HBOT for Veterans: Infrastructure Largely in Place

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As SFTT reported earlier, the VA will soon be providing a limited number of Veterans with access to hyperbaric oxygen therapy or “HBOT” at the VA’s Center for Compassionate Innovation (“CCI”) facilities in Texas and Oklahoma.

SFTT has yet to learn when these programs will begin or how many Veterans will be enrolled in these initial programs.  As important, SFTT and the HBOT community at-large is interested in learning how “test protocols,” “metrics,” and “clinical trials” will be set by the VA and DoD to determine the benefits of HBOT.

As one sorts through the often nasty exchanges between proponents of HBOT and the VA gatekeepers like Dr. David Cifu, one cannot be oblivious to the fact that the VA does not want to encourage the adoption of HBOT in treating Veterans with PTSD and TBI.

The VA’s claim is that “patient outcomes’ using HBOT are inconclusive based on VA and DoD trials.

Could it be – as many have suggested – that the test protocols were flawed to produce “inconclusive” test results?   From SFTT’s experience in monitoring the DoD, it would NOT BE THE FIRST TIME that test procedures have been deliberately modified to produce outcomes more to the liking of current military dogma.

Since the VA has no experience in using HBOTin treating Veterans with PTSD, it seems to make sense to use established experts in the industry like Dr. Paul Harch, members of the International Hyperbarics Association or The Sagol Center for Hyperbaric Medicine and Research in Israel which provides HBOT treatment to 120 patients a day and to the Israeli Defense Force (“IDF”) to agree on standardized test protocols and monitor results.

Many will argue that further HBOT tests are not required given the wealth research currently available.  In fact, found below is an extract from a Jan, 2017 report:

Xavier A. Figueroa, PhD and James K. Wright, MD (Col Ret), USAF Hyperbaric Oxygen: B-Level Evidence in Mild Traumatic Brain Injury Clinical Trials. Neurology® 2016;87:1–7 “There is sufficient evidence for the safety and preliminary efficacy data from clinical studies to support the use of HBOT in mild traumatic brain injury/ persistent post concussive syndrome (mTBI/PPCS). The reported positive outcomes and the durability of those outcomes has been demonstrated at 6 months post HBOT treatment. Given the current policy by Tricare and the VA to allow physicians to prescribe drugs or therapies in an off-label manner for mTBI/PPCS management and reimburse for the treatment, it is past time that HBOT be given the same opportunity. This is now an issue of policy modification and reimbursement, not an issue of scientific proof or preliminary clinical efficacy.”

While Secretary Shulkin is wise to proceed slowly, he must exercise extreme caution in allowing the naysayers within the VA any authority over the initial CCI HBOT trial programs.

HBOT Infrastructure in Place to Help Veterans

Assuming the VA leadership can get beyond the hurdles they largely created, Veterans with “mild TBI” and “persistent” PTSD should be able to quickly access hundreds of HBOT facilities across the United States.  With equipment already in place around the country in hospitals and private health clinics, there is no need to hold up treatment for Veterans to wait for the VA to outfit its facilities.

Follow this link to see a directory of currently active HBOT treatment centers around the country.

Clear treatment protocols and directives need to be established for each private clinic providing HBOT to Veterans.  HBOT is administered in a series of dives or sessions (usually between 28 and 40) over a 6 week to 2 month time frame.  Supervision by a trained clinician is required at each dive.  Clearly, a larger “dive chamber” capable of offering therapy to a number of Veterans at the same will help bring down the costs of HBOT.

Costs “per dive” or “session” vary significantly around the country.    Some hospitals charge $1,800 per session, but most private clinics offer this service at a cost of between $250 and $350 per dive.  Given the bargaining power of the VA, it seems most likely that a series of battery of dives can be accomplished for well under $10,000, which is less than half of what the VA currently spends on Veterans with TBI/PTSD.

As SFTT has stated on many occasions, HBOT is not the “silver bullet” to eradicate this silent wound of war, but many more Veterans with brain trauma will begin to be able to reclaim their lives with less reliance on VA prescription drugs that simply mask symptoms rather than provide any lasting improvement in brain functionality.

This could be a BIG DEAL for ailing Veterans and family members who provide our Veterans such caring support.

