6 Veterans, a Therapist, the Study Controller and 24 hours of Cannabis and Group Therapy.

by dinaheverettsnyder

Abstract/ Background:

The Department of Veterans Affairs says it is treating 400,000 veterans for post traumatic stress disorder (PTSD) in 2012 -of that number 250,000 with service in Iraq and Afghanistan. The VA suspects that tens of thousands of veterans who have engaged in combat over the last ten years have chosen to not seek treatment.

Overall, 2.5 million troops have been cycled through Iraq and Afghanistan. Often, by the time veterans seek help they have added to or complicated their recovery route by engaging in alcohol abuse, drug abuse and put their home lives and relationships at risk. Domestic abuse and homelessness complicates the picture.

Stress Disorder treatment is complicated by various other factors that are preventing our troops and veterans from seeking help:

* Troops are given a mental health screening, if they acknowledge say, insomnia or anxiety, they are pulled from their unit or their home for further testing.

* Stress Disorder treatment will be noted in their medical records and these can be accessed by agencies checking on a veterans fitness to work in the law enforcement field.

* There is currently a backlog of some 894,000 claims for help filed by men and women who served in the military. 80% of them have languished for more than 125 days, the VA’s self imposed deadline to clear a claim.

* The endless waiting for claims to be processed has caused a distinct distrust from veterans towards the very agency entrusted to help them.

There is more: * For every 100 soldiers-approx 40 will have PTSD and women are over represented.

                        * Suicide rates in the US military increased 80% between 2004 to 2008 

                        * Out of 225 soldier suicides fully 20% had previously been formally diagnosed with a mental

                           health issue and fully 50% had visited a health professional for a mental health concern.

                        * 23% of female soldiers report sexual assault and 55% experienced sexual harassment.

                        **The above numbers are acknowledged to be chronically underreported, given the VA’s poor

                           screening process

These issues all compound the problem of addressing the needs of our returning soldiers.

And then there is the issue of prescription medications, their documented side effects and the over zealous prescribing methods of military doctors.

We would like to point out that over zealous prescribing of pharmaceuticals is not an inherent flaw of military doctors but is a flaw of our medical paradigm in general.

Over the years that our troops have been funneled from one war zone to another and, as they have returned to civilian  life, rumors have begun to circulate concerning some of the apparent  suicides. Rumors that these were not suicides but accidental deaths, unwitting deaths. As the number of apparent suicides has risen the rumors have gained traction and a momentum of their own.

Returning soldiers and veterans have reached a critical point, often supported by their spouses and other family members to purposefully NOT seek mental health support from the VA as a direct result of the rumors circulating regarding the links between the prescription meds favored by doctors for “ all” aspects of mental health concerns and the deaths of scores of veterans, otherwise healthy, fit, vibrant people. 

Soldiers and Veterans are more at Risk from the drugs given to them legally

.

OVERDOSE poses a greater threat than suicide and the overdose risk is more than double that of the general population.

Of current veterans receiving VA services nationally in 2005 – 1,013 had died of an accidental overdose. This is estimated to be gross under representation of the true numbers.

A 2012 report on prescription drug misuse states:” access to prescription meds puts veterans at a higher risk of addiction and abuse than the civilian population”. 

Fully one third of soldiers on prescription meds, and almost half of those or 76,000 are taking powerful and addictive opiate painkillers.

2009- VA physicians wrote 3.8 million prescriptions for narcotic pain pills, that is FOUR times as many as in 2001.

Amphetamine prescriptions doubled between 2006 and 2009.

2002 to 2011 the total prescriptions VA physicians rose 37% and during the same period prescriptions for oxycodone rose150%.

Prescriptions for methadone, now used as an inexpensive pain killer, nearly tripled from 2002 to 2009.

The VA use of hydrocodone, often mixed with acetaminophen under the brand name Vicodin has exploded.

The prescription increase for hydrocodone/acetaminophin written for civilian use rose 68% during 2002-2011 while prescriptions for the same, written by VA physicians climbed 360% during the same time frame.

2011 study of more than 450,000 Iraq and Afghanistan veterans found that 4.5% had a drug abuse disorder diagnosis- more than double that of the civilian population and further, the study emphasized that these numbers were likely FAR higher because of the VA’s poor screening process.

SIMULTANEOUSLY

, the same study found that funding for VA services/ substance abuse treatment programs has declined relative to other healthcare services.

Essentially

,

the “ permissive climate of prescription medication use” posed a DIRECT threat to soldiers health.

Other drugs favored by VA physicians

:

Paxil….

Zolof….      The only FDA approved medications for Post Traumatic Stress Disorder (PTSD)

                    Other drugs are used in addition under “ off label” use.

Benzodiazepines…..Ineffective for PTSD

Risperdol………….Ineffective for PTSD

* Viagra Online…..

* Cialis Online…… proven to reduce pain as they contain hydroquinone and morphine substances but these compound the emotional problems of PTSD

Paxil…………..antidepressant

Klonopin………mood stabilizer

Seroquel………anti psychosis drug and highly controversial ( AstraZeneca)

*

  “ combined lethal drug toxicity” or PTSD cocktails usually involve Seroquel.

** There are SERIOUS questions regarding the Ethics and Science of studies used to approve Seroquel.

*** Jorge Amenteros- a Florida child psychiatrist and paid AstraZeneca speaker, was Chairman of the FDA Psycho pharmacologic Drug Advisory Committee responsible for recommending Seroquels approvals.

**** To date AstraZeneca has agreed to pay out $520 million to settle suits pertaining to clinical trials and illegal Senoquel marketing and there are 26 000 Senoquel/AstraZeneca lawsuits on record.

