Operation: Zeus

FDA has approved microdose M**A to treat refractory PTSD in Veterans; it works by keeping neurochemicals like dopamine attached to the receptors longer so we feel more "safe" and calm. It does not have the side effects of SSRIs.

https://psychedelictimes.com/mdma/three-ways-you-can-get-involved-with-the-phase-3-trials-of-mdma-as-a-ptsd-treatment/

Three Ways You Can Get Involved With the Phase 3 Trials of M**A as a PTSD Treatment MAPS' Phase 3 trials of M**A to treat PTSD have been approved. Here's how you can support this research and get involved.

http://jamanetwork.com/journals/jamapsychiatry/fullarticle/1835339

Suicidal Behavior Among Soldiers

Full document on research study, Iraq and Afghanistan Veterans Community Reintegration.

https://drive.google.com/open?id=0B9Jwm6TI1OtbSXBucEkwbW1zUEk

Military Training, Combat Exposure, PTSS & Functioning.pdf

More results from the Iraq and Afghanistan Combat Veteran Community Reintegration Survey.

For Post-9/11 Veterans, Combative Occupations were 3.6 times as likely to experience at least moderate to heavy combat exposure while non-combative occupations were 5.4 times as likely to report experiencing light to moderate exposure. This exposure was assessed by 12 questions regarding both battle and post-battle experiences commonly experienced in Iraq and Afghanistan.

Despite experiencing considerably more combat exposure in frequency and intensity the combative occupations reported no differences in combat stress symptoms (PTSS) or reintegration challenges within the last 30 days compared to non-combative occupations. The combative specialty group was 2.6 times more likely to believe that their occupational training mentally prepared them for combat than the non-combative specialty group.

Final results from the Iraq and Afghanistan Combat Veteran Community Reintegration Survey.

Will post result snippets over the next couple weeks.

Veteran participants were primarily between 27 and 32 years old (41%), male (89%), self-employed or working full time (61%), divorced (47%) and had some college education (52%). In addition, respondents were predominantly Army veterans (82%), serving 3 to 5 years (46%) on active duty (91%) with 7 to 15 months (40%) in combat. Prior to completing the survey, veterans were primarily honorably discharged (88%) over 4 years ago (42%) and also experienced their last combat deployment over 4 years ago (69%). The survey group was approximately equal between non-combative (52%) and combative (48%) occupational specialties. A little over half (54%) of the participants said they had received formal military resilience training.

Nearly all participants (95%) across the occupation and resilience training groups believed that they were physically prepared for what they experienced during their combat deployments. However, only 6 in 10 thought their occupational training morally prepared them for combat. Overall 7 in 10 veterans believed that their occupational training mentally prepared them for combat. In addition, over half of the veterans believed that their military training and experiences provided them with an improved ability to cope with stress after discharge most of time or very often. Just over half of the respondents reported at least moderate to extreme combat exposure levels.

http://www.antiochseattle.edu/wp-content/uploads/2016/03/Russell-Butkus-Figley-2015a-Contribtutions-Organization-and-Leadership-to-Crises.pdf

Great article from one of my mentors, a Vietnam Veteran turned PhD researcher, Dr. Charles Figley.

Would creating a Behavioral Health Corps within DoD help? What about re-establishing President Franklin D. Roosevelt’s mandate for reconditioning and social reintegration services prior to military
discharge? Let me know your thoughts

www.antiochseattle.edu

Great researcher, retired Colonel, combat veteran! Here is a quote from the intro:

"Society hasn't yet grasped that 'transitioning' home from combat does not mean giving up being a warrior, but rather learning to dial up or down the warrior responses (we learned from our training) depending on the situation"

Parenthesis mine. Highly recommend the book for the warfighter community.

http://onceawarrior.com/

Once a Warrior – Always a Warrior In this ground-breaking book, Dr. Charles Hoge explains how transitioning home from combat requires learning how to dial up or down the warrior responses, depending on the circumstances.

My experience is that these non-military researchers have NO CLUE about military context and make silly conclusions about their findings...like this one below. When will the VA recognized the distinction between the warfighter community and veterans. They trained differently, have different motivations, different experiences, and after combat, vastly different neurobiological wiring than their non-combat veteran peers.

http://mobile.nytimes.com/2016/05/30/health/veterans-iraq-afghanistan-psychology-therapy.html

Those With Multiple Tours of War Overseas Struggle at Home The number of veterans with multiple tours of combat duty is the largest in modern American history — more than 90,000 soldiers and Marines.

