This Is Our Military on Drugs
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In many ways, Ryan Begin's experience with drug addiction sounds like an all-too familiar one: A five-year blur of pill popping, overdoses, arrests and hospitalizations; frayed relationships with family and friends; unemployment, isolation, depression and suicidal thoughts.
But Begin's ordeal had something of an unexpected catalyst: His time in the Army. “My life went downhill from the moment I came back from Iraq,” Begin told me earlier this year.
During his second deployment to Iraq, in 2004, Sgt. Begin's convoy was struck by an IED. His injuries left him with an amputated arm that required 30 different surgeries, chronic full-body pain and the kinds of harrowing nightmares and flashbacks symptomatic of post-traumatic stress disorder (PTSD). Upon returning stateside, Begin was treated by military doctors at Maryland's Bethesda Naval Hospital. Their version of treatment? Dose the 23-year-old with dozens of prescription drugs, including narcotic painkillers, antidepressants and antipsychotics. “I had so many pills, I needed a backpack to carry them wherever I went,” he recalls. “I didn't even know what was a symptom and what was a side effect.”
Begin increasingly relied on the drugs to keep pain at bay, bestow a sense of mental calm and alleviate the stress and anxiety inherent, for some veterans, in readapting to civilian life. And with doctors happy to hand over prescription after prescription, Begin had easy access to those vices—which he blames, in part, for spurring several accidental overdoses, suicide attempts and violent outbursts that led to jail time. In 2009, he was hospitalized, and then institutionalized, after attempting to overdose on 90 Valium. Only months later, he repeated the suicide attempt with the anti-anxiety med Klonopin; after his stomach was pumped, he was sent home with a new prescription for the same drug.
“The son that left for Iraq was not the son that came back,” Ryan’s mother, Anna Begin, said last year. “Let me put it as simply as I can: Every single day, my son was suicidal.”
The military's alcohol ban seems to facilitate, rather than mitigate, bingeing and alcoholism.
Begin's ordeal is hardly an isolated incident among soldiers and veterans from this generation's wars. As reported in part one of this series, an estimated 17% of active-duty personnel “misuse” prescription medication, 11,200 soldiers were busted for using illegal drugs in 2011, and between 24% and 38% of soldiers are estimated to qualify as “heavy drinkers.”
In large part, experts say, that's because the military's policies—on everything from on-base alcohol consumption to prescription medications—are making access to addictive substances far too easy for American war-fighters. “These substances have become an integral part of the military experience for so many soldiers,” says Dr. Dessa Bergen-Cico, an addiction expert at Syracuse University and author of War and Drugs: The Role of Military Conflict in the Development of Substance Abuse. “From a public health perspective, this is a problem we really need to be dealing with.”
For soldiers, as for civilians, three categories of substance threaten to become addictive: alcohol, illicit drugs and narcotic painkillers. In the military, however, access to these substances occurs under different circumstances and policies, and those distinctions can make the prospect of addiction among military personnel much more potent than in the civilian realm.
At face value, the military's policies regarding alcohol usage appear reassuringly stringent: As per the military's “General Order No. 1,” a soldier can face discharge or criminal charges if they're found “possessing, consuming, introducing, purchasing, selling, transferring or manufacturing any alcoholic beverage,” during deployments to Iraq and Afghanistan. (The ban on alcohol was issued in part in response to Muslim cultural sanctions.) There's little indication, however, than the order has been rigorously upheld. Reports have consistently emerged from both countries of officers either turning a blind eye to alcohol acquisition and consumption, or even partaking in a few drinks themselves.
Over the last decade, dozens of war-zone crimes committed by soldiers have involved alcohol—illustrating just how loosely the military's ban is enforced: The 2005 rape and murder of a 14-year-old Iraqi girl by a group of American soldiers, for example, occurred after the soldiers “[drank] several cans of locally made whiskey supplied by Iraqi Army soldiers,” according to The New York Times.
The more recent case of Staff Sgt. Robert Bales is yet another example. Bales, who in March allegedly shot and killed 16 Afghan civilians, is reported to have covertly consumed alcohol on-base, before later departing on a killing spree that is arguably the worst war crime to have been committed during the conflicts in Iraq and Afghanistan. (Bales had also been wounded twice in combat and is said to have been going through financial and domestic difficulties.)
Ironically, the military's alcohol ban seems to facilitate, rather than mitigate, binge drinking and alcohol addiction—as is true for many abstinence-based prevention efforts. The sense of restriction inherent in an all-out booze ban lends itself to excessive consumption whenever alcohol is available, and lax enforcement means that soldiers are able to access alcohol—whether from military contractors, soldiers from other countries or even disguised packages from home—with relative ease.
The problem of slack regulations, combined with soldiers stressed to the brink—and often desperate for an outlet—isn't lost on military brass. At least, not on paper. “The enforcement of policies designated to ensure good order and discipline has atrophied. This, in turn, has led to an increasing population of soldiers who display high-risk behavior,” reads a 2010 Army report revealing deep demoralization among troops as evinced by a tripling of suicides since 2001, many of which were related to alcohol and illegal or prescription drug use.
