Quickly giving morphine to wounded troops cuts in half the chance they will develop post-traumatic stress disorder, according to a provocative study that suggests a new strategy for preventing the psychological fallout of war.
Researchers at the U.S. Naval Health Research Center led the study of about 700 troops injured in Iraq from 2004 through 2006.
“It was surprising how strong the effect of the morphine was,” said study leader Troy Lisa Holbrook, an epidemiologist at the naval center. The findings were published in Thursday’s New England Journal of Medicine.
Whether the Pentagon will adopt the practice on the battlefield remains to be seen. Dr. Jack Smith, acting deputy assistant secretary of defense for clinical and program policy, said in an e-mail that the “very interesting findings” are “likely to stimulate further research.”
About 53,000 troops returning from Iraq and Afghanistan have been treated for PTSD, a disorder in which someone who has endured a traumatic event keeps re-experiencing it and the fear it caused. Patients often have trouble with work, relationships, substance abuse and physical ailments.
Researchers have been testing ways to treat it, and the new study looked at whether fast and strong pain relief can help prevent it.
It was unclear whether it was the fast pain treatment or something specific to morphine that made the difference.
But researchers theorize that simply easing pain might reduce the severity of the psychological trauma, or that prompt relief might alter the way the brain remembers the attack or injury – in essence, causing the mind to file away the episode as less traumatic.
Troops in the study initially were treated at military medical facilities in Iraq, mainly for wounds caused by roadside bombs, bullets, grenades or mortar fire. A few dozen had burns or were hurt in crashes or falls. The decision on whether to give morphine was up to the individual doctor, based on the patient’s condition.
Of the 696 troops in the study, 493 – about 70 percent – were given morphine, most within an hour of injury. Two years later, 147 of them had developed PTSD. Of the 203 not given morphine early on, 96 developed PTSD.
That worked out to a 53 percent lower risk of developing PTSD for those treated early with morphine. No other factor, such as the nature or severity of injuries, had much effect on the chances of developing PTSD, Holbrook said.
“These are provocative and thought-provoking findings that should lead scientists to investigate the underlying mechanisms” in future studies, said JoAnn Difede, a PTSD researcher at New York-Presbyterian/Weill Cornell Medical Center.
Difede and Barbara Rothbaum, who heads the Trauma and Anxiety Recovery Program at Emory University School of Medicine, said that until more research backs up the findings, the study probably won’t lead to many more patients in civilian emergency rooms getting morphine.
“At this point, I don’t see it having a huge impact” for civilians, Rothbaum said.
A second study in the journal found that Army wives were more likely to develop depression or sleep problems the longer, or the more times, their spouses were sent to Iraq or Afghanistan.
That study, by researchers at the University of North Carolina and elsewhere, examined medical records for outpatient care of about 250,000 wives of active-duty soldiers from 2003 through 2006.
Compared with wives whose husbands stayed home, those whose husbands were deployed for up to 11 months were 18 percent more likely to be diagnosed with depression and at least 20 percent more likely to be diagnosed with sleep disorders, anxiety and acute stress.
For wives whose husbands were deployed for more than 11 months, problems were even more common: They were at least 24 percent more likely to be diagnosed with depression or anxiety, and about 40 percent more likely to be diagnosed with acute stress or sleep problems.
The researchers didn’t have data showing whether husbands were deployed or at home when the wives were being treated for mental health problems.
That meant the scientists couldn’t conclude whether those problems were caused by worries about the spouse’s safety and the difficulties of being a single parent, or by stress caused by the returning spouse’s psychological problems or other behavior changes.
“I suspect that if you look at the Reserve and National Guard wives, the toll might be even worse,” because they have less social support than families living in a military community, Rothbaum said.
She said the effects of deployment on children also need to be studied so the military can figure out how to provide more help to families.
WOW, what a busy last few weeks I have had. Lots of things have changed over here and I really don’t know where to start. I guess the best place is where the last email left off. Well, the last one that told everything. I have had to go look it up because it has been so long. So, I hope everyone is ready. Do you have your drink, a comfortable spot to sit and are you ready for this?
