Coming Home to a New War: Veterans With PTSD Need Your Help

Do you treat veterans? According to the Veterans Administration (VA), as many as one in five military service members who served in war suffer from post-traumatic stress disorder (PTSD). It is estimated that 30 percent of all vets who served in the Vietnam War suffer from PTSD at some time in their life.¹

Even with these staggering statistics, many veterans feel hopeless and uncomfortable asking for help. Sadly, for this reason, many vets don't get the adequate support they need. These soldiers turn instead to different types of addictive substances including alcohol and "self medication," such as opioids.

Because veterans deserve better care, it's essential to understand how you can help combat veteran PTSD in your acupuncture office.

Coming Home to a New War: The Burden of PTSD

Returning home from war can't be easy. Many troops experience unemployment, feelings of isolation, and PTSD. But, first what is PTSD? From the National Institute of Mental Health:² "Post-traumatic stress disorder (PTSD) is a disorder that develops in some people who have experienced a shocking, scary, or dangerous event. This ‘fight-or-flight' response is a typical reaction meant to protect a person from harm. People who have PTSD may feel stressed or frightened, even when they are not in danger." Commonly, medications such as antidepressants have been the first line of defense to fight PTSD. Oftentimes, it is a losing battle.

Opening Up About Opioids

Opioid use / abuse has become a national health crisis. You may have heard about this epidemic in the tabloids, the news or even witnessed it first-hand in the clinic. Sadly, this extremely addictive drug has affected just about every patient population – including our veterans. What's even more disturbing is that according to a 2011 study by the VA health system,³ "Veterans are twice as likely to die from an accidental opioid overdose compared to the general population."

According to the National Institute on Drug Abuse, "Opioid overdose deaths rose from 8,048 in 1999 to 47,600 in 2017."³ Knowing veterans are at risk for increased mortality, our help is essential. But when is the best time to start treating our vets? The answer is as soon as they step off the battlefield.

Beyond the Battlefield

Insomnia:Veterans with PTSD experience many unpleasant symptoms. However, the symptom they may battle the most is insomnia. A survey of veterans from the Afghanistan and Iraq Wars revealed insomnia was the most commonly reported PTSD symptom.⁴ In fact, among veteran patients diagnosed with PTSD, 70-91 percent experience insomnia.⁵ Furthermore, insomnia is reported to occur in 90-100 percent of Vietnam War-era veterans with PTSD.¹

Considering the above, improving sleep quality is a crucial step in achieving positive PTSD outcomes. Generally speaking, insomnia has been linked with aggravating mental health conditions and increasing the length of the disorder.⁶ Drugs such as SSRIs and SNRIs that are used to treat PTSD have potential side effects; ironically, one of the side effects is insomnia. Other side effects noted with the use of these medications include anxiety, cognitive deficits, tachycardia and cardiac arrhythmia.⁷

Pain:Another common symptom veterans experience is pain. It has been estimated that 74 percent of U.S. veterans experience chronic pain.² With no end to the pain in sight, many veterans may feel they have lost the battle for their health.

Lost the Battle, But Not the War

Adjusting to civilian life is challenging. However, with all the emerging data out now about PTSD, there is much hope! Researchers are finding natural approaches for the treatment of mental health problems. One of those natural therapies is Chinese medicine.

Specifically, there are two well-known, researched protocols to combat veteran PTSD. The first is the NADA (National Acupuncture Detoxification Association) protocol. The NADA protocol has been used for veterans suffering from insomnia-induced PTSD, substance abuse withdrawal and other symptoms associated with post-traumatic stress disorder. In a pilot study, "The NADA protocol was associated with statistically significant improvements in overall scores of both the Pittsburgh Sleep Quality Index and PTSD Check List – Military version."⁸

Sleep quality and in particular REM (rapid eye movement) sleep has been emphasized as most important for improving the health of our veterans. In another randomized, controlled study, the NADA protocol was shown to significantly improve sleep quality.⁹

The second protocol is called battlefield acupuncture. This protocol uses "semi-permanent" needles that may last for a few days. This auricular protocol was developed by a medical doctor by the name of Dr. Richard Niemtzow. (Battlefield Acupuncture also hosts seminars and grants certification options to attendees.) This ear protocol is still actively used on the field by Army medics and has been implemented in VA centers to treat vets.

Leave No Man Behind

According to the VA, there are 18.2 million veterans in America. For all those soldiers who suffer with any physical or emotional battle wounds, traditional Chinese medicine can help immensely. As our profession spreads across U.S. soil, we can positively touch the lives of many more veterans. The VA health care system has approved the use of acupuncture as determined by health care teams, and they are reporting success. There is no doubt: This is only the beginning of acupuncture's spread across the West. Giving veterans the gift of Chinese medicine is a fight we must fight together in our clinics. As the military says, "Leave no man behind." In our case, lets leave no veteran behind!

References

1. Ross RJ, et al. Sleep disturbance as the hallmark of posttraumatic stress disorder. Am J Psychiatry, 1989;146, 697-707.
2. Higgins DM, et al. Persistent pain and comorbidity among Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn veterans. Pain Med, 2014;15(5):782–790.
3. Bohnert SB, et al. Accidental Poisoning Mortality Among Patients in the Department of Veterans Affairs Health System. April 2011.
4. McLay RN, et al. Insomnia is the most commonly reported symptom and predicts other symptoms of post-traumatic stress disorder in U.S. service members returning from military deployments. Military Med, 2010;175:759-762.
5. Lewis VL, et al. Is poor sleep in veterans a function of post-traumatic stress disorder? Military Med, 2009;174:948-951.
6. Ribeiro JD, et al. Sleep problems outperform depression and hopelessness as cross-sectional and longitudinal predictors of suicide ideation and behavior in young adults in the military. J Affect Disord, 2011;136(3):743-750.
7. Ursano RJ, et al. Practice guideline for the treatment of patients with acute stress disorder and posttraumatic stress disorder. Am J Psychiatry, 2004;161(11 Suppl):3-31. Also: Jacoby WG. Public attitudes toward government spending. Am J Political Sci, 1994;38(2):336-361.
8. Carter K, et al. NADA ear acupuncture: an adjunctive therapy to improve and maintain positive outcomes in substance abuse treatment. Behav Sci, 2017;7(2):37.
9. Bergdahl I, et al. Clinical study: auricular acupuncture and cognitive behaviorial therapy for insomnia: a randomized controlled study. Sleep Disord, 2016;2016:7057282.