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Veteran Drug Courts Are Now Needed More than Ever

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Over five years ago, SFTT met with Judge John Schwartz,  one of the early pioneers in the Veteran Court system.  Discussing the rationale for Vet Courts, Judge Schwartz stated the following “We offer hope to these troubled veterans who have served our country so valiantly.  It’s simply common sense.”

Today, Vet Courts are needed more than ever to help Veterans recover their lives.   Indeed, when one reads that the “the modern opioid epidemic originated within the healthcare system,” one must be simply oblivious to the plight of Veterans if we choose to penalize them once again.

Homeless Veteran

Drug Courts began to emerge in the nineties to deal more effectively with a growing drug problem in the United States.  As SFTT wrote earlier,

“Since the mid-1990, the US judicial system has recognized the need to deal with drug-related criminal activity and have established some 2,600 Drug Treatment Courts in the United States.  Drug treatment courts are specialized community courts designed to help stop the abuse of drugs, alcohol, and related criminal activity. Non-violent offenders who have been charged with simple possession of drugs are given the option to receive treatment instead of a jail sentence.   These programs have proven to be remarkably successful for reducing the level of recidivism in our prison system.

Capitalizing on the infrastructure and success of the Drug Treatment Courts, some 50 or so Veteran Courts (now reportedly 300) have sprung up across the United States to deal with veterans who have committed a crime while suffering from substance abuse.  In many cases, these troubled vets have the support of other Vets (often from the Vietnam era) who “mentor” their military colleagues through the rehabilitation process.

This descriptive video from Justice for Vets provides a useful overview of why our Veterans deserves a better choice than incarceration:

Thanks to Judge Schwartz and other inspired leaders in our judicial and police system, Veteran Courts have expanded all across the United States.  Nevertheless, NPR reported earlier this year that many more Vet Courts are required.  Specifically, NPR noted that some states still do not have a Vet Court and that North Carolina has only 3 when the evidence suggests that we require 17.

As SFTT and others have reported in the past, Veterans with PTSD and TBI have been largely neglected by the Department of Veterans Affairs (“the VA”).  Veterans suffering from brain trauma often resort to substance abuse to curb pain and many resort to crime to support their habits.  Should we penalize these brave Veterans for our collective failings to provide our Veterans with the support they deserve?

SFTT would like to thank the many Veterans and volunteers in the legal profession who give of their time to support our Veterans through an often confusing legal system.

When communities reach out to help these brave warriors, our society is enriched. From our perspective, it’s simply a matter of doing the right thing!  We owe these brave young men and women big time!

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Kris Kristofferson and HBOT

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After we recently learned that “the modern opioid crisis originated within the healthcare system,” it is reassuring to note that many misdiagnosed individuals are benefiting from alternative therapies.

Kris Kristofferson and Hyperbaric Oxygen Therapy

A prominent figure that recently came to our attention was Kris Kristofferson, who had been misdiagnosed with Alzheimer’s when it was actually Lyme disease.    According to his wife, the 79-year old singer “suddenly came back,” after 6 “dives” in a Hyperbaric Oxygen Therapy Chamber (“HBOT”).   Says his wife, Lisa, in an article published in the UK Daily Mail:

“We were driving back from his sixth HBOT treatment and he looks over at me and says, ‘Wow, I feel like I’m back.’ And I looked right in his eyes and I said, ‘OH MY GOD, HE’S BACK! It was like, WHOA!'”

As readers of SFTT are aware, the Department of Veterans Affairs (“the VA”) has done everything possible to discredit the use of hyperbaric oxygen in treating Veterans with PTSD and TBI.  More to the point, the VA has been pushing its own failed treatment programs (Cognitive Processing Therapy and Prolonged Exposure Treatment) in the name of “evidence-based” medicine.

When people in the medical profession argue on the basis of “evidence-based” medicine, it has much the same ring as the doctrine of “religious infallibility.”  Let’s take everything with a grain of salt, since there is still much to discover, even for those wedded to the orthodoxy of “evidence-based” medicine.

SFTT is thrilled that Kris Kristofferson is on the road to recovery.  Furthermore, we are not surprised to learn of the benefits of HBOT in treating the “real” cause of his ailing mental health.

