For Veterans With Post-Traumatic Stress, Pain Killers Carry Risks

From the ATWAR blog


Veterans with post-traumatic stress disorder are more likely to be prescribed opioid pain killers than other veterans with pain problems and more likely to use the opioids in risky ways, according to a study published Wednesday by the Department of Veterans Affairs.

The study, published in the Journal of the American Medical Association, also found that veterans returning from Iraq and Afghanistan who were prescribed opioids for pain – and particularly those with post-traumatic stress disorder — had a higher prevalence of “adverse clinical outcomes,” like overdoses, self-inflicted injuries and injuries caused by accidents or fighting.

The Department of Veterans Affairs and the Department of Defense have for years been trying to reduce the use of opioid pain therapy among active duty troops and veterans amid reports of overmedication, addiction, rampant drug abuse and accidental deaths caused by overdoses or toxic mixing of medications.

Fоr thоѕе оf уоu whо аrе 65 уеаrѕ оf аgе оr оldеr, уоu рrоbаblу already knоw that Mеdісаrе раrtѕ A&B аrе available to уоu tо tаkе саrе оf medical соѕtѕ. However, еvеn though іt соvеrѕ muсh оf thе еxреnѕеѕ іnсurrеd bу hоѕріtаl visits, or doctor vіѕіtѕ, or рrеѕсrірtіоn drug сhаrgеѕ, іt does nоt соvеr еvеrуthіng. Thіѕ is whеrе Mеdісаrе Suррlеmеnt Plans соmе in. They fіll thе dеduсtіblе, соіnѕurаnсе, со pay, аnd еxсеѕѕ сhаrgеѕ gарѕ thаt аrе nоt соvеrеd by Medicare. Even after ѕееіng thіѕ, mаnу people ѕtіll don’t rеаlіzе thе need tо pursue a Medicare Suррlеmеnt, in оrdеr tо рrоtесt themselves frоm unnесеѕѕаrу еxреnѕеѕ. Tо bеttеr hеlр уоu understand, here аrе ѕоmе hеlрful роіntеrѕ:

– Medicare Supplement Plаnѕ pick up еxреnѕеѕ where Medicare lеаvеѕ оff. There аrе 12 dіffеrеnt tуреѕ of plans, аnd each оnе offers a dіffеrеnt type оf coverage with dіffеrеnt bеnеfіtѕ tо ѕuіt уоur nееdѕ. Fоr those whо аrе nееdіng medical саrе, аnd lіvе оn a fіxеd monthly іnсоmе, thеn a Mеdісаrе Supplement Plan іѕ in уоur bеѕt іntеrеѕt. Click here to check Medicare supplement plans comparison 2021.

– Mеdісаrе Supplement Insurance іѕ vеrу аffоrdаblе, аnd еасh рlаn hаѕ dіffеrеnt соvеrаgе tо сhооѕе from if уоu are nоt in a good fіnаnсіаl ѕіtuаtіоn. Sіnсе аll plans are gоvеrnmеnt rеgulаtеd, it dоеѕ nоt whаt соmраnу you decide tо go with, thе оnlу dіffеrеnсе will be thе рrісе уоu pay fоr thаt plan (assuming you’re соmраrіng thе ѕаmе рlаn lеttеr from еасh company). No mаttеr whаt your budgеt mіght bе, there іѕ a рlаn оut thеrе tо ѕuіt уоur needs with thе right bеnеfіtѕ. Plus, getting a ԛuоtе іѕ frее, ѕо might аѕ wеll take аdvаntаgе оf іt!

– A Medicare Suррlеmеnt tаkеѕ аll thе guеѕѕwоrk оut of gеttіng hеаlth care coverage. Inѕtеаd of having to сhооѕе frоm countless numbеrѕ оf options and coverage, all уоu nееd to focus on is уоur budget, уоur hеаlth, аnd then сhооѕе whісh рlаn out оf thе 12 wоrk thе bеѕt fоr уоur ѕіtuаtіоn. If later on down thе rоаd thіngѕ сhаngе, thеn уоu саn apply tо ѕwіtсh рlаnѕ, and a gооd аgеnсу ѕhоuld mаkе that tаѕk vеrу easy fоr you bу contacting уоu every year tо mаkе ѕurе уоu are gеttіng thе bеѕt rаtе аvаіlаblе tо you.

