Tag Archives: military

What Works for PTSD? Research is Key

military-boots

A recent article in the New York Times on alternative treatments for post-traumatic stress disorder (PTSD) highlights a key question: how do we know what alternative therapies work to treat our veterans suffering from PTSD?

Dr. Barbara Rothbaum is a psychologist at Emory University who runs an intensive two-week PTSD treatment program that includes complementary and alternative treatments. While compiling a National Academy of Sciences report on therapies for PTSD, she encountered a key issue: “We met a lot of well-meaning clinicians around the country creating programs with equine therapy or wilderness therapy or whatever, and there was no way to know if any of it worked,” said. “Because of that, we couldn’t recommend it.”

This is not to say that the programs do not work—but the evidence base is not strong enough yet. Part of that is a question of research funding. Drug companies have a vested interest in funding multi-million dollar clinical trials. However, many of the organizations running these alternative programs barely have enough funding to carry out the programs, and therefore do not have the extra funding available for the evaluation of these programs—creating a cyclical problem.

“We need to get what doesn’t work OUT and what DOES work IN the regular treatment for PTSD,” said Wayne B. Jonas, MD. “But we can’t do that unless we build evaluation into each program.”

Two recent projects of Samueli Institute are helping to build the evidence base for complementary and alternative treatments for pain, stress and health.

  1. Stress Management – A new report by Samueli Institute boils down more than a decade of research on stress management. It builds upon an earlier study that focused on military-related programs.
  2. Massage– Samueli Institute recently published a systematic reviews and meta-analysis series that is the first to rigorously assess the quality of massage therapy research and evidence for its efficacy in treating pain, function-related and health-related quality of life for pain, cancer and surgical patients.

In his article entitled The Evidence of Enough, Dr. Jonas explains the challenge and the imperative of managing and evaluating the growing body of evidence: “A more rigorous management of the judgment processes for evidence is needed. Lives, money and the mitigation of suffering depend on it.” Read more.

Painkillers: The “Fast Food” of Pain Relief

Photo of multiple pill bottles

While painkillers are an essential tool in care and treatment of injured patients, two studies released this week reveal an urgent need to rethink their use in our military and civilian health care systems and invest in a broader tool set to help patients mitigate chronic pain.

In a study released in JAMA Internal Medicine on June 30, Dr. Toblin and co-authors revealed that in one of the Army’s leading units 44 percent of the soldiers had chronic pain and 15 percent regularly used opioids. These rates are much higher than the general civilian population (26 and 4 percent respectively) and underscore a crisis in chronic pain among our service members and an overreliance on drugs to mitigate that pain. 

The issue extends to the civilian population at large. Just a few days after the JAMA Internal Medicine report on opioid use in the military, the Centers for Disease Control (CDC) released a report on opioid use in the U.S. that found physicians wrote 259 million prescriptions for painkillers in 2012—enough for every adult in the country to clutch a bottle of pills.

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