While Mr. Kristofferson has a choice in seeking “a second opinion” and the type of therapy he prefers to treat his condition, most brave Veterans do not.  Sadly, the VA does not provide Veterans with a “second opinion.”  Also, the Va’s narrow treatment programs referred to as the “McDonaldisation of mental health care” offer no tangible benefits to Veterans or their families.

We sincerely hope that – in the not too distant future – our brave Veterans will be able to avail themselves of Hyperbaric Oxygen Therapy and other “old” and emerging treatment programs through the VA.

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Points of View: Al Jazeera on Treating Veterans with PTSD

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There was a time when many considered Al Jazeera to be a voice of Middle Eastern terrorists.   Whether it was or not is a matter of conjecture, but most would now agree that Al Jazeera has morphed into a credible news organization.

In an era of conflicting points of view, “alternative facts,” political agendas and outright lies; it is difficult to find common ground or agreement on any issue.  As such, it is surprising that Reem Shaddad of Al Jazeera has written such an insightful article on the plight of US Veterans entitled:  “The Battle Within:  Treating PTSD in Military Veterans.”

Department of Veterans Affairs

While one could nitpick some of her conclusions, it is difficult to refute the argument that within the Department of Veterans Affairs (“the VA”) “the McDonaldisation of mental healthcare is a problem.”

” . . . if you go to any VA in the country, you’re going to probably get cognitive processing therapy or cognitive behavioural treatment (actually, prolonged exposure) because those are the evidence-based practices that they use. It’s like if you go to any McDonald’s, a cheeseburger is going to be the same.”

Yep, the VA only serves two flavors of milkshakes (chocolate and vanilla) to treat Veterans with PTSD:

  • Cognitive Processing Therapy, and
  • Prolonged Exposure Treatment.

More to the point, if the VA’s two PTSD therapy programs don’t work, its doctors are likely to prescribe a cocktail of potent drugs to keep the Veteran’s symptoms in check.   This is hardly the outcome our brave warriors and their families should expect.

For an organization that prides itself on providing “evidence-based” medical treatment to Veterans, the GAO and the Rand Corporation have found that these programs resulted in negligible benefits for Veterans with PTSD.   In effect, “evidence-based” medicine seems to apply to every “alternative” therapy program other than the failed programs mandated by the VA.

As distinguished members of medical profession talk about “evidence-based” medical programs to treat PTSD, one can only wonder how warriors with the symptoms of PTSD in the distant past coped without the benefit of clinical trials.

Mind you, acupuncture seems to be have successful for some 2,000 years without the benefit of clinical trials.    The benefits of oxygen therapy programs have been around for centuries and there have been many documented therapy programs listed since as early as the 1930s.    Nevertheless, the folks at the VA – headed-up by chief spokesperson, Dr. David Cifu – still dispute the benefits of hyperbaric oxygen therapy in treating Veterans with PTSD.

Despite efforts by Reem Shaddad and many others to expose the hypocrisy within the VA,  Veterans with PTSD and TBI will need to seek help outside the VA.

SFTT is not convinced that there is a “silver bullet” to cure PTSD and TBI, but it is abundantly clear that the two PTSD therapy programs mandated by the VA are not effective.  For this reason, SFTT endorses a far wider use of alternative therapy programs to provide Veterans with a “real” choice over the VA’s failed programs.

Sure, there will be some “snake-oil” peddlers and charlatans that seek to take advantage of Veterans, but it is unlikely to be nearly as severe as the opioid epidemic perpetrated by the “evidence-based” healthcare system.

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HBOT: A PTSD Therapy for Veterans that Works

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This Saturday (November 11, 2017), Fox TV will air a broadcast on how Hyperbaric Oxygen Therapy (“HBOT”) is helping hundreds – if not thousands – of Veterans with PTSD and TBI.

This special program will be aired on Veterans’ Day. The video below was prepared by The National Hyperbaric Association to demonstrate that “real” therapy is available to the tens of thousands of brave warriors suffering from PTSD and TBI.

HBOT is a proven therapy widely used around the world for patients suffering from brain trauma. Sadly, the folks at the Department of Veterans Affairs (“the VA”) are still peddling the same stale “evidence-based” therapy programs to Veterans that do not work:

  • Prolonged Exposure Therapy (“PE”) and,
  • Cognitive Processing Therapy (“CPT”)

As SFFT reported earlier, PE and CPT “have been largely ineffective in reversing brain damage to Veterans suffering from PTSD and TBI. And yet, the spokespeople steadfastly defend these therapies and argue that other therapies ‘lack evidence’ to justify their endorsement, read ‘funding.’”

