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VA Allows Doctors to Discuss Medical Marijuana with Patients

medical mj

By Debbie Gregory.

Advocates of medicinal marijuana use for veterans believe in its effectiveness in treating chronic pain. Now the Department of Veterans Affairs (VA) has authorizes its physicians and care teams to speak openly with veteran patients about their marijuana use.

Currently, VA doctors cannot prescribe medical cannabis, but thanks to VHA Directive 1315, in states where medical marijuana is legal, VA providers can discuss marijuana use with veterans as part of comprehensive care planning, and adjust treatment plans as necessary.

Veterans enrolled in a state-approved medical cannabis program can discuss their marijuana use so that their doctor can make adjustments to the treatment plan.

The new policy is likened to the VA removing its proverbial head from the sand.

“It not only encourages, but really mandates that their physicians and primary care teams have healthy and in-depth knowledge-based conversations with veterans about cannabis use for whatever ailment their suffering from,” said Lou Celli, the director of national veterans affairs and rehabilitation division at American Legion.

Marijuana remains a Schedule 1 substance — “drugs with no currently accepted medical use and a high potential for abuse,” according to the Drug Enforcement Administration.

Veterans groups say the fastest and most effective way to help veterans get access to treatment is to simply reschedule the drug. That would automatically lift the most onerous barriers to research and allow VA health care providers to immediately prescribe marijuana in states where it is legal.

“We’ve got young men and women with PTSD and traumatic brain injuries coming to us and saying that cannabis works,” said Joe Plenzler, a spokesman for the American Legion.

Military Connection salutes and proudly serves veterans and service members in the Army, Navy, Air Force, Marines, Coast Guard, Guard and Reserve,  and their families.

Army Veteran, Gunman in Colorado Shooting, had History of Mental Illness

matthew-riehl

By Debbie Gregory.

He was once a standout student in law school and an Army medic. But in the very early morning hours on New Year’s Eve, 37-year-old Matthew Riehl shot four sheriff’s deputies who responded to a complaint at his apartment in the Denver suburb of Highlands Ranch, killing Sheriff’s Deputy Zackari Parrish.

At 5:15 a.m, law enforcement was called out to the apartment to investigate a complaint of a “verbal disturbance” involving two men. One of the men told them the suspect “was acting bizarre and might be having a mental breakdown” but the deputies found no evidence of a crime.

They were called back less than an hour later and came under fire almost immediately after entering the apartment and trying to talk with the suspect, who was holed up inside a bedroom. They were forced to retreat.

Riehl was killed during the subsequent shootout with a police tactical team that left a SWAT officer injured.

Deputy Parrish, 29, leaves behind his wife Gracie and two young daughters.

Riehl enlisted in the Army Reserves in 2003, and in 2006 he joined the Wyoming Army National Guard. He deployed as part of Operation Iraqi Freedom from April 2009 to March 2010. He was honorably discharged in 2012.

Riehl had a history of mental issues, and had escaped from a veterans mental health ward in 2014 during a stay for a psychotic episode. His mother told authorities that her son had post-traumatic stress disorder from his Iraq war deployment and was refusing to take his medication to treat the condition.

By mid-2016, Riehl was at the center of a string of worrisome events reported by police in Colorado and Wyoming. He posted tirades on social media about the faculty at the Wyoming law school and sent harassing emails to police after getting a speeding ticket.

Riehl posted videos criticizing Colorado law enforcement officers in profane, highly personal terms. He also used social media to livestream the confrontation leading up to the shooting.

Military Connection salutes and proudly serves veterans and service members in the Army, Navy, Air Force, Marines, Coast Guard, Guard and Reserve,  and their families.

VA To Make Hyperbaric Oxygen Therapy Available for PTSD

Hyperbaric Chamber

By Debbie Gregory.

In a continuing effort to treat Post-traumatic Stress Disorder (PTSD) and reduce the number of veteran suicides, the Department of Veterans Affairs has approved hyperbaric oxygen therapy (HBOT) to some veterans with PTSD.

In a hyperbaric oxygen therapy chamber, the air pressure is increased to three times higher than normal air pressure. Under these conditions, your lungs can gather more oxygen than would be possible breathing pure oxygen at normal air pressure.

It’s suggested that the oxygen-rich environment produced in the brain during a HBOT treatment stimulates the growth of new neurons and neural pathways, although further research is necessary.

HBOT treatment is currently only available to veterans served in the eastern Oklahoma and Northern California VA health care systems. Only veterans who haven’t noticed a decrease in PTSD symptoms from two other, evidence-based treatments are eligible.

Hyperbaric oxygen therapy involves breathing pure oxygen in a pressurized room or tube. HBOT uses pressurized hyperbaric chambers to deliver high oxygen levels.

