After two long-running wars with escalating levels of combatstress
, more than 110,000 active-duty Army troops last year were taking prescribed antidepressants, narcotics, sedatives, antipsychotics and anti-anxiety drugs, according to figures recently disclosed to The Times by the U.S. Army
surgeon general. Nearly 8% of the active-duty Army is now on sedatives and more than 6% is on antidepressants — an eightfold increase since 2005.
"We have never medicated our troops to the extent we are doing now.... And I don't believe the current increase in suicides and homicides in the military is a coincidence," said Bart Billings, a former military psychologist who hosts an annual conference on combat stress.
The pharmacy consultant for the Army surgeon general says the military's use of the drugs is comparable to that in the civilian world. "It's not that we're using them more frequently or any differently," said Col. Carol Labadie. "As with any medication, you have to look at weighing the risk versus the benefits of somebody going on a medication."
But the military environment makes regulating the use of prescription drugs
a challenge compared with the civilian world, some psychologists say.
Follow-up appointments in the battlefield are often few and far between. Soldiers are sent out on deployment typically with 180 days' worth of medications, allowing them to trade with friends or grab an entire fistful of pills at the end of an anxious day. And soldiers with injuries can easily become dependent on narcotic painkillers.
"The big difference is these are people who have access to loaded weapons, or have responsibility for protecting other individuals who are in harm's way," said Grace Jackson, a former Navy staff psychiatrist who resigned her commission in 2002, in part out of concerns that military psychiatrists even then were handing out too many pills.
For the Army and the Marines, using the drugs has become a wager that whatever problems occur will be isolated and containable, said James Culp, a former Army paratrooper and now a high-profile military defense lawyer. He recently defended an Army private accused of murder, arguing that hismental illness
was exacerbated by the antidepressant Zoloft
"What do you do when 30-80% of the people that you have in the military have gone on three or more deployments, and they are mentally worn out? What do you do when they can't sleep? You make a calculated risk in prescribing these medications," Culp said.