Drugged: The Military’s Pill Problem
The post Drugged: The Military’s Pill Problem appeared first on High Times.
Most Americans probably assume that any soldier hit by a rocket-propelled grenade (RPG)—peppered with metal fragments, brain bruised by the shockwave from the explosion, and suffering multiple ruptured discs in the neck and spine—would be whisked from the battlefield to a hospital somewhere in Europe or the U.S., treated, and cashiered out of the military with a Purple Heart.
Staff Sgt. Chas Jacquier learned what really happens, though. When an RPG landed next to him in Afghanistan in 2005, spraying him with shrapnel and delivering a concussive blast, he was medevaced to a field hospital and diagnosed with a suspected traumatic brain injury and an injured spine. But when it came to treatment, he was simply loaded up with a medley of pain pills, morphine, “and some other stuff I don’t know about” and sent back into combat just a few days later, expected to resume leading the unit of 25 men under his command.
“They helicoptered me back to my forward base in a sling,” Jacquier recalls. “When we landed, I got out of the sling, grabbed my rifle and climbed into a truck with my men. Fifteen minutes later, we were in a firefight.” He finished his deployment without getting further treatment (other than more drugs) for his injuries, which he said included a fractured neck vertebra. Jacquier is certain that his untreated injuries worsened during this period.
In 2005, the German news magazine Der Spiegel wrote about how the Nazis developed a powerful methamphetamine, Pervitin, and distributed it to Wehrmacht soldiers like candy (35 million pills over the course of the war) to allow them to fight fiercely for days without sleeping. The Allies, for their part, were handing out the potent amphetamine Dexedrine in equally liberal amounts to their troops.
Today, the pharmacopeia of war is much vaster, encompassing not just amphetamines, but also stimulants like Ritalin, antipsychotics like Risperdal, and anti-anxiety drugs like Xanax and Librium, as well as antidepressants like Zoloft and Lexapro. There are the drugs used to “treat” soldiers on the battlefield—antidepressants and anti-anxiety drugs for post-traumatic stress, opioids for pain, a variety of amphetamines to keep soldiers awake, and Ambien and other sleep aids to allow them to rest occasionally, when they aren’t actually fighting.
“Something is clearly amiss,” says Kathy Platoni, an Army colonel in her 60s who deployed four times to Iraq and Afghanistan as a clinical psychologist on the front lines, treating soldiers for all the stresses and traumas of war. “Most psychologists don’t like to go outside the wire,” she says, using the military’s slang term for leaving the relatively protected confines of the base camp. “But I was outside the wire all the time, which is where the military’s physicians and mental-health professionals need to be.”
Platoni, now a reservist with the Ohio National Guard, is in private practice, where she says she sees her fair share of war veterans, many of them “overmedicated and at risk of suicide, family breakdown, and unable to function in civilian society.” While she is quick to criticize the overuse of drugs by the Veterans Administration, she also attributes much of the crisis that the VA now faces in terms of returning veterans suffering from war trauma to the widespread practice of using drugs on the battlefield to keep troops in the fight. “We’re doing a terrible job of handling mental health on the battlefield,” she says.
Malachi Muncy readily agrees. After enlisting in the Army in 2003 at the age of 17, he became a truck driver. In 2004, during his first of two deployments to Iraq, Muncy drove semi-trailers transporting everything from supplies to tanks from a staging area in Kuwait to bases around Baghdad and Fallujah. On one such run to a base outside Fallujah in August of 2004—which ultimately took 12 hours under a scorching-hot sun due to numerous delays caused by road hazards—Muncy grew frustrated after his convoy was held up overnight for no apparent reason outside the gate to his destination camp. “There had been mortar rounds getting fired at the camp all night—not near us, but we could hear them, so we couldn’t sleep,” he recalls. “Then the next day we were still being held up outside the base. I got fed up and hot, so I took off my Kevlar helmet. My E-5 shouted at me to put it back on, and I said, ‘This is bullshit. We’re here! It’s hot!’ He said he was going to write me up. He called the squad leader, a lieutenant, who told me to get back in the truck. I was angry and swung my helmet against the truck window, smashing it, and he accused me of damaging government property.”
At that point, Muncy says he waved his weapon at the lieutenant, who wrote him up with what’s called an Article 15 (a serious non-judicial violation of the Uniform Code of Military Justice that can end one’s career in the armed forces). “He claimed I had pointed my gun at him with intent to harm,” says Muncy, “though I had no intention of doing that. I was really just throwing a tantrum, waving my gun around.”