Still collecting data on how we are doing with reintegration processes. I have the ear of Vets Experience Chief at VA and need your input. This data is being used to create Healthy Exit and Resilient Reintegration Operation (HER2O) that will help vets bypass traditional VA disability processes. Use this link if you have not already taken the survey.

https://www.surveymonkey.com/r/IAV_Community_Reintegration_Survey

Iraq and Afghanistan Combat Veteran Community Reintegration Survey Web survey powered by SurveyMonkey.com. Create your own online survey now with SurveyMonkey's expert certified FREE templates.

MONEY BALL & THE WARS IN IRAQ IN AFGHANISTAN

The data science cliché has crept into nearly every corner of American industry sectors in the last decade, beginning, of course within the one truly all American pastime of baseball. Money ball made mainstream what tech companies like IBM, Amazon, and Google have known for years. That is, innovative, collaborative leadership that dares to ask those “out of the box” questions combined with deep learning algorithms have evidenced real insight and created cultural change, not just World Series rings. As a former professional baseball player, Army combat veteran, and now over educated, Silicon Valley data science nerd I have applied “money ball” analytics to measuring the risk of posttraumatic stress injury (PTSI) and mild traumatic brain injury (mTBI) for my fellow veterans and those to come in future wars.

The data driven, epidemiological concept took root in 2012-13 during my doctoral research that examined differences in PTSI, coping, and functioning impairments among military occupational groups. Yes, many are unaware that there are hundreds of different jobs within the US military and only approximately 15% have the explicit mission of combat operations to hunt, engage, and eliminate America’s enemies in battle; the majority of these within the Army and Marine Corps. The other 85% are highly valued combat support or combat service support occupations like supply logistics, mechanics, accountants, medical personnel, civil affairs, cooks, chaplains and other seemingly normal jobs one would find in most industry sectors. However, during the last fifteen years of intense, asymmetric warfare in Iraq and Afghanistan even supply clerks, accountants and cooks have been exposed to combat operations and events that they may not have been aware they would encounter during their initial job training. I wanted to create a heuristic that triages the most at risk so the folks at Veterans Affairs (VA) can focus their finite resources where they are needed most. With the help of a fellow bay area data scientist, Devin Brady, I have done just that!

Devin and I presented the risk index/algorithm at the Washington, DC VA Innovation Hackathon this past week and it was well received by both private and public sectors. The concept is simple. By scraping all available open data from the internet regarding those wounded and those who paid the ultimate price (civilians and military personnel), we could determine the etiological risk for PTSI and mTBI. In other words, based off a veteran’s military experiences we can assess the probability of whether or not that individual encountered concussive or life threatening, traumatic events based on available wounded in action and killed in action data sources. Even with non-Department of Defense (DoD) and VA data sources we have a 97% accuracy of predicting exposure risk that may lead to a stress injury and 82% accuracy for risk of experiencing a concussive event. Just like the Oakland A’s General Manager, Billy Beane we are using data science to win. However, in this case we want to win more than a World Series ring. We want to win the battle to get help and VA resources to the Iraq and Afghanistan combat veterans who are at most risk.

QUESTIONS & COMMENTS:

We volunteered to serve the military supported geo-political interests of the US during what will go down in history as a highly volatile time for American diplomacy and economic interests. The majority of us survived what will probably be the most character defining and challenging experiences of our lives (in combat operations). We all volunteered for different reasons. Some of us had no other options, some wanted the free college after service, some to pay off college debt, some for patriotic service and a calling, some for the experience alone, some for the family legacy; most likely it was a combination of many of these factors.

We returned (ETS) to a mostly apathetic and "soft" America, thankful for our service, but somehow different than the America we knew before combat; both because of our experiences and the rapid advances in the American way of life in general while we focused on combat training and operations. We found that although we valued our military service, friendships and experiences, for many of us it placed us behind our peers who never served. Behind in education, technology training, and practical skill sets that transfer to earning a meaningful income and enjoying that slice of the American dream and happiness we swore an oath to defend.

The questions I have are this (and feel free to answer here or just think about your answers privately):

What were your expectations for how your military service would help you advance your own career or self development? Were these expectations realistic?

How have you dealt with feelings of disenfranchisement or disconnectedness from American culture? More specifically, what action steps have you taken to better your life as a civilian and re-connect?

