Forget GM, Where’s the Bailout for Our Moral Bankruptcy?

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It’s a unique phenomenon of perception that causes us to be de-sensitized to small changes that occur over long periods of time.  We’ve all fallen victim to this at some point in our lives.  The extra slice of pizza each night during college that gave you the “Freshman 15”, that extra coffee at Starbucks every morning that drained $600 from your savings by the end of the year (and that’s just the small, excuse me, Tall), or perhaps even the Ambien prescription for your occasional insomnia that has now become a weekly habit. However, it has recently dawned on me that this culture of chronic neglect of proper health has reached truly frightening proportions.  What makes this even worse is the fact that the vast majority of those in society whose job it is to help us safeguard our health have seemed frustratingly indifferent and, in the case I’m about to make, have actively chosen to make the situation worse.

With Independence Day nearly upon us I felt it would be appropriate to honor our soldiers by focusing on a problem of particular importance to them. I speak of course of the massive increase in the medication provided to our fighting men and women abroad. A recent article in Men’s Health magazine provides a chilling tale of the enormous increase in prescriptions to active duty soldiers and the potentially disastrous consequences of heavily medicating a fighting force in the unpredictable and volatile areas of Iraq and Afghanistan.

Valium and Klonopin for anxiety; Zoloft, for depression; Ambien, for insomnia; Thorazine and Seroquel, anti-psychotics, used off-label to treat nightmares, and a host of other narcotics. In fact, the article goes on to include data from the Department of Defense that as of last year around this time, these prescriptions had reached nearly 50,000 a month, a 52% increase since October 2003.  Many of these soldiers are acutely aware of the side effects of these drugs on their ability to function at their posts, but are still ordered to continue their duties regardless. Corporal Michael Cataldi, who had been prescribed a regiment of Klonopin, Zoloft, Ambien, and narcotic painkillers, recalled having a fellow soldier kick the back of his seat every five minutes to keep him awake after being directed to drive a 14-ton armored personnel carrier, complete with canon, machine guns, and ammunition.  Each of these medications came with written directions warning against operating heavy machinery. To place this in perspective (as if it needs any), a U.S. Air Force flight surgeon interviewed for the article went on to point out that “even in peacetime, people in the many combat-support positions…would not be allowed to take such medications and continue to work in their sensitive, demanding jobs.” Indeed, even a civilian construction company would not allow an employee to operate heavy machinery who was taking even one of the four prescriptions used by Corporal Cataldi.

Perhaps even worse than deploying over-medicated troops, is re-deploying them.  Officially, Pentagon policy states that soldiers receiving treatment for psychiatric conditions must have proven stable for a minimum of 3 months before being allowed to return to combat.  However, in practice this is not often the case.  One staff member of a team sent by the Army Surgeon General to investigate medicated soldiers who have returned to battle, admitted “many of these soldiers are sent to Afghanistan…despite a doctor saying they shouldn’t go or leaders knowing they shouldn’t deploy.”  One particularly heartbreaking example is that of Michael R. De Vlieger, a gunner with the 101st Airborne.  After surviving a grenade attack that drove his knee through a Humvee door, De Vlieger’s mental health slowly deteriorated to the point of complete psychotic breakdown.  After spending two weeks at a psychiatric hospital and prescribed four different prescriptions to treat his symptoms, De Vlieger found himself headed back to the combat zone a mere 18 hours after his release.  He admits, “I was in no condition to leave, I’m an infantryman.  If I’m screwed up in my head, it could cost my life or the lives of the men with me.”  In other words, De Vlieger was forced to choose between his own mental well-being and the safety of his fellow soldiers.  He threw his pills away.

It is true that soldiers have been medicated in various ways since the dawn of civilization, most often with alcohol and decidedly self-administered. However, in recent decades the steady rise in prescription medications in our armed forces has reached a critical point where it presents a serious threat, not only to individual soldiers, but to national security as well.  In these days of an all-volunteer Army, fighting in a distant land, it has become shamefully apparent how easily the American public has forgotten about their men and women in uniform.  It was outrageous enough that we allowed our troops to go for so long without adequate protection for their bodies, so why should we be any less furious about not securing their minds?  Regardless of how you feel about the war itself, the sacrifice that these men and women make on our behalf speaks volumes about them.  If we send them to perform their duty being anything less than all they can be, what does that say about us?

Luke Manley, MPH

View posts by Luke Manley, MPH
Luke grew up in and around Boston, Massachusetts before moving north to attend the University of Maine at Orono for his undergraduate degree. After living briefly in Portland, Oregon he is now working as a Research Phlebotomist and Grants Manager for the Psychiatry Department at the University of Southern California. His passion lies in travel and working internationally, especially in the Middle-East. He has spent time in Turkey, researching the Turkish Healthcare system and recently returned from Syria, Palestine, and Tunisia, assisting with the MedCHAMPS project, which is studying cardiovascular morbidity and mortality. In the Fall he will be moving to Washington, D.C. to pursue a PhD and begin his career in International Relations.
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