Got PTSD and COPD? It may be the meds.

Benzodiazepines could increase suicide risk in COPD and PTSD patients

European Pharmaceutical Review
October 12, 2018

“More research will be needed to better understand this link with suicide, but in the meantime we would advise that clinicians reconsider prescribing benzodiazepines to patients who already are at high risk for self-harm.” Dr Donovan

Researchers have found that long-term use of benzodiazepine medications in patients with posttraumatic stress disorder (PTSD) or chronic obstructive pulmonary disease (COPD) could lead to an increased risk of suicide.

Dr Lucas M. Donovan and his team studied 44,555 veterans who received medical care between 2010-2012. Of these individuals, 23.6 percent received benzodiazepines long term (90 days or longer).

Benzodiazepines are anxiety-reducing, hypnotic, anticonvulsant and sedative drugs that are usually prescribed for COPD and PTSD. Symptoms including shortness of breath, anxiety, insomnia can be alleviated with the drug. The use of benzodiazepines is controversial because of the adverse side effects associated with the drug, which includes an increased risk of COPD exacerbations and self-injury.

They found that long-term use of benzodiazepines in COPD patients who also had PTSD more than doubled their risk of suicide. These patients also had higher rates of psychiatric admissions.

However, the researchers did not find that long-term use of benzodiazepines in this patient group increased their risk of death from all causes or respiratory events, as previous studies have suggested.
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Police Say Medication Sent to Veterans Stolen by UPS Employee

UPS employee stole military veterans' pain medication, police say 
WSOCTV News
By Dave Faherty
April 29, 2015

HICKORY, N.C. — Veterans suffering illnesses and pain reported never receiving their medication. Police believe a UPS employee, trusted to deliver the medications, stole them.

Police said the thefts happened at a UPS distribution center in Hickory. Several veterans in the Hickory area said they are outraged. Police said the worker looked for packages from the Veterans Administration and shook them to see if it sounded like pills were inside.

Police said someone stole $36,000 of pain medication during the last six months. "It's a little bit shocking to hear somebody would do that,” said veteran Eddie Gee. "I think it is crazy.

You put trust in these people to deliver your packages,” said veteran Mike Holley John Laughter did two tours in Vietnam. He now has difficulty getting around and needs the medication for a degenerative back problem.

He said he hasn't gotten his pills three times from the VA during the last six months.
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VA Doctor's Answer to PTSD, More Pills, Less Talk

Since I already popped my cork today I will not add more to this.

Dr. Suris is the Chief of Psychiatry of Mental Health at Dallas’ VA Medical Center. Her research into a more efficient PTSD treatment has been called promising because it does not dwell on the traumatic memory.

“You come in and you have a 30 second exposure to your trauma,” Dr. Suris said. “That 30 second exposure is paired with a medication that we know is safe. We’re trying to interfere with that emotional connection. So you don’t lose the memory of the trauma, at all. But, you lose how you respond to that trauma. So if you think about your trauma, you’re not upset. It’s a fact.”

Enough said

Sleep aid may be aiding bad memories to stay

Common Sleep Aid, Ambien, Intensifies Emotional, Negative Memories
By TRACI PEDERSEN
Associate News Editor
Reviewed by John M. Grohol, Psy.D. June 15, 2013

Researchers have identified the sleep mechanism that enables the brain to strengthen emotional memories.

They also found that a commonly prescribed sleep aid heightens the brain’s remembrance of and response to negative memories.

Dr. Sara Mednick from the University of Riverside and her colleagues found that a sleep condition known as sleep spindles — bursts of brain activity that last for a second or less during a specific stage of sleep — are vital for emotional memory.

In earlier research, Mednick demonstrated the vital role that sleep spindles play in transferring memories from short-term to long-term in the hippocampus.

Currently, the U.S. Air Force uses zolpidem as one of the prescribed “no-go pills” to help flight crews calm down after using stimulants to stay awake during long missions, the researchers noted in the study.