“There is nothing more important to us than caring for our nation’s veterans, and that care must include finding different approaches that work best for them,” said VA Secretary David Shulkin.

HBOT is normally used to treat carbon monoxide poisoning, decompression sickness,  and wounds that won’t heal. It has also been used for stroke victims, autism, cerebral palsy, cancer, fibromyalgia and lyme disease. Now HBOT is being used on patients with Traumatic Brain Injury (TBI) as well as PTSD.

The VA intends to use its new research to determine whether hyperbaric oxygen therapy should be made available to more veterans with PTSD, the agency said.

Military Connection salutes and proudly serves veterans and service members in the Army, Navy, Air Force, Marines, Coast Guard, Guard and Reserve,  and their families.

Colorado VA Used Forbidden Lists of Patients Wanting Mental Health Car

Denver VA

By Debbie Gregory.

A Veterans Administration (VA) investigation has revealed that VA facilities in Denver, Golden and Colorado Springs failed to follow proper protocol when keeping tabs on patients who sought referrals for treatment of mental health conditions such as post-traumatic stress disorder.

The “off-book” lists did not always contain complete information or request dates, calling into question whether veterans requesting care received it and how long they had to wait for it.

Unofficial wait lists have been used by VA health care facilities elsewhere. The discovery of the lists created a nationwide scandal in 2014 when 40 veterans died while waiting for appointments at a Phoenix VA hospital.

Whistleblower Brian Smothers said the problems found in Colorado reach across the VA system. He worked on the VA’s PTSD support team in Denver and said he resigned in November 2016 after he was retaliated against for speaking up.

Smothers alleges that Colorado VA facilities in Denver and suburban Golden used unauthorized wait lists for mental health services from 2012 until last September. He said the longer that veterans have to wait for mental healthcare, the less likely they are to use it when it becomes available.

“It was totally unacceptable to me,” he said.

Smothers estimated the lists contained 3,500 entries but did not know how many individual veterans were on them because some names appeared multiple times. It was not immediately clear how long veterans on the lists had to wait for care.

Unofficial wait lists have been used by VA health care facilities elsewhere. The discovery of the lists created a nationwide scandal in 2014 when 40 veterans died while waiting for appointments at a Phoenix VA hospital.

According to Smothers, “VA management knew that these wait lists were absolutely forbidden.”  “But they directed the use of these wait lists anyway.”

Military Connection salutes and proudly serves veterans and service members in the Army, Navy, Air Force, Marines, Coast Guard, Guard and Reserve,  and their families.

Was This A Hate Crime or PTSD?

rodriguez

By Debbie Gregory.

There was a perfect storm brewing in Portland, Oregon’s DarSalam Iraqi restaurant.

Suffering from unsuccessfully treated PTSD, Marine Sgt. Major Damien Rodriguez was allegedly inebriated, a common self-treatment for PTSD, when he and his companion, a retired Marine, took a corner table in the restaurant. He sat where his back could be against the wall, typical behavior of a veteran with PTSD.

His four deployments to war zones had taken a heavy toll.

According to witnesses, after several minutes of not ordering, Rodriguez said that he had to get out of the restaurant. He tried to go through a side door but found it locked, so he stood, wringing his hands. Rodriguez began slinging racial slurs and profanity. Then suddenly, he picked up a chair and hurled it at a waiter.

Ghaith Sahib, the owner of the restaurant, said the incident left him and his staff deeply shaken, especially the employee injured by the chair.

Authorities came down hard on Rodriguez. While this would have normally been a misdemeanor, prosecutors charged Rodriguez with both assault and a hate crime, felony charges that carry a mandatory prison sentence.

Rodriguez was forced to retire following his arrest.

And while special veterans courts have been set up throughout the country to offer therapy instead of jail time to veterans who commit minor crimes most of them bar veterans who have committed a violent crime. This means Rodriguez now faces years in prison.

“What he needs is help. That is what he has needed all these years,” said his mother, Roberta Bello. “But they just want to put him away.”

Raised by a Nigerian stepfather and married to a Guatemalan native, Rodriguez will tell you he is not prejudiced.

“How can they say I hate Iraqis? I gave my soul for Iraq,” he said.

Rodriguez said he did not know what caused him to hit the waiter. It is a blank. “All I can remember, honestly, is being handcuffed by the police,” he said.

After his arrest, Rodriguez entered an intensive program for substance abuse and PTSD. He is saddened that after years of service, he could be conviction for a hate crime.

“I’m sorry about what happened,” he said. “But no one tries to understand what we went through.”

The trial is scheduled to begin December.