*****8 corruption scandals involving Senoquel / AstraZeneca in 13 years and yet the FDA has EXPANDED use of Seroquel.

1997: Seroquel approved to treat schizophrenia

2004: Seroquel approved for “acute manic episodes” associated with Bipolar Disorder.

           ( said to have contributed to the death of 4 year old Rebecca Riley in Massachusetts)

2006: Seroquel approved for “ major manic episodes” associated with Bipolar Disorder.

2009: Seroquel approved for “ maintenance “ treatment of Bipolar Disorder

* MORE recently the FDA has approved Seroquel to people NOT diagnosed with BD, approving the drug as an

    “ additional therapy for patients suffering from depressions who do not respond adequately to their current

      medications”.

2011: Seroquel approved for children between 10-17 diagnosed with BD and children 13-17 with schizophrenia.

Seroquel had $4.9 billion in sales in 2009.…this USE signals a use far above the 1% of population with schizophrenia and 2.5% with Bipolar Disorder.

North Carolina Medicaid spends $29.4 million a year on Seroquel….more than ANY other drug.

Seroquel is KNOWN to cause cardiac arrest and sudden death…” toxicity, cardiac arrest, death”.

Iraq and Afghanistan veterans therefore have the same or exaggerated potential for sleep apnea, endocrine abnormalities/ anomalies and opiod intoxication due to medication for symptoms of traumatic brain injury and PTSD.

NOTE: symptoms of paranoia:

                                                 Intense hyper vigilance

                                                 Withdrawal

                                                 Extreme agitation

                                                 Disassociation

                                                 Psychotic-type flashbacks

                                                 Brief psychotic reactions

                                                 Arousal/ loss of arousal- stemming from brain synaptic relay expressions

In addition there is intense insomnia, anxiety, grief, frustration, depression, risk aversion and risk seeking.

Military personnel and veterans continue to suffer excessive numbers of suicide, addiction, divorce, combat stress related disorders, adrenal fatigue, physical health issues and chronic homelessness. All in all a relentless, vicious cycle not likely to end or slow down in the foreseeable future. The Department of Defense has spent billions of dollars dismantling men and rebuilding them into the mold of a soldier , with little care and no attention to seeing the returning soldiers reassembled as civilians, able to pick up their interrupted lives and continue a productive, healthy and contributory life in Main Street USA.

*) In FY 2012 the VA’s budget totaled $127 Billion for it’s operations, including $65.7 Billion for veterans benefits programs, $54 Billion for veterans health programs and the pentagon projects that it will not reduce size/force/ resources below pre 9/11 levels until 2017 (or beyond). 

Abstract:

The object of the study is to incorporate what is known to be of benefit from observed studies of cannabinoids, the proven benefits of specific supplementation with vitamins, amino acids and the therapy models of the “ 7 Stages of Grief” in a hyper focused, concentrated therapy/ study time frame of 24 hours after a rigorous pre treatment stage of 6 weeks to lay the groundwork and frame for the intense, 24 hour deep therapy.  This would be 6 weeks of weekly group sessions. Additionally  one session of one on one therapy weekly with one twin team therapy session, weekly goals and record keeping for both the participants and the therapist and controller. Spouses and ex spouses would be included in one pre session ( pre the hyper focused 24 hour session) and one more session post the 24 hour session. 

One must bear in mind that dealing with military veterans presents unique challenges to both therapy and treatment  options and the study was designed specifically to overcome their unique abilities, physical and emotional endurance capabilities, training and exposures.

The study controller does not recommend this therapy model for civilian use.

403 Veterans were screened and from that an initial pool of 30 were identified as potentially “prescription drug free” and willing to participate in the study utilizing supplements, vitamins, cannabis juice, cannabis inhalation through a water pipe and intense therapy with one prior group orientation session and two group follow ups and “as needed” individual follow ups.

Of the 30 veterans only 6 were identified as absolutely NOT being on any prescription medication or over the counter drugs for the relief of their myriad PTSD symptoms. Their drug free status was determined by both urine and blood analysis.

For the integrity of the Study it was critical that all participants be absolutely drug free individuals prior to the study and that they clearly understood that participation would render a positive test for cannabis post study and for some time thereafter. This is important to note as the VA has implemented urine testing to identify at risk groups and cannabis remains an unapproved treatment for PTSD and or any extenuating mental health issues or pain management.  

Cannabinoids have been found to have antioxidant properties unrelated to NMDA receptor antagonism. This property makes cannabinoids useful in the treatment and prophylaxis of a wide variety of oxidation associated disease, such as inflammation. The cannabinoids are found to have particular application as neuroprotectants, for example in limiting neurological damage following ischemic insults such as stroke and trauma, or in the treatment of neurodegenerative diseases such as Alzheimer’s, Parkinson’s and ( HIV related) dementia.

Cannabinoid/ marijuana research has elucidated the discovery of an elaborate endogenous endocannabinoid system (ECS), complete with endocannabinoids and enzymes for their biosynthesis and degradation with genes encoding two distinct cannabin (CB1 and CB2) receptors (CBRs) that are activated by endocannabinoids, cannabinoids and marijuana use. A number of variations in CBR genes have been associated with human disorders including osteoporosis, attention deficit hyperactivity disorder (ADHD), post traumatic stress disorder (PTSD), drug dependency, obesity and depression. Nervous system disorders and mood related disorders.

The neuropharmacological and neuroprotective features of phytocannabinoids and endocannabinoid associated neurogenesis have revealed roles for the use of cannabinoids in neurodegenerative pathologies with less neurotoxicity. The remarkable progress in understanding the biological actions of  marijuana and cannabinoids have provided  more thoughtful and evocative results than previously appreciated and raises a number of critical issues on the molecular mechanisms of cannabinoid induced behavioral and biochemical alterations.

