Mudhafer al-Husaini,Erica Goode / New York Times – 2009-01-01 00:27:24
BAGHDAD (December 21, 2008) — For an Iraqi army soldier patrolling Baghdad’s unpredictable streets, each 12-hour shift is an exercise in terror and uncertainty.
So Ahmed Qasim pops a small white tablet called Artane to help him through his duties.
“For me, it helps me to get the job done,” he said. “I can’t bear working without taking Artane. It makes me happy and high, but I still can control myself.”
The abuse of prescription drugs, widely available in Iraq on the black market and through private pharmacies, has significantly increased since 2003, doctors and other health specialists say, nourished by the stresses of the war and the lack of strict government regulation.
Dealers do a brisk business in tranquilizers, painkillers and other drugs, specialists say, and drug abuse is a problem in the prisons and among Iraqis who live in poor neighborhoods or who are unemployed.
But in recent years, Iraqi soldiers and police officers have also turned to drugs to ease the stresses of their jobs. In particular, they are abusing Artane, a medication that is used to treat Parkinson’s disease and that can have euphoric effects when used in high doses.
“They believe that this Artane allows them to become courageous, to become brave,” said one doctor, who spoke on condition of anonymity because he was not authorized to speak publicly about the issue.
“They take it so that there is no anxiety, no fear,” he said, “so they can break down doors and enter houses with no shame.”
No clear evidence exists that the misuse of prescription drugs has a significant effect on how soldiers and police officers perform their duties. Nor are any figures available on how widespread drug abuse is in the security forces or whether most of those who use the drugs do so daily.
But Qasim, 26, estimated that 1 out of 3 soldiers in his army unit take Artane or other drugs while on duty. Jalal Ammar, 45, an Iraqi police officer, said “probably 30 percent” of the police officers he worked with used Artane and other medications. Amir al-Haidari, the manager of drug addiction programs for the Ministry of Health of Iraq, said alcohol abuse was once a bigger problem than prescription drug abuse, “but after the American invasion of Iraq, alcohol became limited because of the security situation and religious restraints.”
Now, he said, “the long duties, the suicide attacks and the killing are all factors that drive the security forces members toward Artane and other drugs.”
Al-Haidari added that the Health Ministry had begun a campaign to close private pharmacies that sell drugs illegally and to place more restrictions on prescriptions. He said the problem was no worse in the security forces than among civilians.
The ministry, al-Haidari said, is also trying to open more treatment centers for addicts. Only one hospital in Iraq, Ibn Rushid psychiatric hospital in central Baghdad, has a ward devoted to treating alcohol and drug abuse.
Gen. Ahmed al-Khafaji, an official at the Interior Ministry concerned with police affairs, denied that drug abuse was a significant issue among Iraqi police officers.
“We don’t accept any kind of addiction within the security forces or our troops from the police,” he said, adding that any police officer who was found to abuse drugs “will be dismissed from our ministry forever.”
Maj. Gen. Qassim Atta of the Iraqi military said the soldiers in Baghdad “have very good mental health and high spirits.”
Asked about the abuse of prescription drugs, he said, “Maybe there are some negative points here and there, but you cannot generalize based on such cases.”
On the street, Artane, Valium and other drugs are known by nicknames, including “the capsule,” “the eyebrow” and “the cross.” Ammar said that when police officers talked among themselves about the drugs, they referred to them as “appetizers” or “takeout.”
Drug use is forbidden in the Iraqi security forces, but Qasim said soldiers took drugs discreetly and that “everyone in the army knows about it.”
© 2008 Hearst Communications Inc.
Posted in accordance with Title 17, Section 107, US Code, for noncommercial, educational purposes.
Posted in accordance with Title 17, Section 107, US Code, for noncommercial, educational purposes.
ABC News Uncovers Soldiers and Drugs Story
(November 29, 2007) — Mental health experts say that a correlation — a comorbidity — exists between PTSD and drug abuse. In that vein, tomorrow night on ABC News, 20/20 covers the issue of some of today’s soldiers turning to drugs, as some had in the Vietnam, to ease the experience of war. Throughout the week, the network’s chief investigative correspondent, Brian Ross, and his counterparts have begun sharing some of the data and stories they collected over the past few months:
In the third year of a joint project with the nonprofit Carnegie Corporation, six leading graduate school journalism students were again selected to spend the summer working with the ABC News investigative unit.
This year’s project involved an examination of whether, as happened in the wake of the Vietnam War, Iraqi war veterans were turning to drugs as a result of the trauma and pain of war. The U.S. military maintains the percentage of soldiers abusing drugs is extremely small and has not increased as a result of Iraq.