For me and many of my combat brethren, it has been over 5 years since our combat experience in Sadr City and about 3-4 years since ETS. I have personally witnessed and experienced the reintegration difficulties and found that it has taken about 3-4 years after ETS to to re-adapt. Of course, social support and meaningful relationships have helped as has a personal mission such as using the GI Bill for education and training. I have seen some keep their military experiences as paramount to their "new" civilian identity and make that work for them in their new life paths. However, I have also seen how this military/combat over-identification became detrimental to the growth and success of some (trapped in the past so to speak). I have seen others shed their military identity and make that work for them too. I think we are all trying to find the balance of what personally works and makes us happy. But we need to share our failures and successes and think about how we think about these things (meta-cognition). Anyway, those have been my thoughts as I examine the current research on combat related PTSD and reintegration. I still believe our generation of combat veterans (the Middle East wars and geo-political big oil wrangling) will go down in history as supremely great and rising to the need of American interests in a very unstable and complex global marketplace.

In the film, American Sniper, there is concept that we combat veterans are all too familiar with: sheep dog. The "sheep dog" concept scene begins with Chris Kyle's family at a Sunday church service. The viewer's are shown bits of his childhood where the paternal influence upon hunting, protection, and duty are clearly characterized. The father makes it known to his sons at the dinner table that they are to be "sheep dogs" among the sheep, protecting them from wolves. This is the warrior ethos, the archetypal vision of a few young boys growing up and playing war or war genre video games. Professional athletes, especially football players, think of themselves as warriors, but they carelessly forget that they are protecting no one, or at least nothing of any real value. My study on reintegration illustrates the protective nature of adopting this "sheep dog" ethos. The results from the 101 respondents (no, not a shout out to the 101st) evidences that combat MOS training and psychosocial support or ethos is actually PTSD protective. Despite being over 5x at risk for experiencing high to extreme levels of combat exposure, the combat MOS group does not practically differ from the non-combat MOS group in PTSD rates or reintegration difficulties! In fact, my study population (which was over 85% former Active Duty Army) showed that combat MOS had lower current (within last 30 days) PTSD prevalence than non-combat MOS. And the combat MOS group reported less current reintegration difficulties than the non-combat MOS group.

This "sheep dog" mentality as we know is trained into regular joes off the street. Sure, some people may have the personality or genetic make up that characterizes that ethos, but without the training and peer support those personal characteristics go to waste. I was fortunate as a non-combat MOS (Medic) to have shared in the "sheep dog" ethos since I was attached to 1st Battalion, 6th Infantry Regiment and trained and deployed with them. While my study and many of my combat MOS friends report statistically more marked to severe reintegration problems after ETS than the non-combat MOS, after 2-4 years they are adapting better than the non-combat MOS. Another interesting finding from the reintegration study, although I must caveat it by saying it is "under powered," but striking nonetheless is that there is no statistical difference in the amount or moral or death and dying type of combat exposure between combat and non-combat MOS. However, and this is the interesting part folks, it is the combat occupational types of exposure experiences that are causing PTSD in non-combat MOS individuals!!! This supports a military where ALL MOS receive extensive combat training and provides a substantial explanation as why Special Forces groups report less PTSD prevalence. Being a sheep dog is resilient.

http://www.havokjournal.com/nation/isolation-relationships-military/?fb_ref=Default&fb_source=message

Isolation and Relationships After the Military • The Havok Journal There are many numbers out there related to veterans that we become accustomed to seeing: 18.5% of Afghanistan and Iraq veterans experience the symptoms of depression and/ or Post Traumatic Stress (PTS)1, 19.5% experienced a Traumatic Brain Injury (TBI)1 while in service, 2.6 million OEF/ OIF/ OND v…

https://uniteus.com/groups/unite-us/sections/8754

The Harsh Reality Women Face When Coming Home From War By: Ashleigh Bryant, Deputy National Director of Communications, DAV (Disabled American Veterans) I witnessed some terrible things in the summer of 2009, in the thick of war in...

http://www.npr.org/2014/11/07/362156306/10-years-after-battle-for-fallujah-marines-reflect-on-iconic-fight

10 Years After Battle For Fallujah, Marines Reflect On 'Iconic Fight' The six-week battle to retake the city from insurgents was the fiercest during the Iraq War. Almost 100 Americans died; 600 others were injured. Veterans commemorated the anniversary on Friday.

Any good ideas to help change the VA? Submit your feedback to this group (Concerned Veterans for America):

http://taskforce.cv4a.org/

Fixing Veterans Health Care Join Concerned Veterans For America's effort to fix veterans health care!

Changing such a large institution like the VA is an extremely difficult process, but this seems to be a step in the right direction. The excerpt below is from CalVet. The only way veterans can improve their lives and the future of other veterans is empower yourself with KNOWLEDGE about the systems and programs..The Veterans Access, Choice, and Accountability Act of 2014 (VACAA), enacted less than 3-months ago, goes a long way toward enabling VA to meet the demand for Veterans health care in the short-term. VA has put considerable focus and attention on ensuring the law is implemented seamlessly, without confusion, and without creating hardships for Veterans. This legislation provides authorities, funding, and other tools to better serve Veterans in the short-term. We are appreciative of this temporary measure to improve access while we build capacity within the VA system to better serve those who rely on us for health care.