Specific supplements were chosen for their unique ability to address, over time the symptoms perhaps more pertinent to veterans namely: fear, trepidation, anxiety, blatant panic attacks, insomnia, unexplained anger and extreme emotional ups and downs along with the physical manifestations of these symptoms such as chest palpitations, blinding headaches, erectile dysfunction, skin irritations consistent with hives, adrenal fatigue and more. 

The amino acid complex * NeuBcalm’d was selected because of its excellent blend of nutritional support for the brain and cognitive function and, because of the unique stress on the brain function of military personnel we elected to supplement the amino blend with stand alone items for a specific time frame. The high quality omegas were chosen to specifically feed the brain a rich diet  to encourage healing. PTSD and other stress induced neural pathway issues cause interruptions  in the predictable pathways of brain activity, often causing relay interrupters or intercepts that become habitual. By making the amino acids that the brain needs immediately bio available it allows the brain to begin the repair of the neural pathways and rebuild the long “ routes” across the neural pathways system. There were 5 items selected to aid the gut and digestive issues, often the area of physical manifestation of underlying anxiety and other mental health and cognitive issues.

An adrenal complex was chosen due to recognition that combat fatigue and the hyper vigilance required of military personnel cause extreme adrenal fatigue which, over time manifests clearly opposing symptoms such as exhaustion, inability to sleep/ relax or stay alert. Adrenal fatigue is also known to undermine the immune and corrode the digestive system.

Method:

After the urine and blood tests confirmed the six participants were completely drug free they met with the therapist and controller to go over the study concept, time line and parameters in detail.

Of the six only one had smoked cannabis before, as a teenager. All six veterans perception of cannabis was that it was a drug, had a social misfit connotation and the words that sprang to mind when conjuring up a cannabis user was : minimum wage earner, loser, reality denial, homelessness, welfare recipient and criminal record. It is a testament to their desire to explore a non pharmaceutical solution to the relief of their chronic symptoms that they have agreed to participate in this study.

The median time frame since their return from deployment was 6 months. One had been stateside for 10 months.  

Subject

             Age           Tours             Marital status                       Children

A.                     27                2                   married- separated                 2

B.                     27                2                   married                                  2

C.                     31                3                   married                                  3

D.                     35                2                   married                                  3

E.                      36                3                   separated                               4

F.                       38               3                    divorced                               2

(All six veterans had experienced combat during their deployment. All six had experienced the death of people in their units. They all know at least one person who has died since returning from deployment. They expressed hyper concern about not submitting to VA doctors for treatment out of concern regarding the rumors of prescription related deaths.  They have all experienced heavy drinking, depression, violent outbreaks, bursts of anger, remorse,  grief, withdrawal, inability to sleep or connect with family in a meaningful manner. They have all expressed a desire to change their behavior and admit to recognizing that such behavior would only leave them feeling more vividly the negative feelings they seem stuck with. Therefore they all have an open desire to explore treatment. Privacy, sealed records, no paper trail, confidentiality….these appear paramount as conditions for staying with the treatment and being honest about their issues. Overwhelmingly they all point to their spouses, ex spouses and girlfriends as being the instigators and supporters of their proposed treatment. Long term goals all include enhanced relationships with their children, ranging in age from newborn to age 17. Deeper and richer relationships with spouses and other close family members and overwhelmingly these people are searching for some inner peace.)

A)  At that time they were given a work sheet that outlined items that were forbidden for the duration of the study.

A) 1. No medications.

     2. No sports drinks, energy drinks or sodas.

     3. No fast foods whatsoever.

     4. No candy whatsoever.

     5. No alcohol whatsoever.

     6. All time had to be accounted for in a personal diary/ no “ lost” times.

B)They were given a list of supplements, vitamins and amino acids along with the dosing schedule.

B) 1.CoQ10/ ubiquinone

     2. Fish Oil

     3) Coconut Oil

     4) Selenium

     5) Magnesium

     6) Magnesium/ potassium/calcium

     7) B6 and B12 and Folic Acid

     8) Chlorella

     9) Spirulina

    10) Cayenne

   11) Glutathione

  12) Melatonin

   13) Glucosamine, chondroitin and MSM

  14) MSM

  15) Acetyl L Carnitine

  16) L Tyrosine

  17) L Tryptophan

  18) 5HTP ( seratonin)

*19) Tongkat Ali

*20) Fenugreek Extract

  21) GABA (gamma amino butyric acid)

  22) L Theanine

  23) Sleep Essentials ** formulation from Swanson Health Products.

  24) DMAE

  25) Adrenal Essentials ** formulation from Swanson Health Products

  26) Blueberry Leaf Extract

  27) Milk Thistle

  28) Hemp Seed Oil

  29) Bromelain and Papaya capsules

  30) Acidophilus and Apple Pectin capsules

  31) Goat Milk Probiotic Blend

  32) Astragalus

  33) Vitamin C with Rose Hips, Acerola cherry, rutin, hesperidin

  34) NeuBecalm’d- a proprietary formulation of amino acids * see notes in “ conclusion”.

  * was given to 2 subjects who were experiencing difficulties with maintaining erections, for week two only, prior to onset of 24 hour study. See notes in “ conclusion”. 

# 34 was only given post the 24 hour study and replaced # 15, 16.  Ultimately # 17, 18, 21, 22, 23, 24, 25 will also be dropped while NeuBecalm’d will continue for approx one year post study.

