This is the second of three articles highlighting the important work of the veteran owned and operated GI coffeehouse movement. In addition to providing desperately needed GI support, GI coffeehouses remain one of the strongest and consistent voices in the antiwar movement - owing to first hand experience of corrupt contractors, officer misconduct and civilian atrocities. Coffee Strong at Fort Lewis is continuing their September fundraising drive, as they are well-short of their $20,000 goal. Please go to http://www.coffeestrong.org/ and donate generously. Under the Hood at Fort Hood http://www.underthehoodcafe.org/ equally deserves your support.
Sending troops to war on psychotropic medication (as I describe in GI Suicides: A National Disgrace) is an absolute violation of basic health and military standards. GIs on psychoactive medication place the lives and welfare of their fellow servicemen at risk, which is the main reason official Pentagon policy has always forbidden it. In 2009, the Senate Armed Services Committee response to this outrage was to "study" it. At the conclusion of their investigation into GI suicides (http://www.fas.org/irp/congress/2009_hr/suicide.pdf), they commissioned the National Institute of Mental Health (NIMH) to "study" the percentage of combat personnel on psychotropic medication. After two years, it's clear from the NIMH website (http://www.nimh.nih.gov/health/topics/suicide-prevention/suicide-prevention-studies/the-making-of-army-starrs-an-overview.shtml) that the federal agency has made very little progress. They blame this on "confidentiality" issues that allow servicemen to opt out of the study.
High Level Bureaucratic Obfuscation
The whole process is classic bureaucratic obfuscation (definition: to make so confused or opaque as to be impossible to understand). If the Senate Armed Services Committee were genuine in their desire to end the deployment of medicated troops, they could have ordered (subpoenaed) the Department of Defense to turn their pharmacy and psychiatric records over to NIMH. The Pentagon, which rightly views the health of troops as a matter of national security, routinely overrules patient confidentiality for any number of reasons. Likewise the Senate could have enacted legislation ordering Obama to halt the deployment of troops on psychotropics. They chose to do neither.
They also decided against enacting legislation forbidding the deployment of troops with PTSD and other psychiatric disorders. Instead they issued a report expressing the "strong expectation" that the Pentagon would screen servicemen for PTSD prior to sending them to the front line. While the Pentagon claims to have improved their screening of new recruits, there seems to be no change in their practice of redeploying the 20-30% of troops developing PTSD and other mental health problems as a result of combat.
Thus in June 2011, Staff Sergeant Jared Hageman, who was hospitalized for PTSD in the psychiatric unit of Madigan Army Hospital at Fort Lewis, was ordered redeployed to Afghanistan for the ninth time -- and shot himself in the head (http://www.coffeestrong.org/).
Fast Forward to March 2011
In March 2011, the Military Personnel Subcommittee of the Senate Armed Services Committee held more hearings (http://www.nextgov.com/nextgov/ng_20100608_2900.php), specifically around the scandalous practice of deploying US troops on mind altering psychotropic medication. Sen. Benjamin Cardin (D-Maryland) quoted internal Army studies showing that 12% of troops in Iraq and 17% in Afghanistan had been prescribed antidepressants, sleeping pills or the antipsychotic Seroquel. The studies he cited revealed that as of early 2011, 5% of troops were still taking psychotropic medication.
The DOD: Breaching Their Own Guidelines
All antipsychotics are associated with extreme sedation, dizziness and cloudy judgment. Yet according to Army Surgeon General Eric Schoemaker, although US Central Command (CENTCOM) policy prohibits the use of the antipsychotic Seroquel to treat deploying troops with psychotic conditions, it permits troops to use it as a sleep aid. This is in clear violation of the 2006 "Policy Guidance for Deployment Limiting Psychiatric Conditions and Medications," issued by the Assistant Secretary of Defense for Health Affairs. The latter explicitly bans the deployment of troops taking medication for chronic insomnia. With good reason, as Seroquel has been implicated in the deaths of two Marines who died in their sleep after taking large doses.
It also came out in the March hearings that CENTCOM allows troops who deploy to combat a 180 day supply of psychotropic medication -- followed by a 180-day refill in the field. Col. John Stasinos, chief of addiction medicine for the Army surgeon general, and Col. Carol Labadie, pharmacy program manager for the surgeon general, defends this practice: "For soldiers on long term psychotropic medication, running out and not taking the medications can be as dangerous as taking too much."
CENTCOM Can't Track Prescriptions (they claim)
In response to questioning, Army Surgeon General Eric Schoemaker was unable to produce exact figures for the number of troops taking psychotropics (http://www.nextgov.com/nextgov/ng_20110303_5243.php?oref=topstory). Shoemaker claims that the defense department -- owing to inadequate funding -- has no way of tracking the prescriptions they issue -- either at the pharmacy level or in the AHLTA electronic health records of individual servicemen. His testimony, if true, totally violates basic standards of record keeping essential for good (and safe) medical care. It has extremely dire implications for health outcomes of GIs treated by military doctors.
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