EMPOWER VETERANS & END SUICIDE

* National Research Strategy for the President's Roadmap to Empower Veterans and End the National Tragedy of Suicide

 

29 July 2019

FROM:  TreatNOW Coalition

TO: TreatNOW Coalition Clinics (OXYMED Australia)

 

RE:  Attached RFI from the VA

  1. Attached find Questions from the VA Request for Information on how to prevent suicides. The full RFI is at: https://www.research.va.gov/PREVENTS/

  2. Hyperbaric Oxygenation is an immediate treatment for suicide prevention, based on data which show that HBOT nearly eliminates suicidal ideation. Clinical evidence confirms that almost all successfully treated HBOT patients are able to reduce their intake of drugs, particularly those that are black-boxed labeled as leading to suicidal ideation.

 

TO: RFIresearchresponse@va.gov

SUBJECT: Request for Information (RFI): National Research Strategy for the President's Roadmap to Empower Veterans and End the National Tragedy of Suicide (PREVENTS)

How can we improve our ability to identify individual veterans and groups of veterans at greater risk of suicide?

An answer is hiding in plain sight: Hyperbaric Oxygen Therapy (HBOT) is proved to virtually eliminate suicidal ideation in those suffering from TBI/PTSD/Concussion/PCS. Further, almost all HBOT-treated brain-wounded patients are able to get off almost all their drugs, including those that warn of “suicidal ideation” as an adjunct effect.

 

An immediate target to prevent suicide among the military and veterans should therefore be all diagnosed cases of TBI/PTSD/Concussion/PCS.

Current estimates of the post-9/11 target population approach 800,000 brain-wounded service members. An equal number exists among pre-9/11 veterans.

 

The RAND Corporation together with Elizabeth Dole Foundation have penetrated the ripple effects of those brain-wounded onto families in stories and statistics of secondary and primary TBI/PTSD/Concussion inflicted by untreated brain-wounds in their spouses.

Whatever the numbers, targeting those already diagnosed with brain wounds will deliver life-giving wound healing to a cohort that does not need long-term strategizing. Epidemics of suicide, drug overdoses, mental health and substance abuse must be treated with the sense of urgency they demand.

 

What is missing is the appropriate treatment.

What is abundantly clear is that current methods of treating brain wounds are not working sufficiently to prevent or lower the suicide rate among military and veteran populations. :

 

Interventions by DOD/VA/Army medicine – whether for TBI, PTSD, Concussion, PCS  -- do not treat the physical wound to the brain. 

Not one of the 80+ therapies, processes. procedures, devices, countless computer applications, nor 100+ prescription drugs have been approved by the FDA for TBI, nor do they HEAL the broken brains! 

 

All the drugs are used off-label for TBI.  All are controversial at some level.  Many of these drugs are too new to have even been explored in literature for their efficacy.

Little or no risk analysis has been performed, and no tracking or cost-benefit analysis is done.

Even worse—no analysis of effectiveness has been done!  Yet neither the DOD nor the VA provides Hyperbaric Oxygen Therapy used off-label to treat and heal brain injury.

 

HBOT is the one therapy proved by multiple clinical trials inside DOD/VA/Army medicine and around the world to treat and help heal the wound to the brain, safely, effectively and at low cost.  This evidence over the last 10 years from over 6,100+ successes in over 90 independent clinics around the US makes this crisis response the best and only proven solution!   

 

A program to immediately treat those already diagnosed with TBI/PTSD/Concussion/PCS can begin immediately while all other efforts for Suicide Prevention proceed. This much is clear from the decades of research and clinical medicine accumulated by HBOT researchers and practitioners: brain-wounded patients treated with HBOT are restored to a Quality of Life worth living. HBOT provides hope.  

Further the brain if afforded the opportunity to heal.  Executive function is restored, and depression is lifted.

 

  1. What are the most critical near-term and long-term areas for research into factors influencing veteran suicide and methods to assess an individual's risk of suicide?