# 17 was given daily for weeks one through three, three times a week for week four, daily for two weeks prior to the 24 hour session and on alternate days for 6 weeks  thereafter.

#29, 30, 31 are taken daily before breakfast and dinner and will continue.

Meeting One:

Introductions.  Outline of study rules, handing out of list A and B.

Discussion on diet and sleep patterns, common fears, common issues, similarities and so forth between participants

And a  discussion on what brought them TO the study, fears, hopes and what they both WANTED and FEARED getting FROM the study. Long term projections and discussions around aging and what that entailed.

Meeting Two:

This meeting was held one day after the first meeting. The meeting began with a game of basketball for the 6 veterans, hereafter referred to as the “team”. After the game the team was divided up into two groups of three.

Generally three is not considered a good therapy or team number but given their military training this was exactly the point, as they are trained to keep the team integrity cohesive against all odds.

The discussion centered on their introductions to each other of themselves, their home lives, children, marital status and anything else they wanted to share.

The therapist and controller held a discussion on the broader aspects of the 7 Stages of Grief:

Shock and Denial

Pain and Guilt

Anger and Bargaining

Depression Reflection Loneliness

The Upward Turn

Reconstruction and Working Through

Acceptance and Hope.

The discussion revolved around applicable scenarios relevant to the team and a group discussion centered around the question,” Is there an imaginary “ schedule” for the stages of recovery?”

* Grief communication is different for different people and circumstances….this was the relevant message to convey.

The session adjourned with  scheduled one on one sessions for the team to be completed before the next meeting, scheduled for one week later.

The team elected to get together once on their own to discuss their thoughts on this sessions deeper meaning for them and to have another round of basketball. All before the next meeting.

Meeting Three:

Prior to the meeting the team did a full workout together at a nearby gym instead of a basketball game, their choice.

At this meeting there was a profound sense of camaraderie already evident between the complete team and we noticed that the two groups of three stayed in close proximity to their members ie; three and three although all six were unified in body language and verbal communications.

The entire team was given a chance to discuss their ability to stay on track with List A…the NO NO list.

We introduced the full supplement protocol for the team and the finer points for two members (*) based on their concerns and symptoms.

At this meeting the team was given comprehensive instructions regarding their supplements, food choices and a two hour discussion ensued.

> STARTING from this point on, each team member would be on the full supplement and vitamin protocol

WE consider this the DAY ONE of the study

NOTE: all weekly team sessions are four and one half hours long while all private sessions are the standard 55 minutes, all twin team sessions are 95 minutes long and couple sessions are also 95 minutes.

Meeting Four / Week ONE

:

This is the first full week that the team has been on the supplement schedule. Each team member has had one private therapy session this week. The team has gotten together three times this past week to play basketball and work out at the gym.  Discussion centered around their own discussions with spouses and other family members in this last week and the team expressed frustrations with the feedback from spouses/ family. “ Deadlines to recovery” Deadlines to external answers, internal demons, relationship dynamic with children and the smaller public they came into contact with daily…the team watches each other intently as the conversation flows, quick to agree and looking down/ away when disagreeing or not being able to relate. We encourage them to voice dissent as well as agreement and force the issue on several points.

The team agreed that the supplement protocol was giving them a feeling of control and wondered and joked about possible placebo effects with one member expressing doubts of anything more than placebo.

Week Two:

This is the second full week on the supplement schedule. Each team member has had one private therapy session this week and one individual session with the controller. The team again reported that they had all gotten together  three times during the week for gym/ basketball and everyone agreed that they felt it was as important to them as the therapy, if not more so. 4 of the team had gotten together and painted the interior of one team members home, surprising his wife and children which seemed to delight the whole team ! The other two members had helped the gym owner move equipment around and secured free gym memberships for all six team members.

This week we have instructed the team to limit red meat to 4 ounces per serving, no chicken at all and one extra vegetable for dinner. We have also taken popcorn out of the allowed foods group along with peanuts and pretzels because these are foods commonly associated with alcohol ( bar snacks).

The team was instructed to break into groups of two with opposite team members ie: three from group A to team up with opposing three from group B for their previously one on one therapy sessions.

Week Three:

This is the third full week  on the supplement schedule. The team reported that their twin team therapy sessions had gone well and all reported not feeling nearly so isolated as one month prior. On a scale of 1 to 10 with 1 being MOST isolated and 10 being LEAST isolated the overall consensus was a hearty 7. Note: in private therapy the scores had dipped as low as 1 with the highest score being a 4 in the previous weeks.

They were still getting together three times a week for gym/ basketball and that morning had jogged a pre dawn 5 mile. No one complained about the food restrictions OR the List A NO NO , a first.

WE discussed their health, previous symptoms and the supplement regime. The consensus verbally was that everyone felt healthier, physically and mentally. This prompted the therapist and controller to center the remainder of the time on aspects of denial and a focus on the Stages of Grief and what had brought them to the study.

The session ended with the team being emotional and angry at being accused of focusing on denial and lack of inner accountability. They certainly did not like to be accused of focusing on external team building and suppressing their true needs and state of mind but all agreed after prompting that this was in fact the truth. Eye contact between the team was minimal and when leaving it was clear that the team had suffered its first crack in cohesion. This would be dealt with during the one on one therapy sessions to address their OWN part and culpability. 

Week Four:

This is the fourth full week on the supplement schedule. The team reported on their previous couples therapy with spouses and ex spouses. There was discussion of thoughts and feelings on how the last team session had played out and how it had affected their week, their mood, sleep and relationships with smaller civilian population exposure.

