PTSD Treatments

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

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

Yuval Neria

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

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

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

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

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

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

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PTSD update for Feb 2, 2013

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New material surfaces daily on the internet and in user discussion forums dealing with the treatment of Post Traumatic Stress Disorder (“PTSD”). Regrettably, most of this advice is not supported by good clinical scientific studies or trustworthy explanation. The road to health and wellness is a long process and treatment procedures will be different based on the particular individual, the extent of the stress and his or her current social and financial circumstances.

SFTT or “Stand For The Troops” has put together an eminent circle of physicians, clinical psychologists and therapists to evaluate these promising treatments. While some of these emerging new techniques will appear on a regular basis on SFTT, visitors are firmly counseled to refer to their physician or primary care giver before altering treatment.

Found below are highlights of recurring themes as we mobilize forces to deal with the ravages of PTSD.

Cincinnati State, Cincinnati VA Medical Center to offer PTSD classes

Cincinnati State, in conjunction with the Cincinnati VA Medical Center, will offer two free classes this month on Post-Traumatic Stress Disorder (PTSD). The classes are geared toward the Emergency Medical Services community and other first responders.

See all stories on this topic »

PTSD taking a toll on returning veterans

He spoke last week, a day before attending Massachusetts funeral services for his friend, who had PTSD and served at Iraq’s Abu Graib prison during one of two deployments. “I don’t think he’d ever say, ‘Hey, I want to kill myself,’ but … certainly …

See all stories on this topic »

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Maj. Ben Richards Hyperbaric Treatment Update

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Yesterday evening, WWLTV.com in Louisiana carried a very moving “progress report” on

Maj. Richards’ tragic story was chronicled by New York Times columnist Nicholas Kristof who wrote an article in August entitled “War Wounds.”  For reasons that seem inexplicable to the average American, the Veterans Administration, the Defense Department and our government seemed to wash their hands of any responsibility of the injuries suffered by Maj. Richards.  Eilhys England, Chairperson of SFTT, immediately contacted Maj. Richards and put him in touch with Dr. Paul Harch (shown in the video below) who has been providing Ben with Harch Hyperbaric Oxygen Treatments pro bono.

We are thrilled that Maj. Richards has made so much progress and SFTT is most grateful to those West Point classmates, friends and colleagues who have generously contributed to a fund to support his family while undergoing this treatment.

While we don’t leave our troops behind on the battlefield, why should their needs be neglected when they return home? If you feel strongly about supporting our brave heroes like Maj. Ben Richards, consider becoming a member of SFTT. Your generous contributions help our team find and evaluate promising treatment programs so our brave heroes can reclaim their lives.

For only $35 a year you can stand with us and Stand for the Troops


Choose your Membership and click the button «Become a Member»:

Become a Member

For those who wish to submit your membership contribution by check, please make the check payable to SFTT and send to the following address:

SFTT
PO Box 11179
Greenwich, CT 06831

Members can opt to receive flash updates, a Membership card and a vehicle decal.   Members who donate $100 or more can request a complimentary T-shirt.

PO Box 11179  ?  Greenwich CT 068321  ?   203-629-0288   ?  www.SFTT.org

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Opioids May Not Be Good for Treating PTSD. Really?

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If the devastating implications weren’t so gut-wrenching, many of us would be rolling in the aisles with laughter.   Unfortunately, Karen Seal of the San Francisco VA Medical Center has sadly concluded that “the use of opiate pain medications in those patients (veterans suffering from PTSD) is, frankly, risky.”  According the Austin Statesman, “a growing body of research shows that PTSD and powerful prescription drugs can be a deadly mix.

“Six months ago, a study of 141,000 veterans of the Afghanistan and Iraq conflicts concluded that combining prescription opioids such as oxycodone and hydrocodone with PTSD was like pouring kerosene on a fire: Those with mental health diagnosis were nearly three times more likely to be prescribed opiates than veterans without PTSD. Worse, they were also much more likely to have poor outcomes, including overdoses.”