  2. What are the biggest gaps in capability to identify and address the social, behavioral, and biological determinants of health leading to suicidal behavior in veterans? Consider associated conditions such as mental illness, traumatic brain injury (TBI), chronic traumatic encephalopathy (CTE), posttraumatic stress disorder (PTSD), and depression, as well as social determinants of health and research in intervention and postvention strategies.

  3. How can various disciplines (e.g. neurology, endocrinology, psychology) work together to better understand and address individual risk factors that lead to veteran suicide? How can different disciplines work together to develop individual intervention strategies?

 

A guide to properly treating brain wounds can be found in Functional Medicine. Other names for proper diagnosis and treatment of brain wounds are integrative/translational/wholistic/complementary and alternative medicine. By whatever name, the core of this view of medicine is not to treat just symptoms but to discover and treat root causes.

Palliation of symptoms has a role to play, but in the case of brain wounds, a fundamental rethinking of how brain wounds are currently “treated” has to begin with thinking in brain-wound-healing terms.

It is a maxim in computers that you must fix a broken hard drive before the software will run better. Similarly, in treating brain injuries, the principles of wound healing must be applied before all the behavioral, cognitive, emotional and physical interventions can be maximized. This calls for integrated conversations among all mental health and brain-wound specialists from the time a veteran or military member present for help, particularly if they are combat veterans [a parallel for this is the increasing use of Veterans Courts nationwide. In an increasing number of jurisdictions, combat veterans who come before the court are remanded to veterans courts for a more thorough and comprehensive medical workup to ascertain “extenuating circumstances” or similar impairments.

 

Wherever that workup is done, but especially in primary care facilities, the “concussion cascade” must be understood for the multitude of immediate and incipient injuries caused by brain damage, particularly blast injury.

An immediate take-away from this wholistic approach is that medical professionals in the VA must work learn about alternative therapies that are working outside traditional protocols. They must work together, not in isolation, to provide access to ALL care for brain wounds.

Accurate diagnoses must lead to “informed consent” at a minimum: brain wounded patients must be told that HBOT and alternative therapies are available, insured, and not lead to stigma or punishment for revealing mental health issues and seeking real brain-wound treatment.

 

In a phrase, DoD/VA/Service medicine must open up to “out-of-the-box” actions that can go to work immediately, safely, effectively, and cost-effectively.

Building the infrastructure inside military/veteran medicine can be part of a strategy, but treatment can begin today.

  

DOD/VA/Army medicine confirmed in June 2016 with solid science and objective physical evidence that blast injuries cause physical wounds to the brain.

Formerly "invisible wounds" have been revealed through post-mortem autopsies to be both visible damage through Traumatic Brain Injury (TBI) as well as probable cause for secondary symptoms of PTSD and other debilitating, life-altering behavior.

The implication of the finding is that those wounds should be and can be healed through application of "wound-healing" protocols in place for decades. And the stunning reality is that there is a treatment that is proved with similar scientific evidence to be an already approved indication for wound healing: Hyperbaric Oxygen Therapy.

 

Consider: We now know that blast injury is a physical wound to a body organ, the brain.

Blast waves to the body, with or without unconsciousness, result in an immediate and significant metabolic crisis for the now wounded brain.

 

Studies are underway to better link the acute pathobiology of blast injury with potential mechanisms of chronic cell death, dysfunction and neurodegeneration.

Current findings about blast injury point to disruptions in cellular processes that may underlie long term impairment.

 

In a phrase, blast injuries and concussion are physical wounds which can't yet be "seen" in life, but are accompanied by symptoms which can be observed.

Physiological damage -- ripping and tearing and shearing and bleeding and bruising and swelling -- lead to chaos in the head and link to clinical characteristics of concussion: balance problems, migraine symptoms, cognitive impairment and numerous other observable and measurable dysfunctions, and vulnerability to repeat injury.

Concussions are physically damaging; a wound that must be treated the way we know how to treat wounds we can see.

Treatments of the physical injury that can interrupt this damaging cascade of degeneration should be implemented immediately.

 

Medicine has well-known explanations of the nature of wounds and the phases in wound healing.