Muncy’s gun was taken from him for the drive back to Kuwait. There, he was punished by having to build a gazebo for a soda machine and sent to see a shrink, who put him on Prozac and said, “You’re free to go.” Incredibly, under the circumstances, that included getting his weapon back.
Explains Muncy, “It sounds crazy, but they couldn’t keep truck drivers long enough, so they needed me to keep driving, even though I had supposedly threatened my E-6 with a gun!”
Muncy kept driving the Kuwait-to-Iraq route while taking the Prozac, along with Wellbutrin, until he completed his first deployment in 2005.
Paula Caplan, a Harvard University clinical and research psychologist who specializes in treating veterans, says, “There’s a lot of pressure to get soldiers back into the field, especially in today’s all-volunteer military.” But that pressure can do serious harm to the soldiers sent back to the front lines on drugs. Prozac, she says, isn’t something that a truck driver in a war zone should be driving on. She notes that in a hot environment like Iraq, its side effects can become much worse.
When Muncy got back from his first deployment, he stopped using the meds until, diagnosed by the Army as bipolar and suffering from PTSD, he was put on Lamictal right before his second deployment. An anticonvulsant developed for epileptics, Lamictal is also used to treat bipolar disorder, but it includes among its side effects suicidal thoughts and the development of a serious, possibly life-threatening rash.
In 2014, the organization Iraq Veterans Against the War (IVAW) conducted more than 30 interviews with returning soldiers based in Fort Hood, Texas, which were assembled into a document called “Operation Recovery: The Fort Hood Report.” These soldiers, along with their family members, tell of the struggles they faced during deployments in Iraq and Afghanistan from 2009 through 2014—the period of the U.S. military’s announced drawdowns in troop strength. Nine of the interviewees are soldiers who tell of being deliberately drugged by military doctors and psychiatrists anxious to keep them in combat on the front lines.
One soldier told of being deployed three times in seven years, always to Iraq, where he had the misfortune of being hit by improvised explosive devices (IEDs) five times, leaving him with multiple traumatic brain injuries. Constantly angry and afraid that he would “snap,” the soldier says the only treatment he ever received was drugs, including antidepressants and “nightmare pills.” He says, “None of the meds have ever helped. And whenever I said they weren’t helping, they would just up the dosage. They wouldn’t even try other meds. And I never felt anything different after they upped the dosage either.”
Returning soldiers tell of getting cocktails of meds for pain or mental issues. As one soldier who had PTSD and a brain injury from multiple blast concussions explains in the IVAW report, “I only got to see a psychiatrist. I don’t think I ever got to see a counselor. I asked to see one but they really didn’t give me that option. I was usually on five or six different types of medications at any given time. Once I got to see a psychiatrist, he tried different combinations of it. He tried antidepressants, anti-anxiety, sleep medications, headache medications … some kinds of mood stabilizers.”
He adds, “Some of the stronger ones that I remember are Xanax, Klonopin, Ambien, this other sleep medication … I can’t think of it off the top of my head.” Others included Topamax, Abilify and Tramadol—“it’s a pain medication …. I can’t think of what it was called, the other sleep medication. It really messed me up, too.”
Another soldier, a tank driver with a traumatic brain injury that went undiagnosed until his discharge, actually had a 200-pound tank-door lid accidentally dropped on his head during training. He also suffered from combat stress and some other physical injuries.
Asked if he was given multiple medications, the soldier replied, “Oh God. I would say approximately 30 different kinds. I took antipsychotics, antidepressants, anti-anxiety, and I took tranquilizers, muscle relaxants, and they prescribed me one or two painkillers. Generally, just about anything you could think of …. At certain points,” he adds, “I was on multiple different psychotic medications. I tried probably a full array of different kinds. I’m sure at some point I was taking two different kinds. It’s really, really blurry for me to recall a lot of this, because of all the medications. I was given so many medications that I even showed my list of what I was taking to a medical doctor, outside of the military, and they said, ‘You shouldn’t be taking this many drugs in such short a period of time.’ There’s so many different cross-levels, medication reactions that could have happened that were really bad.”
As Paula Caplan, the Harvard clinical psychiatrist, notes: “It’s pretty rare, when people in the military are put on psychotropic drugs, that it’s just one, and anytime that happens you can have side effects—not just of the drugs themselves, but of the interactions. So when the military gives these drugs to combat soldiers in the field, they are effectively conducting experiments without the soldiers’ consent.”