“The VA has very little evidence to show that PE and CPT therapy programs have done much to reduce the incidence of PTSD symptoms among Veterans against the “gold-standard” standardized PCL-M tests currently used by the VA. The chart below illustrates the point (50 is considered base level):

Prolonged Exposure Cognitive Process Therapy

Aside from being very expensive to administer, the ‘evidence based medicine’ supporting the effectiveness of PE and CPT programs currently administered by the VA is SADLY LACKING.”

It is most interesting to note that the VA has done everything possible to discredit HBOT to promote their own failed therapies.   In many cases it has led to tragic consequences, such as the recent suicide of Eric Bivins.

What Does the VA Have Against HBOT?

It is difficult to understand the VA’s hardline against HBOT, particularly when the overwhelming statistical “evidence” clearly demonstrates that the VA’s own therapy programs are severely flawed.  Furthermore, this is the same institution that hooked Veterans on opioids (and indirectly fueled a national epidemic) based on flawed clinical trials.

Dr. David Cifu Testifying

Dr. David Cifu, the Dr. Orange of PTSD at the VA?

How many more times do we have to listen to Dr. David Cifu testify before Congress that he (read “the VA”) knows best when treating Veterans with PTSD?   It is ironic to note that in David Cifu’s quest to discredit hyperbaric oxygen therapy, his employer (Vincent Viola – once tapped to be Secretary of the Army) is alleged to treat his racehorses with HBOT.

Clearly, Vincent Viola knows a bit more about the benefits of HBOT considering that Always Dreaming won the Kentucky Derby this year.

One might ask why thoroughbreds get the benefit HBOT while Veterans are denied HBOT at the VA?  I don’t know the answer, but I suspect that the “serious” money lies in new clinical trials and “breakthrough” drugs peddled by Big Pharma.

Or is it the VA’s special take on insanity?:  Providing Veterans with the same battery of lame therapy programs and psychotic drugs, but hoping for a more positive outcome.”

It is sad to see our Veterans being sold down the river by less-than-candid mouthpieces of a rudderless VA, but the truth is as clear as the Presidential report on Fighting Drug Addiction and Opioid Abuse.  Look no further than the damning statement: “the modern opioid crisis originated within the healthcare system.”

If you think that common sense and a desire to genuinely help our Veterans with PTSD and TBI will manifest itself soon – you are likely to be disappointed.

As they say at the Beltway Racetrack, “the fix is in!”

If you genuinely want to help our brave Veterans, write your Congressmen (and women) and Senators and State and Local representatives.  Also, do take the time to learn the benefits of hyperbaric oxygen and give generously to SFTT and the National Hyperbaric Association to support our brave Veterans.

Veterans Day is more than waving the flag.  Don’t let the festering sore at the VA continue to kill hope among our Veterans and their loved ones.

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GAO to Investigate VA Over Treatment and Therapy of Veterans with PTSD

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At the request of Reps. Mike Coffman, R-CO., and Ann McLane Kuster, D-N.H., the Government Accountability Office (“the GAO”) agreed Sept. 27 that it “will review the way the Department of Veterans Affairs (“the VA”) treats patients who suffer from post-traumatic stress disorder (PTSD) and other combat-related conditions.”  In particular, the GAO will focus on “how heavily the VA relies on powerful psychotropic drugs to treat patients.”

OxyContin - Veteran Addiction

As reported in the Armed Forces News, “this decision is a victory for combat veterans everywhere who are suffering from PTSD and who have been prescribed a cocktail of very powerful drugs to mask their symptoms in lieu of other forms of interactive therapy that work to bring down the stress levels of PTSD to a point where they are no longer debilitating,” said Coffman.

While this new GAO study may come as a big relief to many Veterans with PTSD (and their families), the tragic findings will surprise few who monitor the shoddy treatment procedures provided to Veterans with PTSD at the VA .