The so-called "concussion cascade" that follows the wound to the head creates conditions that impede healing in the closed, heretofore unseen environment inside the skull.  

A blast or jolt to the head begins a series of negative consequences. These can include inflammation; interrupted blood flow; oxygen starvation/hypoxia; tissue and nerve fiber ripping and tearing; cell stunning/ inactivation and/or cell death.

 

This insidious biological set of degenerative processes may or may not lead to permanent damage. This acute inflammation phase is the body’s natural response to injury.  After initial wounding, the blood vessels in the wound bed contract and a clot is formed. Blood vessels then dilate to allow essential cells, antibodies, white blood cells, growth factors, enzymes and nutrients to reach the wounded area.

Unlike with a wound that can be seen, there is solid evidence that this brain inflammation can continue and linger for a long time, impeding healing and increasing the likelihood that more physical damage is occurring and is likely to occur. It has been "common knowledge" that most blast injuries and concussions heal themselves. That is far too simplistic. What may be true is that symptoms abate. Yet damage that can lead to mental and physical degeneration may lead to lingering symptoms and chronic degeneration.

 

The logical extension of the DOD/VA/Army findings in the LANCET article is that we must treat the wound to the brain using wound-healing protocols. [Baughman Shively, S., Iren Horkayne-Szakaly, Robert V Jones, James P Kelly, Regina C Armstrong, Daniel P Perl. Characterization of interface astroglial scarring in the human brain after blast exposure: a post-mortem case series. The Lancet, Neurology, June 2016.]

 

Wound Healing. 

The use of Hyperbaric Oxygen Therapy (HBOT) addresses directly this negative cascade of damage and degeneration both in the acute phase of wound stabilization and in the acute and chronic phases of wound healing.

 

Consider the known benefits of using HBOT for wound healing:

  • Decreasing levels of inflammatory biochemicals

  • Increased oxygenation to functioning mitochondria

  • Increases in blood flow independent of new blood vessel formation

  • Angiogenesis from the addition of oxygen: (growth of new blood vessels in the acute and chronic phases)

  • Up-regulation of key antioxidant enzymes and decreasing oxidative stress

  • Increased production of new mitochondria (the energy factories of the cells)

  • Neurogenesis: (growth of new neuronal tissue and Remyelination during and after the treatments are completed)

  • Bypassing functionally impaired hemoglobin molecules, the result of abnormal porphyrin production, thereby allowing increased delivery of oxygen directly to cells

  • Improvement in immune and autoimmune system disorder

  • Direct production of stem cells in the brain

  • Increases in the production of stem cells in the bone marrow with transfer to the Central Nervous System

 

The validity of using HBOT for healing the wound to the brain is validated in the most recent research [Attached HBOT Research and Science].

Unsurprisingly, delivering oxygen under pressure safely and economically leads to effective wound healing. And numerous other interventions for comorbid maladies have a much better chance of effectiveness when the concussion cascade is interrupted and reversed.

 

How can we develop and improve individual interventions that increase overall veteran quality of life and decrease the veteran suicide rate?

How might we better understand the progression of veterans as they transition from military to civilian life in a way that supports identification of suicide risk factors, protective factors, and opportunities for intervention that addresses veterans at various stages of transition, before the point of crisis?

 

An immediate goal of military medicine should be to recognize that combat damages the body and, in hundreds of thousands of cases, the brain.

As an Army BG put it: “If the blast is powerful enough to tear off a limb, imagine what is does to their brain.”

 

The moral of his observation is that all combat veterans suffer some physical damage, and that TBI and PTSD impair physical, emotional, social, cognitive and and decision-making functions.

TreatNOW Coalition clinics have discovered over a decade or more that combat veterans frequently have misdiagnosed or no diagnoses for brain injury.

At a minimum, all combat veterans with diagnoses of TBI/PTSD/Concussion/PCS should immediately be sent for brain-wound healing in an HBOT clinic.

 

See:  http://treatnow.org/treatments/treatment-centers/

 

What are currently known effective and promising or emerging practices for suicide prevention? What factors make these practices effective? What additional research is needed to demonstrate the effectiveness of promising practices?

