive Order to eliminate the state-by-state licensure model for all federal and private-sector health professional employees servicing federal government programs—notably agencies (such as the VA and the Department of Health and Human Services), health benefit programs (such as Medicare and TRICARE), federally-funded health sites (such as community health centers and rural clinics), and during federally-declared emergencies or disasters.  Read more . . .

Veteran Choice Options Expanded
Thank bipartisan support for helping veterans, or lingering anger over the previous scandals at the Department of Veterans Affairs, but whatever the reason, Congress is managing to get legislation passed addressing veterans’ needs. First, Congress finally worked out a deal on funding for Veterans Choice. If you believe that veterans should be able to seek out and get the best care wherever they prefer, whether it’s within the VA or from a private health care provider, Veterans Choice is a nice half-step, but hardly a sweeping change. (The booming demand for treatment through the program can be interpreted in veterans’ interest in exploring other treatment options.)  Read more . . .

Brain and PTSD Studies

No Surprise Here:  PTSD May Be More Physical than Psychological
The part of the brain that helps control emotion may be larger in people who develop post-traumatic stress disorder (PTSD) after brain injury compared to those with a brain injury without PTSD, according to a study released today that will be presented at the American Academy of Neurology’s Sports Concussion Conference in Jacksonville, Fla., July 14 to 16, 2017. “Many consider PTSD to be a psychological disorder, but our study found a key physical difference in the brains of military-trained individuals with brain injury and PTSD, specifically the size of the right amygdala,” said Joel Pieper, MD, MS, of University of California, San Diego. “These findings have the potential to change the way we approach PTSD diagnosis and treatment.” In the brain there is a right and left amygdala. Together, they help control emotion, memories, and behavior. Research suggests the right amygdala controls fear and aversion to unpleasant stimuli.  Read more . . .

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

Feel you should do more to help our brave men and women who wear the uniform or our Veterans? Consider donating to Stand For The Troops

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Opioid Abuse, Veterans and Mea Culpa

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With 80 people dying each day from overdoses of opioids, it is not surprising that Federal, State and Local authorities are seeking emergency measures and money to treat opioid abuse.

OxyContin - Veteran Addiction

Less surprising is the moral outrage and lynch-mob mentality of those who seek vengeance against those they deem responsible for the epidemic.  Just today, I read in the New York Times that the McKesson Corporation, “the nation’s largest drug distributor . . . finds itself at the center of the nation’s opioid epidemic.”

According to New York Times editor Gretchen Morgenson, McKesson shareholders and investors are likely to question the lavish pay packages earned McKesson executives while promoting the sale of lethal opioids to an unsuspecting public.

I do not doubt that corporate greed has played a large role in this terrible epidemic, but let’s not forget their important enablers:

I realize it is a lot easier to blame some Colombian or Mexican War Lord for our nationwide drug addiction, but it seems undeniable that the U.S. government and trusted private and public associations have colluded with drug companies to create this “semi-legal” drug epidemic.

The consequences are heart-wrenching for many families who have lost loved-ones to this terrible addiction. Large towns and cities across the country have been devastated. Communities can no longer support themselves due to drug addiction by large segments of their population.

Rather than seek villains from this terrible tragedy, it is an opportunity for all citizens to reflect on the dysfunctional medical and substance control and testing process that enabled privately-owned companies to “legally” hook so many Americans on prescription drugs.  The “mea culpa” has plenty of self-serving enablers who would do well not to point fingers.

Sure, Big Pharma may eventually pay the price, but political party operatives have had their hands out at every stage of the addiction process to accept  “political contributions” to keep the regulatory process well lubricated.

The Veterans and Opioids

As SFTT has reported on numerous occasions, the VA has regularly resorted to using opioids and other toxic prescription drugs to treat Veterans with PTSD and TBI.  The VA and the Department of Defense (the DoD) have long known of the side-effects of opioids, but both have cited the FDA and “clinical trials” as evidence that their treatment procedures have strong support from the medical community.

According to the VA (whose numbers are generally suspect), some 68,000 Veterans are addicted to opioids:

“The Center for Investigative Reporting, using data provided under the Freedom of Information Act, said prescriptions for four opioids (hydrocodone, oxycodone, methadone and morphine) surged by 270 percent between 2000 and 2012, leading to addictions and a fatal overdose rate that was twice the national average.

“In 2014, the VA said it issued 1.7 million prescriptions for opioids to 443,000 vets to be taken at home.

“Citing a VA Office of Inspector General’s report, the Center for Ethics and the Rule of Law (CERL) said: “Between 2010 and 2015, the number of veterans addicted to opioids rose 55 percent to a total of roughly 68,000. This figure represents about 13 percent of all veterans currently prescribed opioids.”