Here we go………
After going to Fallujah and getting shot at for nothing,(ya’ll have to read the ruined my lucky streak post), when I got back to Anaconda, they wanted me to go to Camp Fallujah/MEK again. I grabbed two guys and off we went. We went to BIAP and sat there for 3 days before I made a deal with the Marines that brought us out of TQ/Ridgeway the first time, and made it out there. It was quiet a trip. I talked them into taking us to the first check point and dropping us there. We do that kind of thing all the time. The reefers peal out of the convoy as we pass the exit and the convoy never slows down they just keep on truckin’. That is about what we were doing, except they had to take us to the first check point because it was to far from the main road to the gate. Two of the escorts and my 3 truck stepped out of line and gassed on it as we passed Abu Garubi prison. We took the exit and made the check point. They handed me the radio and they left and we went to the gate. At the gate the 2 guys guarding it were surprised to see Americans showing up at night without escorts. I explained to them what we had done. They hit the roof. Said that our escorts should not have done that. I took up for our escorts and told them that I said that it was ok to drop us like we had. Well, they radioed in and the Lt. in charged told them to tell us to go away. 3 Americans, and he told them to tell us to go away! I couldn’t believe my ears. The soldier standing there said that he was sorry that he couldn’t let us inside the gate and that he wasn’t going to send us away even though that was his orders. He showed us where there was a place to park outside the wire and under a guard tower. He radioed the tower and told them to watch over us, we were Americans. About 4 hours later, we all 3 got a knock on our doors waking us up. They had a change in the duty and they new guy had a fit when he found out we were out there. So, they took us out of our trucks and brought us inside and gave us a tent to sleep in. Then about 0600 the next morning we were all woke up by mortar fire the shook everything around. After we looked to see if anything had gotten blown up we started trying to find someone to take us back out to our trucks. I talked to 2 Sgt’s and 1 Capt. They were al very hot about what had happened to us the night before. They asked who were our escorts and I would not tell them. I said that I would take the responsibility of them dropping us where they did, because I told them that it was alright. I told the Capt. that they were a great group of guys and that I did not want to get them into trouble. If I had told them I needed to be brought all the way to the gate then they would have done so.
He didn’t have a problem with that. His problem was with the Lt that wouldn’t let us inside the wire. I was told that the guys ass was grass, and that it WOULD NOT happen again. That was cool with me and we got 1 of the Sgt to take us back to our trucks. We delivered our ice and were out of there that night. The Marines were really nice to us all day. I think they felt bad that we had to sleep outside the wire like that. The guys that were with me and I are ok now with what happened. We kid each other that we don’t need shooters and escorts, we have slept outside the wire in Fallujah, we are tough. But it is a joke. Even though we all did sleep better under the watchful eye of the guard tower than we did when they gave us beds inside the camp. Go figure……….
The guys were great and I have them on the convoy that I am on now. They want to stay with me. They say that I am fun and that even though they know that I push the edges a bit, that I will take care of them and not do anything to endanger their lives. After that deal in Fallujah I wasn’t sure that they would want to run with me again. But it is a story for the grand babies and we are all alive and ok. They know that I did my best in making sure that we were watched over while out there and that is enough for them. I would trust them to watch my back as well, any time and any place.
OK, I know ya’ll have been sitting there wondering, “What happened?” So I am going to fill ya’ll in on it all now. I want everyone to remember, I have said many times that I would not lie or cover up any thing that I go through. So, I don’t want any one freaking out over this all and telling me to come home. I am not coming home. I am staying here and doing my job. What I am going to relate to you happens every day here. I have just been very lucky that my convoys have only had rocks thrown at them, till yesterday. Having said that, I will tell ya’ll all that has happened, starting from leaving TQ last week.