 

Most studies on suicide among combat veterans show that brain wounds caused by combat – blast, impact, accidents, IEDs, etc. – lead to increased risk of suicidal ideation.  

In 2018, active duty Army suicides reached a five-year high; suicide among active-duty Marines reached an almost 10-year high; active-duty Navy suicides hit a record high.  Sexual assault in the military also reached a four-year high in 2018.

There is zero evidence that DoD and the VA talk about, much less practice, brain wound healing. 

 

Hyperbaric Oxygen Therapy treats wounds to the brain.

Hyperbaric oxygen therapy enhances several natural processes related to wound healing: it reduces inflammation, inhibits apoptosis (cell death), reduces Intracranial pressure; and promotes neurogenesis and angiogenesis.  This is significant: HBOT promotes growth of new neuronic tissue and new blood vessels.

 

The combination of oxygen (typically 100% O2) and pressure (varying, depending on the diagnosis) leads to the production of more stem cells available for wound healing as well. All this has been proven by rigorous, scientific studies that have explored the role of oxygen and pressure in the brain healing process.

 

What is not controversial is that HBOT aids tremendously in wound healing, typically 20-40 percent faster healing than the norm.

In the case of acute concussions and within ten days of the injury, Dr Daphne Denham, MD out of Fargo ND and Chicago, IL demonstrated (http://bit.ly/2jwdUwI) that patients (248 out of 250) diagnosed with acute concussions completely resolved her/his symptoms in five or less treatments (average of 2.4 treatments per concussion).

 

That’s back in school symptom-free, within a week, sometimes over the weekend.

You can learn more about this by viewing a short film entitled “Concussion Help in a Hyperbaric Chamber?”: https://tinyurl.com/ybldktqn.

 

What tools, platforms, methods, or technologies are needed to advance:

 

Understanding of suicide risk factors

 - Assessment of individuals most likely to be at risk of suicide.

 - Evaluation of protective factors leading to the prevention of suicide.

 - Improvements in social connection and community engagement of veterans. 

 - Identification of opportunities for intervention far before the point of crisis

 

What are barriers to the adoption of existing tools, platforms, methods, or technologies that identify suicide risk factors or provide effective interventions?

How can we develop strategies to better ensure the latest research discoveries are translated into practical applications and implemented quickly?

What types of organizations should be engaged in developing and implementing the National Research Strategy?

Which existing consortia or partnerships should be involved, and why?

Are there existing organizations that have been effective in identifying and mitigating veteran suicide risks?

Are there programs and resources within communities that have been successful?

What factors made these programs successful?

 

Seven states have now passed legislation calling for the use and funding for HBOT to treat TBI/PTSD [see: http://treatnow.org/contact/state-campaigns/.

It would be judicious that Federal, State and Local organizations learn from the State experiences and the reasoning behind legislation in Oklahoma, Texas, Indiana, Kentucky, Arizona, Florida and North Carolina.

 

How can the Federal government strengthen the public health system, including mental health and crisis intervention education and training programs, to ensure an adequate, well-trained medical workforce that is well-equipped to respond to the challenge of veteran suicide?

What are the primary barriers to adoption of current best practices for the assessment, evaluation and implementation of public health approaches targeting suicide prevention?

 

Refer to the CDC Field Epidemiology Manual for the immediate and urgent actions that can and must be taken in the grips of nationwide suicide and brain injury epidemics. Here’s a way to put the Servicemember Suicide Epidemic in perspective.

 

A Princeton University meningitis epidemic in 2013 spurred the CDC and the FDA to approve the emergency import and use of the Bexsero Vaccine from Europe and Australia, which specifically protects against the B strain of meningitis. The estimated cost to fight the outbreak was in the hundreds of thousands.

* Total number of deaths in the US from the Meningitis B outbreak on the Princeton campus: One.

 

The Ebola hemorrhagic fever outbreak in West Africa in 2014 that led to a pandemic has resulted in 28,639 recorded cases of Ebola worldwide and 11,316 deaths.

