Magic Bob the Law dog sends us this intriguing piece.

Madigan Army Hospital
and Bent Brain clinic

For years they’ve been trying to pound Valium® down the throats of the troops with all those pesky personality disorders. They surely wouldn’t want any genuine, full-blown psychoses afoot. That would never do, now would it? That’s compensable. Everyone remain calm. This calls for a program review and absolving the guilty.  Get. Col Homas back here, pronto. Now, with Madigan behind us, let’s see where we were.

Doctors, for years have taken the conservative approach and smoked PTSD guys under the table heavily with Thorazine and some of the other high-powered dopamine antagonists. Check out the Pink Peggy site if you doubt me. Vets over there talk about it incessantly as in “I forgot to eat my meds this morning and I’m feeling, like, ‘roid rage. You know?”  Or “Man,  I called Peggy today and she told me my claim was back in ‘gathering evidence’ and it really pissed me off. Now I have to go and eat more meds, man.” VA hands this stuff out like candy at Mardi Gras. They encourage you to eat it often. They mail me enough painkillers to get everyone in the neighborhood high for two weeks. One thing you do not have to worry about with the doctors down at VAMC American Lake is getting short-changed on drugs. I hear it’s true nationwide for the most part.

When I got out of the hospital (permanently) in June 2010, I had to get on a “pain medication contract”. I went down and met with my new PCP. I’d been in the hospital so long my old one had a stroke and retired. She asked me point blank “So ha meeny do you   ate in a one day?” I said 4? 5? She worried that if I only got the prescription once a month, I might run short in between and should have a buffer for “just een the case”. Being a doctor and a mathematician, I watched her pencil 5 X 30=150, then change the 5 into an 8 for a safe supply of 180 a month. I know what about twenty of you are thinking.  Man, that’s worth more than 100% comp. every month down on 34th Street. No way, dude. I’m not giving up my high quality VA medical insurance…

Chlorpromazine came out in 1950 and immediately zoned guys out so efficiently they put away the rubber teeth grippers and the electroshock gear. This was golden for doctors. For VA it was a cash cow. They could tranq the whole Psych ward with this stuff and lay off about half the orderlies. When you’re buying Thorazine by the boxcar load, it’s insanely cheap.

The problem for Vets, as I see it, was trying to drive a motor vehicle on this. How are you supposed to get to your support and immersion group at the CBOC when you can’t even find the door (yours, the car’s, or any doors)? You see the problem, too, so it’s not just me. This led to newer versions that were of a lower calibre. The Benzodiazepine group of psychotropics became all the rage in the sixties. Hell, they even tried LSD and Disco Biscuits about then, too. The most promising, as most know by now, was Prince Valium. Advances for a decade or more were few as these seemed to fill the bill. Well, not exactly as they are fond of quipping over at Avis. Valium was horribly addicting which is exactly what you didn’t want in a bent brain box. It seems pretty well-known that over 50% afflicted with this issue are already prone to a steady diet of drugs and alcohol addiction. VA Doctors know this but do it anyway. It’s like calling in an air strike with Napalm on a 3-alarm apartment fire.

This neanderthal attitude has given way to newer, less-potent drugs (Paxil, celexa, Lexapro and Zoloft) and finally blossomed into a desire to accomplish it with as few as possible. The serotonin re-uptake inhibitors do a wonderful job of turning loud, rude dudes into quiet, unopinionated, Ophray Winfrey rerun addicts. I saw this first hand with a gal we know. It came down to a choice of whether her husband wanted the new, improved, Type B, 80 IQ, prefrontal lobotomy wife or the old Type A, aggressive, argumentative, cuttingly sarcastic and witty one. He opted for the latter. That was like a choice between Nancy Pelosi and the wicked witch of the West.

Princess Paxil

Type A

So what do we have left in the bent brain treatments cupboard? Verbal therapy, for one. Since I’ve never really been diagnosed with it, I can’t say. I can certainly describe the feeling after two years in-country. Edgy. Stay near a wall. Don’t go out much. Keep to yourself. Check every hour or two to make sure there’s one in the chamber. Keep yourself informed by talking to yourself. Loud booms are probably cause for concern. The usual. It wears off for some. It did in my case by about 1988. Cupcake informed me it was time to put the bent brain box back in the attic and get on with life. Since I hadn’t been medicating myself with anything stronger than scotch for the last sixteen years, it wasn’t hard.

Many with this affliction are damned by earlier medical choices and have developed permanent psychoses as a result. I don’t think anyone blames you for it, but it means staying on these drugs for life. That’s the ugly trade off. Worse is some well-meaning shrink who decides to tamper with success and change your drug type or dosage regularly. Some have described a wild and woolly ride until they get their feet in the stirrups. Again, I have not walked a mile in those shoes so I cannot say. I’ve been toasted out of my mind on Dilaudid for a year and paddled a sofa down the river but nothing as intense as 6  blue vals a day. My experiences in that theater of war were one (1) at a party with a fifth of Anne Green Springs as a chaser. That was interesting. Six is right out without Anne. Of course, anyone attempting to eat 20 mg. of Dilaudid at one sitting wouldn’t be (sitting). It didn’t faze me after a year. The fact that I could eat that many with nary a hiccup in the normal sinus rhythm of my heart scared the poop out of me. That’s why I weaned myself off.

With all that said, here’s the latest in the article:

Despite this reduction, the VA told Nextgov last May that it had purchased $72 million worth of benzodiazepines from Oct. 1, 2001 through March 31, 2012.

Right on, dude. Savin’ the taxpapers money. Buyin’ smart at the Drugmart. I can hear Tommy Chong in the background saying “Right on. Right on. Right ooooon.”

Why is it that the military/VA complex thinks they know better? Why is it that cutting-edge psychiatric practices on this subject only percolate down to the site of origin after it’s common knowledge to everyone including the village idiot? Perhaps this article will open your eyes. Realize that if some of the newer pills were cheaper, VA would be buying those in bulk instead.

The next time you pick up that bottle of Vals, remember why they call it “practicing medicine”. It’s a work in progress.