For those expecting that this “new” GAO study will result in any improvements in the treatment our Veterans receive, I refer you to the December, 2014 GAO study of the VA with the title of “Improvements Needed in Monitoring Antidepressant Use for Major Depressive Disorder and in Increasing Accuracy of Suicide Data.”

Here is a brief summary of the conclusions reached in this GAO audit as reported by SFTT in March, 2015 in an article entitled GAO Hammers VA on Protocols for VA Suicides:

– 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

If Representatives Coffman or McLane Kuster expect different patient outcomes, they are likely to be as disillusioned as Kimi Bivins, the wife of Veteran Eric who tragically committed suicide earlier this year.    There is little need to request a GAO study to find out how dysfunctional the VA has become.  Simply listen to Kimi describe how her husband was treated at VA facilities.
Even as far back as 2012, the VA knew that opioids were not appropriate for treating PTSD, and yet, the VA continued to provide Veterans with lethal prescription drugs knowing full well the consequences.
While SFTT could point out many similar government studies on inefficiencies at the VA, it seems to be far easier for politicians to request new studies, since they never bothered to read the existing studies or insist on much needed reforms.
Sadly, the VA has become a “law unto itself” and no amount of well-intentioned “studies” or GAO audits will do anything to turn the VA around unless politicians on both sides of the aisle take a sledgehammer to break up the VA into manageable components.   As of today, the VA is simply too large to succeed in its mission.
We can continue to study the problem, but for the sake of our brave Veterans and their families, it is time to take action!
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SFTT Military News: Week Ending Oct 13, 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.

North Korea Steal Military Documents from South Korea
A South Korean lawmaker says North Korea computer hackers stole hundreds of secret military documents from South Korea. The documents are said to include plans for destroying the North Korean leadership if a war takes place. The South Korean official, Lee Cheol-Hee, is a member of the ruling Democratic Party of Korea and the National Defense Committee. He said on Tuesday that defense officials talked about the stolen documents. Officials believe North Korean hackers were able to see classified military documents stored at a South Korean defense data center. The attackers reportedly gained control of the documents in September 2016.  Read more . . .

Vast Majority of Americans in their 20s Unfit for Military Service
The military is facing a growing recruiting crisis: 71% of Americans between 17 and 24 can’t meet the minimum criteria for service, which places the burden of service on an ever-small and shrinking pool of troops with a family history of joining the military. At an Oct. 12 Heritage Foundation panel in Washington, D.C., Rep. Don Bacon, a Nebraska Republican and former Air Force one-star general told attendees “the single most important ingredient to readiness is the constant flow of willing volunteers.”  Read more . . .

Opioids for Veterans with PTSD

How the VA Contributed to the Prescription Drugs Epidemic
. . . the Department of Veterans Affairs has played a little-discussed role in fueling the opioid epidemic that is killing civilians and veterans alike. In 2011, veterans were twice as likely to die from accidental opioid overdoses as non-veterans. One reason, as an exhaustive Newsweek investigation—based on this reporter’s book, Mental Health, Inc.—found, is that for over a decade, the VA recklessly overprescribed opiates and psychiatric medications. Since mid-2012, though, it has swung dangerously in the other direction, ordering a drastic cutback of opioids for chronic pain patients, but it is bungling that program and again putting veterans at risk. (It has also left untouched one of the riskiest classes of medications, antipsychotics—prescribed overwhelmingly for uses that aren’t approved by the Food and Drug Administration (FDA), such as with post-traumatic stress disorder.)  Read more . . .

Treating PTSD with Artificial Intelligence (AI)
There is a real appeal to shouting into the void: the ubiquity of Google search as confessional, the popularity of PostSecret, the draw of confiding in a trusted friend with the hope verging on understanding that our secrets won’t be shared all point to this. A group of researchers from the University of Southern California, with funding from the DARPA wing of the Department of Defense, believe that desire might drive a preference among veterans with PTSD to anonymously discuss their symptoms with a computerized avatar.  Read more . . .

service dogs for Veterans

Veterans Advocate for Congressional Action on Service Dogs
Veterans’ advocates are urging Congress to make the Department of Veterans Affairs (VA) support organizations that provide service dogs to veterans suffering from post traumatic stress disorder and other conditions. The Association of Service Dog Providers for Military Veterans held a press conference Tuesday with members of Congress to advocate for the Puppies Assisting Wounded Servicemembers Act (PAWS Act), which would provide $25,000 grants for eligible organizations to train and pair service dogs with a veteran. The bill would also prompt the VA to launch a pilot program looking at the links between service dogs and mental health.  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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The Department of Veterans Affairs and Service Dogs

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The Department of Veterans Affairs (“the VA”) receives considerable public criticism for its failure to provide service dogs to Veterans with PTSD and TBI.