Even by the VA’s own admission, these numbers are staggering.  More to the point, the use of these opioids may have helped Veterans cope with their pain, but it has done little if anything to help treat Veterans suffering from PTSD and TBI.  In fact, many Veterans will argue that the use of these prescription opioids has led to deeper depression and anxiety and, in some cases, suicidal tendencies.

Frankly, the use of opioids in treating PTSD and TBI has been largely unsuccessful.  There are many less invasive treatment alternatives for PTSD and TBI, but the VA seems reluctant to pursue them.

Why?  Has the insatiable greed of corporations and their government enablers blocked the pursuit of new treatment alternatives?

I certainly hope not, but I remain sceptical.

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What do NFL and Military Helmets Have In Common?: Not Much!

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Like many, I am moved by the tributes paid to military Veterans and active service members at NFL games.  Nevertheless, both the NFL and the military have come under sharp criticism regarding the number brain injuries suffered on both the playing field and battlefield.

chronic_traumatic_encephalopathy

Both the NFL and military have stonewalled the problem for many years, but it now appears that the NFL is taking action to introduce a “safer” helmet in the hope that they can reduce concussions and permanent brain injuries for professional athletes. Hopefully, better protective gear will work its way through college and high school football programs.

The Vicis Zero1 helmet has now been purchased by 25 NFL teams and will be introduced during the 2017 season. According to initial press releases:

In testing against 33 other helmets to measure which best reduces the severity of impact to the head, the Vicis ZERO1 finished first. Included in the study were helmets from Schutt and Riddell, which currently account for approximately 90 percent of helmet sales.

Vicis was founded by neurosurgeon Sam Browd and Dave Marver, former CEO of the Cardiac Science Corporation, with the goal of reducing the high rate of concussions in football. While it would take years of play and further studies to conclusively prove that they’ve been successful, the studies show that they’re on their way to making an impact.

Found below is a video explaining how this helmet helps provide additional protection to football professionals:

While the safety requirements for battlefield and football helmets differ significantly, it does appear that the NFL has acted a lot quicker than the military to protect its professionals.

Reducing brain injuries at their point of origin is far preferable to treating neurological damage to sensitive brain cells in the aftermath.

The US Army – and other DoD components – have long been aware that current helmets offer battlefield personnel little protection against IED devices typically found in Afghanistan and in the Middle East.  Indeed, SFTT has been reporting on various studies by the military embedding sensors into military helmets.

According to my calculation, the US Army has over 10 years of sensor data to draw on.  Surely, this is sufficient to draw some conclusions and develop a better-designed helmet capable of providing additional protection against concussive brain injury.

While the military continues to “study” the issue, it is encouraging to see the NFL to take action.  Frankly, I don’t buy the NFL sales pitch that the league rushed in to protect the health and safety of its players.  If true, they would have done so long ago when the NFL first started studying brain injuries.

As the New York Times reported earlier, the NFL leadership buried extensive “concussion” evidence collected between 1996 and 2001 to deflect potential claims by former NFL players who had suffered brain damage.

As we have seen in the case of body armor,  DoD leadership and the NFL have much in common:  a strong propensity to hide the facts from their employees and the public at large.

While one can find many faults in the way the NFL leadership has acted “to protect the safety of its players” and the integrity of their franchise, NFL teams are now treating brain injuries far more seriously than the DoD.

In addition to helmets, several NFL teams are now treating players with suspected brain injury with hyperbaric oxygen therapy (HBOT).    Sadly, the Department of Veterans Affairs continues to block the use of HBOT in treating Veterans with PTSD and TBI.

Could it be that DoD personnel charged with evaluating HBOT therapy failed to employ the proper protocols in 2010 clinical testing procedures?  If so, why?

SFTT remains hopeful that both the VA and the DoD will act quickly to introduce helmets that afford more protection to battlefield personnel and approve HBOT as an acceptable treatment procedure for PTSD and TBI.

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Veterans with PTSD Knew that VA Opioid Prescriptions Were Wrong

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After many lives of many brave Veterans with PTSD have been lost, the State of Ohio has finally taken action against pharmaceutical drug companies for hyping opioids.

Opioids

According to the New York Times reporter,  

The State of Ohio filed a lawsuit on Wednesday against the pharmaceutical industry over the opioid epidemic, accusing several drug companies of conducting marketing campaigns that misled doctors and patients about the danger of addiction and overdose.

Defendants in the case include Purdue Pharma, Teva Pharmaceutical Industries, Johnson & Johnson, Endo Pharmaceuticals, Allergan and others.

