As veterans with PTSD continue to die by suicide, FDA demands do-over for MDMA trials

Flying in the face of stats from the U.S. Department of Veterans Affairs that say veterans continue to commit suicide at higher rates than non-veterans, the U.S. Food and Drug Administration last week declined to approve MDMA, a psychedelic compound, as a treatment for post-traumatic stress disorder. 

MDMA as medicine: Stemming the tide of veteran suicides in Western North Carolina

Around midnight on Christmas Eve in 2006, Jonathan Lubecky found himself alone in a Raleigh tavern listening to church bells chiming off in the distance.

Equinox Ranch is up and running

Not long after pulling off the busy NC 107 onto the small, single-lane road leading to Equinox Ranch, leafy green trees form a tunnel over a narrow street.

Saving our lifesavers: Donaldson pleads for help

A comprehensive assessment of Haywood Emergency Management Services completed in 2019 suggested that aggressive shift schedules put employees at greater risk for sleep disorders, PTSD, anxiety, depression, substance abuse and suicide. 

Confession is good for the soul

Some bare their souls to priests and ministers. Some seek out therapists and counselors. Some look for help from friends and family members.

And some write books. 

Studies show correlation between PTSD and substance abuse

By Taylor Sexton • Special to SMN | Emma Jordan lives in Hatteras, North Carolina, where she spends her days working hard, soaking in the sun’s rays, and struggling with PTSD and substance abuse.

“My whole deal was to bottle it up, leave it somewhere buried deep down inside,” Jordan said. “Somewhere you can’t think about it.” 

Running through life with PTSD

By Taylor Sexton • Contributing writer | I was 5 years old when I watched my father’s fist fly into the wall next to my mother’s head. I remember how the little bear figurines on the wall crashed to the floor with the shelf that held them. I remember picking up the broken pieces from the white carpet with my mother and staring into her pained, tear-stained face.

It’s one of the earliest memories I have, but I only just recently remembered it. It was locked away deep within my subconscious, so imagine my surprise when the scene popped back up 13 years later in the form of nightmares, haunting me night after night. 

National Guard soldiers deserve better

The Smoky Mountain News cover story last week about the troubles faced by returning National Guard soldiers after deployments in Irag and Afghanistan will hopefully open many people’s eyes to this issue.

Reporter Giles Morris wrote about the post-traumatic stress issues faced by Staff Sgt. Shane Trantham, but that story is likely shared by thousands of returning soldiers.

The meat of the issue is this: the National Guard soldiers don’t return home as full-time soldiers like their combat-duty comrades in the Army, Navy, Air Force and Marines. They are citizen-soldiers, and when they come home they return to old jobs and try to resume their lives in small towns and communities.

The problem is that they don’t have the support system found at military bases. Full-time soldiers have military hospitals and counselors they can see for free, their spouses and families live next door to each other and share the war experience daily, and those soldiers don’t have to worry about what they’ll do for a job because most of them remain in the armed forces.

And here’s another reality: today’s soldiers — whether full-time or citizen-soldiers — face multiple deployments. In past wars when soldiers survived a stint on the front lines to return home, it was very unlikely they would be re-deployed to combat zones. That’s not the case with today’s leaner military force.

The Department of Defense is working to improve the services available to these returning vets — especially counseling services — but it still has a long way to go. As this country transforms its military to fewer full-time soldiers and more high-tech equipment, the National Guard has become a regular part of our combat force. The treatment of these part-time soldiers by the government, however, has not kept pace with the new role we’ve thrust them into. Spending more money to help transition these soldiers back into civilian life is a moral responsibility the U.S. government — and taxpayers — must embrace.

 

A good deal at Wal-Mart

Speaking of spending money ...

It’s not a very sexy story, that’s for sure, but Haywood County commissioners made a wise move last week by deciding to purchase the old Wal-Mart near Tuscola High School.

The current Department of Social Services and Haywood County Health Department buildings are, in a word, dumps. They date from the 1920s and the 1950s, and trying to renovate buildings that old to meet today’s standards is simply a losing proposition.

