Early administration of morphine to military personnel wounded on the front lines during Operation Iraqi Freedom appears to have done more than relieve excruciating pain. Scientists believe it also prevented hundreds of cases of post-traumatic stress disorder, the debilitating condition that plagues 15% of those who have served in Iraq and Afghanistan.
That conclusion is based on findings published today in the New England Journal of Medicine. They suggest that a simple treatment can stop a single horrifying event from escalating into a chronic, incapacitating illness.
Small clinical trials and observational studies have hinted that opiates and other medications could disrupt the way the brain encodes traumatic memories, thus preventing the incidents from being recorded with too much intensity. The new findings -- troops who received morphine within a few hours of their injuries were about 50% less likely to develop PTSD than those who didn't get the powerful painkiller -- are a strong endorsement of that theory.
Psychiatrists and neuroscientists aren't sure why some people develop PTSD while others don't, but the leading theory is that too much of the stress hormone norepinephrine at the time of a traumatic event causes the brain to malfunction when it records the memory.
The idea behind the preventive treatment approach is to disrupt the transmission of norepinephrine in the brain, either by blocking its release or by preventing it from binding to a receptor. In either case, a drug would have to be administered very early, while the memory was still being encoded.
I think this is fine. Every little bit helps, but what about soldiers and Marines who aren't injured? What can we do for them to prevent PTSD?
Don't send them to unnecessary wars might be a good start.
PTSD often doesn't set in 'til years after a Veteran returns to civilian life. I think experience shows that enough of them have self-medicated with opiates and other stuff and that it has the short term effect they seek, but exacerbates the condition in the long term to the point of ruining their lives and those of others.
Science needs to work on after-the-fact prevention of PTSD. We'll be working on non-physically-wounded PTSD Vets for fifty or more years as it is.
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