Purdue, the maker of OxyContin, a time-release opioid, released a statement saying, “We share the attorney general’s concerns about the opioid crisis and we are committed to working collaboratively to find solutions,” and calling the company “an industry leader in the development of abuse-deterrent technology.”

As most Veterans treated by the Department of Veterans Affairs (“the VA”) are aware, opioids were the prescription of choice for Veterans suffering from PTSD.

Despite overwhelming evidence available to the VA and the Department of Defense (the DOD) that this was probably not a wise course of action, the VA persisted in treating the symptoms of PTSD with dangerous prescription drugs.

It is only now with opioid and drug addiction ravishing communities across the United States that some local and State governments are beginning to take action.  In the interim, thousands of Veterans with PTSD have suffered through over-medication with opioids by doctors at the VA.

More to the point, the VA continues to insist on dated and ineffective treatment programs for Veterans with PTSD and TBI.   Under the inept counsel of Dr. David Cifu, these same treatment therapies continue at the VA today.

It is difficult to predict when this tragic saga will end, but clearly there are no indications that the VA plans to make any substantial changes to current programs.  As such our brave Veterans will continue to receive the same flawed therapy and, most likely, a healthy supply of prescription drugs to mask the symptoms.

Where are our leaders in Congress and leaders within the VA to put an end to this tragedy?  Cynical though I am, I have a difficult time believing that Big Pharma political campaign donations would be the reason.

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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.

Temazepam_10mg_tablets-1

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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SFTT Military News: Highlights of Week Ending Jan 13, 2017

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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.

If you have subjects of topical interest, please do not hesitate to reach out. Contact SFTT.

Marines Going Back to Old Battlefield in Helmand
When about 300 Marines deploy to Helmand this spring, they will be returning to a province where hundreds of U.S. servicemembers died in more than a decade of war to subdue the Taliban. Now the situation has deteriorated so significantly, there are fears the province could fall to the same enemy. The Taliban nearly overran Helmand’s capital, Lashkar Gah, several times over the last two years, including twice last summer and fall. Afghan forces have repeatedly dispatched elite fighting units and NATO and Afghan airstrikes to keep the Taliban at bay.  Read more . . .

China Reacts to Rex Tillerson’s Comments on China
China escalated its war of words against the incoming Trump administration Friday, declaring in state media that Secretary of State nominee Rex Tillerson’s warning over Beijing’s military buildup in the South China Sea could signal the first shots of “a military clash.”  Read more . . .

Dr. David Shulkin Selected as New VA Secretary
President-elect Donald Trump on Wednesday named the Department of Veterans Affairs top health official his pick to run the entire veterans bureaucracy, a surprise move that puts a non-veteran in line for the David Shulkin, VA Secretarypost for the first time. Dr. David Shulkin, who has served as VA Under Secretary for Health since June 2015, is the first nominee held over from President Barack Obama’s administration. Trump made the announcement at his first press conference since the November election, and after a lengthy search which included dozens of potential candidates.  Read more . . .

More Troops and Newer Equipment for U.S. Army?
The U.S. Army’s chief of staff said Thursday he is prepared to brief the incoming Trump administration on plans to increase modernization and add more soldiers to the ranks. “We do want to be bigger,” Gen Mark Milley told an audience at an Association of the United States Army breakfast. “We, the Army, think our capacity needs to increase … we think our capability — the technical capability of our systems and formations — needs to increase, and we think our readiness needs to increase.” The Army, like the rest of the U.S. military, is poised to reverse a persistent trend of deep cuts to end strength and modernization under the Obama administration with the inauguration of President-elect Donald Trump next week.  Read more . . .

Scientist “Go to War” to Answer Questions about  PTSD
But there is so much we still don’t know. Why do some people who are exposed to stress hormones suffer psycho­logical scarring while others don’t? How do the effects accumulate? How many days of intense stress are too many? Is the constant fear of an insidious, unseen danger worse than episodic battles? Does it make a difference if you feel there’s something you can do to try to stay alive?   Read more . . .

New Hampshire Looks to Help Veterans with PTSD/TBI
Post Traumatic Stress Disorder and Traumatic Brain Injury have become the signature ailments among veterans of the wars in Iraq and Afghanistan. The New Hampshire Legislative Commission on PTSD and TBI released a report in 2014 that looked at how many veterans in the state had these injuries and whether they felt they were getting the help they needed. Colonel Richard Oberman recently became the chairman of the Legislative Commission on PTSD and TBI. He’s also Deputy State Surgeon and Commander of Clinical Services with the New Hampshire Army National Guard.  Read more . . .