The DSS building ranks in the bottom 1 percent of social service facilities in the state. Maybe there’s another county with a DSS building this in need of repair, but I’d have to see it to believe it.

No, there’s little argument about the need for new facilities, so then comes the argument about whether the county can afford the old building. If it gets the federal stimulus loan it is applying for, the interest rate will be as good a deal as possible. So now is a good time. Despite the recession, Haywood and every other county has a responsibility to provide certain services to its residents. Some people don’t want any money spent on health care for the low income or social services for the poor and elderly, but that’s an argument for another forum. The county must provide these services and do so in an adequate facility or face the loss of state funding.

Finally, the hulking, empty retail space was a blight. By renovating the building, putting several hundred workers into it and then the accompanying client base, this move will effectively re-energize that area of the county. If the designers do a good job on the exterior and all the green building attributes make their way into the final architectural plan, this facility could become a showcase of sorts.

Haywood’s commissioners deserve praise for this move, not the heat they’re taking from some.

(Scott McLeod can be reached at This email address is being protected from spambots. You need JavaScript enabled to view it.)

Soldiers face a second battle at home

Citizen soldiers.

The National Guard’s moniker evokes the best of American values and hearkens back to a Greek ideal. The citizens of a nation, its moral fiber during times of peace, should be ready to take up arms during war.

Increasingly, though, the phrase also represents a contradiction.

National Guard soldiers returning home from multiple deployments face a complex world. The same instincts that served to protect them on the battlefields and roadways of Iraq and Afghanistan can shut them off from their families and their lives as civilians.

“I’ll be honest with you. As soon as we got the call that we were going back, I knew my marriage was over,” said Staff Sgt. Shane Trantham of Haywood County’s 211th Military Police Company.

Sgt. Trantham’s experience, as he will tell you, is not unique. National Guard soldiers returning from the combat zone are expected to resume the life they left behind as fathers, mothers, friends and co-workers, but in many cases they don’t have the support they need to transition successfully.

Episodes like the Ft. Hood shooting have instigated increased scrutiny into the psychological impact of two simultaneous wars on the men and women who execute them.

But while intentions are good, resources are stretched and, perhaps even more importantly, the military culture is still one in which psychological issues are thought of as weaknesses.

Nine years into the country’s war on terror, soldiers are starting to get the support they need, but for some of them the damage is already done.

A father at war

Staff Sgt. Shane Trantham learned his military police company was being deployed on Christmas Eve in 2002. He kept the news a secret until after the holiday. On Jan. 2 his youngest daughter was born. Newly married with a newborn baby, he left on Jan. 10 for his deployment.

“The first thing you have to think of as soldiers is what’s going to happen when you’re gone,” Trantham said. “You’re passing all of that to someone else, and that places a huge amount of stress on the family. I don’t know what’s worse. What we go through over there or what they’re dealing with at the house.”

Trantham, who graduated from Tuscola High School in 1995, spent most of his time in Iraq driving convoys on main supply routes, the principal targets for improvised explosive devices, in ragtop Humvees without armor. He remembers the scene after a U.S. Abrams tank was blown skyward by a homemade bomb fashioned from four daisy-chained 150 mm shells and a primitive detonation system. The blast killed two crew members and wounded two others.

“That stuff was everyday stuff,” Trantham said.

The National Guard experience is unique in that when soldiers demobilize they return home and resume life without the support of their comrades or the services of a base command.

“It was like, ‘If you need help here’s the chaplain’s phone number,’” Trantham said. “And that wasn’t even close to what we needed. It affected everybody, not just the young people.”

Trantham worked for a utility company in Asheville reading meters.

“For six months I lived in a bottle. I’d get off work and get a 12-pack and go after it ‘til it was gone,” Trantham said.

At the same time he was dealing with post-combat stress, Trantham was also trying to hold onto his marriage, a relationship that had stalled during his absence.

“I told my wife, ‘I left in January of 2003 and I came back in January of 2003.’ Life just passes you by and you’re trying to play catch-up,” Trantham said.

Like many soldiers, he had a hard time fitting into the household dynamic, and in particular sharing power with his wife.

