In order to more accurately identify and serve rural Veterans, the Veterans Health Administration (VHA) is improving the method it uses to define urban, rural and highly rural land areas.
The Department of Veterans Affairs (VA) announced today that primary care has been added to the services available to Veterans through VA's Patient-Centered Community Care (PC3) contracts, a key and evolving part of the non-VA medical care program. Eligible Veterans are already able to access inpatient specialty care, outpatient specialty care, mental health care, limited emergency care and limited newborn care for female Veterans following childbirth under PC3.
Secretary Robert McDonald delivers remarks during AMVETS National Conference in Memphis, TN
Posted: Fri, 22 Aug 2014 18:13:29 +0000
“We can’t make the traumatic memory in your head go away. But we might be able to take away the intense emotions associated with that memory, so that it’s simply a memory and no longer upsetting.”
That’s according to Dr. Alina Suris, chief of psychology at VA North Texas Health Care System in Dallas, and could be a critical first step in dealing with the triggers for post-traumatic stress.
Suris and her team of researchers have conducted some preliminary studies in which they’ve successfully interfered with traumatic memories at the cellular level. However, she emphasized that her research, while promising, is still in its infancy.
“We’re not erasing memories,” she explained. “We’re quieting the emotions associated with those memories. You’ll still have the memory… but your emotional response to that memory won’t be so overwhelming or debilitating.”
Anywhere from 11 to 20 percent of Iraq and Afghanistan Veterans develop PTS symptoms, according to VA estimates. These include flashbacks, nightmares, depression, social withdrawal, emotional numbing, hyper-alertness, anxiety and irritability.
“Traumatic memories can be ‘cued’ at any time,” Suris continued. “You’ll see something on TV. Or you’ll see a green Army truck going down the street. When a traumatic memory is triggered, something happens at the cellular level. There’s a chemical response that involves cortisol.”
Cortisol, known more formally as hydrocortisone, is a steroid hormone. It is released by the body in response to stress. “Your heart may start to race,” Suris said. “Your palms may get sweaty. A panic may begin to rise up inside you.”
“But what if we could interfere with that chemical response?” she asked. “What if we could intercept it before it really gets going?”
During her preliminary research, Suris and her team asked Veterans to write down their most traumatic battlefield experiences. Once a Veteran captured his most terrifying experience on paper, researchers edited it down into a 30-second script.
During a follow-up visit, the Veterans were asked to relax in a comfortable recliner. Each Veteran was then given either a steroid pill or a placebo pill. After the medication was given a chance to work, they listened while a narrator recited their 30-second script to them.
“We know that Veterans with PTSD have trouble mounting a cortisol defense to help them deal with memories that get triggered by certain cues,” Suris said. “We believe that by giving oral steroids, we may be able to supplement what the body needs to handle the trauma memories in a more healthy way.”
The results have been encouraging.
“During our follow-up assessments, those Veterans who received the steroid expressed significantly fewer PTSD symptoms,” Suris reported, “while those who were given a placebo continued to have significant symptoms such as avoiding places, people, activities or thoughts that remind them of their trauma.”
Currently, the two most common therapies for treating PTSD are Cognitive Processing Therapy and Prolonged Exposure Therapy.
“These are good, evidence-based therapies,” Suris said. “They work. They are the best we have right now.”
The current research seeks a treatment that is just as effective. “It would be quick, efficient, and economical. Most important, it would likely be more palatable to Veterans because of significantly less demand on their time in therapy,” Suris said.
“Our Veterans deserve the best we can offer them,” she added. “That’s why we invest heavily in research here at VA and are constantly looking for ways to improve the care we provide.”
To learn more about how VA is helping Veterans with PTSD, visit www.ptsd.va.gov.
Tom Cramer is a former newspaper reporter who now works as a feature writer for VHA’s Office of Communications in Washington, DC. He lives in Columbia, Maryland with his wife Eileen.