When most of us think of war casualties, we envision a battlefield comprised of rising smoke and strewn bodies across a tattered landscape. Perhaps an image of a veteran in a wheelchair with obvious external ramifications in the form of amputation would come to mind. But the thought of an intact returning soldier or Veteran with no overt missing limbs is not an image we routinely associate with a casualty of war. Yet, the reality is that the most common casualties walk among us every day. Some of the most debilitating wounds veterans carry are not visible to the naked eye, such as those in the form of Post-Traumatic Stress Disorder or PTSD.
2.7 million Americans have served in Iraq and Afghanistan since 2001; approximately 20% have been diagnosed with PTSD.
PTSD is best known for affecting veterans and first responders but affects millions of others who have experienced or witnessed traumatic events. When we experience a traumatic event, our fight-or-flight survival response is temporarily activated. Once the threat passes, the built-in response will ideally return to the resting state. However, when extensive or prolonged trauma occurs, such as a soldier’s experience in war, this stimulus-response cycle can become “stuck,” attempting to process the threat. The processing can cause flashbacks, nightmares, or intrusive thoughts that force them to re-experience the trauma long after the dangers have passed. When these symptoms persist for longer than one month after a traumatic event and cause significant distress or problems in the individual’s daily life, the condition is diagnosed as PTSD. Left untreated, it can lead to avoidance, hopelessness, detachment from family and friends, severe depression and anxiety, and even suicidal thoughts and actions. Loud noises and many other everyday stressors can serve as triggers that elicit severe symptoms of panic, flashbacks, and feelings of imminent danger. People with PTSD cannot escape their inner cycles of stimulus and response and become prisoners of war within the confines of their minds. The disorder has proved extremely difficult to treat, with a remission rate under 30% when utilizing conventional treatment options. These treatment options have included a combination of psychotherapy and oral medications, namely SNRIs and SSRIs. Unfortunately, medicines from both classes have intolerable side effects (including weight gain and sexual dysfunction) and require 6-8 weeks of treatment to deem effective. The associated side effects cause many patients to stop taking these medications before even knowing if they would have been effective. Of the 70% who do not get remission of symptoms, many commonly resort to alternative coping methods, including substance abuse and self-injury.
Over 30,000 veterans have died by suicide since September 11, 2001 — over four times the number of U.S. military personnel who died in combat in Iraq and Afghanistan.
Conventional treatment is failing the majority of those that suffer. We have known this for a long time but had nothing more to offer. Now we do. Emerging research has shown promising results with many alternative therapies, including intravenous ketamine. Ketamine’s usefulness in treating PTSD emerged in the 1990s during the Gulf War. Physicians began noticing that the soldiers given ketamine as a surgical anesthetic were much less likely to develop symptoms of PTSD when compared to those given alternate medications. Since then, multiple trials have been conducted and have shown that safe, low-dose ketamine infusions alleviate suffering in over 70% of patients. Unlike other antidepressant medications, which take 6-8 weeks to take effect, symptoms can dissipate within hours after an infusion. It is also very well tolerated, with only transient side effects quickly dissipating once the treatment is complete.
“Ketamine-mediated synaptic plasticity changes appear to occur within a matter of hours after ketamine administration with rapid reduction of core PTSD symptoms and reduction in comorbid depressive symptoms in patients with chronic PTSD.” (Mt. Sinai Hospital)
While ketamine is not a cure for PTSD, it presents a novel option that has shown tremendous success in creating a space for recovery that we have not had before. Mental health disorders are complex by nature, and effective treatment is, thus, multifaceted as well.
We now have a fast, safe, and effective treatment, yet the barriers persist to those needing it most. The most significant obstacle to Veterans receiving the treatments has been the associated cost which averages $400/infusion. At Mbody Healthcare, we are not only a Veteran owned business, but we are also prior recipients of ketamine treatments, and we know the benefits firsthand. We are currently offering the infusions to Veterans for $99/infusion. However, we are actively exploring ways to reduce this and possibly provide them free of charge in the future. The rapid action of the treatment is what makes it so valuable because we know this population does not have the privilege of time. Most of those suffering have exhausted all other options and need help now. And we have the means to help them. So please help us help them by spreading the word to any Veteran you may know that may need help. They have suffered long enough. Now is their time to heal.