The silencing of soldiers.

• Author: Calhoun, Laurie
• Position: Essay

On August 17, 2010, veteran National Guardsman Matthew Magdzas shot and killed his wife, April, their daughter, Lila, the family's three dogs, and then himself. For his post-traumatic stress disorder (PTSD) symptoms, including back pain for which no physical cause was identified and haunting, recurrent nightmares, Magdzas had been prescribed Lcxapro, Ultram, and Clonazepam. One hundred and twelve other National Guardsmen also took their lives in 2010, the rate of suicide among that group having increased by 450 percent since 2004. (1)

One facet of PTSD is simply the generalized inability to readjust to a nonwar environment after deployment. Veterans often become adamant, as did Magdzas, about having loaded guns ready at hand for purposes of self-defense, though there is usually no plausible threat anywhere near their typically suburban neighborhoods. A further contributing factor is the general alienation experienced by war veterans who simply cannot relate to ordinary people--those who have not lived through the exceptionally stressful experience of combat and have no idea what the veterans have been through. The Guardsmen, sometimes referred to as "weekend warriors," arc particularly vulnerable to alienation upon their return home from active combat duty because they do not have access to the sort of support system that full-time, career soldiers may find among their similarly situated comrades after deployment. Soldiers who, unlike the draftees of Vietnam or the National Guardsmen, return to military bases after tours of duty abroad may benefit from an informal type of "talk therapy" simply by communicating with their buddies about their similar, often harrowing experiences.

However, record numbers (and percentages) of the regular-force veterans of the wars in Afghanistan and Iraq have also committed suicide ("Army to Report" 2009). Many of the soldiers who have taken their own lives, like Magdzas, were prescribed a battery of medications intended to ameliorate their PTSD symptoms. Some of the drugs being provided to soldiers are known to increase violent and specifically suicidal tendencies, as is clearly printed in the contraindications that accompany the prescriptions. The U.S. Food and Drug Administration (FDA) now requires that the packaging of antidepressants in particular include explicit warnings about these dangers. But rather than examining what role the drugs themselves might have played in the decisions of so many young veterans to end their lives--ironically, after having survived life-threatening tours of duty--the emphasis in reporting is on the lack of an adequate support system in civil society after deployment. The problem of soldier alienation has existed for as long as wars have been fought abroad, but it appears to have become much worse in the twenty-first century than it was in the past, judging by the record percentages of troops who have committed suicide.

It is easy to ignore the possible contribution of prescription medications to the plight of soldiers such as Magdzas because they have suffered more than sufficient trauma and stress to explain their decisions to end their own lives. Indeed, in a perverse sort of self-confirmatory circle, such drugs are prescribed for symptoms that often include suicidal tendencies, thus providing an ironclad defense against any allegation that the drugs themselves might have contributed to the tragic ends to which some of the soldiers under their influence finally came. This curiously impervious logic is equally applicable to and helps to explain the trend in society more generally toward the increasing use of psychiatric medication in lieu of analysis and nonmedicinal therapies in treating persons who seek professional help with their psychological problems. (2) The "pro-med" trend has been accelerated and intensified by recent changes in insurance policies to cover drug therapy but not talk therapy, thus providing psychiatrists with a strong financial incentive to opt for the use of drugs in treating their patients. When a patient's health insurance policy covers drugs but not dialogue, many doctors will write prescriptions rather than lose a client. (3)

In the case of veterans' suicides, rather than acknowledging that the disorientation caused by an overload of prescription drugs in the system--or even a modest dose of what are psychotropic, mind-altering agents--may have led soldiers to take their own lives, advocates of the therapeutic use of such medications maintain that, in fact, they have prevented even more tragic deaths from occurring. This hypothesis is difficult to refute, the counterfactual claim being that if fewer soldiers took the drugs, even more suicides would occur. Any attempt to test such a hypothesis, by withdrawing drugs from the persons currently under medication, would be interpreted by the drugs' advocates as irresponsibly placing the patients in even greater danger of seeking a solution to their trauma and anxiety through self-inflicted death.