The students’ assignment was to get the unofficial side of the story from soldiers, young men of their own generation.
An introduction to the investigation:
From High at the Mountain Post, the first installment in this week’s series of ABC News reports:
They were prepared for war. They were prepared to die for their country. But Fort Carson soldiers say they weren’t prepared to come home and fight a different battle — addiction to illegal drugs.
Many of this country’s bravest men and women who volunteered to defend America in a time of war have come home wounded — physically and mentally — and are turning to illicit drugs as they adjust to normal life, according to soldiers, health experts and advocates.
“Lots of soldiers coming back from Iraq have been using drugs,” said Spc. William Swenson, who was deployed to Iraq from Fort Carson. “Right when we got back, there were people using cocaine in the barracks; there were people smoking marijuana at strip clubs; one guy started shooting up,” he said.
Fort Carson, just outside Colorado Springs, is home to 17,500 active duty personnel. Four thousand eight hundred service members are currently deployed in the “sand box,” as soldiers call Iraq and Afghanistan. ABC News spoke to more than a dozen soldiers who described widespread abuse of illegal drugs at Fort Carson by service members back from the war. …
Fort Carson’s leadership declined to discuss substance abuse issues with ABC News despite numerous interview requests. Fort Carson also said it could not comment on the individual cases of the soldiers we interviewed, citing privacy concerns.
In interviews with ABC News at the Pentagon, however, the U.S. Army strongly denied there was an increase in drug abuse among soldiers deployed to Iraq. According to Dr. Ian McFarling, acting director of the Army Center for Substance Abuse Programs, less than one half of one percent of soldiers in Iraq have tested positive for illegal drugs.
“That’s a testament to the kind of leadership we have is that they believe that that’s not the place that they should be doing drugs,” said Dr. McFarling.
But Dr. McFarling said that once soldiers return from Iraq, the positive rate for drug tests doubles to more than one percent. In addition, Dr. McFarling said five percent of soldiers back from Iraq seek help for substance abuse issues from clinical providers.
The U.S. Army does offer treatment for soldiers dealing with drug abuse, and Fort Carson has a busy Army Substance Abuse Program. But some soldiers are forced off post because Fort Carson offers no inpatient services; others get treatment in the community to avoid the stigma associated with seeking help, soldiers and advocates said.
Since the Iraq war started in 2003, Colorado Springs hospitals and counseling services have seen a dramatic increase in active duty soldiers seeking treatment for substance abuse. Penrose-St. Francis Health Services went from treating no active duty soldiers for substance abuse before the war to between 30 and 40 now, said Phillip Ballard, the hospital’s inpatient psychiatrist.
According to Ballard, “Now that we have larger numbers than the military facilities can treat…it falls upon the civilian community to treat those patients.”
Veterans’ advocacy groups charge that the problem of substance abuse is much greater than the Army wants to publicly acknowledge, and it’s growing. “I’ve met with veterans from coast to coast, and I will tell you that there is a catastrophe on the horizon,” said Paul Sullivan, director of Veterans for Common Sense.
Three thousand fifty-seven veterans of the Iraq and Afghanistan wars were potentially diagnosed with a drug dependency from fiscal year 2005 through March 2007, according to figures provided to ABC News from the Veterans Health Administration. From 2002 through 2004, only a total of 277 veterans were diagnosed with drug dependency, the numbers show.
From Part Two, Tale of Three Medics:
When Spc. Matthew McKane listens to questions, he tilts his head to one side. When he answers, his speech is plain and matter-of-fact. A boyish grin occasionally creeps across his doughy cheeks and plays at the edges of his mouth, like a kid who got caught sneaking a cookie.
If only it were that simple. As a medic in Iraq, the 22-year-old McKane saw the ravages of war firsthand and found he couldn’t deal with it. McKane said he turned to self-medication by using drugs to numb the senses, and he was not alone. Now McKane fears he will soon be discharged from the Army because of his drug use. Another medic, Spc. Jeffrey Smith, has already been kicked out for drug use and other misconduct charges and says he is dealing with his psychological trauma without medical or veterans’ benefits. And yet another Army medic, Sgt. James Worster, is dead from a drug overdose in Iraq.
Their stories are not unique. Many soldiers turn to drugs as a way to cope with psychological trauma from the war, according to advocates, health professionals and combat veterans. “I guess the stress just overpowers your decision making. You just [need] a little bit to get away from reality,” McKane said. “You make stupid decisions.”
He arrived in Baghdad in June 2006 and a day later was working in the emergency room.
