Iraq and Afghanistan war veterans suffering from post-traumatic stress and traumatic brain injuries increasingly are turning to experimental remedies — ranging from yoga and acupressure to marijuana and hyperbaric oxygen treatments — as alternatives to the traditional medicine and prescription drugs offered by the Department of Veterans Affairs.
The Department of Defense and the VA are themselves researching or using “complementary and alternative medicine,” like acupuncture, to address the growing numbers of veterans seeking care.
According to records reviewed by News21, the VA already has spent at least $65 million on research projects in 40 cities across the country looking at whether current medical practices combined with certain meditation interventions and vitamins, among other methods, will help troops returning from war. About seven percent of that amount has been spent researching treatments for post-traumatic stress disorder.
The VA also created 10 Mental Illness Research Education and Clinical Centers, known as MIRECCs, where doctors and psychologists are studying further possibilities for healing combat-related trauma.
“We're trying to kind of look at lots of novel interventions, different ways that we can help people perhaps increase resiliency or cope with stress or deal with suicidal crisis,” said Lisa Brenner, a rehabilitation psychologist and director of the MIRECC in Denver.
She and her research team are studying alternative treatments, such as yoga, acupuncture and acupressure, that may curb the number of suicides among veterans. The research still is “in the early stages,” meaning there is not enough positive evidence yet to recommend alternative treatments to patients.
Lisa Davila, who specializes in patient-centered care at the Denver VA Medical Center, said some alternatives might offer a solution to prescription pill dependency that can lead to abuse and suicide.
“There is a big need, it is a valid way to not take as many narcotics,” she said. “We need to look at alternatives. I have learned that our veterans are wanting that, and they’re open to that.
“I think we realize that we just need some more resources, that the model of care has evolved. We need to look at the whole person and in order to do that we need more choices. We need more aspects of care that maybe 10, 20, 30 years ago seemed a little out there or not well researched,” Davila said, “but the research is showing that this is beneficial and with the way things are going, we can do a lot of good for our patients without medication.”
Davila said the alternate treatments not only address the symptoms of combat trauma but also ease the transition back into day-to-day life.
“I’ve heard from multiple sources that they need alternatives to their care,” she said. “Whether you’re a nurse, a physician, whatever it may be, you wouldn’t be here if you weren’t focused on the patient, and patient-centered care is basically just putting the veteran at the center of their care, finding out what their values are, what matters to them, what they want.”
Dr. Dan Jones, director of the VA’s PTSD Recovery Program in Oklahoma City, said his clinic found many solutions, including group therapy, to be effective — though many other possibilities are not yet commonly practiced.
“There is no magic pill for PTSD,” Jones said. “We are trying to find the things that are most effective. I don’t know if we are going to come up with one single thing. I think it depends on the therapist as well as the patient, and it’s going to have to be what is most effective for that patient.”
Jones said the VA has yet to endorse any alternative treatments because it hasn’t found enough clinical evidence that they work.
“However, while the limitations of the current evidence preclude investigators from drawing strong conclusions to inform clinical practice or public policy regarding the optimal use of CAM (complementary and alternative medicine) therapies for PTSD, they do point to numerous opportunities for future research,” according to the VA national website.
Staff Sgt. John Welsh, deemed by the military to be unfit for duty because of PTSD, is recovering in El Paso, Texas, at the Fort Bliss Restoration and Resilience Center. Patients at the center are required to try everything from meditation and outdoor retreats to acupuncture and Reiki energy healing.
Welsh said his recurring memories of war resulted in daily panic attacks, particularly when he was in crowded areas.
“There’s not a moment that goes by that you’re not on full alert, meaning that you’re either going to get shot at, you’re going to get mortared and attacked, you’re going to deal with people trying to kill you just by driving up to you and clicking a bomb and blowing you up,” he said. “I needed to find a way to turn it off.”
Welsh experimented with acupuncture and liked it. Although he hasn’t been able to “turn it off” just yet, he’s better able to manage his PTSD.
“I never thought that acupuncture would literally help me, calm me, center my mind,” he said, describing his initial skepticism toward getting his ears pricked with a bunch of hair-thin needles. “It’s kind of weird, almost voodoo-like, but it works. It works for me.”
The VA continues to look for more options, but, in the meantime, most veterans interviewed by News21 aren’t satisfied with prescription medication or other remedies and are paying out of pocket for the treatment they think works.
Arizona Air National Guard Capt. Sherry Mammano returned home in 2006 from her first tour in Iraq and unexpectedly found solace in alternative therapy.
“I came home kinda pissed off at the world. I came home to getting divorced, a thing a lot of soldiers experience as a result of deployment. Couldn’t sleep, anxiety, depression, and I did what everyone else did. I took all the pills that I was given, and I did that for quite awhile, maybe like three of four years,” she said. “It was on my second deployment that I said I don’t want to come home and experience the same things I experienced last time.”