Military Connection salutes and proudly serves veterans and service members in the Army, Navy, Air Force, Marines, Coast Guard, Guard and Reserve,  and their families.

Alarming Rate of Suicide Among Servicewomen and Female Vets

female veteran

By Debbie Gregory.

Female military veterans run a 250% higher risk than civilian women for suicide, a startling finding that experts say poses disturbing questions about the backgrounds and experiences of women who serve in the armed forces.

Though suicide has become a major issue for the military over the last decade, most research by the Pentagon and the Department of Veterans Affairs has been focused on men.

Research regarding women in the military, especially in combat roles, is still a new and emerging area. Though the U.S. military has long provided camaraderie and a sense of purpose to men, it has been a harsher place for women.

Risk factors for female servicemember/veteran suicide may include: deployments in hostile environments, exposure to extreme stress, physical or sexual assault while in the service and service related injuries. In addition, there are also general risk factors such as alcohol or substance abuse, homelessness, financial problems, relationship issues.

The VA’s currently has the following suicide prevention initiatives and resources for women veterans in place:

  • Regional and national residential inpatient programs that either provide treatment to women only or have separate tracks for women and men.
  • Outpatient mental health services through VA medical centers, Vet Centers, community-based outreach clinics and partnerships with other local treatment providers across the country.
  • Evidence-based therapies for PTSD that have been shown to decrease suicidal ideation, available at every VA medical center.
  • Support for treating the effects of military sexual trauma.

Establishing mental health programs that are effective for women veterans will go a long way in ensuring they are receiving the best care possible, hopefully turning this issue around.

Military Connection salutes and proudly serves veterans and service members in the Army, Navy, Air Force, Marines, Coast Guard, Guard and Reserve,  and their families.

Service-related PTSD Disability Claims have Tripled in the Last Decade

 

ptsd

By Debbie Gregory.

More than 20 percent of veterans receiving federal disability are suffering from post-traumatic stress disorder, a figure that has tripled in the last decade, from approximately 345,000 cases in fiscal 2008 to more than 940,000 cases today.

This includes all age groups, not just veterans from the recent wars.

PTSD symptoms usually start soon after the traumatic event, but they may not occur until months or years later. They also may come and go over many years. If the symptoms last longer than 4 weeks, cause great distress, or interfere with work or home life, the individual probably has PTSD.

Some of the common symptoms of PTSD include:

  • persistent memories of the event, nightmares, re-living the event over and over
  • not talking to anyone about the event, avoiding any situation that may trigger your bad memories
  • feeling numb and detached, depressed, disinterested in normal life activities, and
  • feeling on high alert all the time, always watching for danger.

PTSD can happen to anyone. It is not a sign of weakness. A number of factors can increase the chance that someone will develop PTSD, many of which are not under that person’s control. Both the VA and Defense Department have worked in recent years to combat the stigma of seeking help for mental health issues.

PTSD is treatable. Many places within VA provide PTSD treatment. General programs that provide mental health services include VA medical centers, community-based outpatient clinics (CBOCs), and Vet Centers.

Vet Centers also offer services to families of Veterans for military-related issues. There are no fees or charges for Vet Center services, and services are confidential.

Military Connection salutes and proudly serves veterans and service members in the Army, Navy, Air Force, Marines, Coast Guard, Guard and Reserve,  and their families.

Can an Injection Alleviate PTSD?

ptsd study

By Debbie Gregory.

The U.S. Army has commissioned a study to see if an anesthetic injection to the neck can alleviates the symptoms of Post-traumatic Stress Disorder (PTSD.)

Stellate ganglion blocks have been used to treat shingles and arm pain, but the $2 million Army study is the first to examine whether the treatment might be helpful to those with PTSD.

During the procedure, a doctor uses ultrasound to guide the needle carefully into the stellate ganglion, a mass of nerve tissue in the neck, and injects the local anesthetic. The injections work on blocking messages along nerve fibers that influence the fight-or-flight response, which can include symptoms such as nightmares and hot flashes.

The study is being led by scientists at RTI International, a North Carolina-based research and development institute. It has begun recruiting active duty troops who have PTSD at military hospitals in North Carolina, Hawaii and Germany.

Some military doctors have already begun treating PTSD patients, particularly Navy SEALs and Army Green Berets, with the shot. It appears that once the treatment has been administered, the shot eases the patient’s anxiety enough so that they can receive other treatments.

“Once people have the shot, they get dramatically better immediately,” said Col. Jim Lynch, command surgeon at the joint Special Operations Command-Africa

Early experiments with the injection have proved effective.

The military is cautiously optimistic about the treatment, but won’t endorse it until there is sufficient evidence that proves its efficacy.

The researchers expect to complete the study in 2018.

