Posted: January 30, 2018

Posted: January 30, 2018

PTSD Monthly Update

In This Issue

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Feature Topic

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For Providers

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Research at the Center

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PTSD in the News

January 2018 Issue

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Feature Topic

Medications for PTSD, Explained

Drawing of two woman sitting in an office - a therapist and a client

The symptoms of PTSD can affect every area of your life. The good news is that there are treatment options that can help. While psychotherapy, sometimes called "counseling", has been shown to be the most effective treatment for PTSD, certain medications have also been proven to help decrease many of the core symptoms.

Is Medication is Right for Me?

Medication may be a good choice if you don’t want to try talk therapy now or if you can’t fit weekly therapy appointments into your life. Some people find that taking certain medication for PTSD while they are in therapy makes the process easier. Talk to your health care provider about which medications are right for you.

How do Medications Work?

Drawing of a therapist and patient

Watch a short video to learn more about PTSD how medications work.

What Medications Work Best?

Recommended medications for PTSD are called Selective Serotonin Reuptake Inhibitors (SSRIs) or Selective Norepinephrine/Serotonin Reuptake Inhibitors (SNRIs). They are both types of antidepressant medicine. These can help you feel less sad, worried, and improve your overall functioning. SSRIs include sertraline (Zoloft), paroxetine (Paxil) or fluoxetine (such as Prozac), and the SNRI venlafaxine (Effexor).

Do I Need to be Cautious about Certain Medications?

Some doctors have prescribed medications known as benzodiazepines for patients with PTSD to help with symptoms such as anxiety or insomnia. These medications may be known as Valium, Xanax, Klonopin or Ativan.

Benzodiazepines may help these symptoms in the short term, but we now know that they do not improve the overall symptoms of PTSD. Their helpful effects do not last and they come with possible safety concerns.

Atypical antipsychotics are another class of medication occasionally used for symptoms of PTSD. They also can have concerning side effects and are not typically recommended to treat PTSD.

What Medications Can I Take to Improve my Insomnia or Anxiety?

The first-line medication recommendations for PTSD, the antidepressants, are effective in treating your anxiety and insomnia symptoms. You also can benefit from cognitive behavioral therapy. Talk to your provider about safer, more effective treatment options.

Prazosin is a medication that works by decreasing the adrenaline produced by your body when you are stressed and has been shown to help some Veterans with trauma-related nightmares. Ask your health care provider if it may be right for you.

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For Providers

Consult with PTSD Experts

PTSD Consultation Program

The National Center's PTSD Consultation Program offers free PTSD consultation to any provider who treats Veterans in any setting.

PTSD Lecture Series

Free continuing education credits for our monthly lecture series.

Download a calendar reminder to save the date for the 3rd Wednesday of each month at 2 pm ET.

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Subscribe to receive monthly emails that include a registration link and instructions for joining the live lectures.

February 2018 Lecture

  • February 21: PTSD Treatment Via Telehealth, Leslie, Morland, PsyD

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Research at the Center

Ketamine for treatment-resistant PTSD

Center investigators continue a ketamine trial (a drug which is typically used for sedation but also has rapid antidepressant effects) for treating PTSD in active duty military personnel and Veterans who do not respond to antidepressant treatment. The trial is part of the Consortium to Alleviate PTSD award and may yield a novel medication option for PTSD.

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PTSD in the News

VA’s National PTSD Brain Bank collaborates with PINK Concussions Group. VA announced a collaboration between its National Center for PTSD and the nonprofit organization PINK Concussions, encouraging women to donate their brains for the purpose of research of the effects of TBI and PTSD. Read more.*


Be sure to forward this update to others so they can subscribe. We send one update per month to keep you informed of the latest PTSD developments.

Thank you,

The Staff of VA’s National Center for PTSD

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Produced by VA’s National Center for PTSD - Executive Division
Email: ncptsd@va.gov | Visit our Website: www.ptsd.va.gov

*Links will take you outside of the Department of Veterans Affairs website to a non government site.
VA does not endorse and is not responsible for the content of these linked websites.

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January 24, 2018

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 Inside this issue

TREA: The Enlisted Association's Washington Update

·         • The Shutdown Is Over: What Next?

