Army Suicide Report Ignores Suicide-Producing Drugs

Why are troops killing themselves?

The long awaited Army report, “Health Promotion, Risk Reduction, Suicide Prevention” considers the economy, the stress of nine years of war, family dislocations, repeated moves, repeated deployments, troops’ risk-taking personalities, waived entrance standards and many aspects of Army culture.

What it barely considers are the suicide-inked antidepressants, antipsychotics and antiseizure drugs whose use exactly parallels the increase in US troop suicides since 2005.

In the report Chief of Staff General Peter W. Chiarelli acknowledges antidepressant risks, saying there’s “fair quality evidence that second generation antidepressants (mostly SSRI) increase suicidal behavior in adults aged 18 to 29 years” while adding that “other research evidence shows the benefit of antidepressant use.”

But nowhere does he acknowledge the suicide potential of antiseizure drugs so widely used for pain and as “mood stabilizers” by troops even though the FDA mandated suicide warnings on Lyrica, Topamaz, Depakote, Lamictal, Tegretol, Depakene, Klonopin and 16 others in 2008.

(Lamictal also has the distinction of wasting more taxpayer money than any other drug according to a July American Enterprise Institute report. Medicaid spent an unnecessary $51 million on Lamictal instead of buying a generic last year, thanks to GSK salesmen. You go, guys!)

When asked by NPR’s Robert Siegel if the high number of medicated troops contributed to suicide, Gen. Chiarelli said, “The good thing about those numbers is… the prescriptions were all made by a doctor.” Asked why troops who had not even deployed were among the suicides, Chiarelli said there were other stressors involved.

In June Marine Times reported 32 deaths on prescription drugs in Warrior Transition Units (WTUs) since 2007 and said an internal review “found the biggest risk factor may be putting a soldier on numerous drugs simultaneously, a practice known as polypharmacy.”

But instead of citing dangerous drugs and drug cocktails for turning troops suicidal (and accident prone and at risk of death from unsafe combinations) the Army report cites troops’ illicit use of them along with street drugs. (The word “illicit” appears 150 times in the Army report and “psychiatrist” appears twice.)

No, it’s not the 8,000 urine samples in 2009 which showed prescription drug traces according to the Army report — it’s the fact that 21 percent of the drugs were “illicit.”

No wonder the revised suicide report form suggested by the Army report doesn’t even have a box to enter “adverse reactions to drug or drug combinations.” Instead, it has a box that asks how long before a suicide a patient was “compliant” with the prescription. Was the medication “taken as prescribed? Skipped?” Taken “In excess of prescription? In different manner (e.g., crushed instead of in capsule)?”

Nowhere is there the possibility that the medication was taken as prescribed and compliance not noncompliance was the problem.

On the same day the Army report was released, another suicide report which ignores the elephant in the room called Big Pharma was released.

In response to a request from the Illinois Department of Juvenile Justice for help after the recent suicides of two youths in two of its eight WTU-like facilities, the Illinois Models for Change initiative compiled a “Report on the Behavioral Health Program for Youth Committed to Illinois Department of Juvenile Justice.”

Like the Army report, the Juvenile Justice report notes lack of staff training and resources, lack of assessment tools, lack of aftercare, family problems and repeated moves and dislocations to explain suicides without mentioning suicide-causing psychoactive drugs themselves.

The team of mental health and corrections professionals mentions youths who fail to “follow the medication orders” and revert to street drugs but nowhere in the 146-page report are the health and mental health effects of psychoactive drugs mentioned. Even though 98 percent of youth at one facility are on them, according to the report! Denial is not just the name of a river in Egypt.

Worse youth are screened for suicide when they enter facilities not after they’re put on psychoactive drugs.

The report explores poor food and dorms with no electric sockets so youth “cannot have TVs in their rooms and only walkmans” and visitor policies, but doesn’t pursue the one reference to psychoactive drugs: the youth who says he is pretty much “knocked out” on the antidepressant Trazadone they give him.

Like the Army report, the Juvenile Justice report ignores the pharmaceutical elephant in the room and the tax dollars and human costs of feeding it.

