11/11/16

Help the Medicated Military

© Oleg Dudko | 123rf.com
© Oleg Dudko | 123rf.com

A U.S. Air force pilot was assigned to transport a B-1 bomber from near the Persian Gulf to South Dakota. The trip took nineteen hours and crossed nine time zones. Every four hours, he took a “go pill”—a tablet of Dexedrine. After landing, he went out for dinner and drinks with a friend from the base. When they were driving back to the base, he began hitting his friend, saying that “Jack Bauer” had told him they were going to try and kidnap him. He was eventually charged with auto theft, drunk driving and two counts of assault.  But a court martial judge found him not guilty “by reason of mental responsibility.”

 

 

Four military psychiatrists concluded that Burke suffered from “polysubstance-induced delirium” brought on by alcohol, lack of sleep and the 40 milligrams of Dexedrine he was issued by the Air Force.

In her article for the LA Times, Kim Murphy went on to say a growing number of lawyers are blaming the U.S. military’s heavy use of psychotropics for their client’s aberrant behavior and the related health problems. In 2012 the U.S. Army surgeon general indicated there were almost 8% of active duty Army on sedatives and more than 6% using antidepressants. This was an eightfold increase since 2005.

A former military psychologist said: “We have never medicated our troops to the extent we are doing now … And I don’t believe the current increase in suicides and homicides in the military is a coincidence.” An Army pharmacy consultant said the military’s use of prescription drugs is comparable to the civilian world. “It’s not that we’re using them more frequently or any differently.” Grace Jackson, a former Navy staff, psychiatrist said: “The big difference is these are people who have access to loaded weapons, or have responsibility for protecting other individuals who are in harm’s way.”

According to a 2007 review in Military Medicine, the modern Army psychiatrist’s deployment kit will likely contain “nine kinds of antidepressants, benzodiazepines for anxiety, four antipsychotics, two kinds of sleep aids, and drugs for attention-deficit hyperactivity disorder.” Military doctors believe it would be a mistake to send battalions into combat without these medications, which they see as helping to prevent suicides, calm shattered nerves and help soldiers rest.

Psychiatrist Peter Breggin said that before the Iraq war, soldiers couldn’t go into combat if they were using psychiatric drugs. “You couldn’t even go into the armed services if you used any of these drugs, particularly stimulants,” just 10 or 12 years ago. Now some people are saying psychiatrists won’t approve their deployment unless they take psychiatric drugs.

An Army Pfc. Pleaded guilty to murdering a Taliban commander in Afghanistan. After the death of a good friend, he began hearing a harsh female voice. He was also depressed. He didn’t tell doctors about the voice—only that he was depressed and thinking of suicide. He was prescribed Zoloft for depression and trazodone for sleep. The voices became worse and he began seeing hallucinations of his dead friend. Eventually he walked into the cell of the Taliban commander and shot him in the face. He was eventually sentenced to a ten-year prison term.

Both the American Psychological Association and the American Psychiatric Association in a 2010 hearing urged the Army to stay the course on psychotropic drugs.

Military Times reported that many troops are mixing several different kinds of pills—an antidepressant and an antipsychotic to prevent nightmares, an anticonvulsant or anti-epileptic to prevent headaches. And these medications are being prescribed, consumed and swapped in combat zones. Dr. Grace Jackson said: “It’s really a large-scale experiment. We are experimenting with changing people’s cognition and behavior.”

Data obtained from the Defense Logistics Agency (DLA) showed the DLA spent $1.1 billion on psychiatric and pain medications from 2001 to 2009. The use of psychiatric medication has increased by 76%, with the use of some drug classes more than doubling. Orders for antipsychotic medications were up over 200%; annual spending more than quadrupled from $4 million to $16 million. Anticonvulsant use increased 70%; spending more than doubled from $16 million to $35 million. Spending on antidepressants decreased from $49 million in 2001 to $41 million in 2009, a drop attributed to cheaper generic versions hitting the market during that same time period.

The Army’s highest-ranking psychiatrist told Congress that 17% of the active-duty troops and as much as 6% of deployed troops are on antidepressants. Doctors and lawmakers are questioning whether the drugs are responsible for the spike in suicides within the military—trend that parallels the increase in psychiatric drug use. Dr. Peter Breggin said there was overwhelming evidence that the newer antidepressants commonly prescribed can cause or worsen suicidality, aggression, and other dangerous mental states. “Imagine causing that in men and women who are heavily armed and under a great deal of stress.” But many military doctors believe the risks are overstated and not fully treating depressed troops would be the greater risk.

Military Times said the Defense Department repeatedly denied its requests for copies of autopsy reports that would show the prevalence of these drugs.

From 2001 to 2009, the Army’s suicide rate increased more than 150 percent, from 9 per 100,000 soldiers to 23 per 100,000. The Marine Corps suicide rate is up about 50 percent, from 16.7 per 100,000 Marines in 2001 to 24 per 100,000 last year. Orders for psychiatric drugs in the analysis rose 76 percent over the same period. Other side effects can include increased irritability, aggressiveness and hostility.

Dr. Peter Breggin published an article in Ethical Human Psychology and Psychiatry, “Antidepressant-Induced Suicide, Violence, and Mania: Risks for Military Personnel.”  He noted where the activation side effects of newer antidepressants mimicked the symptoms of PTSD, increasing the hazard when they are prescribed to military personnel. He recommended that the military study the relationship between psychiatric drug treatment and suicide as well as random or personal violence. He also recommended that antidepressant be avoided when treating military personnel. See his website for more information on the relationship between antidepressants, suicide and violence in soldiers.

There is a strong probability that the increasing suicide rates among active-duty soldiers are in part caused or exacerbated by the widespread prescription of antidepressant medication. By themselves, these drugs cause a dangerous stimulant-like profile of adverse reactions. These symptoms of activation can combine adversely with similar PTSD symptoms found so commonly in soldiers during and after combat.

In September 28, 2016, US Senator John McCain introduced the Veteran Overmedication Prevention Act (S. 3410), a companion bill to HR 4640, the Veteran Suicide Prevention Act. Psychologist Philip Hickey reported the bills seek to fight against suicide deaths in military personnel by ensuring that accurate information is available on the relationship between suicides and prescription medication. If passed, these bills would bring information currently being withheld from the public on these relationships. A press release from Senator McCain said:

This legislation would authorize an independent review of veterans who died of suicide or a drug overdose over the last five years to ensure doctors develop safe and effective treatment plans for their veteran patients. We have a long way to go to eradicate veteran suicide, but this legislation builds on important efforts to end the tragedy that continues to claim far too many lives far too soon.

“Data suggests that every 65 minutes a veteran takes his or her own life.” One way to address this is by determining if there is any association between suicide and the medical treatments being received by veterans for service-related conditions. Congressman David Jolly said the following in a press release about his sponsorship of the Veteran Suicide Prevention Act:

Specifically, the Veteran Suicide Prevention Act would require the VA to record the total number of veterans who have died by suicide during the past five years, compile a comprehensive list of the medications prescribed to and found in the systems of such veterans at the time of their deaths, and report which Veterans Health Administration facilities have disproportionately high rates of psychiatric drug prescription and suicide among veterans treated at those facilities.  The VA would then be required to submit to Congress a publicly available report on the results of their review, along with their plan of action for improving the safety and well-being of veterans.

As suggested by Philip Hickey, honor the veterans who have served our country by writing your legislators in the Senate and the House in support of these bills:

Senate: S 3410 – Veteran Overmedication Prevention Act

House: HR 4640 – Veteran Suicide Prevention Act