His first patient was an elderly Iraqi woman who had been shot in the kneecap by a .50-caliber machine gun that “basically like blew her whole bottom leg out,” McKane said. McKane’s friend and fellow medic, 26-year-old Jeffrey Smith, described the setting as “complete insanity.” …
Smith said to escape from the daily chaos and stress, if even for a short time, many soldiers working in the hospital began to abuse Ambien, Percocet and Prozac, as well as prescription painkillers available on the black market in Baghdad. But eventually even those drugs weren’t enough for some.
On Sept. 18, 2006, McKane said he and fellow medic Sgt. James Worster decided to use propofol, a powerful general anesthetic used to keep patients knocked out while on life support.
“[It was] us just being stupid, and just trying…a different coping mechanism, dealing with stress,” McKane said. “All I remember is we passed out. And I remember waking up like hours later and looking over at my friend, just to see, you know, just to talk to him about the whole thing. And I noticed he wasn’t on his bed anymore, and he was on the floor laying on his back.”
Worster was dead from an overdose of propofol, McKane said. According to McKane, “All I remember is me standing up there after it happened…getting the glares from everybody in the hospital. I felt like I was never going to make it out of Iraq…I felt the only way to get out was to commit suicide.”
It was Worster’s second tour in Iraq, his widow Brandy Worster, 26, said. In between his deployments, Brandy said her husband saw a psychologist two to three times a week and took an antidepressant medication.
“He had a lot of problems from the first time [in Iraq] he never really got over,” Brandy said. “[He] dealt with things from children that were our son’s age to adults, whether it was Iraqis or other soldiers, probably seeing the worst he’s ever seen.”
Brandy blamed her husband at first, she said, but eventually the blame turned to acceptance and a need to move on. She said she tries to “give good memories” to their son, Trevor, who will be four years old this fall.
“I can understand why soldiers sometimes take something, so [they] don’t have to think about it,” she said. “They’re having to deal with all of this and not have any ways to combat what they are seeing.”
From Part Three, Hidden Wounds Lead to Drugs:
As more U.S. service members return home from Iraq and Afghanistan after witnessing the horrors of war, more will turn to drugs and alcohol to cope. That’s according to mental health experts who say there is a strong correlation between Post-Traumatic Stress Disorder, or PTSD, and substance abuse. PTSD is an anxiety disorder that afflicts people who have been through a traumatic event.
Dr. Phillip Ballard, a psychiatrist at Penrose-St. Francis Health Services in Colorado Springs, Colo., said he has seen a significant increase of soldiers from nearby Fort Carson seeking inpatient treatment for substance abuse.
“PTSD has as part of its core diagnosis the use of substances as self-medication for the relief of depression, anxiety, whatever feeling they may have,” Ballard said. “Sometimes it’s considered to be a weakness or a less than manly thing to ask for assistance or ask for help so they do the best they can do with what they have available…they use the chemicals and drugs they’ve used in the past to numb feelings up.”
Between 30 and 50 percent of people with post-traumatic stress disorder will also abuse substances, according to Ballard. As many as half of all PTSD patients treated in the Veterans Health Administration also have a substance abuse problem, according to the Department of Veterans Affairs’ own information.
That is potentially a big concern since as many as one out of every four soldiers, or 28 percent, in combat brigade teams could be at risk for developing PTSD, according to a Department of Defense Task Force on Mental Health report from June 2007. Almost 40 percent of soldiers who have returned home report psychological symptoms, according to the report.
Col. Elspeth Ritchie, the psychiatry consultant to the U.S. Army Surgeon General, acknowledged that post-traumatic stress is a risk factor for the abuse of drugs and alcohol, but said that the Army has not been able to quantify how strongly the two are linked. The Army maintains that there has been no increase in the rate of illegal drug use among soldiers since the beginning of the wars in Iraq and Afghanistan.
ABC News was able to interview numerous U.S. service members who say they turned to drugs to help cope with their PTSD symptoms.
Gamal Awad, a former major in the U.S. Marine Corps, said he smokes marijuana to help cope with PTSD. Awad was first diagnosed with PTSD by a Marine psychiatrist after the 2001 attack on the Pentagon during which he said he picked severed limbs out of the rubble. Despite the diagnosis and his ongoing treatment for PTSD, Awad was still deployed to Kuwait and Iraq, which he said made his condition much worse.
“I was having suicidal thoughts…I would go out on convoys with the purpose to die. I just wanted to be hit by an IED or get shot. We’d get hit with, you know, mortar rounds or rockets, I wouldn’t take cover. I would just stand there,” said Awad.
Awad said military doctors prescribed him a range of antidepressants and sleep medication, but he fell into a spiral of depression and misconduct that led to his discharge from the Marines. A civilian doctor then prescribed marijuana, which is legal in California for medicinal use, to treat Awad’s PTSD symptoms.