“You know the saying –– staff sergeants run the army,” Trantham said. “Then you come home and someone else is in charge. I’ve seen so many soldiers lose their marriages over that power struggle.”

Trantham said he knew his marriage was doomed when he got word of a second deployment just a few months later. “There’s so much distance created in a family. You become a picture and a telephone,” Trantham said.

After he got back from his second deployment, Trantham wasn’t comfortable sleeping in a bed, he was quick to anger, he had nightmares. He realized how serious the situation had gotten during a summer thunderstorm.

“In my head I thought it was a mortar attack and it just froze me to the couch,” Trantham said.

In two years, Trantham experienced two wars, the loss of a marriage, the deaths of his uncle and grandfather then started a new full-time job with the National Guard. The transformation forced him to acknowledge his mental health issues.

“All that changed my life. I was talking to the doctor and I said, ‘Look, maybe there’s something going on,’” Trantham said.

Trantham got a post traumatic stress disorder (PTSD) diagnosis and was prescribed an anti-depressant, but the drugs created new problems.

“I had no emotions. Being a soldier you have to be able to maintain yourself in any situation and something inside me was saying ‘This won’t work,’” Trantham said.

Ultimately, it was counseling that helped Trantham deal with his issues.

“The turning point was that counselor telling me that what I was feeling was normal, that most people would have cracked and I didn’t,” Trantham said. “It’s not been easy, but things are falling back into place.”

As a full-time staff sergeant in charge of the headquarters of Haywood County’s National Guard, Trantham said he has watched the system change for the better, but it has taken the bulk of eight years for it to happen.

Trantham’s grandfather, Rubin Inman, spent 30 years in the same National Guard unit, so the staff sergeant has a sense of historical perspective.

“This ain’t Vietnam and this ain’t Korea. This is a whole new thing, and the Army wasn’t ready for it but they’re catching up,” Trantham said.

The problem

with multiple deployments

Ron Putnam, veterans service officer for Haywood County, is the guy many veterans turn to when they don’t know where else to go. He and county service officers like him all over North Carolina help soldiers get the benefits and services they have earned.

“Now days, for the first time in history, society, the medical field, the government has learned to try to get a hold of these guys early,” Putnam said. “We’ve finally woken up to the fact that we’re wearing these kids out.”

Putnam served in Lebanon and later in the Gulf War. He sees the issues facing current returning veterans as part of a broader shift in the military culture between Vietnam and the present. An all-volunteer army, rapid advances in communications, and a lightning fast workplace environment have created a new complex of issues.

The biggest challenge is dealing with the impact of multiple deployments on an individual and their family.

“The problem with these new kids is the multiple deployments allow for no relief at all from duty,” Putnam said. “In Vietnam, if you could get through it, you were done. Now you just barely have time to stand down, de-brief, and get relief. How in the world can you get back into any kind of home life?”

Putnam said the Internet and instant messaging have also added complexity to life in a combat zone.

“Let’s say you get an email that your baby’s sick and you gotta get up in the morning and go on patrol,” said Putnam. “That’s a two-edged sword.”

During the 1980s, that level of contact was unheard of.

“I called home from Lebanon one time and it was mandatory because our building had just blown up and they were trying to make sure we weren’t dead,” Putnam said.

Putnam said the economy has added additional stress. Many veterans come home to a life armed with a GED after spending three years or more with free housing and subsidized living expenses. Throw a young family into the mix and the worst job market in recent history and you’ve created an inhospitable environment that makes it increasingly hard for veterans to seek counseling help.

Veterans worry a mental health record will affect their ability to re-enlist or find work.

“Your new vet is just like your old vet in some respects,” said Putnam. “He wants a Chevy, baseball and apple pie. He wants a job. Does he want people to know he has mental health problems?”

Putnam sees veterans from World War II, Korea, Vietnam, the Gulf War, in addition to those from Iraq and Afghanistan on a regular basis. His experience has shown him that veterans share many issues, but each generation of soldiers has had to deal with a unique set of challenges. For this generation, the pressure of multiple deployments is brand new.

“Even the saltiest born-again hardest vet from World War II cannot say they’ve had five deployments,” Putnam said. “My analogy for the vets and the young families is it’s got to be like being on LSD. It’s just one extreme to the other.”