There was some consensus of resentment, anger and resignation towards the inability of others to perceive what the team had and was experiencing as a result of being a veteran. Two team members broke down and expressed emotional overload at being unable to tap into their inner selves, expressing profound resentment at the perception they had that the civilian population was oblivious to their sacrifice and their ( team member)  recognition that the public was, by and large completely unaware of military life and its subtle shadowesque feel. The team came alive at this point, with everyone expressing similar feelings of being invisible or of being shadows in society. They felt angry and hostile, not AT the public and unsure exactly where to lay their “ blame” as such. Discussion centered on “ who are we/ what are we/ before and after deployment” and the larger issue of moving forward. Finding positive ways to become “ visible” . Measurements of success from their own perspective.

Time was devoted to the discussion of translating skills learnt in the military such as reading situations, each other, hostile faces and terrain, making snap decisions and the yearning while deployed for things “ back home” and the ways in which those yearnings manifested, for better or worse.

The team is physically well but emotionally frayed and this was the most tense meeting to date. Note that in the last week they also had private couple therapy sessions which exposes them  to being vulnerable and they do NOT really want to be open. This observation is not a reflection on spouses or ex spouses since their therapies are individually tailored, rather this is a broader observation of the men at this point in their journey.

Their homework this week was to write out their own examples of their own path within the context of the Stages of Grief…they are free to include childhood incidences all the way to the present. They were also instructed to wish for something deeply personal for themselves,  and to wish for something for another team member. This fell under the teaching of being kind to oneself and secondly the random act of kindness.

The controller explained that this needed to be on two sheets of paper which would be put into two separate jars at the next session. Further, there would be NO discussion regarding the contents, it would be anonymous to the greater team and the sheets regarding a personal wish would only be shared later during the individual therapy sessions while the random act of kindness was merely something to be put into a “ bubble” but had to be reality based. 

Week Five:

This is the fifth full week on the supplement protocol.  Everyone arrived straight from the gym, put their homework in the jars and discussions picked up where it had left off the week prior. The focus this week was on Love, disappointment, irritation, yearnings and acts of kindness and forgiveness.  FEAR is very central to these emotions for people in the military. Their training is hyper focused on KEEPING IT TOGETHER, on NOT letting the TEAM down and on GETTING THE JOB DONE.

For the first time we saw team members initiate conversation that was reflective of the ways in which they were NOT keeping it together. Curiously they had all expressed scores ( in personal score cards done daily) that they were sleeping better, or at least deeper and or for longer. They acknowledged fear in the moments falling into sleep and anxiety upon waking. Their score cards indicated less pain in their chest upon waking, more lucid feelings immediately after waking and less overall irritation throughout much of the day. Scores also reflect panic/ anxiety spells are briefer in duration and at least half of the episodes do not inspire chest pain or inability to breathe through and see beyond ie: the light at the end of the tunnel. 3 team members had had severe tinnitus during panic episodes, these are diminished by 80% from week one.  2 team members had, prior to the study  taken to sleeping for a part of the day due to extreme hyper vigilant and panic attack inducing PTSD episodes. They report a reduction in the hyper vigilance of at least 35% but are not willing, at this time to try an adjustment and reduction of daytime sleeping. They are however no longer chewing their nails and placing themselves strategically  within the meeting room, so we agree to let it slide. They find our willingness to accommodate them presumptuous on our part which leads to discussions on why THEY and the other team members are there in the first place and our ( therapist and controller) commitment to the team, the study and the follow up to the study.

This prompts an angry discussion about the study and its creation….” too late to help those already fallen by the wayside of prescription deaths”, the anger, hostility and fear is evident. They are feeling better and it is this which now allows them to have a clearer picture into the loss of those around them, in a productive and compelling way.

Unfortunately it is at this point in recovery that some may lash out physically, often at wives or girlfriends, even towards each other. For this reason we have included 3 free standing weighted punching bags in the conference room. One team member spends a solid 7 minutes pounding away before being able to reenter the discussion.

Other team members watch with weary understanding and we note that this has not divided the team one bit, nor has it brought them any closer. They are accepting now some differences within the team and each others experiences and places on the path to recovery. The rest of the session is self directed as the team clearly uses the skills being taught in therapy and taps into their own “ reason” reflexes. This is a clear breakthrough as the team takes on the responsibility to direct and redirect each others anger and frustration. Emotions run very high but everyone remains in control or removes themselves briefly and body language is controlled and fluid. The “ measurements of success” seem to have bubbled to the surface for the older team members but the younger ones don’t take the bait. This will be dealt with in their one on sessions this week.

Their homework for next week is to bring in photos of loved ones, favorite pets and their dream vehicles/ current or past project vehicles. The theme for the photos is “ Cherish”.

Week Six: 

This is the sixth full week on the supplement schedule. The team met once for a gym workout and played basketball twice this last week. Various team members got together this week to help each other fill out forms and paperwork for various things and even helped each other with vehicle issues and a broken fence. This week we have prepared 8 by ten glossies ( pictures) of domestic abuse victims, small children in metal cots in foreign orphanages, animal abuse images, images of mangled cars from accidents and other images of death, trauma and the ravages of violence. There is also an image of a flag draped coffin sitting on a tarmac.

The theme this week is “ What If”….” Control and the lack thereof” and “ Repercussions of Choice”  and “ Life and Death”.  The team is NOT happy once they realize where this weeks discussion will take them. They all voice the opinion that they feel misled, having brought in items that they felt were happy and positive  “ Cherish” and which will now be taken down another, darker fork in the road.  They are directed to match up  the images of orphans with images of their own children, to match up the faces of domestic abuse with the smiling faces of their wives, girlfriends and ex spouses. “ What If, Control and loss of control and the repercussions of choice” have a profound effect on the discussions and serves to center the team. They all have a visceral response to the flag covered coffin as discussion turns to memories of the previous weeks discussion about their fallen friends and our study being too late for some best friends and fallen veterans who died state side, after serving their country and their own teams so well.  The team is emotional and we note their eyes return carefully to the glossies, now lined up on a table in portrait stands, easily seen from where they all sit. 