From June 1 to September 30, 2014, VA completed more than 19 million Veteran appointments in our facilities and made nearly 1.1 million authorizations for Veterans to receive care in the private sector and other non-VA health facilities—a 46.6-percent increase over the same period in 2013. This was all done under existing programs prior to the passage of VACAA, and sets the stage for strengthening existing partnerships between VA and the private sector. We have much we can share with one another to the benefit of Veterans.

VA has signed contracts with two private health care companies to help VA administer the Veterans Choice Program (Choice Program) under VACAA. The Choice Program is a new, temporary benefit allowing some Veterans to receive health care in their communities rather than waiting for a VA appointment or traveling to a VA facility. It does not impact your existing VA health care or any other VA benefit you may be receiving. We will begin implementing this benefit on November 5, as required by law. A call center is now operational to answer your questions and verify your eligibility for this program.

As part of this new program, we are issuing a Veterans Choice Card to every Veteran who is potentially eligible for the new, temporary health benefit. The Choice Card allows Veterans to elect to receive care outside of VA when they qualify for the new program based on the distance of their residence from a VA care facility, or when wait times for VA health care exceed the standards established in law. The Choice Card does not replace the identification card you already use to access other VA benefits; please do not throw away that identification card.

The Choice Card will be issued in three phases. The first group of Choice Cards along with a letter explaining eligibility for this program is currently being sent to Veterans who may live more than 40 miles from a VA facility. The next group of Choice Cards and letters will be sent shortly thereafter to those Veterans who are currently waiting for an appointment longer than 30-days from their preferred date or the date determined to be medically necessary by their physician.

The final group of Choice Cards and letters will be sent between December 2014 and January 2015 to the remainder of all Veterans enrolled for VA health care who may be eligible for the Choice Program in the future.

We are continuing to work with our partners—Congress, Veterans Service Organizations, and others—to get the information about this health program out to Veterans in as many ways as possible. Please visit our Web site at www.va.gov/opa/choiceact where we have provided helpful information on Choice Program eligibility. We will work with our partners to keep you informed as we improve our delivery of high-quality, timely care.

Veterans Access, Choice and Accountability Act - Office of Public and Intergovernmental Affairs Veterans Access, Choice and Accountability Act

We are repeating the "broken, angry, disenfranchised" combat veteran paradigm from the Vietnam era. Providing band aid measures helps a bit, but we need research and data to make HUGE sweeping changes to the processes that keep creating the problems.

http://www.nytimes.com/2014/11/02/opinion/sunday/maureen-dowd-a-cup-of-gi-joe.html?_r=2

A Cup of G.I. Joe Howard Schultz of Starbucks says America is good at sending people to war but bad at bringing them home. He has a plan to help.

New Secretary's take aways from his "town hall" type visits to several VA campuses. Here is to hoping real change is coming...
http://www.blogs.va.gov/VAntage/15821/va-is-critical-to-medicine-and-veterans/

VA is critical to medicine and Veterans | VAntage Point During preparation for my confirmation as secretary of Veterans Affairs (VA), I was repeatedly asked, “Why doesn’t VA just hand out vouchers allowing veterans to get care wherever they want?” For a department recovering from serious issues involving health care access and scheduling of appointments,…

In 1973, the percentage of veterans in the U.S. House and Senate was 73.8 percent. Now, the percentage is down to 20 percent.

The military has special needs that are different from the civilian world. We clothe them, we pay them, we give them a place to live and then we ask them to go and put their lives on the line and possibly die for us.

Care and thought have to be given before committing our military to battle, to war. Without military experience it is too easy for our senators and representatives to just vote to go to war.

Our commitment to people in the military doesn’t end when they are discharged or retire. We have a moral and legal commitment to them to help them heal and to re-enter the workforce.

Unfortunately, some members of Congress have abrogated their obligations.

Gee, ya think?

Ruh roh

http://nypost.com/2014/10/22/welcome-to-the-new-back-door-draft/

Welcome to the new 'back door draft' The US military is quietly entering a new “Stop Loss” era. The news, which could affect thousands of men and women now serving and others who recently left the Armed Forces, came last week. The big...

The new and improved "Greatest Generation" https://m.facebook.com/story.php?story_fbid=10152808769232940&id=793747939

Legendary Marine General Jim Mattis On What Makes This Generation of American Veterans Different... Last week, legendary Marine Gen. Jim Mattis gave a speech to the Marines Memorial Club that everyone’s talking about.