Long before clinical trials were completed, vaccination of volunteers by the US Army started in mid-October 2014, using the experimental Canadian-developed VSV-ZEBOV vaccine. Médecins Sans Frontières, who helped support the study, are recommending that all contacts of new Ebola patients and frontline workers receive the vaccine: "Even if the sample size is quite small and more research and analysis is needed, the enormity of the public health emergency should lead us to continue using this vaccine right now ... Replication of a targeted approach focusing on those most at risk of infection should therefore happen immediately and we urge governments in affected countries to start using this vaccine as soon as they can within the framework of the existing trial." 

The estimated cost to fight the outbreak was $32.6B worldwide and millions in the US.

* Total number of deaths in the US from Ebola: One.

 

The Zika virus pandemic spurred President Obama to request $1.8B for emergency research. That sum added to the $100M already spend by NIH on the family of viruses related to Zika. Contracting the virus may or may not lead to children born with microcephaly.

* Total number of microcephaly births in the US cause by Zika: Zero.

 

20+ service members commit suicide every day in the US.

This suicide epidemic may be due in part to traumatic brain injuries (TBI) incurred in combat.

Diagnosed incidents of TBI exceed 320,000, with some estimates at 800,000.

Even in the face of an epidemic that dwarfs other epidemics, the DOD/VA/Army will not use a treatment that has been shown to be safe and effective at reversing the symptoms of TBI and in helping to repair underlying brain damage -- even as the Defense and Veterans Affairs departments spent $9.3 billion to treat post-traumatic stress disorder from 2010 through 2012, but neither knows whether this sum resulted in effective or adequate care [Institute of Medicine data].

 

Estimated total of suicide deaths in active duty and veterans: 48,000+, some presumably a result of their brain damage.

Failed attempts approach 100,000. Total number of patients killed in controlled HBOT studies: Zero. 

Estimated number of brain-injured service members accidentally killed using drugs as prescribed: 1,300+

 

What are effective methods to quickly transition promising practices into clinical and community practice? Where have these methods been demonstrated to work previously?

Again, the solution is hiding in plain sight:  allow brain-wounded to go on civilian/ private market to obtain pre-approved treatment.

The value in immediate use of the private clinics to confront the epidemics:

- No need for new hearing or legislation:  CHOICE/MISSION already exists and is funded

- Provides immediate help to veterans with brain injury and relief to an overloaded VA system

- Starts a process of providing needed services unavailable in VA or DOD

- Delivers on the Administration's promise to act quickly to cut through Establishment bureaucracy

- Saves money and lives

- Results from science and clinical practice can be available in 60 days.

- Expected results: >85% success rate based on 6,100+ patients to date.... many done pro bono.

- The Authority for the VA and Congress to intervene exists in at several pieces of legislation related to epidemics and gaps in care. It is hard to find any stakeholder that does not recognize the need to address the simultaneous epidemics: the US Food and Drug Administration (FDA), payers such as health plans and large employers, pharmaceutical manufacturers, state policymakers, as well as provider and patient groups.

 

On December 2016, the President signed The 21st Century Cures Act.

A major component of the law is an effort to expedite approval of breakthrough medical technologies for patients with life-threatening illnesses and limited treatment options. Without specifically focusing on the suicide epidemic, opioid crisis or brain injuries in general, the Cures Act spelled out conditions for breakthrough interventions like HBOT: available immediately, with a record of safe and effective use, a strong propensity to treat causes of the disease of addiction, with broadly-distributed access.

 

Congress passed and the President signed the Pandemic and All-Hazards Preparedness Reauthorization Act (PAHPRA), Public Law No. 113-5, March 2013. Epidemics were at the heart of the call for speed, safety, innovation, and red-tape-cutting.

 

Congress passed the VA Mission Act in June, 2018.

This legislation’s formal name is the VA Maintaining Systems and Strengthening Integrated Outside Networks Act. 

It is designed to allow veterans to go outside the VA system to procure therapies that are not available in VA facilities - HBOT is not available within DOD or the VA for TBI.  Multiple chambers exist within the DOD inventory but they are restricted use.