The following week will be profound. Everything thus far has been the lead in to what they will face in the next weeks session.

1. For three days prior to the following session, week “ 7” day one or as the team has dubbed it “ Ground Zero”, the

    team will take one ounce of fresh juiced cannabis leaf and bud, (a sativa strain), twice daily. This will be in

    addition to their supplement protocol. There is a separate chart to fill in for the cannabis juice which they will

    bring to the Ground Zero event.

2.  The evening before Ground Zero the six team members would meet and have “ The Last Meal”.  The only rule

     Being that The Last  Meal had to occur outside and be completed by 9 pm.

3. They would arrive for the studies 24 hour  hyper session in full uniforms with their duffel bags minus any and all

    weapons. Cell phones were to be turned off  for the duration of the time ( 24 hours). No timepieces/ watches.

4. The team would, after signing in, be allocated a spot where they had to change out of their uniforms and into

      their gym clothes and line up. They would not be allowed to speak during this time.

5. They are to have their one ounce of cannabis juice prior to arrival at ground Zero, but no other nourishment.

The team exhibit’s a measured undercurrent of excitement and tension. Nervous and fearful about their expectations and hopes as well as the potential loss of control or lack of any discernable outcome at all ! There is a  deliberate attempt at “ Keeping it Together” which they point out to each other with a humor that is surprising considering not only the tension but the events that occurred the last time the team was accused of glossing over important issues. Everyone is clear on the instructions and the team departs.

Ground Zero:

We had arranged to have a rotating team of 12 volunteer veterans on hand, outside, for shifts of 6 men at a time in case they were needed for some unforeseen  incident. We also had two paramedics on hand for the entire duration of the 24 hour study period, including the nine hours post the study time frame, until all six team members had departed the building.

( There was NO incident and NO health crisis that necessitated the use of a paramedic, nor the intervention of the standby staff,  but we felt that it was a cautious and necessary addition since a study of this sort had never, to the best of our knowledge, ever been performed. )

5am:  The team arrives and everyone is very quiet. This is the first time that everyone sees each other in full uniform and we note them taking each others full measure.

>The conference room has been blacked out with dark sheeting, no windows or lighting except for lamps with red light bulbs. We have provided 2 sound machines, one at each end of the room, set to the sound of “ Rain”.

There are lavender oils in a diffuser and the room is cool and sweet smelling. We have prepared protein smoothies and once the team has undressed and changed into their military PE sweats they each sit down on beanbags provided and drink the 12 ounce smoothies. There is no talking, at all. We indicate that they need to apply face paints in a cammo design to each others faces and no one smiles as they complete the task. We hand out sleep masks and everyone puts them on, now effectively “ blind”.

Body language is rigid and tense. The therapist introduces the concept of this day…Ground Zero…as death… rebirth…hope…new beginnings…loss…grief…awakening…searching…journey…shedding…need…forever.

“ The team has been able to articulate the mechanics of deeper emotions and been willing to explore their guilt, grief, fears and desires, however it is also true that you have only truly articulated the mechanics…today it is your choice to engage fully in the return to your personal ground zeros of which there  is not one but many, how many is your journey to explore. You have come to a safe place, entrusted yourselves and each other to this experience and in that you have already arrived. The eight people in this room will stay together for the next 24 hours no matter what happens and afterwards you will sleep, right here, for as long as you need to. When you awaken you will be allowed to leave with your team member and your designated driver. What your emotional journey unveils will be kept within this room and the hearts of the team.  This is a study, too true, but it is a study created for you, an experience enhancement for you and for those who come after and each will be unique to the individuals of those teams“.

Masks off…a water pipe had been prepared with a Sativa strain of cannabis and each team member used it and passed it forward. Body language had relaxed the second the masks came off and the team looked to each other for reassurance in look and gesture. Finally there were smiles as each team member surveyed the decorated faces of their team mates.

We reminded them that the No Speaking Rule time frame had lapsed and they each chuckled in turn, making light of each others make up and attempts at using the water pipe and cannabis.

After twenty minutes the team was “ stoned” and joking, the mood relaxed as they contemplated their prior perceptions of cannabis, using cannabis and all the connotations.

Conversation included what the juiced cannabis tasted like ( disgusting in that “ therefore very good for one” way) was the consensus. To the physical feelings: tingly, increased stamina, felt the effects in the heart/ less tightness and on it went. After passing the water pipe around again we began to explore some deeper issues.

Each team member had prepared an index card of questions for their twin member, of things that had come up during their twin sessions and they were asked to sit across from their team member and alternate questions and answers.

The goal with this was to allow them to begin their exploration in a non obvious, non threatening way and allow the cannabis to assist with the removal of entrenched “Guarded veils”.

Plates of fruit, crackers and cheese were passed around and the team was asked to exchange index cards and ask the same questions to other team members.

Some fitting, military choice pop culture music was played while the team took a break and passed the water pipe around. The music seemed to mesmerize the team and a new level of awareness seemed to descend upon the room. We led the team into a discussion on grief and guilt…what if…could have been me…why am I here…who was I…who am I now…who do I want to be…why am I sad…what if I die right now…why shouldn’t I ( fill in the blank)  the definition of hopeless…what Should I be angry about if I cant be angry about ( fill in the blank)

After 6 hours the team was devolving as each member became more and more self absorbed in expressing their OWN thoughts and perceptions centering around the information of the last 6 weeks.