More evidence that Hero Reintegration Pay would vastly improve the current VA model. Veterans with PTSD and receiving "disability" pay had more severe symptoms than those not receiving "disability" pay. However, those receiving compensation for said PTSD injuries had greater symptom improvements than those not receiving any compensation and had less incidences of homelessness and poverty.

http://www.ncbi.nlm.nih.gov/pubmed/21969464

Long-term outcomes of disability benefit... [Arch Gen Psychiatry. 2011] - PubMed - NCBI PubMed comprises more than 23 million citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.

https://events.recruitmilitary.com/events/austin-all-veterans-job-fair-october-30-2014?utm_source=Facebook&utm_medium=Event&utm_content=Austin%20job%20fair&utm_campaign=austin_oct2014

Austin All Veterans Job Fair for Military Veterans RecruitMilitary has held 10 events in Austin, drawing 1,851 attendees and 180 exhibitors.

http://www.utsandiego.com/news/2014/oct/18/jeremy-sears-veterans-affairs-su***de/

STOP the MADNESS!!! This must not keep happening. Call or write to your congressmen and/or women and tell them to enact Hero Reintegration pay for combat veterans. It is simple, combat veterans fill out all VA/DoD service related/connected health forms within 90 days of ETS. This data is uploaded into the VA system along with the DD214 verifying deployments and months served in a combat zone. The combat veteran automatically gets Hero Reintegration pay (E5 BAH plus dependents rate) for double the time served in a combat zone. For example, 12 months verified combat duty gets 24 months Hero Reintegration; capped at 48 months. No paperwork, no hoops, no appointments, no seeking help or treatment. Of course, if the vet wants the Compensation and Pension process for health issues connected to service he or she can go at anytime. Within 90 days of Hero Reintegration ending, the VA contacts the vet (at monthly intervals until the final payment) and requests that they come in for an appointment to determine the nature of their service connected health issues (including PTSD); it is the veterans' choice. If the vet is deemed to have a service connected health issue he or she receives Vested Warrior Pay, NOT disablity pay. The antiquated "disabled vet" and "wounded warrior" model must stop!!! It is insulting to our service.

Who's to blame for Marine vet's su***de? The lessons learned from Jeremy Sears's su***de differ depending on whom you ask.

Re-experiencing such as flashbacks and nightmares along with avoidance (of reminders) behaviors are most experienced by Non-Combat MOS veterans (as reported by IAV Reintegration Study). While emotional numbing and being hyper-vigilant are most experienced by Combat MOS veterans. Thoughts?

The financial incentive confounds a lot of veteran health data. My solution (I am working on it with political leaders) is to create Hero Reintegration pay for all veterans with verifiable combat and hazard duty pay on their DD214 upon ETS; similar to Congressional vested service pay for life. DoD has veteran fill out exit health survey about injuries or illnesses sustained during service and this is electronically uploaded into VA health record. The earned combat service benefit is paid at the E5 plus dependents BAH rate beginning day one of ETS, no questions, no C&P exams, no VA appointments. Minimum is 2x every month of service in a combat zone; this can be combined with military medical retirement pay and prorated with military retirment pay. As the end date of Hero Reintegration pay nears, VA contacts veteran and asks them if they want a C&P exam. Any injuries or illnesses remaining after the Hero Reintegration become Vested Warrior Pay (not disability). The whole "wounded warrior and disabled vet" culture needs to change.

http://www.pnj.com/longform/news/military/2014/10/11/va-house-divided-ptsd/17044385/

Save Our Heroes: The struggle with PTSD Some veterans shun treatment for PTSD for fear of losing financial benefits.

77% of the Iraq and Afghanistan Veteran Reintegration Study participants self-report significant stress injury symptoms within the last 30 days. Being told to abandon or move on from severely wounded, dying or dead while in combat is most related to these self-reported stress injuries. This evidences both the kinetic nature of urban war, strict mission focus of our warriors, and a moral injury component. American culture prides itself in taking care of the weak and wounded. The warrior ethos demands we never leave behind a fallen comrade. As a result, our returning warriors experience emotional numbing as they reintegrate back into the community and attempt to find meaning for such life altering experiences.

Unlike American combat veteran study findings, an Israeli study finds no link between and drug/alcohol abuse or criminal behavior. These findings suggest an interaction with American culture upon combat veteran experiences that is radically different than Israeli culture.
http://www.ariel.ac.il/images/stories/site/projects/APL/Papers/PTSDCriminal_paper_with_revisions_30JUN2013.pdf

www.ariel.ac.il