Almost anyone with half-a-wit could have reached the same conclusion several years ago.  In fact, SFTT has reported on many occasions that the prescription of opiates to those with PTDS symptoms has certainly exacerbated problems for veterans and may have turned these troubled warriors into junkies.  Why?   Institutional barricades have been erected to protect those complicit in providing improper treatment to tens of thousands veterans who certainly deserve better care.   Why should anybody be surprised that the government is now throwing another $100 million to help better diagnose PTSD.   Can we expect a better outcome?  If you think so, then you probably believe in the tooth fairly.

What about the 2006 study reported by the Austin Statesman quoting University of Washington pain researcher Mark Sullivan who wrote that the: “Use and abuse of opioids appears to be common in individuals with post-traumatic stress disorder.”   Wouldn’t it have been wiser to throw $100 million at alternative treatments for PTSD than for the VA and Defense Department to pretend they are  now doing something “right” because the pharmaceutical lobby was calling the shots all along.

I don’t mean to be cynical, but drugs are big business and the pharmaceutical companies that provide expensive, addictive and dangerous drugs have a vested interested in keeping the public and their Beltway puppets in the dark on the long term effects of these powerful drugs.  Who suffers?  The taxpayer and the brave young men and women who have sacrificed so much for this country.

If you want your voice to be heard, consider adding your voice to SFTT and help get our veterans the treatment they deserve.

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A former Marine comments on the V.A.’s Shameful Betrayal

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In a heart-breaking story by Mike Scotti entitle ” below:

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THE Department of Veterans Affairs, already under enormous strain from the aging of the Vietnam generation, the end of the Iraq war and the continuing return of combat troops from Afghanistan, announced in April that it would increase its mental health staff by about 10 percent. But too many veterans waging a lonely and emotional struggle to resume a normal life continue to find the agency a source of disappointment rather than healing.

The new hiring is intended to address the infuriating delay veterans face in getting appointments. The V.A. says it tries to complete full mental health evaluations within 14 days of an initial screening. But a review by the department’s inspector general found that schedulers were entering misleading information into their computer system. They were recording the next available appointment date as the patient’s desired appointment date. As a result, a veteran who might have had to wait weeks for an appointment would appear in the computer system as having been seen “without a wait.” That allowed the agency to claim that the two-week target was being reached in 95 percent of cases, when the real rate was 49 percent. The rest waited an average of 50 days.

As a veteran of both Iraq and Afghanistan, I found that news maddening. While the schedulers played games with the numbers, veterans were dealing with mental wounds so serious that getting proper attention at the right time might have made the difference between life and death. Even worse was that the V.A. had failed twice before to change; the inspector general found similar problems in 2005 and in 2007. This suggests a systematic misrepresentation of data and an unwillingness to stop it.

Unfortunately, the problem goes even deeper. There are potentially hundreds of thousands of veterans who are struggling with post-combat mental health issues who never ask the V.A. for help. Some, hamstrung by fear of stigma, are too proud or too ashamed to ask for help. Others don’t ask because they’ve heard too many stories from peers who have received poor care or been ignored.

I have close friends who could no longer drive because of their lingering fears of roadside bombs. Others had gone to the V.A. because they had suicidal thoughts, only to receive a preliminary screening, a pat on the back, a prescription for antidepressants — and a follow-up appointment for several months later.

I’ve had my own struggle: in 2001 I was part of the initial force of Marines who landed in Afghanistan, and in 2003 took part in the heavy fighting of the first wave of the invasion of Iraq. Since coming home, I’ve had my mind hijacked by visions of the corpses of children, their eyes blackened, at the side of the road. I recall carrying the coffins of fallen brothers. I remember losing friends who probably knew exactly what was happening to them, as they bled out on the side of a dusty road in Iraq.