The Pros and Cons of Marijuana in Medicinal Applications
A new report from the National Academies of Sciences, Engineering, and Medicine offers a rigorous review of scientific research published since 1999 about what is known about the health impacts of cannabis and cannabis-derived products – such as marijuana and active chemical compounds known as cannabinoids – ranging from their therapeutic effects to their risks for causing certain cancers, diseases, mental health disorders, and injuries.  The committee that carried out the study and wrote the report considered more than 10,000 scientific abstracts to reach its nearly 100 conclusions.  The committee also proposed ways to expand and improve the quality of cannabis research efforts, enhance data collection efforts to support the advancement of research, and address the current barriers to cannabis research.  Read more . . .

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

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Veterans Affairs: Hope on the Way for Those Suffering from PTSD and TBI?

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With the expected change in the administration of the Department of Veterans Affairs (“the VA”), hope could well be on its way to provide more effective and timely treatment for the tens of thousands of Veterans suffering from PTSD and TBI.

Regardless of one’s political affiliation, the VA doesn’t seem to have a handle on treating Veterans with serious brain injury.  One hopes that the “new” VA will be more open to alternative therapy provided in the private sector, rather than current dogmatic approaches that have produced few – if any – positive approaches to treating PTSD and TBI. Maj. Ben Richards explains in far more detail below:

I just finished watching an exceptional documentary on PBS by Bob Woodruff entitled Medical Medicine Beyond the Battlefield.   The video, which may be watched below if you can spare 58 minutes – details some incredible medical breakthroughs in helping Veterans recover their lives after they have lost limbs in combat.  Truly miraculous!

Approximately 36 minutes into the video, Mr. Woodruff focuses on how the VA is dealing with brain injury.  Shortly thereafter, he chronicles the issues faced by Elana Duffy, an intelligence Sgt. First Class who suffered traumatic brain injury while serving in Iraq (39 minutes).

It is evident that the VA is not making as much progress in treating neurological disorders as they are on other medical rehabilitation fronts.

While concerted efforts are being made to understand and treat PTSD traumatic brain injury, it appears that “progress” within the VA has been impeded by dogmatic positions maintained by Dr. David Cifu and others. In effect, Veterans suffering from PTSD and TBI are given few treatment alternatives outside the narrowly defined treatment programs so vigorously defended by VA administrators.

SFTT has long held the view – based on feedback from many Veterans – that the VA is not in a position to provide the necessary care and treatment to truly help Veterans suffering from PTSD and TBI.   This is a huge problem for Veterans and their families and one needs to “think outside the box” or the confines of VA orthodoxy to embrace new treatment alternatives.

It is terribly sad that the VA has become a political ping pong ball to the chagrin of many Veterans. The release of the Commission on Care report recommending 18 major reforms within the VA triggered an immediate backlash from employees and lobbyists who felt threatened  by the findings.

J. David Cox

J. David Cox

Like others, “I was appalled by the outburst of J. David Cox, the President of the American Federation of Government Employees, who threatened VA Secretary with ‘physical violence.’Cox was ‘prepared to whoop Bob McDonald’s a – -,’ he said. ‘He’s going to start treating us as the labor partner … or we will whoop his a – -, I promise you.'”

Against this particularly toxic background, it is difficult to know whether a new VA Secretary will be able to implement the reforms outlined in the Commission on Care report.

Former U.S. Senator Scott Brown to Head Department of Veterans Affairs?

According to recent information, former U.S. Senator Scott Brown of Massachusetts is apparently a front-runner for the post of Secretary of Department of Veterans Affairs in the new Trump administration.

As reported in the Boston Herald and several other respected media sources, Scott Brown is

 . . . under consideration for the Cabinet post of Veterans Affairs secretary — said he would create a 24-7 manned hotline for suicidal soldiers, take back bonuses and raises awarded to incompetent VA staffers and outsource PTSD and other serious mental health cases to private professionals.

“People are hurting and they need some real help,” Brown said last night, hours after he spoke with President-elect Donald Trump. “There are some great angels working in the VA right now and they need a morale boost.”

If true, this could very well accelerate outsourcing the treatment of Veterans suffering from PTSD and TBI to private healthcare providers.   Sen. Brown is quoted as saying, “The VA’s trying to do it all — they can’t. We need to outsource that and get those people help right away.”

There is no way of knowing whether Sen. Brown will be offered the job of VA Secretary or will be confirmed to this “cabinet-level” position, but implementing the steps recommended by the Commission on Care would be a major step forward in getting Veterans the help they deserve.

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