War and Drugs: Veteran Battles Ep 3 – A Hopeful Future
Hosted by Lauren Brande & Written by Dan Wagener | Published 5/31/18
Welcome back to Let’s Talk Drugs. I’m Lollie, and in our last episode we looked at the challenges that veterans face once they return home from active duty. Not only is the adjustment to normal everyday life difficult, they may also be faced with fallout from injuries, chronic pain, and PTSD from the countless traumas that war can inflict. Coping with these difficulties is made even more difficult by the confusing systems that are there to help veterans, but are often under supported by the U.S. government and unable to provide the extensive care that many veterans need upon returning home.
If you’re a veteran struggling with PTSD and addiction, you might not have any idea where to turn for help. Although the Veterans Administration, or VA, is an option, wait times can be long for appointments, and many veterans live long distances from medical centers. If that’s the case, where do you even start to look for treatment?
You might also wonder how treatment works. What kinds of medications or therapies will be used? Will I get to be around other vets, or treated by people who understand what I’m going through? What actually helps people like me get better?
In this episode, we’re going to continue to look at veterans and addiction. Whereas the last two episodes focused on drug use and addiction, this episode is going to explore the hopeful future for veterans: treatment.
We spoke with 2 different people with different perspectives on this topic. One is Jay Russell, who you might remember from our previous podcast. Jay is a veteran who is recovering from PTSD. The other is Mark Calarco, the national medical director for American Addiction Centers. He’s worked extensively with veterans in recovery from PTSD and addiction.
They both had some interesting insights into where to get help and what kinds of treatments can be effective for veterans with PTSD and substance abuse, also known as a dual diagnosis or co-occurring disorder.
A Wealth of Resources
We’ll begin with Jay. He struggled with PTSD for a long time and has experienced that sense of hopelessness that is so familiar to so many veterans. But, he found a way out. He is currently a treatment consultant with American Addiction Centers and helps other veterans find recovery programs. We asked him what worked for him and what kind of resources he thought could be helpful for veterans in need.
The Veterans Choice Program is a program offered through the U.S. Department of Veterans Affairs. The VA will pay for a veteran to receive care from a community provider if the VA can’t provide the care the veteran needs or the nearest VA facility is too far or difficult for the veteran to get to.1
Those who are interested in this program should be aware that the VA published a notice in the Federal Register that it expected funding for this program to run out in mid-January 2018. It’s unclear how this program will be funded in the future.1
Jay also talked about specific treatments that helped him with his PTSD.
During eye movement desensitization and reprocessing (EMDR), a therapist moves their hand back and forth in front of a client’s field of vision. The therapist asks the client to think about a disturbing event and track the therapist’s hand.2
It’s unclear exactly how EMDR works. But it is believed to activate the same mechanisms involved in rapid eye movement (REM) sleep and help the client process the memory. The theory is that the symptoms are from the person being unable to process what happened to them.
Research on EMDR is mixed. One study with 17 Vietnam veterans with PTSD found that EMDR produced modest to moderate improvements in symptoms.3 According to Francine Shapiro, the creator of EMDR, 24 randomized controlled trials demonstrated positive effects of EMDR in the treatment of trauma.4 However, a review in Scientific American found that while EMDR was more effective than no treatment or supportive listening, it was not superior to exposure treatment.5
In exposure therapy, a therapist helps a person face a situation that triggers a trauma or fear. The gradual exposure helps lessen the fear and helps the person learn to cope with the trauma.6
Support groups are another helpful resource for recovering veterans, and many of them are completely free to join and attend.
Support groups for PTSD are available across the country, in many communities. One place you can start is the National Alliance on Mental Illness, which has a helpline and area-specific resources for people and family members who have PTSD.
The New Frontier of PTSD Treatment
When we asked Mark from AAC what treatments he thought were most effective for treating veterans with addiction and PTSD, he shared several cutting-edge therapies that involved drugs traditionally used for other purposes.
Ketamine, a dissociative anesthetic, is an emerging treatment for PTSD. A study published in 2014 found that intravenous infusion of ketamine led to rapid reduction in PTSD symptoms, as well as reduction in depression symptoms.7
A study jointly funded by the Department of Defense and the Department of Veterans Affairs will further study how ketamine can help veterans who suffer from PTSD.9
One of the concerns with this treatment is that ketamine can be abused, and researchers aren’t sure what happens to the brain with repeated injections of ketamine.8
Mark also mentioned another medication, modafinil, which is normally used to treat narcolepsy, shift work sleep disorder, and hypersomnia.
