As we welcome 2019, I have a collective New Year’s resolution to propose: Let’s offer real and lasting help to our veterans with post-traumatic stress disorder. When they volunteered to serve, we promised to care for them if wounded. We must keep that promise.
As many as 11 million Americans suffer with PTSD, and up to 80 percent of those afflicted seek no help. Of the 1.9 million veterans deployed to Iraq and Afghanistan since 2001, 20 percent or more are affected by PTSD, while the Department of Veterans Affairs estimates that 620,000 veterans throughout the system have PTSD. Most remain undiagnosed and untreated.
PTSD is the signature wound of the last 25 years of war. It can precipitate insurmountable struggles with unemployment, homelessness, substance abuse, suicidal depression, and violence. Its victims are consumed; their families are ravaged. Too often, they die young.
It’s reminiscent of another public health crisis. I was in medical school when AIDS was identified, and spent 10 years researching HIV to help develop new medicines. But I see one significant difference between the response to AIDS then and PTSD now: A real movement arose to stop AIDS. Public outcry was loud, the government mobilized meaningful support for drug development, and Congress responded to demands for advanced, accessible care.
But the epidemic of military-related PTSD surges on, with no outrage and no coordinated effort to combat it. Despite broad bipartisan support for veterans and the military, the nation’s response to military-related PTSD is woefully inadequate. When service members and veterans dare to disclose symptoms, they are frequently misdiagnosed or given drugs such as benzodiazepines and opioids that compound their problems. In my research on PTSD drugs, I’ve heard the defeated stories of veterans who feel let down by their country. Their symptoms are vicious; their current treatment options are inadequate.
The only two FDA-approved PTSD medications were developed more than 17 years ago. Neither has demonstrated consistent efficacy in military-related PTSD, and the Department of Veterans Affairs has acknowledged a critical need for new PTSD treatments.
The company I manage is developing an investigational new drug designated as a breakthrough therapy for PTSD by the FDA, and our clinical trials have involved over 500 veterans who experienced traumas during military service in 2001 or later. Retrospective analyses showed response to treatment was more promising for veterans whose trauma had occurred within the past nine years, compared with those whose trauma occurred longer ago.
In short: There is an urgent need for treatment early on. Time does not heal the wounds of PTSD — just the opposite.
Congress has been willing to legislate. The 21st Century Cures Act prioritizes mental health parity, the John S. McCain National Defense Authorization Act shifts military research operations to the Defense Health Agency, and the VA Mission Act of 2018 improves access to healthcare. These are positive, if small, bureaucratic steps. It’s time for a sweeping national initiative to save lives.
It took hundreds of billions of dollars to develop the F-35 bomber. Where is the investment for fighting PTSD? A 2018 Harris poll conducted on behalf of my company found that 88 percent of Americans surveyed agree that PTSD is a significant problem among veterans. Only 31 percent felt there were enough resources for veterans with PTSD, and 72 percent agreed the government should do more for them.
Collective action is overdue. We need stronger public and private commitment to address military-related PTSD without delay. Investment in late-stage development of new treatments must grow. Congress can act to champion a new generation of effective PTSD therapies that will motivate more of those suffering to break their silence and seek care. This must be a shared endeavor as we finally confront military-related PTSD.
Too many of our veterans are beginning the new year with old, invisible wounds. Let’s resolve to offer them real help: advanced and effective medicines early on and increasingly elevated quality of care. They deserve their best chance to heal, and we can take decisive action in 2019 to make that happen.
Seth Lederman is a physician and scientist specializing in small-molecule drug research. Early in his career at Columbia University, he studied HIV infection and discovered the CD40 ligand, the molecular basis for the helper T cell. He is CEO of Tonix Pharmaceuticals.