Military Connection salutes and proudly serves veterans and service members in the Army, Navy, Air Force, Marines, Coast Guard, Guard and Reserve,  and their families.

Veteran Sought Mental Health Care Before Murder- Suicide

Stiles

A few days before 30-year-old Army veteran Joshua Stiles fatally shot his wife and took his own life, he had tried to get help, but he was turned away.

Stiles, who had been suffering with PTSD, depression and anxiety for years, shot his 22-year-old wife, Brittney Stiles, and then fled the scene. He committed suicide after a police chase.

According to Stiles’ sister, Jennifer Johnson, her brother had contacted a mental health treatment facility, but was told he needed to make an appointment.

He was willing to voluntarily commit himself for psychiatric treatment, but there wasn’t a bed available at Decatur Morgan Hospital. His sister said he then tried Veterans Affairs.

“They said they would send him some paperwork to fill out,” Johnson said. “They said if he was feeling suicidal he should go to the emergency room. At that moment, he wasn’t feeling suicidal. He just knew he was struggling with PTSD and depression.”

Johnson said her brother had been suffering with PTSD long before his military service.

Both Josh and Jennifer had spent time in foster care before going to live with their grandparents.

Josh and his wife had an ongoing domestic dispute the weeks leading up to the tragedy. The two reportedly were arguing at their home and the woman left. Brittney Stiles returned to the home after Joshua called her and threatened their two-year-old daughter if she wouldn’t come home.

Once Brittney returned home with the child, Joshua shot her. Their daughter, who was in the backseat of the mother’s car, was not harmed.

Authorities used a spike strip to deflate tires on the truck. Joshua Stiles reportedly lost control of the truck, hit a tree and then went in a ditch. Authorities surrounded him and used tear gas because they didn’t see any movement.

But as they got closer to the pickup, they realized he had shot himself.

“He wasn’t this person,” Johnson said. “My brother would’ve never done this if he was in his right mind. I wish I could’ve saved him, and I tried. But, the mental health system just makes it too hard.”

There are numerous resources for veterans who are struggling with mental issues, among them, Give an Hour, a non-profit that provides free and confidential mental health resources for those who serve, past and present, and their loved ones; the David Lynch Foundation’s Operation Warrior Wellness (OWW) program, which offers the Transcendental Meditation-based Resilient Warrior Program, a simple, easy-to-learn, evidence-based approach to relieving symptoms of PTSD and major depression and developing greater resilience to stress; and the Veterans Crisis Line  (800-273-8255) which connects veterans in crisis and their families and friends with qualified, caring Department of Veterans Affairs responders through a confidential toll-free hotline.

Military Connection salutes and proudly serves veterans and service members in the Army, Navy, Air Force, Marines, Coast Guard, Guard and Reserve,  and their families.

Veteran Treatment Courts Offer Alternatives

vet treatment court

By Debbie Gregory.

Many military veterans have had life experiences that are very different from their civilian contemporaries. Depending on when and where they served, veterans may have experienced a vast array of physical, emotional and psychological injuries.

Untreated, unhealed emotional and psychological injuries lead to further veteran illnesses, such as Post Traumatic Stress Disorder (PTSD), anxiety and depression. These illnesses can lead to substance abuse, the commission of crimes, and even suicide. Special Veterans Treatment Courts seek to provide veterans suffering from these issues assistance that will help keep them from slipping into real legal problems.

Documented evidence suggests that a significant number of Vietnam veterans experienced severe problems adjusting to civilian life. So too, have many more recently minted veterans returning from Iraq and Afghanistan.

The Veterans Court offers opportunity for the VA, local support organizations, and local communities to offer treatment as an alternative to time in jail.

The first Veterans’ Court in the U.S. was established in 2008 in Buffalo, New York. Veterans’ Courts are modeled after Drug and Mental Health Courts, in that they promote sobriety, recovery and stability through strict court appointed measures.

Usually Veterans Courts hear cases involving misdemeanor charges, and veterans who choose to participate are assessed by a mental health professional and their treatment needs are determined. Most of them receive treatment through the VA’s health network.

Veterans Treatment Courts increase the likelihood of successful rehabilitation through early and continuous judicially-supervised treatment.

Veterans Treatment Courts also provide veterans with services and benefits that aid in their successful transition back into society.

Below are some resources that may assist any veterans in need of legal assistance:

Justice For Veterans

National Association of Veteran Advocates

American Bar Association Military Pro Bono Project

Jail Diversion and Trauma Recovery Program

California Veterans Legal Institute

Military Connection salutes and proudly serves veterans and service members in the Army, Navy, Air Force, Marines, Coast Guard, Guard and Reserve,  and their families.