The World War II era military was about 12 percent of the country’s total population. During the Cold War, it contracted to about 2 percent. Today, the all-volunteer military is only about a half percent of the country’s population.

Because today’s wars are fought by a relatively small portion of society, Putnam worries that people treat the soldiers as if their war experience is their own problem, not the country’s shared responsibility.

He thinks that if veterans are to reintegrate back into their lives, they’ll need the help of the civilians around them.

“One issue is these young people being willing to ask for the help they need and the other part is society embracing them, and particularly the employers being willing to take a chance on them,” Putnam said.

Lessons from Vietnam

Putnam believes many of the strides today are a result of hard lessons learned during the Vietnam era. While there is no such thing as a typical war experience, Rick Strubeck’s tour in Vietnam was the kind you see in the movies.

Drafted at age 18, the Pennsylvania native landed in Vietnam in 1970 with an infantry assignment. He spent eight months in the jungle then drove an ammunition truck for four months.

Strubeck returned home at the height of the anti-war movement and remembers being spat on. He looks back on the experience with a sense of understated pain.

“I went through a pretty tough time for about the next 15 years,” Strubeck said.

Strubeck couldn’t sleep, so he drank himself to sleep. He ruined his marriage, wrecked three good jobs, and still didn’t care.

“I felt like I wouldn’t see the next sunrise, and I just threw caution to the wind,” Strubeck said.

At a John Denver concert in Madison Square Garden in the mid-’70s, Strubeck’s combat experience exposed him to a group of friends. The lights went out and the flash cameras set him off. He jumped out of his seat and fought his way through 15 rows to the exit.

“The people I went with were afraid to ride in the car with me on the way home,” Strubeck said.

He filed a disability claim with the VA for exposure to Agent Orange that never got recognized.

“I attributed all of my problems to Agent Orange and at the time if you mentioned Agent Orange, they didn’t want any part of you,” Strubeck said.

Finally, in the early 1990s, after being diagnosed with bone cancer, Strubeck also got a PTSD diagnosis that helped him move on with his life. He spent seven years in counseling.

“I thought I was crazy or an alcoholic and it turned out I had PTSD,” Strubeck said.

Strubeck credits the counseling with turning his life around.

“It gave me self-worth, and it made me realize I and my family were more valuable than I was giving them credit for,” Strubeck said. “I needed to live up to my responsibilities and stop hiding behind my combat experiences.”

After 20 years of sobriety, Strubeck looks back and wonders what life could have been like had he gotten the proper help upon his return from Vietnam.

“I’m glad they’re helping these guys now, but it still really hurts me to think of all the guys who are pushing up daisies because they ruined their lives,” Strubeck said. “War is hell and combat is bad. It’s something you never forget.”

Strubeck has a simple message for returning combat veterans.

“I just hope they have a good response to these programs, and I hope the guys are wise enough to take advantage of it,” Strubeck said.

DOD-funded programs support local counseling initiatives

For the first time in history, the government, the military and private healthcare providers are working together to deliver the appropriate counseling resources to returning war veterans.

This year, the Haywood Regional Medical Center, working with a Department of Defense grant in conjunction with the Smoky Mountain Center and the Mountain Area Health Education Center, has launched a counseling clinic for returning veterans and their families. The pilot program is aimed at providing support to soldiers and their families in an environment that encourages confidentiality and an integrated approach to their behavioral and medical health needs.

At the same time, the North Carolina National Guard has spent the last year putting in place a new system for reintegrating its citizen soldiers back into their civilian lives. The Yellow Ribbon Program, also DOD-funded, is a four-phase curriculum designed to make National Guard service men and women aware of the resources available to them when they come home.

 

The long road back

Glenda Sawyer, a licensed clinical social worker with over 30 years of experience counseling military personnel, is in charge of the Service Members Counseling and Support Center at Haywood Regional Medical Center. Sawyer has spent the bulk of her career counseling Marines deployed from Camp LeJeune, but her new challenge is to reach out to soldiers without a base. Haywood County has more combat veterans than any other county in Western North Carolina, and many of them are members of the National Guard.