There’s not much research out there on the use of Modafinil for PTSD. A study published in 2016 found that it helped reduce PTSD symptoms in rats after they were exposed to a stressful experience.10 Though there is evidence supporting the use of these medications, Mark emphasized the importance of a combined approach to veteran recovery: therapy and medication, rather than either on its own.
Mark then turned to the NSS-2 Bridge device, a new therapy that’s mainly been used for opioid withdrawal.
The NSS-2 Bridge device is a small nerve stimulator placed behind the ear. A battery-powered chip in the device emits electrical impulses that stimulate cranial nerves in the brain. These stimulations have been found to provide relief from withdrawal symptoms from drugs such as oxycodone and heroin.11
Like modafinil, there isn’t much research out there on the Bridge device for PTSD. But researchers are continuing to investigate new treatments for PTSD, which is notoriously difficult to treat.
Another potential treatment is the use of MDMA, or Ecstasy. Clinical trials have shown that Ecstasy offers significant relief for PTSD patients, and last August the FDA designated MDMA as “breakthrough status” for treatment of PTSD, opening the door for more trials.12
Mark cautions that MDMA (also known as Ecstasy) and similar drugs that are typically used recreationally could potentially be problematic for people in PTSD treatment due to their effects on the brain—especially if the person has a history of addiction.
MDMA, and other drugs such as methylphenidate—an ADHD drug that’s also been used to treat PTSD—can be abused, and there’s irony in using these drugs to treat a population that has a high rate of drug and alcohol problems. It’ll be interesting to see how research develops in this area, and we look forward to a more hopeful future for our veterans.
We’d like to thank Jay Russell and Mark Calarco of American Addiction Centers for talking to us about this critical issue. And to all the veterans out there who may be listening: thank you. From the bottom of our hearts, thank you for everything you have sacrificed to keep us safe. Now we must help you. You don’t have to suffer under the weight of addiction and PTSD forever. Reach out to us at and we will find you the best recovery program to get you the help that you deserve. Don’t wait until it’s too late.
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- U.S. Department of Veterans Affairs. (2018). Veterans Choice Program (VCP).
- EMDR Institute, Inc. What is EMDR?
- Pitman et al. (1996). Emotional processing during eye movement desensitization and reprocessing therapy of Vietnam veterans with chronic posttraumatic stress disorder. Comprehensive Psychiatry, 37(6), 419-429.
- Shapiro, F. (2014). The Role of Eye Movement Desensitization and Reprocessing (EMDR) Therapy in Medicine: Addressing the Psychological and Physical Symptoms Stemming from Adverse Life Experiences. The Permanente Journal, 18(1), 71-77.
- Arkowitz, H. and Lilienfeld, S. (2012). EMDR: Taking a Closer Look. Scientific American.
- National Alliance on Mental Illness. (2017). Posttraumatic Stress Disorder.
- Feder, A. et al. (2014). Efficacy of intravenous ketamine for treatment of chronic posttraumatic stress disorder: a randomized clinical trial. JAMA Psychiatry, 71(6), 681-688.
- Levine, S. (2017). Ketamine is being used as a cutting-edge treatment for depression, PTSD. New York Daily News.
- Yale School of Medicine. (2017). VA study to examine ketamine’s potential to treat posttraumatic stress disorder.
- Cohen, S. et al. (2016). The wake-promoting drug modafinil stimulates specific hypothalamic circuits to promote adaptive stress responses in an animal model of PTSD. Translational Psychiatry, 6(10), e917.
- U.S. Food and Drug Administration. (2017). FDA grants marketing authorization of the first device for use in helping to reduce the symptoms of opioid withdrawal.
- Welch, A. (2017). FDA designates MDMA as ‘breakthrough therapy’ for PTSD. CBS News.
How Our Help Line Works
If you’re seeking addiction treatment for yourself or a loved one, our ProjectKnow.com help line is a private and convenient solution. Caring advisors are available 24/7 to discuss treatment options with you.
Calls to this helpline are 100% confidential and will be answered by American Addiction Centers (AAC).