In fact, the Pentagon is known to be conducting experiments with drugs designed to produce “super soldiers.” Among these experiments are efforts to find a vaccination against pain, to prevent inflammation from injuries for up to 30 days, as well as artificial blood that could increase the body’s oxygen-holding capacity and technologies or drugs that could allow soldiers to go for long periods without sleep—for example, by letting half the brain sleep at a time. But these are all still in the early experimental stage. By contrast, giving traumatized soldiers opioids and other drugs to numb the pain of injuries, as well as amphetamines to keep them awake and allow them to keep fighting, are mainstays of the current military.
Colonel Platoni, who has seen the handling of wounded soldiers at the front up close and personal, attributes the current focus on getting injured soldiers back into combat to two factors: a macho culture in which soldiers don’t want to be seen as shirkers or “pussies”—including a laudable sense of unit solidarity where an injured soldier doesn’t want to let his comrades down—and what she calls the military’s “numbers game.” As Platoni explains, “Especially since the cutbacks and drawdowns during the Obama administration, it can be difficult to impossible to get replacements when a soldier is sent home, so the pressure is on the medical staff to do whatever they can to get the soldier back in the field.
“There’s a lot of pressure on field doctors to get soldiers back to their posts. If you don’t get the person in front of you to their unit, the unit can have too few people to be deployed. And with that concern at the fore, everything else can begin to fade. The old doctors’ maxim—‘Do no harm’—can get lost.”
The irony, Platoni notes, is that in sending damaged soldiers back into battle while on medication, the field doctor is increasing the chances that someone else could die.
While the military’s “numbers game” is certainly nothing new, the problem is much worse in today’s all-volunteer services, where, absent a draft, the number of soldiers is much lower, leading to longer and often multiple deployments. There is also an enhanced focus on inculcating in troops a powerful loyalty to one’s immediate team.
Jacquier, now out of the Army and trying to deal with the PTSD and physical injuries he suffered in his two deployments, says of the doctors in the field: “They basically enabled us to make our decision on whether or not we wanted to stay or go forward—and at that point, I was a senior enlisted guy in charge of 25 soldiers. I didn’t want to leave my soldiers behind, and so even though I was struggling with what was going on, having a hard time with it, I made a decision to stay. They didn’t even really seriously check me out there—there was no serious evaluation done all the way until I got back home. It was basically just: ‘Here’s these medications.’ I was getting shots in my lower back and in my buttocks to be able to deal with pain constantly, and having to pop pills and everything in order to mitigate the pain that I was feeling the entire time.
“I look at it now,” Jacquier adds, “and think about the mental state that I was in underneath the amount of medication that I was having to take, and the risks that I was putting myself and my soldiers under by being in that state. I justified it to myself, [thinking] that even on my worst day, I’m still better than half these guys—talking myself up in my mind to be able to justify that. But I look at it now, and if something had gone wrong—if I had lost a soldier after that point—what kind of mental questioning would I have gone back through with myself, wondering, ‘Did this happen because I made a poor decision based off these drugs?’ or ‘Did I not react as well as I would have based on being slowed down from these injuries?’—and just having to live like that.”
Efforts by High Times to learn whether the Pentagon has any policies in place regarding what drugs a soldier can be given while on active duty in a war zone hit a wall. Clearly, if the Pentagon doesn’t have a drug-use policy, it should.
According to Robert Friedman, a professor of clinical psychology and director of the psychopharmacology clinic at Weill Cornell Medical College, prescriptions for antipsychotic drugs alone for active-duty troops between 2005 and 2011 rose by 1,083 percent—and this was during a time that troop levels in the combat zone were falling.
Dr. Charles Ruby, a psychologist and retired lieutenant colonel in the Air Force who is now director of the International Society for Ethical Psychology and Psychiatry, says: “The military is notorious about having policies for everything, so there probably are policies about which drugs can be used.” (He notes that, under pressure after a rash of suicides among soldiers given Seroquel, the Army stopped automatically turning to the powerful antipsychotic drug for PTSD cases and now requires a special waiver.) But, Ruby says, “In my experience, commanders in the field would not want any policy—including one on use of drugs—that restricts how they use their men.”
For his part, Jacquier is pessimistic about any real change regarding this utilitarian drugging of combat troops. “As a soldier, you’re just a serial number—a disposable item,” he says. “Nothing is going to change in the field. It’s always going to be mission first.”
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