Why Ketamine Could Be the All-in-One Solution to Curb Veteran Suicide Rates

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Ketamine
Ketamine was launched decades ago as an anesthetic for animals and people, then became a potent battlefield pain reliever in Vietnam and morphed into the trippy club drug Special K. Now. it is finding new life as a treatment for depression and suicidal behavior. (AP Photo/Teresa Crawford)

Gregg Peterson is the co-founder and CEO of Bexson Biomedical.

Our society is suffering from two health crises that existed before COVID-19, but have been worsened by social distancing and quarantine conditions -- opioid addiction and suicide.

As is so often the case, whatever mental health consequence our society is suffering, it unfortunately affects our U.S. military population to an even greater degree.

After experiencing a small dip in 2018, drug overdose deaths in the United States rose 4.6% in 2019 to 70,980, the vast majority of which involved opioids. Studies of opioid overdoses among male Afghanistan/Iraq-era U.S. military veterans estimate that around one in seven active-duty Army service members are taking prescription opioids.

According to a September 2019 Veteran Suicide Prevention Annual Report, between 2005 and 2017, the most common risk factor for veteran suicide was Opioid Use Disorder. The deadly link between opioids and increased mortality spans both overdose deaths and suicide, but the other key driver of veteran suicide is post-traumatic stress disorder. Prevalence of combat-related PTSD in U.S. military veterans since the Vietnam War is as high as 17%.

All of these risk factors for suicide -- opioid use, addiction and PTSD -- are more prevalent in our active-duty military and veterans than the already high rates in the general population. A recent Associated Press article reported Defense Department numbers showing a 20% increase in active-duty suicides in 2020. But even before COVID-19, veterans, including National Guard and Reserve members, sadly took their lives at a rate of 20 per day.

The impact of these ailments can bridge generations, with the human cost of trauma, depression, addiction and suicide flowing down to a patient's children. The economic and societal impact of these diseases is astounding, with hundreds of billions of dollars in health care treatment costs and reduced economic output.

Indeed, the data all shows that U.S. active-duty service members and veterans desperately need new non-opioid therapies and pain management strategies. Injury and pain are inevitable in the work of our warrior class, and initial opioid use is where our veterans' problems can start to compound. Potent non-opioid pain treatment can allow us to prevent the inception of difficult conditions, such as chronic pain and addiction, right where they start.

In similar fashion, immediate behavioral therapy after traumatic events is key to reducing the likelihood of developing PTSD. A multi-therapeutic approach may be even more effective. In fact, early use of some non-opioid therapies, such as ketamine, for pain management may substantially mitigate the onset of PTSD.

The good news is that new therapies are in development through both public and private investment. The National Institutes of Health has funded research into new non-opioid therapies with hundreds of millions of dollars via the HEAL Initiative, and several biopharma companies have promising new drugs in development.

At Bexson Biomedical, we hope to alleviate suffering from the opioid crisis with safe and potent non-opioid therapies for pain management. We have assembled an expert team of chemists, physicians and engineers to develop new pain therapies targeting the NMDA receptor.

That receptor is involved in acute pain signaling, as well as the fundamental processes that graduate this initial process into chronic pain. At a molecular level, chronic pain is a learned process, and blocking the neurotransmitter at this receptor can help prevent the "habit of pain" that is often associated with prolonged opioid use. We are working with safe, existing drugs that block the NMDA receptor, as well as developing new compounds targeting it.

Ketamine blocks the NMDA receptor and was originally approved by the U.S. Food and Drug Administration for anesthesia. Recently, a new formulation was approved for depression as well. While not yet FDA-approved for pain management, ketamine is used off-label by some pain management physicians and is even identified as a pain reliever in the U.S. military's Tactical Combat Casualty Care Guidelines.

And, fundamental to our larger goals at Bexson, data suggests ketamine can be effective not only in treating pain, but in preventing development of PTSD after trauma. When ketamine was administered to treat burn victims, patients not only received effective pain relief, they were less likely to develop PTSD as a result of the event.

While the FDA is rightly expediting vaccine and antiviral research for COVID-19, this cannot be at the expense of the addiction and mental health diseases waiting for solutions. With the right support, the U.S. may be only a few years away from a major breakthrough treatment for the pain and emotional trauma far too common in our veterans. Academic research, federal funding, and public and private funding support for small biotechnology companies -- so often the engine of innovation for new therapies -- can make all the difference. Our active military and veterans need and deserve these breakthroughs.

Our veterans shouldn't have to choose between pain relief and a healthy, thriving life.

-- The opinions expressed in this op-ed are those of the author and do not necessarily reflect the views of Military.com. If you would like to submit your own commentary, please send your article to opinions@military.com for consideration.

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