And I’ve felt the shame of having suicidal feelings. Like many others, I chose to hide them. Yet, even in the darkest days of my own post-traumatic stress, when I was considering choosing between making my suicide look like an accident or taking a swan dive off some beautiful bridge, I never considered going to the V.A. for help.

My image of the V.A., formed while I was on active duty, was of an ineffective, uncaring institution. Tales circulated among my fellow Marines of its institutional indifference, and those impressions were confirmed when I left Iraq for home. At Camp Pendleton, Calif., a woman with a cold, unfeeling manner assembled us for a PowerPoint presentation and pointed us to brochures — nothing more, no welcoming sign of warmth or empathy for the jumble of emotions we were feeling. Her remoteness spoke volumes to me of what I might expect at home.

To regain veterans’ trust, the V.A. must change its organization and culture, not just hire more people. First, its leadership must be held accountable for employees’ behavior, and anyone caught entering misleading data should be fired. The agency must reach out, with public awareness campaigns and with warmth, to veterans who may be suffering in silence. It must help reduce the social stigma that attaches to the mental health issues the veterans face.

Dedicated V.A. personnel run a suicide-prevention hot line, but it is only a temporary salve for emergencies. One impressive and highly effective alternative to the V.A.’s traditional treatment process is the Wounded Warrior Project’s Combat Stress Recovery Program, which emphasizes the importance of interpersonal relationships, goal-setting and outdoor, rehabilitative retreats and seeks to avoid the stigma associated with traditional treatment.

What this generation of veterans needs from the V.A. is a recognition that when the color of life has faded to gray, you need to talk to someone about it today, not weeks or months from now. We need America to acknowledge what war does to the young men and women who fight it and to share the message that dragged me out of the darkness: It’s O.K. if you’re not O.K.

Mike Scotti, a former Marine, is the author of “The Blue Cascade: A Memoir of Life After War.”

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We hear you Mike.   Our thoughts – and action – are with you and the thousands of brave heroes who deserve proper treatment from the V.A.

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PTSD and the VA: A Disservice to Disabled Troops

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In an editorial opinion published in the New York Times on May 26th entitled ”

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The Departments of Defense and Veterans Affairs have repeatedly promised to do a better job of handling the medical evaluations of wounded and disabled service members. Instead, they are doing worse.

The processing of disability cases is getting slower, not faster. Efforts to ensure a “seamless transition” out of the military are falling short. Men and women are languishing without treatment, struggling to readjust to civilian lives as they cope with post-traumatic stress disorder, brain injuries, drug addiction and other service-related afflictions. The system that should be producing reliable results is mired in delays and dissatisfaction.

A new report by the Government Accountability Office lays out the problem. In 2007, the two departments began combining their separate, complicated and cumbersome processes for disability evaluations into one system. The system is now in place worldwide, and officials from both departments promised the Senate Veterans’ Affairs Committee a year ago that it had become “more transparent, consistent and expeditious.”

But the accountability office found otherwise. It said processing times for disability cases had actually gone up — to an average of 394 days for active-duty troops and 420 days for National Guard members and reservists in 2011, well over the departments’ goals of 295 and 305 days. In fiscal year 2010, 32 percent of active-duty troops and 37 percent of Guard and Reserve troops completed evaluations and received benefits within established timelines. Last year, those figures fell to a dismal 19 percent and 18 percent.

What’s going on? The report says the causes are not fully understood, but it points to persistent staffing shortages, problems in collecting and reporting data, and differences among the service branches and between the Pentagon and the Veterans Affairs Department in the way cases are diagnosed and tracked. The accountability office says it will make recommendations later this year as it sees whether promised improvements are taking hold, including a hiring push by the Army — a huge source of processing bottlenecks — and the V.A.

Senator Patty Murray, chairman of the Veterans’ Affairs Committee, deserves credit for focusing attention on these and other failings in a series of hearings, including one last Wednesday that examined the bureaucratic delays. She also used the hearing to bring up disturbing reports that doctors at an Army base in Washington State had repeatedly — and wrongly — rejected soldiers’ legitimate post-traumatic stress disorder claims.