·         • VA Revises Regulations on Reimbursement for Emergency Treatment of Veterans

·         • USAA Will Cover Pay Delayed Due To Government Shutdown

·         • TREA: The Enlisted Association Supports H.R. 4345

·         • Tricare Lowers Some Costs for New Select Plan

 

TREA: The Enlisted Association's Washington Update

 

 

The Shutdown Is Over: What Next?

 

 

Congressional Republicans and Democrats came together earlier this week to reopen the government on Tuesday.

The current deal keeps the federal government funded through February 8th. It is designed to allow enough time to come together and agree on a longer term, hopefully up to 18 months, spending plan even though disagreements over immigration and federal fiscal policies remain.

This budget legislation also includes a provision to provide back pay for troops and other federal workers for the time they missed because of the lapse in operations.

Rep. Joe Wilson (R-SC), chairman of the House Armed Services Committee's readiness panel, said Monday that 2,000 South Carolina Guardsmen who were preparing to drill this weekend were sent home instead, and 750 Guard mechanics were laid off.

Senate Minority Leader Chuck Schumer (D-NY), said the new budget deal comes with a promise from Republican leadership that negotiations on the expiring Deferred Action for Childhood Arrival policy will continue over the next few weeks, with a possible vote in early February.

Pentagon leaders and pro-defense lawmakers have lamented the short-term budget extensions as bad for military planning and morale, and repeatedly pushed for a full-year plan. But Republicans have thus far insisted on hefty increases for defense spending alone in any such deal, and Democrats have demanded equal increases for other non-military programs.

TREA: The Enlisted Association urges that both parties come together, negotiate in good faith, and reach  a full-year budget that addresses our country's priorities while lifting the sequestration cap in a timely manner. The brinksmanship must end.
 
 

In Cases of Another Shutdown, Here's What Happens to the Commissaries and Exchanges


During the Shutdown Exchanges Will Stay Open but Most Stateside Commissaries Begin Shutdown Process

Exchanges and MWR Programs:

· Exchange operations continue unchanged.
· MWR programs funded with nonappropriated funds continue unchanged.
 
Commissaries

· 38 commissaries in Europe, one store in Puerto Rico and 28 stores in the Pacific (including two in Guam), will remain open. 
· Commissaries in five remote stateside locations remain open: Marine Corps Mountain Warfare Training Center Bridgeport and Fort Irwin in California; Coast Guard Air Station Kodiak and Fort Greely in Alaska; and Dugway Proving Ground, Utah.
 
· Remainder of stateside commissaries, including those in Alaska and Hawaii, will follow an orderly shutdown to prepare for closing so they can reduce their stocks of perishables and properly safeguard equipment and facilities...most will remain open until regular closing times. For these stores, orders already placed, processed and on the road, will be accepted. Orders that have not been processed or are not on the road, should be cancelled.
 
 

Here Is TRICARE's Shutdown Plan


TRICARE has Announced the Following With Regard to the Government Shutdown:

Federal Government Shutdown

The Military Health System will continue to provide health care to its beneficiaries during a government shutdown. While we can't predict the exact consequences of a shutdown on every part of our MHS, we may see some impacts on the delivery of health care services within our military hospitals and clinics. Inpatient, acute and emergency outpatient care in our medical and dental facilities will continue, as will private sector care under TRICARE. We anticipate most medical and dental providers, along with most retail pharmacies, will honor TRICARE copays and cost shares. If for some reason a TRICARE network provider or pharmacy requires you to pay up front for care, call your regional contractor to discuss it with the provider. If the contractor can't immediately resolve the issue, you can still choose to get care with that provider and save your receipts to file for reimbursement.
You can go to this website in ordert to get more specific information on various DoD health care functions:  https://tricare.mil/shutdown

 

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VA Revises Regulations on Reimbursement for Emergency Treatment of Veterans

 

 

Last week the U.S. Department of Veterans Affairs (VA) announced that it has, through a Federal Register notice, revised its regulations concerning payment or reimbursement for emergency treatment for non-service connected conditions at non-VA facilities.

VA will begin processing claims for reimbursement of reasonable costs that were only partially paid by the Veteran's other health insurance (OHI). Those costs may include hospital charges, professional fees and emergency transportation, such as ambulances.