TQ is near Fallujah. I chose the mission. I had not been there and wanted to go. As you all know, I am a tourist, that happens to drive a truck in a war zone for fun. (I hope ya’ll are laughing at that.) Our trip from Anaconda to TQ was uneventful for the most part. I had a few problems with he CC of the flatbed convoy that we were running with, but from what I hear, everyone does. Anyway, we got to TQ and dropped our trailers. The flatbed convoy left the morning after we got there and I couldn’t leave till later, so that left me trying to find escorts back to Anaconda. I talked to the Marines and they said that they could escort us out that night. I let them know that we had to stop at Camp Fallujah to drop off some ice there. The escorts didn’t have a problem with that. We met them that evening and got started around dark. About 10k outside the wire, the escorts stopped and killed their lights. they told us to do the same. Then we saw and heard the choppers do their thing. They lit up this “field” (for lack of a better word) bigger then shit. Pardon my language. But it was awesome. I bet they put 8 to 12 rounds into that area. Blew the hell out of what ever was out there. Then, we started rolling again. We pulled into Camp Fallujah around midnight and went to bed.
The next morning, we got up and started trying to find some equipment to get the ice trans loaded onto the storage trailer there. It was that afternoon before we were able to get started on it. The temp was up around 118, and I am so glad that I work in reefers and not flatbeds. At least we could stay cool while we moved the ice. It took us about an hour to get it all transferred. When we were through, I told Tracy, one of my drivers, to leave his unit running and go park back in the staging area. I then went and told our escorts that the unit was on and they could crawl up in there and grab themselves a good nap before we had to pull out that evening. The word must have gotten around, because, I think at one time that afternoon there were about 30 troops in that trailer, either sleeping, reading or just trying to stay cool. I guess that is one benefit to pulling a reefer. You get the chance to make a few troops day a little bit easier and not have to really work at it. All 4 of us were glad that we could offer that to the escorts. It really made me feel good and I know that they enjoyed it.
The rest of the trip was uneventful. We left that night and went to BIAP and sat there for a day and had to get new escorts. We then went on to Anaconda. As soon as I hit Anaconda, I had to put another convoy together and make a run to Taji. We were out and back in 1 day again. I got rocked on that trip on our way back into Anaconda. No biggie on that one, I am getting used to it. When I got back to Anaconda, I was told that we should not have dropped the trailers at TQ and were going to have to go back to get them. When I left out I had asked if we were dropping them of trans loading the ice. My supervisor, didn’t know and said that we may end up bob tailing back. Once I got back, he didn’t remember saying that. Oh well. I really didn’t mind coming back out here. This camp sits next to a lake and I missed out on getting to swim last time because I didn’t have my swimming gear with me. I was planning on getting wet while here this time. But again I miss out. The lake is now off limits for a while. Several of the troops have gotten sick and until they rule out the lake, we can’t go in the water.
Back to the story. I grabbed 2 guys to come out here with me and went to work on making sure that we were going to get escorts. Reefers sometimes gets forgotten, so ya have to make sure the right people know the you are going out so they can get you the escorts and shooters. I got to sit in Anaconda the next day. That didn’t hurt my feeling any at all. I kind of have a new boyfriend and we were able to spend some time together. He is a CC as well and with both of us being CC’s we are never on the same convoy. So we keep in touch and try to meet up when even we can. Again we ran with the military flatbeds and some KBR flats. It was a mess from he start. The military had an air problem that delayed us, then MCT wouldn’t let us leave. They made us wait for about half an hour. When we finally did get rolling, we got caught in a traffic jam around what we call the meat market area. That area is a dangerous area. I again, for the second day in a row, got rocked. At least this time the person throwing the rocks didn’t have a good aim. They missed my windshield and just hit the truck. Then we got on down to the Baghdad area. Now here is when the real fun starts.
We were told the night before that we would be going a new route. Policy is that there be at least 1 person in the convoy that knows that route and has run it. The Lieutenant said that the second truck knew the route. Come to find out, no one knew the route and we got lost in Baghdad. We made several u-turns and I was so confused that I didn’t even know where we were or how to get back the way we came. I didn’t even realized for sure that we were on a road that I have traveled many times till I saw the Mosk. After several u-turns, the escorts decide that we are going to go to BIAP and either cut through there or get directions or something. I really didn’t catch what was said about that. I was like all the other KBR drivers and just wanted to get some place safe and sort it all out there. We were doing to many u-turns and all for us to stay safe for very long.