Wounded and disabled service members should not be forced to wait endlessly without treatment or benefits while the government evaluates their injuries. Nor should they have to battle their own government for honest treatment. The evaluations should be accurate, not consistently wrong. Ms. Murray noted on Wednesday that there were about 27,000 military personnel in the system, three times the number in 2010. Many more are on the way. “Clearly, much work remains to be done,” she said. She is right. There is no excuse for more backsliding and delay.

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Enough “lip service” as Hack would say.  Let’s rollup our sleeves and help these brave heroes.

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Are Opioid Prescriptions the Right Answer for treating PTSD?

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In a series of alarming reports, the V.A. and medical profession are beginning to wonder if treating PTSD with Opioid prescription drugs is the right course of action.   Referring to V.A. records, U.S. Medicine reports that “more than 141,000 Iraq and Afghanistan veterans have been diagnosed with non-cancer pain. The prevalence of PTSD among that group is 32%, with 19% diagnosed with other psychiatric disorders.”

Of this group, “11% have been prescribed

U.S. Medicine goes on to report that “veterans with PTSD also were more likely to take higher opioid doses (22.7% vs. 15.9%), two or more opioids (19.8% vs. 10.7%) and concomitant sedative-hypnotic drugs (40.7% vs. 7.6%). Receiving prescription opioids was associated with adverse clinical outcomes for all veterans, but adverse effects were most pronounced in veterans with PTSD. Those outcomes included general wounds and injuries, accidents and overdoses, violent injuries and suicide attempts. While previous studies have shown that prescription opioids are more often prescribed for patients with psychiatric disorders, this trend was even more pronounced when the patient was diagnosed with PTSD.”

Lead author Karen Seal  of a recent study published in the Journal of the American Medical Association on the medication prescribed to veterans believes that the study results are troubling. ”The message to me is to keep redoubling our efforts to really have conversations with patients about these risks, and really provide them alternatives to just taking Vicodin or oxycodone or morphine, which has become very, very common in our society.”

It is becoming clear that our military leaders are now beginning to realize that these addictive drugs may, in fact, exacerbate the problems associated with PTSD rather than treat them.   In fact,  Bob Brewin of Veterans for Common Sense reports that  “the Army Surgeon General’s office is backing away from its long-standing endorsement of prescribing troops multiple highly addictive psychotropic drugs for the treatment of post-traumatic stress disorder and early this month warned regional medical commanders against using tranquilizers such as Xanax and Valium to treat PTSD.

“An  Valium, could intensify rather than reduce combat stress symptoms and lead to addiction.

“The memo, signed by Herbert Coley, civilian chief of staff of the Army Medical Command, also cautioned service clinicians against prescribing second-generation antipsychotic drugs, such as Seroquel and Risperidone, to combat PTSD. The drugs originally were developed to treat severe mental conditions such as schizophrenia and bipolar disorder. The memo questioned the efficacy of this drug class in PTSD treatment and cautioned against their use due to potential long-term health effects, which include heart disorders, muscle spasms and weight gain.”

This greater awareness of the risk of prescribed opioids only confirms indications that SFTT has received from its sources “upwards of 80% of veterans suffering from PTSD also have an addiction problem.”     These new revelations are truly frightening and place a far greater sense of urgency in treating PTSD properly unless we plan on turning our brave veterans into addicts rather than cure them.

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VA Care for Patients with PTSD

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As military service members deployed in Iraq begin come home, the alarm bells are beginning to sound as the Veterans Administration (“VA”)  now seems over-stretched to deal with alarming number of cases of service members with PTSD.