Although it is thus simple to write off suicides as directly caused by the mental instability for which medications were prescribed, in some cases it cannot be denied that the drugs themselves physically caused soldiers' deaths. Marine veteran Andrew White died in his sleep of a prescription medication overdose on February 12, 2008. White had been prescribed Klonopine and Hydrocodone in addition to Seroquel, the dose of which had been increased from 25 milligrams to 1,600 milligrams over the course of the six months during which he had sought relief from his PTSD. (4) Another former marine, Corporal Chad Oligschlaeger was found dead in his barracks of a prescription drug overdose on May 20, 2008--"multiple drug toxicity" being the official cause of death. For his various problems, most of which were symptoms of PTSD, Oligschlaeger had been prescribed Seroquel, along with Clonazepam, Zoloft, Lorazepam, Inderal, and Chantix. Seroquel, a drug being widely prescribed to soldiers before, during, and after their service, is a psychotropic medication whose psychiatric uses include the treatment of schizophrenia, bipolar disorder, mania, and depression, but it is provided to soldiers as a sleep aid. The other drugs on Oligschlaeger's prescription list are used to treat depression, anxiety, high blood pressure, and smoking addiction. (5)

The potential interaction effects of such "multi-med cocktails" are unpredictable and may prove, as in White and Oligschlaeger's cases, to be deadly. Yet drugs have become "the answer," according to the Veterans Administration (VA). Indeed, drugs are liberally prescribed to soldiers even preemptively, before they go to war, at the slightest expression of anxiety. According to a June 2010 internal report from the Defense Department's Pharmacoeconomic Center in San Antonio, Texas, 20 percent (213,972) of 1.1 million active-duty soldiers surveyed were taking medications such as Seroquel and 125 other psychotropic drugs currently being prescribed (Brewin 2011a, 2011b). Even highly addictive substances such as Valium and Xanax are readily available to soldiers who manifest anxiety--a perfectly normal reaction to the extraordinary nature of their experience--before, during, and after their service.

Once the patients' systems have become accustomed to these drugs, those who abruptly stop taking them may suffer severe withdrawal symptoms. For this reason, soldiers are provided with lengthy, easily renewable prescriptions in order to ensure that their ability to perform is not disrupted during their tours of duty. By receiving prescriptions even before going to war, soldiers thus become regular users of drugs that they may never have taken or had access to before their service. All of this amounts to a financial coup for the pharmaceutical firms that furnish drugs to the Pentagon through enormously lucrative contracts, the most obvious effect of which is to incline military physicians to prescribe the medications: they are already in abundance, ready at hand, and a part of standard protocol. Pentagon contracts are posted daily online, but to give a sense of the magnitude of the financial interests at stake, on March 31, 2010, alone, Cardinal Health, Inc., was awarded two contracts in the amounts of $315,552,575 and $20,056,210; DMS Pharmaceutical Group was awarded contracts for $35,137,641 and $34,101,402; AmerisourceBergen Drug Co. received $20,049,630; and Dakota Drug Company, Inc., garnered $17,892,000. All of these contracts were for pharmaceuticals (U.S. Department of Defense 2010).

Although the dispensation of drugs to soldiers has reached an unprecedented level in the twenty-first century, with prescriptions now provided readily on request, the "medication" of soldiers took place also in Vietnam, the difference being that the free-flowing drugs in that conflict were not written into Pentagon contracts and furnished by the military and the VA. Still, the popular drugs of that era--including marijuana, LSD (lysergic acid diethylamide), and heroin--were readily available to soldiers. Although during the Vietnam War the Pentagon had an official antimarijuana policy, the policy ultimately had the effect of promoting the use of highly addictive heroin, which was readily available in pure form for a pittance in Vietnam. As a result, many veterans returned to their homes with a serious addiction to a hard drug, having smoked the opiate during their service in order to make their experience more bearable (Brush 2002).

The soldiers of earlier wars, including World War II, often had reputations as heavy drinkers easily provoked to anger and involved in drunken brawls during their leaves. Whether through alcohol, illegal recreational drugs, or prescription medications, many soldiers have sought a psychological release from the harsh reality that their deployment entails. It would be a mistake, therefore, to focus on a moral critique of the use of drugs...