Mr. President — this breakthrough is real, and it happened during your Presidency. The two landmark VA clinical trials that prove the Stellate Ganglion Block works for PTSD were initiated and completed under your leadership — a global medical first. You already signed the Executive Order on innovative therapies for veterans. The evidence has now emerged. Use your executive power to cut through the bureaucracy and get this proven treatment to our veterans — quickly and effectively.
02 The Procedure, Live
SGB — the Stellate Ganglion Block — is an outpatient injection of an FDA-approved anesthetic into a small nerve cluster in the side of the neck. That cluster controls the body's "fight-or-flight" response. In PTSD, the response is stuck on. SGB resets it.
An ultrasound-guided dose of bupivacaine — an FDA-approved generic anesthetic in safe clinical use for over a century — into the stellate ganglion at the side of the neck.
The injection temporarily blocks the sympathetic nerve cluster that drives the chronic "fight-or-flight" response in PTSD — allowing the nervous system to recalibrate to baseline.
Most veterans feel relief in minutes to days, not weeks or months. Up to 85% report enduring symptom reduction — often after years of other unsuccessful treatment.
03 The Solution
The anesthetic used has been in clinical practice for over 100 years.
A generic, off-patent anesthetic — pennies per dose.
Already reimbursed by Medicare under CPT code 64510.
One outpatient shot. Many veterans feel relief in minutes.
04 As Featured On
SGB has been investigated by the most-watched newsmagazine in America and the most-listened-to podcast in the world. The cultural validation is already there. What's missing is the policy.
"It's not a placebo. It's not magic. It's medicine — and it's working for veterans who had run out of options."
Watch the full segment"When the needle came out of my neck, it instantly took me from downtown NYC rush hour to a quiet country road with nowhere to be."
Watch on YouTube05 The Readiness
This is not a new program from scratch. It's an expansion order — do more, in more places, now. The infrastructure, the staff, the billing code, the bipartisan votes — all already in place.
One shot. Up to 85% enduring relief from PTSD — more than twice the efficacy of the VA's #1 treatments. The drug is FDA-approved, generic, and Medicare-reimbursed. The VA already does it.
Direct it to expand — today.
06 The Directive
SGB works. The bipartisan TREAT PTSD Act is teed up in Congress. The VA infrastructure is ready. Every word of your April 18 EO on innovative therapies applies with twice the force here. This is the largest single action any President can take to end the veteran suicide crisis.
Direct the VA to immediately expand its current SGB program to treat every veteran with PTSD — in more places, with more providers, starting now.
07 The Draft Executive Order
By the authority vested in me as President by the Constitution and the laws of the United States of America, including section 301 of title 3, United States Code, and consistent with the VA MISSION Act of 2018 (Public Law 115-182), section 1703 of title 38, United States Code, and section 7304 of title 38, United States Code, it is hereby ordered as follows:
An average of 17 United States veterans die by suicide each day. As a Nation, we have a solemn obligation to care for those who have borne the battle, and we are failing to meet it. Since September 11, 2001, more post-9/11 service members and veterans have died by suicide—30,177, according to Brown University's Costs of War Project—than the 7,057 killed in post-9/11 combat operations. PTSD affects an estimated 11–20% of OIF/OEF veterans and more than 1.3 million veterans in their lifetimes.
The first-line PTSD treatments currently offered by the VA produce a clinically significant response in approximately half of patients, often only after weeks or months, with dropout rates of 20–40%. The status quo is insufficient. A proven, safe, and rapidly effective primary adjuvant treatment exists, and it is the duty of the Federal Government to make it available to every veteran who needs it.
It is the policy of the United States that no veteran diagnosed with PTSD shall be denied timely access to Stellate Ganglion Block (SGB) treatment because of the inaction of the Federal Government.
Within 30 days, the Secretary of Veterans Affairs shall:
Within 90 days, the Secretary of Veterans Affairs shall deploy the Education Debt Reduction Program, all available incentive authorities (Physician Performance Pay, market pay, recruitment / relocation / retention incentives, Title 5 and Title 38 pay flexibilities), Community Care reimbursement, and dedicated training infrastructure (workshops, simulation, proctorship) to recruit, train, and retain the clinical workforce required.
Within 60 days, the Secretary of Defense shall make SGB available through the Military Health System for active-duty service members with PTSD, ensure continuity for those transitioning to veteran status, and report on DoD research relevant to SGB for PTSD and combat-acquired TBI.
Within 90 days, the Secretary shall review Medicare coverage for SGB under CPT 64510 and report on whether expanded coverage, a PTSD-specific indication, or a CMMI demonstration would accelerate access for veterans receiving care outside VA and for first responders, law enforcement, and survivors of violent crime.
Within 180 days, and every 180 days thereafter for 2 years, the VA Secretary shall report to the President on implementation, clinical outcomes, total program cost vs. traditional PTSD care, and recommendations for further action.
This order shall be implemented consistent with applicable law and subject to the availability of appropriations. It does not impair existing executive authority or create any enforceable right or benefit.
The Secretary of Veterans Affairs is authorized and directed to publish this order in the Federal Register.
08 Take Action
The draft is written, sourced, and ready. Read the full Executive Order as a scrollable PDF — and download a copy to share.