“The purpose of this is to take care of people not connected to a military installation,” Sawyer said. “As a percentage, guardsmen tend to have a higher incidence of mental health issues.”

The Veterans Counseling Program at HRMC also attempts to treat the military family as an entire unit. In Sawyer’s experience, separating post-combat symptoms from family issues is artificial, but the Veterans Administration does not have programs for family counseling.

“There’s really nothing for families at the VA and many times it’s the family, usually the spouse, that initiates the call for help,” Sawyer said. “They’re not coming because of PTSD, they’re coming because they need marriage counseling.”

Sawyer said the program integrates medical treatments like pharmaceuticals and physical screenings with counseling techniques to help soldiers regain a sense of normalcy.

“When they’re over in Iraq and Afghanistan, they’re constantly in hyper-arousal –– that’s the fight or flight instinct –– and they miss that because it’s like a natural high,” Sawyer said.

Veterans returning to their families often use coping mechanisms that push away the people they love.

“When they see something terrible, they numb out,” Sawyer said. “It’s not conscious. It’s a coping mechanism and that just doesn’t stop when they get home.”

Sawyer also said the economy has made a difficult situation nearly untenable. Military personnel are increasingly re-enlisting because of the combined effect of emotional and financial pressures.

“The economy is so bad. You’re talking about a lot of people who may only have a high school education, and they can’t find work,” said Sawyer. “For a lot of them, that’s why they joined up in the first place.”

Faced with a difficult re-integration to a civilian life that offers little potential for success, on the one hand, and high-risk pay on the other, many soldiers re-enlist. The impact, according to Sawyer, will be felt across society.

“We’re just now seeing how bad it is,” said Sawyer. “It’s right now that people are coming back form third and fourth deployments.”

Sawyer said the center is currently treating 18 veterans and family members and has added a full-time nurse practitioner to address medical issues. Sawyer said the combined medical and psychological approach is most appropriate for transitioning veterans because the overall aim is to get them feeling again.

“Everything is about re-conditioning themselves to be in a calm and relaxed state instead of an aroused one,” Sawyer said. “To feel again and get back in touch with their emotions.”

The center also has the advantage of being totally confidential. One of the largest barriers for soldiers who need counseling support is still the military culture, which stigmatizes any kind of perceived weakness.

“There is still stigma, even though the military is working hard on it. Particularly in low levels of command,” Sawyer said. “The biggest thing is confidentiality. Knowing that they can come in and no one in their command will ever know.”

While the Service Members Counseling Center at HRMC signals a new level of public-private cooperation around veterans services, the National Guard has also stepped up its own efforts to help its soldiers return to their civilian lives.

The Yellow Ribbon Program, funded in 2008 by the Department of Defense, is a mandatory curriculum for National Guard members that encourages the participation of family members.

John Gattis, formerly Command Staff Sgt. Major of the North Carolina National Guard, is the program’s administrator. Gattis said Yellow Ribbon is a proactive approach that maintains contact with service members throughout all the stages of their deployment. Because it’s mandatory, Gattis believes more soldiers will feel free to utilize its resources without worrying about what other people think.

The program deals with demobilization by maintaining contact with service members during each of their first three months back from their deployment in a series of all-day workshops.

The monthly checkups include surveys that can help soldiers inventory the effects of combat-related mental health issues. In the past, some soldiers have not used counseling supports for fear it could jeopardize their futures in the military.

“All we’re asking them to do is be honest with their assessment and identify potential problems,” Gattis said. “It’s not designed to identify problems in order to keep them out of the military as was once thought. It’s been developed for them.”

The program is in place just in time to deal with the return of the 30th Heavy Brigade Combat Team –– comprised of National Guard troops from North Carolina and West Virginia –– later this year.

Gattis believes it’s crucial to ensuring a successful transition back to civilian life.

“We are at war and as long as soldiers are returning from combat zones, we have to take care of them,” Gattis said.

For more information about Yellow Ribbon visit www.nc.ngb.army.mil/index.php/yellow-ribbon/.

For information about the Service Members Counseling and Support Center call 828.452.8354.

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