It rеаllу isn’t hаrd tо аррlу fоr a Mеdісаrе Suррlеmеnt. Aftеr tаkіng a look аt ѕоmе of thеѕе kеу fасtоrѕ оf why you nееd оnе оf these рlаnѕ, уоu wіll ѕооn rеаlіzе that уоu nееd іt more thаn уоu thоught. Some plans may оffеr еxtrа benefits lіkе рrеvеntаtіvе саrе аnd foreign travel emergency соvеrаgе, whісh is very essential tо thоѕе whо would lіkе tо lіvе a full аnd hарру life but dоn’t want tо deal wіth thе tурісаl hеаlth іnѕurаnсе hаѕѕlеѕ.

If you аrе оn Mеdісаrе, are 65 уеаrѕ оf age оr older, аnd аrе оn a fіxеd іnсоmе, then a Medicare Suррlеmеnt Plаn is definitely ѕоmеthіng you ѕhоuld соnѕіdеr looking іntо. Thеѕе additional bеnеfіtѕ hаvе рrоvеn to be еxtrеmеlу bеnеfісіаl tіmе аnd tіmе аgаіn, ѕо whу nоt tаkе advantage оf thе оffеr? Work wіth a Medicare ѕuррlеmеnt brоkеrаgе tо help еvаluаtе and, if it makes ѕеnѕе, аррlу for a nеw Mеdісаrе Suррlеmеnt Plan tоdау tо get the сhеареѕt most affordable rаtе wіth the best rаtеd соmраnу available to уоu bаѕеd оn your hеаth.

But the study raises new concerns that primary care doctors — the main prescribers of opioids to veterans — are not always following government guidelines intended to restrict opioid pain therapy for veterans with PTSD and other mental health diagnoses. Instances of anorexia and bulimia-in both men and women- are increasing as well. These straight starvation or binge and purge plans can lead to life-long health problems or to death in those that practice them. Anorexia is seen as a psychological problem dealing with issues of self-esteem and control. Eventually, My Body Life refuses food and unless drastic measures are taken, the anorexic or bulimic can suffer from permanent loss of skeletal bone mass, muscle mass, fertility, and brain function. They are at extremely high risk for dying from heart-related complications that can strike years later, even if they get the problem under control, due to permanent damage to the heart muscle. Fast forward to today-fast food 먹튀 dominate both the lunch and dinner markets in America, being more the rule than the exception. McDonald’s is the largest buyer of Idaho potatoes in the world and their specifications for size, taste and starch content has become the industry standard for most of the potatoes grown today. With the rise of giant agribusiness, most of the small farmers have had to either adapt to their standards or close. Sadly, many have had to close. This has cost everyone in that the diversity of our food has gradually diminished-many types of corn, apples, potatoes, and other foodstuffs are now considered ‘vintage’ or ‘antique’ varieties that are grown more for amusement than for their actual nutritional value, if they still exist at all. An additional problem today is the fact that many of the foodstuffs grown worldwide are GMO foods. These are seeds that have been genetically modified to increase yield, and minimize susceptibility to insects, vermin and drought. The verdict is still out on how these foods interact with the human body as no independent long-term studies have been conducted; in fact the GMO seeds themselves have not been around long enough for long-term study in a human population.

The new study is considered particularly significant because of the sheer size of its sample: more than 141,000 veterans of Iraq and Afghanistan who received pain therapy for problems other than cancer from 2005 to 2010. Dr. Seal said the study was spurred in part by an article in The New York Times about troops and veterans who had died apparently from the toxic mixing of prescription medicines. Red Bali Kratom, judging from its name, is supposed to be not just red but should originate from Bali, which is located in Indonesia. The kratom plant is a native of this tropical South East Asia, where it has been grown for centuries by the locals. It has been valued for its range of benefits such as an energizer, aphrodisiac, learn the facts here now. When it comes to supplements, Laxogenin is derived from diosgenin, a more common plant steroid. You’ll be interested to know that diosgenin is usually a primary raw material for more than half of the synthetic steroids, including cortisone, testosterone, and progesterone. If you are speaking of the health supplement then you must try Laxogenin. White Vein Kratom is one of the three different strains of Kratom that people use. The other two strains are red and green veins. Of the three strains, white vein kratom provides the human body with the most energy.