Surveys of soldiers themselves corroborate the problems surrounding alcohol access: A groundbreaking survey, published in 2009, polled 16,000 active-duty soldiers and found that 43% were “frequent binge drinkers” and that a significant proportion of soldiers drank excessively more than twice each week. Illicit drugs are yet another problem. In particular, soldiers fighting in Afghanistan are surrounded by opium—the country produces 90% of the global supply—and this easy access has turned some American troops into addiction-addled users. The Pentagon hasn't released numbers on the specific extent of the military's heroin problem. But a series of Army reports, released earlier this year, revealed that the eight American soldiers deployed to Afghanistan died of heroin overdoses in 2010 and 2011. Furthermore, the report noted, the number of soldiers busted for heroin use has soared since the war's dawn—from 10 soldiers in 2002 to 116 in 2010.
Soldiers overseas have myriad options when accessing, including bartering with Afghan locals or scoring the drug from members of the Afghan Army. “Despite the claims of the US government that it is actively engaged in trying to curtain the drug trade in Afghanistan,” noted Jeremy Hammond at Foreign Policy Journal last year, “heroin is readily available to US troops, including just outside the Bagram military base.”
Access to alcohol and heroin, combined with the stresses wrought by lengthy wars, repeated deployments and the unique circumstances of this generation's military population (all-out booze bans, combat zones rife with opium) are problematic enough. But the availability of prescription drugs is, arguably, a dilemma even more severe—and one that threatens to leave thousands of soldiers and veterans grappling in the throes of addiction. Even worse: the military's own doctors often serve as ostensible “dealers” providing soldiers with these habit-forming prescription cocktails. “The medics or the doctors are working with what they have, often to help a soldier cope with physical pain or a problem like insomnia,” Bergen-Cico says. “But these prescription drugs take so much of the edge off that they become addictive psychologically as well as physically.”
Medications like opiate-based painkillers Vicodin and OxyContin and the antipsychotic Seroquel are prescribed with stunning frequency among military personnel. More than 110,000 active-duty soldiers were prescribed at least one prescription medication, most often an antidepressant or antipsychotic, last year. A 2010 Army study concluded that 14% of soldiers were prescribed an opiate painkiller—95% of which were for OxyContin. Between 25% and 35% of wounded soldiers are addicted to such meds, according to a Pentagon report issued last year.
The availability of prescription drugs leaves thousands of soldiers and veterans in the throes of addiction.
And with so much medication floating around—much of it prescribed in 180-day supplies to soldiers on extended deployments—trading and sales among troops are exceedingly common. “They'll often have a medicine cabinet full of drugs, and they'll pass them around,” Dr. Judith Broder, a psychiatrist and founder of a nonprofit counseling service for soldiers, told me last year. “That this isn't being tracked is terrible.”
Despite acknowledging a growing problem with prescription narcotics, the Pentagon still doesn't effectively track the meds. Officials are, however, making an effort. Earlier this year, top brass announced plans to expand random drug tests—which already screen for marijuana, cocaine and amphetamines, and sometimes steroids or opiates—so that they'd include Xanax and Vicodin. The military's research community is also at the forefront of investigations into the biological mechanisms behind addiction: A $15-million Army program, for example, launched just last week, will see scientists nationwide pursue “the discovery and development of new medications to treat alcohol and substance abuse in the context of post-traumatic stress disorder and combat injury.”
Former Staff Sgt. Begin considers it something of a miracle that he stopped the pill-popping before a suicide attempt succeeded. Ironically enough, his recovery only started when he abandoned his military doctors, and the drugs they prescribed, in favor of yet another “illicit” product—one that, in contrast to substances like alcohol and Oxy, military leaders flat-out refuse to tolerate: pot.
In March 2011, Begin saw a civilian doctor and was prescribed medical marijuana for his chronic bodywide pain. Not only did the weed relieve Begin’s aches, but it soothed the anxiety, insomnia, rage and instability associated with PTSD. “I told my military doctor that marijuana was helping me more than anything else,” Begin recalls. “He said I could choose: Keep smoking pot, or keep getting prescriptions. I went with the pot, and that was it.”
Yet the Obama administration seems to be going out of its way to prevent Begin and other vets from accessing pot for pain. In addition to raids and arrests by the DEA on medical-marijuana suppliers, last September the National Institutes on Drug Abuse (NIDA) blocked the first-ever FDA-approved clinical trial to evaluate marijuana as a potential treatment for PTSD. With an estimated 37% of this generation’s vets afflicted with PTSD, and few truly effective treatments available, Begin begs to differ.
That’s why he launched an online petition asking the feds to change their course on marijuana as a treatment for PTSD. Since then, Begin has met with legislators in his home state of Maine, and works as a veterans liaison for a nonprofit, the Medical Marijuana Caregivers of Maine. His top priority: Having the state add PTSD to the list of conditions for which patients can qualify for medical marijuana.
Now, Begin smokes a few joints every day—enough to curb his physical pain, stave off anxiety attacks and help him sleep. His military service meant access to myriad narcotics, stimulants and depressants, as it still does for thousands of active-duty soldiers and veterans. But Begin, for one, would prefer access to what he considers the much lesser of all evils. “I just didn't want to be shoved full of pills anymore,” he says. “I know this works for me.”
This is the second in a three-part series on the epidemic of addiction among US soldiers and the military.
Katie Drummond is a reporter for Forbes magazine, a contributing editor at The Daily, and a freelance writer for outlets including Wired.com, New York magazine and Prevention.