As reported earlier by SFTT, the VA provides service dogs to blind Veterans, but has balked at providing service dogs to Veterans who are less than totally physically disabled.  The recurring argument from VA spokespeople is that there is a lack of “clinical evidence” to support the benefits of service dogs.

service dogs for Veterans

Consider this testimony by Dr. Fallon of the VA:

“I would say there are a lot of heartwarming stories that service dogs help, but scientific basis for that claim is lacking,” said Michael Fallon, the VA’s chief veterinary medical officer. “The VA is based on evidence based medicine. We want people to use therapy that has proven value.”

The argument is a brief synopsis of Dr. Fallon’s testimony to the House Subcommittee and Government Reform provided in April, 2016.

Dr. Fallon’s testimony and defense of the VA’s status quo is similar to the testimony of Dr. David Cifu on PTSD therapy and Dr. Alvin Young (aka Dr. Orange) on the lethal side effects of Agent Orange used on the deforestation of Vietnam.

The VA has set itself up as “judge and jury” to determine what range of medical services it will provide to Veterans.  Any “new” therapy that has not been blessed by “evidence based medicine,” is summarily dismissed by the gatekeepers at the VA.  In fact, the VA often uses spokespeople and expensive long-term clinical studies to avoid providing much needed therapy to Veterans.

Furthermore, there is strong evidence to suggest that the DoD purposely manipulated testing procedures on hyperbaric oxygen therapy (“HBOT”) to produce clinical outcomes more to their liking.

As reported earlier,  Prolonged Exposure (PE) and Cognitive Processing Therapy (CPT) have been largely ineffective in reversing brain damage to Veterans suffering from PTSD and TBI.   And yet, the spokespeople steadfastly defend these therapies and argue that other therapies “lack evidence” to justify their endorsement, read “funding.”

“The VA has very little evidence to show that PE and CPT therapy programs have done much to reduce the incidence of PTSD symptoms among Veterans against the “gold-standard” standardized PCL-M tests currently used by the VA.   The chart below illustrates the point (50 is considered base level):

Veterans Affairs Fails at PTSD

Aside from being very expensive to administer, the “evidence based medicine” supporting the effectiveness of PE and CPT programs currently administered by the VA is SADLY LACKING.”

While the general public and Congressional leaders may buy the pitch from VA Spin Doctors, Veterans are seeking other forms of therapy outside of the VA.  The problem is that few can afford to do so.

The Case for Service Dogs for Veterans

Training a service dog is relatively expensive.  Most estimates suggest that the cost of training a service dog to be in the neighborhood of $20,000.  The training of a dog can last some five months after the dog reaches maturity (about six months) to another 18 months depending on the rigorousness of the training.  In addition to training the dog, the Veteran needs to spend a considerable amount of time with the service dog to develop an effective relationship.

As we reported earlier, Maj. Ben Richards spent seven weeks in intensive training with his new service dog, Bronco.  According to Ben, it was about 4 hours of training a day (generally in the morning) and a few weekend sessions.  Taking into account “training the Veteran” could add considerably more to the overall cost.  For those interesting in learning more about the steps involved in training a service dog, I refer you to this excellent FAQ provided by Psychiatric Service Dog Partners.

While the VA currently does authorize the use of service dogs for Veterans, many State and charitable organizations have sprung to the support of Veterans.  In addition to Ben’s heartwarming story, many other Veterans have benefited from the companionship of service dogs.

Several organizations like 4PawsforAbility and Train a Dog and Save a Warrior,- SFTT Rescue Coalition Partner – are actively training and providing service dogs to Veterans.  These organizations and several others rely on the generous contributions of others to support our Veterans.

While the VA continues to study the benefits of service dogs, new results are not expected until 2019.

One might justifiably ask why it takes the VA 9 years to study the benefits of service dogs for Veterans with PTSD (yes, Congress mandated a study in 2010), but Dr. Fallon and the VA spinmasters will provide you a compelling answer if you are naive enough to buy it.