When she returned the second time in 2010, she took a four-month leave and sought solace at 7 Centers, a yoga studio in Sedona, Ariz.
“I thought it was crazy when people talked about seeing through their third eye, but after awhile I was like, this really works, and it just clicked,” she said.
She began practicing yoga among Sedona’s red rock mountains, and said it was the first time in her life she did not have cable or even a television. Mammano now teaches yoga to fellow service members at the Guard's Allen Readiness Center in Phoenix.
“If you just took a normal person teaching yoga and put them on a military base, people would not necessarily resonate or respond with that person, but to say, ‘Hey I have been deployed, I have experienced what it’s like to be deployed, I have experienced the issues we come home with and this is how I handled it.’ Being a veteran, I lend credibility to that,” Mammano said.
Her yoga class started with three and grew to 60, which she credits to her military organizational skills and her basic approach.
Lt. General Eric Schoomaker, former surgeon general of the Army, said the DOD, VA and the Samueli Institute, a private, nonprofit research group, all are looking for answers in alternatives, but finding treatments that are safe and effective takes time. He said that in scientific and medical communities, most treatments take "14 to 17 years for the culture of practice to change," if the studies are found successful.
“It takes an extraordinary amount of time, much more than I think people would be patient to tolerate, to get good practices out in common use,” he said.
Some veterans seeking more immediate results are using marijuana.
Retired Marine Cpl. Sean Azzariti smokes pot in his Denver apartment every day to cope with hypervigilance and stress after deployments to Iraq in 2003 and 2005. He was a supporter and advocate of Colorado’s Amendment 64, which allows recreational use of cannabis. While Colorado allows medical use of medical marijuana, PTSD is not on the list of qualifying medical conditions to obtain a prescription to the drug.
He said that marijuana made it possible for him to use prescription medication as a last resort.
“Marijuana is just an extension of who I am at this point," Azzariti said. "I am becoming more a part of myself when I smoke. I am not a crazy high-strung vet, I can be me and don't have to be overmedicated.”
Azzariti, whose military duties required him to ferry supplies to combat zones, said he still has days where he draws the blinds to avoid interaction with people, adding, “Trying to explain PTSD is like trying to explain blue to someone that is blind.”
But, he added: “I came back with all my limbs. I didn’t really have to do anything where it makes me question my morale. I’m so grateful that I went there twice and I came back the way that I am because I know a lot of people that are not in the same boat.”
Twenty states have legalized medical marijuana. At least four specify PTSD as a qualifying condition: Connecticut, Delaware, New Mexico and Oregon.
Oklahoma Army National Guard Spc. Ryan Terry, 24, deployed in 2011 to Afghanistan and returned in February 2012. His days are no longer spent tallying supply lists, but rather drinking cans of Dr Pepper, repairing video game consoles for spare cash, and trying to deflect the frequent feelings of suicide.
“Just even having the thoughts, it makes you angry at yourself and then because you're angry at yourself, you want to hurt yourself, so it's a pretty vicious cycle,” Terry said.
In high school, Terry was a varsity track star. Now, he and his roommate, a soldier Terry met while deployed, spend hours on the living room couch watching TV, apprehensive to walk out of their own front door. Both suffer from PTSD.
Sitting on his bed with scattered half-empty orange pill bottles from the VA, Terry said prescription medications are the only things that give him relief from the stress.
Seeking “something else” that works, Terry has started group therapy. He said talking about his problems has helped, but medications remain his main source of relief.
“I'm 24 years old and I feel like I'm 60 because I have so many medications I'm supposed to take every day,” said Terry, the veteran from Mustang, Okla.
In 11 states — Oklahoma, California, Colorado, Florida, Idaho, Minnesota, Nevada, Ohio, Virginia, Washington and Wisconsin — various state and private groups are researching the use of hyperbaric chambers to treat PTSD and traumatic brain injuries with the use of oxygen.
In hyperbaric treatment, patients sit in a sealed tank which is then filled with highly pressurized oxygen meant to stimulate and replenish cell growth. More red-blood cells travel throughout the bloodstream and the bruised or damaged tissue can repair at a faster rate.
The treatments are not accepted by the VA, however.
“Painkillers and psychotropic drugs, that’s how they deal with brain injury right now. Any kind of brain injury, that’s how they treat them,” said Oklahoma Secretary of Veteran Affairs Rita Aragon, a retired major general of the Air National Guard. “The drugs depress them (veterans) or make them crazy.
“We have to start serving those who served us.”
Bonnie Campo was an Ethics and Excellence in Journalism Foundation Fellow, and Jake Stein was a Hearst Foundations Fellow this summer for News21.