We put on some sound connectors/ intuits and reminded the team that this was merely a recording. Sounds of prerecorded heavy artillery fire, men’s yells, screams and panic sounds muffled by the sound of machinery filled the room. The team chuckled somewhat, observing that it was clearly a Hollywood sound production and the conversation turned to what the sounds of war really sounded like, felt like. It had a taste they all agreed.

We noted that the team became very articulate and all members participated, drawing inspiration from each other and elaborating quite freely. Cannabis had definitely dulled the raw ends of emotion and was allowing them to articulate situations that had drawn anger and frustration or denial to participate in previous sessions, particularly the one on one sessions. 

After 9 hours the team had moved beyond any concept of time and we instructed them to use the bathroom, eat and stretch their legs.

Food was handed out and 2 team members promptly dashed to the adjoining  rest rooms to throw up.

Clearly they were at an emotional point but still not near the goal.

After 12 hours we felt that the team was saturated and discussions began in earnest.

After 14 hours they began to express their fears about being targeted as ex military, exploring this observation became riveting for half of the team who had at first scoffed at the feelings being presented. Keep It Together…The team member who began the thread was quickly overtaken as everyone began to explore the politics and rumor mills of the military and the feeling of isolation they felt in some measure while deployed, and the different forms of isolation upon reentry to the states and civilian life.  They all agreed that returning to the states had been an eye opener and that things looked and felt very different after their experiences overseas. They talked about wearing civilian clothes and being lost in the crowd, lost at home as the routines of family carried on around them. This drew comparisons to army life, barracks, MRE’s and the myriad details of the life they had led overseas and on base. They compared talking to civilians in the states while feeling intrusive memories of deployment clanging around in their heads and their overwhelming need and desire to escape the reality and the memories. The smells, sounds and things that became triggers for panic, anxiety and even joy.

Memories of battle surfaced, raw visceral memories that were relived in the moment.

Memories of situations that prompted individual team members to join the military surfaced.

By the 19th hour everyone had experienced tears, anger, grief, intense fear and hilarity. By this point each team member had either thrown up, had diarrhea or both. 5 of the team members had used the punching bag, 2 had also punched the floor and a door,  and only one had not punched anything.

By hour 21 every team member had run the full gamut of emotions and experienced not only their military trauma but issues that had lain dormant since before their military careers.

Every single team member remembered small details from their childhood that elicited surprise, warmth, fondness, love, longing, anger and regret. They had explored their relationships with their deployment teams and cried over lost opportunities with wives, children and fallen friends. They also talked at some length about their recognition of the “enemy” as being so much more human, far more real than any training had prepared them for.

Passionate observations about the militaries encouragement towards a military family culture that in many ways isolated them and got in the way of their transition into civilian life upon their return from deployment. Memories of their basic training and sergeants, corporals and things they did not realize at the time, or saw easily through, all this and more one or another pointed out, often elaborated upon by another team member.

By hour 22 everyone appeared exhausted although surprisingly no one was yawning. We began to lead them back through their emotional drain and into a discussion on next steps. Each member was asked to write themselves a brief note on an index card: “ Dear______, When you are no longer stoned and with your mates you may forget that_____________but this card is to remind you_________ and_________.”  They were led through several such prompts and encouraged to put forth their own words of wisdom to their future selves. They filled index cards with points to raise with spouses, girlfriends, children and parents.

Hour 23 arrived and one team member announced that he was so tired that he felt ill. Two other team members began a discussion about what actual exhaustion felt like and the three of them discussed their previous issues with sleep, self inflicted sleep deprivation and their hyper vigilance.

We announced the 24th hour and six hollow eyed team members looked around, expressed amazement that merely 24 hours had gone by when it felt like at least one whole lifetime, and 4 of the men promptly fell asleep.

The other two team members were deep in discussion about the deaths of their friends which had occurred once back in the states.  We decided to let them talk despite now having exceeded the 24 hours, and it was almost 40 minutes later before the conversation dried up and the men fell asleep.

The average time that the team slept was seven hours, the last one to wake up slept for 9 hours.

The entire team woke up clear headed despite the long, heavy therapy session. Everyone felt that they had slept very deeply with minimal sleep disturbance. The consensus was that “ it’s a helluva way to have to get a good nights sleep”! No one reported feelings of depression or anxiety that would cause them concern and all team members submitted to a brief physical. They were required to get dressed into their full uniforms, clean  up and depart in a quiet, orderly fashion. The designated drivers were all veterans and there seemed to be a gentle camaraderie, curiosity and respect between everyone as they dressed, packed up, met their drivers and departed. 

                                    ******************************************************

*NOTE:  As a result of what came out during the 24 hour session the therapist and controller decided to add in a group therapy session for the wives and girlfriend, in one session, and the parents and siblings of the team members in another session. We had not anticipated that this would occur but it became evident that the team needed an independent advocate/ support/ bridge which added another element or layer to their total experience and ability to integrate what they had experienced.

These sessions were held on day two after the 24 hour session and day four, respectively.

The team met one week after the session for a follow up and again one week after that. On the third week they elected to hold an event for everyone including the veterans who had driven them home, the teams  parents, siblings and the children. 

**NOTE: The team members continued their cannabis juicing for one week post the study to provide additional bio available nutrition and it remains relevant to point out that raw, juiced cannabis juice is not a hallucinogen in any way.