Based on the sound work of many charitable organizations training service dogs, it is beyond reasonable for the VA to soft-peddle its failed therapy programs and help these struggling organizations provide service dogs to Veterans.  Wouldn’t it help provide “real” evidence to support their long overdue study?

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Veterans with PTSD: The VA Way or the Highway

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It is easy to find fault with the Department of Veterans Affairs (“the VA”), particularly when it comes to Veterans with PTSD.

Department of Veterans Affairs

Secretary of Defense, Robert McNamara, tried to employ body count statistics to assess our progress in the war in Vietnam.  Similarly, the VA has erected a statistical house-of-cards to deceive Veterans and their loved that the VA has the answers for Veterans coping with PTSD and TBI.

Like McNamara, the VA “knows what is best for Veterans” and has erected insurmountable statistical barriers to prop up their failed strategies.  In effect, the VA is telling Veterans:  “It is my way or the highway!

Paraphrasing a joke: “The VA uses statistics as a drunk uses a lamppost — For support rather than illumination.”

Sadly, it is no laughing matter when we consider the thousands of combat Veterans suffering from PTSD and TBI.  More importantly, reflect on the often tragic consequences for their families and loved ones.

While Congress and the public continue to be seduced by the steady stream of assurances that the VA provides the best possible care to Veterans with PTSD and TBI, the FACTS tell a far different story.

FAKE NEWS from the VA on Veterans with PTSD

Found below is a video of Dr. David Cifu, Senior TBI Specialist at the VA, testifying before a Congressional Committee:

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

– Cognitive Behavioral Therapy (“CBT”)and,

– Prolonged Exposure Therapy (“PET”).

As these “therapy” programs have failed miserably according to independent studies (see below), the VA has “coped” with the problem by prescribing a lethal concoction of prescription drugs which treat the symptoms of PTSD rather than deal with the underlying problem.

And we wonder why we have an opioid epidemic in this country?

REALITY CHECK at the VA

While Dr. David Cifu continues to entertain a Congressional Committee on the efficacy of the VA’s protocols, experience for yourself one woman’s harrowing experience with the VA which eventually led to husband’s suicide:

The story of Kimi Bivins is not the exception to the type of treatment Veterans with PTSD receive at the VA. Based on many similar stories, the VA is failing our Veterans and their loved ones.

I encourage readers to read Kimi’s harrowing description of what actually takes place at a VA facility.

While the folks at the VA casually dismiss anecdotal stories, VA claims that Veterans receive the best therapy possible is simply not supported by the evidence.

No less of an authority that the National Academies of Sciences (Medical Division) reported in a 2014 study entitled “Treatment for POSTTRAUMATIC STRESS DISORDER in Military and Veteran Populations,” that CBT and PET barely made a statistical dent in providing Veterans with PTSD any lasting improvement in their condition.

Consider Maj. Ben Richards‘ compelling evidence documenting the failed experiments at the VA in helping Veterans with PTSD.

Standing behind a well-entrenched bureaucracy of statistical inaccuracies and dogma, the VA goes out of its way to discredit other treatment alternatives. Consider this bitter “scientific” debate between Dr. Cifu and Dr. Paul Harch on the efficacy of hyperbaric oxygen therapy or HBOT in treating PTSD and TBI.

Finding a Middle Ground for Veterans with PTSD?

With so little known about the brain and how to treat trauma, it seems absurd for the VA to insist that they have all the answers.  The evidence clearly suggests that the VA doesn’t have a clue.

Nevertheless, the VA argues that “alternative therapies” that do not pass scientific scrutiny and FDA approval will not be endorsed by the VA.  As we have seen countless times – from body armor testing to hyperbaric oxygen studies – the DoD uses test protocols that deviate from accepted standards.

If the tests are flawed, one is likely to draw the wrong conclusions!

For the vast majority of Veterans with limited economic means, the VA is effectively making life and death decisions based on flawed testing and a reluctance to embrace other treatment alternatives.

This is probably done with the intent of protecting Veterans from charlatans and snake oil peddlers, but doesn’t it also block Veterans from receiving promising therapies from legitimate sources?