According to a recently published Rand study, excerpts of which are reported  by Health Affairs, “There is a large and growing population of veterans with severe and complex general medical, mental, and substance use disorders including schizophrenia, bipolar I disorder, PTSD, and major depression. Substance use disorders may occur alone or in combination with any of these other diagnoses. Over the five-year study period, the population of veterans with mental and substance use disorders grew by 38.5 percent, with the largest growth occurring in veterans receiving care for PTSD. Half of the veterans with mental and substance use disorders also had a serious medical disorder. Study veterans also accounted for a much larger proportion of health care use and costs than their representation among all veterans receiving VA health care. “

The sad reality is that this report is based on statistics compiled by Rand for 2007 and, as such, the severity of the problem is likely to be far greater for veterans with additional deployments past 2007.

As Jason Ukman of the Washington Post reports, “the cost of medical care for veterans is expected to skyrocket in coming years.”   According to sources referred to by Mr. Ukman, “The number of veterans seeking mental health services has increased sharply. Last year, more than 1.2 million veterans were treated by the VA for mental health problems. In fiscal year 2004, the figure was roughly 654,000. The largest increase has been among veterans diagnosed with PTSD.”

The severity of this problem is already taxing over-stretched VA resources and is likely to increase as  troops in combat zones return home.  How we deal with these troubled warriors will say much about our military and political leadership.

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Can US troops wear third-party body armor?

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As previously reported on SFTT – ! You can find more information about generic medications here.

In August 2007, Arkansas Fourth District Representative Mike Ross sent a letter to the Secretary of Defense and the Secretary of the Army requesting clarification.  Secretary of the Army Pete Geren formally acknowledged in September that insurance and medical benefits would not be withheld if combat injuries (or death) were sustained while a service member was wearing unauthorized body armor.  Nevertheless, Secretary Geren went on to add that “every Soldier, regardless of rank, is required to use/wear U.S. government approved equipment, such as the Interceptor Body Armor (IBA) system.”

In order to clear up any possible misunderstanding, Arkansas Representative Mike Ross again sent a letter to the Secretary of Defense requesting further clarification.  In a letter dated what appears to be November 2, 2010, Clifford L. Stanley on behalf of the Under Secretary of Defense (Personnel and Readiness) responded as follows:

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Dear Representative Ross:

Thank you for your letter dated October 13, 2010, regarding the upcoming deployment of the Arkansas’ 39th Brigade Combat Team and the impact of body armor worn on benefits.  This issue falls under the purview of the Under Secretary of Defense (Personnel and Readiness), and I have been asked to respond.

As you allude to in your letter, rumors regarding Servicemembers’ Group Life Insurance (SOLI) payments and Department of Defense medical care as it relates to battle injuries or death when wearing commercially procured (Dragon Skin) body armor arise on occasion.  Eligible benefits and medical support associated with SGLI or the Department of Defense (DoD) are paid or provided if a member is injured or killed in action while wearing commercially purchased body armor.  The DoD Will not discriminate, as it relates to military health care, between Service members who wear government issued or commercially purchased body armor.

Title 38, United States Code, is the statutory authority for the portfolio of SGLI products (SGLI, SGLI Traumatic Injury Protection (TSGLI),  Family SGLI, etc.) for which the Department of Veteran Affairs (VA) is responsible.  Department of Defense staff consulted with VA and reaffirmed that wearing unapproved body armor, in and of itself, does not disqualify members for SGLI or TSGLI payments. Additionally, the question of privately purchase body armor is addressed on the VA’s myths and rumors website (web address follows):  http://www.insurance.va.gov/SGLISITE/SGLI/mythsRumors.htm.

Medical benefits, as with SGLI payments, are not contingent on the type of body armor worn by Service members.  The Services do not seek reimbursement for medical expenses connected to members wounded in combat when wearing commercially procured body armor.

Thank you for your concern in this matter, and for your support of the Service and family members of the 39th Brigade Combat Team.

Sincerely,

Clifford L. Stanley

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A facsimile of Mr. Stanley’s letter on third-party body armor may be downloaded from the SFTT website.

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