Then I hear on the radio that we are taking fire from the left. Then one of the flatbed drivers says that he is loosing power and his truck has been hit. I and my 2 drivers were at the back of the convoy behind the flatbeds bobtail. The is usually where we ride when we ride with them. The flatbed’s bobtail stopped to pick up their driver and I led the rest of the convoy on around them. I heard the shots, but none hit me or my drivers or our trucks. The bobtail and the last gun truck caught back up with us and let us know that the driver he picked up was OK and unharmed. Then the escorts missed the turn for BIAP. We had to make yet another u-turn. But this time, everyone was gassing on it and me and everyone behind me got left behind a bit. I could have caught up to them before the front part of the convoy got out of site, but I couldn’t leave my guys back there.
I tried to stay where I could see the truck that was in front of me and my guys behind me. That wasn’t easy. I had to plow my way thought and intersection and tell the guys to do the same. Luckily we all made it thought without hitting anything. I had to radio to the CC of the flatbeds that I had lost site of them and was going to need help. I was so turned around I did know where I was or what exit they were taking. They did slow down and give us a chance to get caught up. We made our turn for BIAP and finally pulled through the main gate. The Lieutenant didn’t know that we had taken fire or that we left a truck and that it was on fire. She had taken fire and in my opinion, was to busy reporting it to make sure that the rest of the convoy made it through the fire zone OK. I have all this on video and will send it to some of you if you want to see and hear what went on. It was wild and got me all fired up. I really can’t say that I got scared when I heard that the convoy was taking fire. All I could think about was getting my guys through it and hope that nobody else would get hit. Then I was pissed.
When we rolled through the gates of BIAP, I was steaming. I called my supervisor and told him that I was going to pull my guys off the convoy and we would find other escorts out to TQ. He told me to go calm down for a minuet and call him back and let him know what we were going to do. But “don’t do anything crazy” he said. The convoy went to the staging area and we all got together and had a little talk. I told the Lieutenant that if there was not someone on this convoy that knew that way FOR SURE, that I was going to pull my guys and we would find other escorts. he just looked at me and didn’t say a word. This was my second time out to TQ and I didn’t know the way. The CC for the flatbeds said that he knew that way. He promised me that he could get us there. He said that he has run this many times and we would not be getting lost again. By that time, I was even more pissed off. I had it in my mind to pull the guys. I called Rick, my supervisor and told him that I was going to pull them. He said that he had talked to the foreman of the flatbeds and assured me that Shawn, the flatbed CC, knew the way and he wanted me to go ahead and roll with them. I wasn’t sure about it, but we rolled with them. The rest of the trip was a calm ride for the most part. The military had 3 flats on the same truck and we had to sit on the road while they changed them. Several of the drivers wanted to leave the trailer the second time we stopped so the they could change the 2 flat tires they had on it. But that was not what we did. They changed the flats and we rolled. What should have been at most a 6 hour trip, became a 11 hour trip. It was a long day yesterday. But at least everyone is all in one piece and OK.
I did not leave this morning with them going back to Anaconda. That wasn’t all my decision. The camp manager wanted to email a few people about the trailers and see if he could get approval to keep them. So I told him he could have the time to do that and that I would get the Marines to escort us out tonight or tomorrow. I didn’t really want to run back with them, so this works out just fine for me and my guys. Right now it doesn’t look like we are going to get out of here tonight. I am hoping that we will tomorrow or tomorrow night. I have to go back in and check with MCT to see what the Marines have come up with. As a matter of fact, I need to get that done now. So, I am going to end this here for now. I know that I have told ya’ll enough for now and that I am going to get several emails about what happened and all. That is OK. I know that ya’ll are going to be excited about it all and some may ask me to come home. As I said in the beginning of this email, I am not coming home. I am staying here and doing my job just like the other 100′s of driver that have been shot at. If we all left just because our convoy was hit, there wouldn’t be any drivers over here to help the military. We all have to do our part. Many may come over here for the money in the beginning, but after a while, it is a sense of duty. I know ya’ll may not understand it, and that is fine. Just know, I am doing what I want to do and what makes me happy. I believe in this and will continue to do my small part to try and make the world a better place for all our children to live in.