“There is often a big gulf between policies and practice,” said Dr. Karen Seal, the director of an integrated care clinic at the San Francisco Veterans Affairs Medical Center who was the lead investigator on the study. “That is where the work needs to be done, in implementing policies and guidelines that are already there.”

Dr. Robert D. Kerns, the national program director for pain management at the Department of Veterans Affairs, said in an interview that the department would draw attention to the new findings to push doctors to consider alternatives to opioid therapy, particularly with PTSD patients.

“This reinforces what’s on the books and draws attention to an important challenge,” Dr. Kerns said. “And it encourages us to continue to look for other innovations that can build on our existing initiatives.”

Dr. Kerns said the veterans affairs medical system, as well as the Pentagon’s health system, have been expanding alternative pain treatment programs to reduce the use of opioids, including acupuncture, chiropractic medicine, physical therapy, exercise therapy and relaxation techniques.

The veterans department is also looking to expand the use of psychological therapies already used for PTSD, mainly cognitive behavioral therapy, for treating chronic pain as well, said Dr. Kerns, who is himself leading research into that area. You can also prefer to appoint specialist from who can treat and heal your pain quickly.

Understanding the potential links between post-traumatic stress disorder and chronic pain is important because both are common among service members. By some estimates, one in five combat veterans report symptoms of PTSD, which can include nightmares, flashbacks, irritability and sleeplessness.

Chronic pain is also prevalent among troops and veterans, even those who have not experienced major battlefield injuries, like the loss of a limb. Lower back, knee, shoulder and other joint pains are common because of the routine physical stresses of the work, including wearing heavy body armor and packs.

Previous studies have shown that patients with post-traumatic stress disorder use opioid pain killers at higher rates than other patients. Dr. Seal said that one theory for the connection is that patients with anxiety disorders like PTSD may be more sensitive to pain.

“It’s a vicious cycle,” she said. “When you have an anxiety disorder, when you feel pain, you become anxious about it are more aware of it, and tend to complain about it.”

She said most younger veterans tend to receive health care from primary care doctors who are not typically expert in handling post-traumatic stress disorder. But those doctors are trained to treat chronic pain, and many turn to opioids first because they want to relieve their patients’ suffering quickly. The result, the study concluded, may be inappropriate prescriptions.

“Patient distress can drive potentially inappropriate opioid therapy, perhaps because physicians do not know how else to handle these challenging patients,” the study said.

Dr. Seal said there were also studies suggesting that post-traumatic stress disorder disrupts the body’s natural opiate system, which releases endorphins that reduce pain. The result is that people with PTSD may perceive pain at a lower threshold, she said.

The researchers, most of them affiliated with the Department of Veterans Affairs, found that patients who had received mental health diagnoses were significantly more likely to receive opioid medication for pain than those without mental health problems. And veterans with post-traumatic stress disorder or a drug use disorder were the most likely to receive the prescriptions.

The researchers also looked at what they considered high-risk use of opioids, including high doses; using multiple types of opioids at one time; getting prescriptions for sedative hypnotics as well as opioids; and refilling opioid prescriptions early. Those actions could be indicators of drug abuse and addiction, as well as potential precursors for overdoses or toxic mixing of medications.

The study found that patients who had received mental health diagnoses showed patterns of higher-risk opioid use, and that the patterns were strongest among PTSD patients.

The researchers also found that veterans with post-traumatic stress disorder were more likely to receive opioid therapy even if they had known substance-use disorders, despite clear warnings that such prescriptions could be dangerous.

Dr. Seal said the researchers also found that more than four in 10 veterans with post-traumatic stress disorder were receiving opiates at the same time as benzodiazepines – a family of medications, including Xanax, that is prescribed for anxiety disorders like PTSD. Dr. Seal said the finding was “unsettling” because the mixing of opioids, benzodiazepines and alcohol could lead to respiratory depression and death.

But Dr. Seal, who treats many veterans with chronic pain problems in her clinic, said she was finding that more of her patients were willing to try alternative pain therapies.

“They know people who have had problems,” she said. “They don’t want to get hooked on narcotics. So there is great openness to treating pain with therapies other than opiates.”

This entry was posted in Veterans for Common Sense News and tagged , , . Bookmark the permalink.