 

Congress passed the Support for Patients and Communities Act in October 2018.

And these stakeholders, which in the United States include regulators such as the US Food and Drug Administration (FDA), payers such as health plans and large employers, pharmaceutical manufacturers, state policymakers, as well as provider and patient groups, are all active in their own ways in an attempt to address brain wounds and opioid-related injuries and deaths.  

In 2017, more than 72,000 people in the US died of drug overdoses, hundreds of them veterans using prescribed drugs.

At least two-thirds of overdoses were linked to opioids, based on preliminary data from the Centers for Disease Control and Prevention. That’s the highest number of Americans who ever died of drug overdoses in a single year — and more than were ever killed by guns, car crashes, or HIV/AIDS in a single year in the US.

Suicides accounted for 129 deaths per day; that’s over 47,000 civilian suicides a year, added to the 7,300+ military suicides and the failed 16,000 attempts every year.

 

On March 5, 2019, the President signed the Executive Order on a National Roadmap to Empower Veterans and End Suicide.

The EO calls for immediate action to identify the latest research discoveries and translate them into practical applications for quick implementation. While the year-long Task Force works, HBOT can be used across the country to inform the strategy of the public-private partnerships already existing in the states.

Oklahoma, Texas, Indiana, Kentucky, Arizona, Florida and North Carolina have all passed legislation calling for the use of HBOT for brain wounds; North Dakota is not far behind.

Veteran Service Organizations have identified HBOT as a legislative priority. The epidemic must be met with immediate action commensurate with the crisis.

 

The suicide epidemic, coupled with opioid addiction epidemic, qualify as adequate incentive for the VA to intervene with Hyperbaric Oxygen Therapy and any other alternative therapy with a record of safety and published, scientific validity.

This combination drug-device has been called one of the safest devices ever reviewed by the FDA.

The published record of efficacy for the past thirty years is additional evidence of the need for immediate adoption.

Previous FDA/CDC efforts can serve as guideposts to facilitate and expedite review of HBOT under rigid rules to address unmet medical need in the treatment of a serious or life-threatening conditions. Spurred by the tens of thousands of deaths, suicide and the opioid epidemics certainly qualify as sufficiently alarming to push for FDA-approved emergency use of HBOT: fast track designation; breakthrough therapy designation; accelerated approval; priority review; and breakthrough devices program.

What are methods and models to evaluate and measure outcomes and effectiveness of interventions?

How best to establish relevant data-sharing protocols across Federal partners that align with community partners?

How can Federal data, such as that from the Federal Interagency Traumatic Brain Injury Research (FITBIR) informatics system, be best leveraged in combination with local or regional data to provide new insights into trauma or the progression of disease?

Are there technological limitations that prevent use of Federal data from generating information to predict outcomes?

 

The only thing lacking for data sharing among IT systems is political will.

A platform already exists that will incorporate data from HBOT and other alternative clinical treatments into a “Brain-Wounded” Patient Medical Record that is fully HIPAA-compliant. Bayesian analysis can be utilized to fuse and analyze relevant data fields to produce evidence under guidelines set in IRB-approved protocols and according to rules set by relevant oversight agencies. The most important data, of course, for purposes of demonstrating safety and efficacy, are contact information for brain-wounded military and veterans, along with outreach efforts to enroll all 800,00+ post-9/11 brain-wounded, and an equal number of veterans from pre-9/11.

 

What data or types of data are required to advance research efforts?

Are there existing sources of data or validated datasets related to veteran suicide, mental health, risk determination, brain injury, or other relevant areas that have been previously underutilized in Federal efforts?

 

Entire data sets exist from peer-reviewed research [16 studies, over 600 cases] where results data show the safety and efficacy of HBOT therapy for TBI/PTSD [see attached HBOT Clinical Studies_2019]. Bayesian analysis of those data already show that HBOT is safe and effective. In fact, Dr. Wolf, a principle co-author of the first Army study states in his recent USAF paper reanalyzing the data in the cornerstone DOD/VA/Army study: "This pilot study demonstrated no obvious harm [and] both groups showed improvement in scores and thus a benefit.  Subgroup analysis of cognitive changes and PCL-M results regarding PTSD demonstrated a relative risk of improvement . . . . There is a potential gain and no potential loss.