This change comes on the heels of an earlier announcement that VA was taking immediate action to address delayed payments to community providers, found here.

Effective Jan. 9, VA updated a portion of its regulations in response to an April 2016 U.S. Court of Appeals for Veterans Claims decision that stated VA could no longer deny reimbursement when OHI pays a portion of the treatment expenses.

VA will apply the updated regulations to claims pending with VA on or after April 8, 2016, and to new claims. By law, VA still may not reimburse Veterans for the costs of copayments, cost shares and deductibles required by their OHI.

VA will work directly with community providers to get additional information needed to review and process these claims. Previous claims do not have to be resubmitted unless requested by VA.

More information on the amended regulation along with guidance may be found here

 

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USAA Will Cover Pay Delayed Due To Government Shutdown

 

 

In case of another government shut down, USAA plans to offer no-interest loans to active duty servicemembers that are members of USAA so that they will not run in to financial hardships while they are waiting for the government to be funded.

For more information, go to: https://www.military.com/paycheck-chronicles/2018/01/19/usaa-will-cover-pay-delayed-due-government-shutdown.html

 

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TREA: The Enlisted Association Supports H.R. 4345

 

 

TREA: The Enlisted Association is strongly supporting HR 4345, the Veteran Treatment Court Coordination Act of 2017. Congressman Charlie Crist (D-FL) and Congressman Jeff Denham (R-CA) are the original cosponsors. It currently has 51 other cosponsors. 

The legislation would direct
 the Attorney General to establish and carry out a Veteran Treatment Court Program to provide grants and technical assistance to the State circuit court systems that have adopted a Veterans Treatment Court Program or have filed a notice of intent to establish a Veterans Treatment Court Program with the Secretary of Veterans' Affairs.

This ensures that the Department of Justice has a single office to coordinate the provision of grants, training, and technical assistance to help State, local, and Tribal governments to develop and maintain veteran treatment courts.

It is TREA: The Enlisted Association's opinion that veteran treatment courts are an effective way to help veterans charged with non-violent crimes receive the help and the benefits to which they are entitled, and to prevent recidivism that clogs up the judical system. If we can identify veterans who are likely to not re-offend by making sure they get needed treatment and counseling, we can save money, keep veterans out of the legal system by keeping them healthy and productive, and we can lessen the burden on judical resources - a win-win-win for all involved.

Unfortunately, only 300-350 of the roughly 30,000 counties in the United States have veteran treatment courts. This legislation is aimed at coordinating and easing the devlopment of more of these vital judical resources. 

TREA: The Enlisted Association will be putting out a legislative alert on this bill in the coming days to urge you to contact your Members of Congress to support HR 4345. 

 

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Tricare Lowers Some Costs for New Select Plan

 

 

Military families, including retiree families, will pay lower co-payments than previously announced for the new Tricare Select plan, according to an announcement in the Federal Register by the Defense Health Agency.

For example, active-duty families in Tricare Select will pay $21 for a primary care outpatient visit, reduced from the previously announced $27. This co-pay applies to families of service members in uniform before Jan.1. Specialty care visits would require a $31 co-pay, reduced from the previously announced $34.

Working-age retirees and their families in Tricare Select will pay $28 for a primary care outpatient visit, reduced from the previously announced $35.

Last fall, Defense Department officials announced the Tricare Select co-pay schedule for active-duty families and retiree families, which allowed those who had entered the military before Jan. 1 to be "grandfathered" into the previous method for calculating co-pays. But while grandfathering usually allows a lower payment rate to continue despite a changing fee system, those currently in the system would pay higher co-pays than those entering the military after January 1.

At the time it was announced, Defense Health officials said the co-payments for the grandfathered group are an average of what the beneficiaries now pay, while the co-payments for those coming into the military this year were set by law in the 2017 National Defense Authorization Act.

This new schedule of co-payments still sets co-pays of those already in service higher than those entering the military this year. For example, those coming into the military will pay a $15 co-payment for a primary care outpatient visit, compared with a $21 co-payment for those in uniform before Jan. 1.

The Defense Health Agency calculated the co-payments of those grandfathered based on past costs, the release states, rather than using the percent-of-services-used model employed by the former Tricare Standard and Extra plans.

TREA: The Enlisted Association will keep you updated with any further changes.