When dogma or “approved” therapies become the LAW, then it seems unlikely that much progress will be made to help our brave Veterans recover their lives.  The VA would do well to encourage Veterans to seek alternative therapies and provide an interactive sounding board for Veterans to voice their opinions on these programs.

Honesty and transparency and a willingness to accept mistakes is the sign of a responsive institution.   Today, the VA hides behind a dogma based on self-delusion and falsehood.

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Veteran Suicides: The VA Releases “New” Statistics

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The Department of Veterans Affairs (“the VA”) recently released a report showing state-by-state disparities in suicide rates among Veterans.  Sadly, the data tracks Veteran suicides rates through 2014 leaving a significant time gap in determining whether the trend in 20+ veteran suicides a day is improving.

Veteran Suicides

(U.S. Army photo by Stephen Baker)

The news media has been quick to seize on some of the notable anomalies in the data, some of which is highlighted below from PBS news:

  • Suicide among military veterans is especially high in the western U.S. and rural areas;
  • Suicide rates in Montana, Utah, Nevada and New Mexico averaged 60 per 100,000 individuals compared to the national average of 38.4 (overall in the West was 45.5);
  • Women veterans had a suicide rate 2.5 time higher than for female civilians;
  • A VA study (last year) found that veterans who received the highest doses of opioid painkillers were more than twice as likely to die of suicides than those receiving the lowest doses;  
  • 65% of Veteran suicides were age 50 or older. 

It is difficult to generalize from this somewhat dated report other than to say that Veteran suicide rates are considerably higher than the national average.

Furthermore, it would appear that the VA’s propensity to dispense potent prescription drugs – primarily opioids – may have contributed to high suicide rates among Veterans.

Just who is to blame for the opioid epidemic sweeping the United States?  Finger-pointing suggests that many are to blame for the epidemic, but new candidates emerge daily.

For instance, the New York Times recently reported that insurance companies may need to shoulder part of the blame for opioid abuse.  Why?

“Opioid drugs are generally cheap while safer alternatives are often more expensive.

“Drugmakers, pharmaceutical distributors, pharmacies and doctors have come under intense scrutiny in recent years, but the role that insurers — and the pharmacy benefit managers that run their drug plans — have played in the opioid crisis has received less attention. “

Nevertheless, some institutions took measures far earlier to stem addictive drug treatment.   For instance, Mother Jones reports that: “Partnership HealthPlan, the main public insurance provider for Medi-Cal patients in rural Northern California, discovered an alarming trend: Many counties where Partnership operated had among the highest rates of opioid prescribing and overdose in the state. Hydro­codone was the top-prescribed medication among Partnership patients, who include more than 570,000 Medi-Cal recipients from the vineyards of Sonoma County to the redwoods on the Oregon border. In Lake County, a poor, rural area bordering Sonoma, enough opioid painkillers were prescribed in 2013 to medicate every man, woman, and child with opioids for five months, according to a report by the California Health Care Foundation.”

Unfortunately, the VA is largely unaccountable to anyone and Veterans have few affordable choices other than to rely on treatment options provided by the VA.  With a dismal track record in providing treatment for Veterans with PTSD, it is hard to see how any meaningful progress will be made by the VA in curbing VA suicides.

More disturbing is the thought that Veterans with PTSD incurred from the Gulf Wars and continued deployments in Afghanistan and Iraq will soon be approaching their 50th birthday.   If the VA statistics are credible that “65% of Veteran suicides are over the age of 50,” then we may actually see an uptick in suicide rates among Veterans.

Despite repeated assurances to Congressional Committees, Dr. David Cifu and his cronies at the VA don’t have a clue on how to treat PTSD.   Cocktails of lethal prescription drugs are clearly not the answer, but the VA’s blind insistence that Cognitive Behavioral Therapy and Prolonged Exposure Therapy are the only effective treatment programs is simply ludicrous.

Whatever the reasons, Veterans with PTSD and TBI may not really have a viable financial alternative outside the treatment barriers currently erected by the VA.

Even though the information is dated, the VA has done a good job illustrating the extent of the problem.  While one can draw many inferences from the data, it would be totally wrong to suggest that the VA has a handle on the problem and absurd to think that they have answers!

No wonder Veterans with PTSD and TBI have lost faith in the VA.

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