“In light of the present results, it would be worthwhile to investigate whether the administration of benzodiazepine-like drugs may be increasing the retention of highly arousing and negative memories, which would have a countertherapeutic effect,” they wrote. “Further research on the relationship between hypnotics and emotional mood disorders would seem to be in order.”
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Also found
Ambien Side Effects

Other side effects including tolerance to the pharmacologic effects of zolpidem (the active ingredient contained in Ambien) have been reported rarely. Withdrawal symptoms after either abrupt cessation or fast tapering may occur. Withdrawal symptoms may include agitation, restlessness, anxiety, depression, insomnia, tremor, nausea, abdominal discomfort, and sweating.

Medication from US won't be mailed to troops in Germany

4 minutes ago
Medication from US won't be mailed to APOs in Germany
By NANCY MONTGOMERY
Stars and Stripes
Published: September 19, 2012

HEIDELBERG, Germany — Prescription medications addressed to military post office boxes in Germany soon will be flagged by U.S. postal clerks stateside and not sent.

William Kiser, the top postal officer for U.S. forces in Europe, said that U.S. post offices would stop sending the medications and a variety of other items the German government has banned or restricted from import. The target date is Jan. 1, Kiser said.

Postal clerks will match restriction codes for the items with ZIP codes.

Late last year, German authorities began confiscating mailed medications, U.S. officials said, enforcing a law the Germans say has been on the books for years.

U.S. authorities only learned recently, after packages were confiscated, that the mailed medications they thought were legal — covered under the status of forces agreement and viewed as domestic mail — were not.

The longtime practice had been encouraged by Tricare, the military health insurer, as both less expensive and more convenient, especially as more military health centers closed along with their garrisons.
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Lawmakers press VA on improper drug orders

Lawmakers press VA on improper drug orders
By Cid Standifer
Staff writer
Posted : Thursday Jun 7, 2012

Lawmakers are keeping the Veterans Affairs Department on the hot seat over “unauthorized purchases” of pharmaceuticals in violation of federal acquisition regulations, even as VA officials insist they’ve slashed the number of improper buys from more than 70,000 last September to 434 in March — a 99 percent drop.

At a Wednesday hearing before the House Veterans’ Affairs Committee, a panel of VA officials assured lawmakers that veterans were never put in danger or denied needed medications during the years when a computer system allowed pharmacy ordering officers to place orders outside the VA’s Pharmaceutical Prime Vender contract with McKesson Corp.

However, since the orders weren’t properly bid out to get the best price, VA violated federal purchasing laws. The committee first grilled VA about violations in February, though the violations may have begun as early as 1994, when the VA initiated its first Pharmaceutical Prime Vendor contract.
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Lawmakers to question VA pharmaceuticals purchasing practices

Lawmakers to question VA purchasing practices
By Patricia Kime - Staff writer
Posted : Monday Jan 30, 2012 10:01:06 EST
The House Veterans’ Affairs Committee is looking into whether the Veterans Affairs Department spent $333 million on pharmaceuticals, medical equipment and other purchases without having contracts for the transactions.

The committee will meet at 10 a.m. Wednesday to question VA officials on whether the department made purchases last year without contracting for them and whether the unauthorized buys have been going on for years — an issue reported in December by Bloomberg News.
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The VA Brush-Off for Spc. James Eggemeyer

James Eggemeyer in his trailer in Stuart, Fla.Darrell Jones photo

Politics
The VA Brush-Off
The Department of Veterans Affairs routinely delays disability claims by wounded soldiers for months and years, often shunting them into homelessness. But there’s a simple way for the government to get disabled veterans the help they deserve. It can trust them.
By: Aaron Glantz September 17, 2008

Twenty-five-year-old Spc. James Eggemeyer injured himself before he even set foot in Iraq, while jumping out of an AC-130 gunship during parachute training at Fort Bragg, N.C. As he leapt from the plane, his arm got tangled in one of the lines of his parachute. Instead of drifting gently through the air to the ground, he was dragged alongside the plane as if on a short leash. “My parachute was twisted up like a cigarette roll, and I hit real hard,” he says. “My ankle and my knee and my back and my shoulder (got hurt). I tore my rotator cuff. I feel like a 50-year-old man.”