“It’s the one thing that’s given me some sort of peace, some sort of sleep for more than three or four hours, and it’s medical marijuana,” Awad said. …
Col. Ritchie said she was unaware of cases of soldiers turning to drugs to cope with the trauma of their experiences in Iraq. “That has not been my experience,” said Col. Ritchie. “My psychiatrists and social workers who see soldiers report to me of their experiences with soldiers all the time, and none of them are seeing that particular explanation.”
Col. Ritchie said in her experience, soldiers more commonly turn to drugs to recreate “the intensity, the adrenaline high” that they got during combat.
Psychological trauma and drug use, however, are nothing new for combat veterans, said Steve Holsenbeck, a former psychiatrist at Fort Carson who served in the military from 1973 until 1993. Many of this nation’s homeless are veterans of previous wars who are still grappling with psychological issues from their service, he added.
“I suspect we’ll see a lot of what we continue to see from Vietnam,” Holsenbeck said. “I think it’s going to look exactly like it looked then and like it looked after the Crimean war and after probably the battles between Spartans and Athenians. You’re going to see people who are veterans, who came back; everything piled up on them; they got addicted to alcohol or drugs, lost their employment; they lost their families; they end up on the street.”
Follow links for each article to read them in full, and to access a variety of multimedia presentations that go along with each story.
* Are PTSD-Medicated Veterans Dying in Sleep — or Committing Suicide?
* Amidst Warrrior Transition Unit Overdoses, Army Surgeon General Schoomaker Blasts Streamlined Disability Pilot Project as ‘Fast Bad Process’
* Combat Veterans, PTSD and Prison
* Army to Expand Efforts to Educate Officers on PTSD
* Army Surgeon General ‘Learning Lessons’ From Fort Carson Investigations
* DoD’s 2005 Survey of Health Related Behaviors
* Some OEF/OIF Troops Returning Addicted to Military-Given Meds
* Times Argus: Some Troops Self-Medicating in Field
* NPR’s On Point: Troops in Combat Zone on Anti-Depressants
* Drug War: More Details on Medicated Troops in Combat
I am a retired USA First Sergreant. I spent a lot of years in the SPECOPS community, and the intelligence arena (including the “alphbet” agencies), from the Vietnam era to 1997. We saw HEAVY alcohol and drug use from those returning from extended time “in the field”, mainly in dealing with the “PTSD” type issues. Spouses were a continual “fountain” of information for the leadership in dealing with our troops, as the medical community seemed to continually bury it’s head and find many (unrelated) areas to blame. COL Ritchie, in her comments, seems VERY out of touch, and ill-informed (as is usually the case, in my experience). Her comment about soldiers turning to drugs to recreate “the intensity, the adrenaline high” is so far off the mark it is sad. The senior enlisted leadership, if she ever took the time, could give her a much better picture of the troops she is “hearing” about (does she see any herself?). Being “unaware” DOES NOT make her an authority, and to me, shows not only a leader who lives in another world foreign to the soldiers who depend on her, but an ignorance to the reality they must live through during their “tour”.
By Anonymous 1sg, at 11/30/2007 08:38:00 PM
Thanks, 1sg, for your comment and service.
You point to a good part of the problem: Her being unaware. So, what’s the next move then? If she’s not hearing about such things, it’s not too late to be proactive about finding out if there is, indeed, a problem out there that they might be overlooking.
ABC News found these cases. It’s the Army’s turn now to take the lead, and be proactive about attempting to find out how deeply the problem does — or does not — run throughout the military system.
By Blogger Ilona Meagher, at 12/02/2007 12:03:00 AM
Building Resiliency for our troops
It seems the DoD and Navy are convinced they can build a Marine and Soldier’s capacity to withstand the riggers of war and multiple deployments with medication. Seven new test drugs are being deployed to alter or inhibit the neurochemical processes research suggests are involved in the development of Operational Stress and PTSD.
I have been working with this issue from a body/centered treatment perspective for 15-months and have found great results. However,
The VA declines to recognize the California MFT psychotherapist license and will not work with me in any particular way.
The DoD and its consultant have this to say:
(1). The treatment process utilized must support the Combat Operational Stress Control Continuum Model detailed in MCBul 6490. IT DOES!
(2). The process must be validated by research. WHICH IT DOESN’T
Please help me find a way to get funding and a university to coordinate the process of tracking and validating this very efficient and effective model for supporting our troops without medication. More can be read at www.OperationRecovery.org
bob Bornt, MFT
While a wide variety of events can trigger post-traumatic stress disorder, this PTSD blog focuses solely on the combat-related variety. As a new generation of combat vets returns to civilian life and seeks out resources, PTSD Combat is here to help.
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