Conclusion:

Six weeks of grueling team therapy and one on one sessions paved the way for the 24 hour study and were of enormous value to the team individually and as a whole. However the individual team members, their spouses, girlfriend and parents were adamant that the 24 hour session was the break through point for the team.

The team felt that the 6 weeks of therapy was grueling, often unfair and resulted in deep frustration and anger which was non specific. They also agreed that the weekly sessions and the team commitment was the single biggest external factor that made them get dressed and arrive for the actual “ ground Zero”. Each member admitted to “ crisis” points during the six weeks but stuck with it because they felt compelled to “ make it” to the ground Zero.

Each team member also pointed out, independently of each other that they threw up or had diarrhea early on during Ground Zero because they KNEW that they were out of control ( as a result of the cannabis) and the panic/ fear/ anxiety was simply overwhelming although they also ALL agreed that leaving the building never crossed their minds at all. They had felt removed/ detached from their anxiety and could feel it as a separate entity in some ways.

The team members who had punched the punching bags/ floor/ door were surprised to report that although they had struggled with violence in the past, that they were actively aware of their choice to get up while under the influence of cannabis and that hitting had been a mechanical action, not a relief action. They will continue to explore this in one on one therapy.

It is the belief of the therapist and the controller that the success of the 24 hour study would have been much more difficult to achieve if there had not been a prior period of team building and group therapy to build a platform of trust and lay the groundwork for all that the 24 hour study brought to bear. It is also our absolute belief that none of the success of the 24 hour Ground Zero would have been possible or realized without the aid and support of cannabis as an enhancer, mood stabilizer, relaxant and buffer to the depth of emotions which surfaced for each and every member of the study group. 

In the follow up group sessions with spouses, parents and siblings they have all remarked on how their team member has changed in small and not so subtle ways since the weekly sessions began. They all agree that the bigger change from within was felt when the team members returned after the 24 hour study.

The therapist has done a follow up session with each of the team members, their spouse/ girlfriend and the parents. The change has been consistent and everyone agreed that positive changes have been seen, felt and maintained.

Everyone further agrees that there is still work to be done, that nothing is completed and relationships both personal and public are an ongoing dynamic. The team agreed that that aspect was no different whether one was a veteran or a full time civilian.

The team members rated the use of the supplements as VER beneficial and all 6 veterans have reiterated that they intend to keep up with the supplement protocol because of the benefits they have each personally felt.

The issues with erectile dysfunction have resolved and the team members no longer consider it of any issue whatsoever.

On a scale of one to ten, with ONE being NO successful outcome and TEN being perfect outcome, the team voted the study as a whole at: 8, 8, 9, 8, 9,8.   Spouses and girlfriend rated the members changes after the study, in no particular order as: 8, 7, 8, 8, 7,7.

The team members unanimously concurred that without the cannabis they would NEVER have achieved the levels of emotion and raw, naked depths that they did. The entire team concurred that without cannabis they would have labored away at the weekly team sessions and one on one sessions perhaps for a year or two or even three. One team member was adamant that he would have left the team despite the positive reinforcement of the team and weekly sessions because he would have given up on finding relief at all.

*NOTE: The physical activity pursued by the team outside of the weekly sesssions has been an integral component not only to their feelings of being a team/ unit but has given them a greater purpose which they all felt they had somehow lost in the pressure to “ fit in” in suburbia. They aim to keep meeting weekly at the gym and on the basketball courts. The men have been planning a weekend event for themselves as a group, with their older children to foster and nurture those relationships.

End.

The controller is satisfied with the way in which the study was designed and executed and would like to thank those who reviewed the draft of the study for their input. 

The controller states no conflict of interest in the study.

All supplements and food was donated for this experiment and the team members had no out of pocket expenses.

The controller does own a website that promotes the use of * NeuBcalm’d, the amino acid complex used for a portion of the supplement protocol, however the income derived from sales of this product are used to purchase additional bottles of product which are donated directly to those who cannot afford to purchase the items on their own. NeuBcalm’d is a patented, FDA approved blend of amino acids for use with traumatic brain injury, attention deficit disorders, hyperactivity, hyper vigilance associative disorders and autism. To review the literature on NeuBcalm’d please go to  www.sangozimedicine.com 

All other supplements used can be found commercially or by going to www.swansonvitamins.com

The creator of the study and the controller of the details and analysis is Dinah Everett Snyder.

You may visit her website at:   www.dinaheverettsnyder.org   or contact her directly at dinaheverettsnyder@hotmail.com

REFERENCES:

Elisabeth Kubler-Ross- author of the 1960 book: On Death and Dying- The 5 Stages of Grief.

The Grief Institute: The Stages of Grief

Primal Therapy

5 Stages of Emotions

Cannabinoids: mechanisms and therapeutic applications in the CNS

http://www.ncbI.nlm.nih.gov/pubmed/14529462       

Cannabinoid receptors in brain: pharmacogenetics, neuropharmacology, neurotoxicology, and potential

therapeutic applications

http://www.ncbi.nlm.nih.gov/pubmed/19897083

Role of endogenous cannabinoids in synaptic signaling.

http://www.ncbI.nlm.nih.gov/pubmed/12843414

Report:  Upholding the Promise: Supporting Veterans and Military Personnel in the Next Four Years.

                                                      by Phillip Carter

www.cnas.org/files/…/CNAS_UpholdingThePromise_carter_2.pdf

http://www.themilitarysuicidereport.wordpress.com/2012/11/page/2/    

http://www.statesman.com/news/news/prescription-drug-abuse-overdoses-haunt-veterans/nsPLW/-134k

http://www.costsofwar.org/articles/us-veterans-andmilitaryfamilies

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