Military doctors prescribed several drugs: the painkillers Vicodin and Percocet and the steroid hydrocortisone. Then, in April 2003, they ordered the heavily medicated soldier deployed to Iraq. For the next year, Eggemeyer drove a Humvee, running supply convoys all around the country. His convoys were attacked twice. His worst day occurred early on, when the military truck in front of his Humvee hit a civilian vehicle.

“One of the cars in the oncoming traffic hit another car that was coming toward us and caused that car to swerve across the intersection and slam into the truck in front of me. The truck in front of me hit it pretty good and killed everyone inside,” he says. He slammed on the brakes to avoid adding his Humvee to the pileup. Then he got out and loaded an entire family of dead Iraqis onto an American helicopter.

“A Black Hawk had come in when my first sergeant called the medics, and they flew, and the people got taken out,” he says. “But they were already dead, and so they just got transported: a little girl, two adult females and a guy.” After that, Eggemeyer’s condition worsened. The longer he stayed in Iraq, the worse his body felt. He also started to take more of the painkillers and the steroids the military had given him. The more he took them, the more he needed to dull the pain.
But violence wasn’t the only thing Eggemeyer had to deal with overseas. While he was in Iraq, he filed for divorce. Then Eggemeyer checked his bank account, and, he says, $7,000 had somehow gone missing. So, for the duration of his time in Iraq, Eggemeyer’s parents took custody of his son, Joseph, who had been born just two months before his deployment.

Returning to Fort Bragg in April 2004, Eggemeyer was quickly discharged from the military. Already experiencing symptoms of post-traumatic stress disorder, he started fighting with his captain and was given a “general discharge under honorable conditions,” which allows him to use the services of the Department of Veterans Affairs but denies him access to benefits of the GI Bill. Eventually, his PTSD and other injuries led him to become homeless, and he filed a disability claim with the VA. He continued to live literally on the street, sleeping in vehicles, for more than nine months as the VA bureaucracy sorted paper and asked for more, piling delay on delay.
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http://www.miller-mccune.com/article/676

Move over Freud: Psychiatrists embrace pill power

This article is long overdue. In 1992 I did temp work for a group of psychiatrists. Six of them! They had only one doctor, the head of the group, who focused on medication only. The others, did both. What I noticed was the mental health hospital was relying more on therapists and social workers than psychologists or doing it themselves. Some of the patients seeing the group were in and out quickly for just medication follow ups. This happened a lot. It made me wonder how much help they were really getting.

Many years later, I went to a psychologist to deal with the stress I was under living with PTSD in the house. Medication was not mentioned. She knew I just needed someone to talk to who understood PTSD.

For my husband, he's been on medication and in therapy with the VA for a long time. Because of the newer veterans coming into receive treatment as well, there was a time when his appointments were cut back to once every three months. Even he noticed the difference and was not doing well dealing with the length of time between appointments.

For some veterans, depending on how deep their wounds have cut, they can do without medication as long as they are receiving therapy. For others, they need both. While some decide they don't want therapy at all, they are not really healing but just staying stabilized.

To just be about the medication and forget all that goes into what is wrong with the person is not the answer.

Move over Freud: Psychiatrists embrace pill power
Mon Aug 4, 2008 4:17pm EDT

By Julie Steenhuysen

CHICAGO (Reuters) - Psychiatrists in the United States are trading in the analysis couch for a prescription pad, according to a study released on Monday that found fewer psychiatrists offer psychotherapy.

The shift to briefer visits for medication management, reported in the Archives of General Psychiatry, appears to be linked to better psychiatric drugs and pressure from managed care companies, which offer richer financial incentives for brief office visits.

"Psychiatrists get more for three, 15-minute medication management visits than for one 45 minute psychotherapy visit," said Dr. Ramin Mojtabai of Johns Hopkins University in Baltimore and formerly of Beth Israel Medical Center in New York, where he did the research.