The VA/Clinical Practice Guidelines define a “B evidence rating” as “a recommendation that clinicians provide (the service) to eligible patients.

At least fair evidence was found that the intervention improves health outcomes and concludes that benefits outweigh harm. . . [emphasis added] Hyperbaric oxygen therapy for mild traumatic brain injury and PTSD should  be considered a legitimate adjunct therapy if future studies demonstrate similar findings or show comparable improvement to standard-of-care or research-related treatment modalities." [NOTE: subsequent worldwide studies already published and those underway show comparable improvements.] http://bit.ly/2faBldN

 

How should we draw upon technology to capture and use health data from non-clinical settings to advance behavioral and mental health research to the extent practicable?

How can both clinical and non-clinical data be better used to inform research efforts, and enhance current models of predictive analytics?

Are social determinants or risk factors being used to target services or provide outreach? If so, how? How are the beneficiaries with social risk identified?

Are there especially promising strategies for improving care of patients with social risk?

 

How are costs for targeting and providing those services evaluated? What are the additional costs to target services, such as case management, and to provide additional services (e.g., transportation)? What is the return on investment in improved outcomes or reduced healthcare concern?

 

How can we improve coordination among research efforts, prevent unnecessarily duplicative efforts, identify barriers to or gaps in research, and facilitate opportunities for improved consolidation, integration, and alignment?

How can we develop a public-private partnership model to foster collaborative, innovative, and effective research that accelerates these efforts?

 

DoD has a multitude of Hyperbaric chambers sprinkled around the globe.  

HBOT facilities at Travis AFB and Joint Base San Antonio are already being used in a tiny Pilot Demonstration project to treat and heal PTSD/TBI.  

Evidence already collected shows overwhelming success in treated patients. While the number of patients is still small, the private sector, working in concert with VA facilities and VSOs and community organizations can begin NOW to treat and starting healing 1,000 brain-wounded patients.

 

Scientifically-collected results can start to be produced in 30 days from start. Over a dozen large government facilities exist in the US that could be put to immediate use to treat PTSD/TBI/Concussion. These brain wounds impair executive function, lead to depression and frequently are treated with black-box labeled drugs that warn of suicidal ideation.

HBOT has been proven to shrink suicidal ideation to near-zero and has been shown to allow patients to withdraw from almost all prescribed drugs, particularly those that increase suicidal thoughts. It is imperative that veterans be told – under principles of informed consent – that a treatment exists that is benign, readily available, safe, effective and covered by insurance.

Thousands of brain-wounded veterans have been treated by over ninety private clinics working free or at dramatically reduced costs to heal brain wounds.

According to Dr. Larry Brilliant, credited by the World Health Organization with the seminal vision for ending smallpox on the planet, the bedrock principles in any epidemic are: Early Detection, Early Response.  It is critical to recognize that service member suicide is at epidemic levels. A sense of URGENCY is required. Also required is application of fast-track approval of interventions that, while experimental, are proven in evidence-based clinical data to be safe and, based on evidence-based facts, effective. HBOT certainly fulfills both criteria.

 

Data from over 600 patients in 16 peer-reviewed studies demonstrated positive medical improvements in treated subjects.

The 90+ clinics participating in the TreatNOW Coalition have successfully treated over 6,100 patients, and have immediate capacity to treat 1,000 patients, starting today. The capacity is already in place to collect the data on all patient interactions and make the repository available to appropriate participating researchers.

Results will be available within 30-60 days or start. Of course, all other modalities, including conventional and alternative therapies like SAW/TRIBE, EMRD, psychopharmacology, functional medicine, etc., can and should be utilized.

HBOT practitioners have been working with the alternative therapy communities for decades and have much to contribute with the complementary effects of integrated therapies.

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