Various forms of psychotherapy, either alone or in combination with medications, are recommended to treat depression, post-traumatic stress disorder, bipolar disorder and other psychiatric illnesses.
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http://www.reuters.com/article/healthNews/idUSN0444133020080804

Users Rate Their Drug and Non-Drug Treatments for PTSD

While I do post up reports on medications and new treatments for PTSD, I tend to stay out of giving advice on them except to say that people need to be informed, talk to their doctors and just because one medication is not working, that does not mean none of them will work on you. Our body chemistry is as different as we are. What works for your friend, may not work for you, or you may need a combination of medications instead of just one. Always be honest with your doctor and if you are not feeling better on a new medication in a couple of days, call him. If you are feeling worse, call him as soon as possible but do not play doctor yourself and take yourself off the medication. Most of us tend to finally feel better and then think we are cured without understanding it's the medication that did it.

My Mother was always very healthy. When she turned 75, her age caught up with her and suddenly everything was wrong. For a woman who didn't even want to take Tylenol,, it was hard for her to understand she had to take medication for her heart. Years later, more medication was added to take care of additional problems she had. When I took her to the doctor's appointments, the doctor would tell her that she was stable and the next thing out of her mouth was "Well then I can stop taking the pills." She just didn't want to understand the medication was making her stable. One lesson in facing that you are on medication for a reason and it's why you are feeling better.

I am on a low dose medication for my blood pressure and for allergies. If I go off the allergy medication, I end up with a sinus infection. While I hate taking anything, I know I need to. The doctors had a hard time finding the right medication for my allergy and sinus problems. They switched the well known ones, finding out that they were not working for me or making me too sleepy. They ended up putting me on medications no one else I know ever heard of. One lesson in keep trying.

My friend Lily over at Healing Combat Trauma did a great job on medication today. Go here and take a look at the links she's provided.

July 21, 2008
There's a Revolution Going On: Users Rate Their Drug and Non-Drug Treatments for PTSD
http://www.healingcombattrauma.com/2008/07/theres-a-revolu.html

Many Frontline Troops Turn To Meds To Cope

Many Frontline Troops Turn To Meds To Cope
David Martin: They're Using Anti-Depressants, Sleeping Pills To Combat Stress Of Battle

June 10, 2008


(CBS) As the wars in Iraq and Afghanistan continue, we're learning that a large number of troops are turning to medication to deal with the stress of battle.

Each year, between 20 and 40 soldiers are evacuated from war zones for mental problems brought on by combat, says CBS News National Security Correspondent David Martin, and many more stay in the battle with the help of medication.

A recent survey found 12 percent of soldiers in Iraq reported taking either anti-depressants or sleeping pills. That works out to about 19,000 soldiers, half of them using anti-depressants.

"We are in new territory," Martin quoted an Army psychiatrist as saying, meaning, Martin explained, that never before have anti-depressants without dangerous side effects been available to soldiers facing repeated combat tours.

Starting in the late 1980s, anti-depressants that didn't cause dizziness, drowsiness and other complications began to come on the market. Then, Martin observed, came Iraq and Afghanistan, with their multiple combat tours and demands for increasing numbers of troops -- and the Pentagon approved prescribing drugs such as Zoloft, Prozac and Paxil for soldiers who otherwise might have to be evacuated from the war zone.

"Post-Traumatic Stress Disorder (PTSD) has become one of the signature wounds of this war," Martin pointed out. "Now, anti-depressants are emerging as one of the signature medications."

Paul Rieckhoff, executive director of the Iraq and Afghanistan Veterans of America, told Early Show co-anchor Harry Smith Tuesday, "This high rate of the use of anti-depressants and sleeping pills is really just a symptom of a deeper problem. We're sending folks back over and over again in a tremendously stressful environment, and it's taking its toll. The anti-depressants and sleeping pills are one way that the military and the individuals are trying to meet that threat."
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http://www.cbsnews.com/stories/2008/06/10/earlyshow/main4168696.shtml