Martha Rosenberg is a columnist/cartoonist who writes about public health. Her first book, titled Born with a Junk Food Deficiency: How Flaks, Quacks and Hacks Pimp the Public Health, has just been released by Prometheus Books. She can be reached at: martharosenberg@sbcglobal.net. Read other articles by Martha.

11 comments on this article so far ...

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  1. franco_american1962 said on August 3rd, 2010 at 9:42am #

    I have read much in the way of psyche critique, including the “anti-psych” literature of the 1960s and early 1970s (Foucault, Laing, Cooper, et.al.) Both the “old- guard” left, and the “new- left”, anti-drugging critique accept the “reality” of madness as the coin of the realm. Both “positions” admittedly have a different take, principally Marxist and Liberal-statist, respectively. I am a Libertarian-Humanist, as T. Szasz, and disagree with madness as disease. Rather, I see psychiatriy’s mission as that of medicalizing ” problems in living”, and of transforming moral values into health values.

    I think that the singlemost confounding issue on this present debate, is the manner in which the myth of mental illness informs this “dialogue”. Whether one is speaking of the old-guard, Marxist left, as in the likes of Laing,Cooper Foucault, or, the new-left, anti-drug critique, as articulated by the likes of P. Breggin, and R.Whitaker, the result is as predictable as it is expectable: mental illess qua disease-state is still the coin of the realm.

    The transformation of moral values into health values, has unquestionable been the bane of our culture, where “problems in living” have become any one of present mental illnesses or, that weasel term, disorder. It is indeed lamentable to see such unanimity, however, given such a captive audience, its no surprise that any liberal psychiatrist can, simultaneously, expiate personal guilt, and find a means of taking credit for having reinvented the wheel that is psychiatry. This is what liberal psychiatry wants more than anything: that of social engineer. And I believe, to date, it has been a resounding success.
    I fear that the only outcome of this “over-medicating” critique will be a consolidation of the psych profession in general. Little will actually change, as the force and coercion now deployed by the psych enterprise will go unabated. Plus ca change.

  2. BartFargo said on August 3rd, 2010 at 11:21am #

    Alright then franco_american, how do you suggest individuals go about solving their “problems in living”?

    Realize that most schizophrenics are completely unaware they have any “problem in living” at all, even though they may have lost their job, home, and family as a result of their “problem in living” and are now sleeping on a park bench and experiencing persistent malnutrition, pneumonia and skin infections. Many will even actively refuse medical attention of any sort.

    Or how about the person suffering from a bipolar “problem in living” who during the manic phase simply doesn’t want to solve their “problem” because they feel so good- despite the fact they’ve spent away their life savings, caught a few STDs as a result of promiscuous sex, and engaged in risky behavior like using IV drugs during their episode.

    Or the person experiencing the “problem in living” of serious depression, who may lack any hope, confidence, or even energy to try and better his condition and instead stays in bed for a week or two at a time.

    Or the person experiencing the “problem in living” of epilepsy- which is what many of the drugs mentioned in the above article are used to treat. Seizures are physically demonstrable and potentially life-threatening phenomena that demand attention. Since surgical ablation of the epileptogenic center invariably leads to side effects, medication and avoidance of triggers are currently the only other options. That antiseizure drugs have an increased risk of suicide is regrettable, but the risk of death from uncontrolled epilepsy or uncontrolled bipolar disorder is much greater.

    Medication can only go so far in treating any patient- the need for one-on-one, group, and family psychotherapy still exists and should always be an integral part of psychiatric therapy. But medications likewise also have their place in psychiatric medicine, enhancing the gains made during therapy sessions, and (to put it broadly) giving the patient the strength and stability needed to cope with or overcome their disorder.

    Something tells me you have very little knowledge of the fields of mental health and neurology, (beyond what you’ve read in one-sided critiques of it) nor do you have much experience interacting with patients suffering from mental or neurological disorders, and so instead you simply play semantics couched in pseudo-intellectual abstractions that fit your anti-pharma agenda.

  3. franco_american1962 said on August 3rd, 2010 at 1:11pm #

    Alright then franco_american, how do you suggest individuals go about solving their “problems in living
    Anomy and the loss of the individual. Perhaps it is no fault of your own, however, maybe you ought not search for the oracular. May I suggest first understanding the “complementarity responsibility and liberty”. No appeal to the “collective” will solve the problem of the first statement of this response, but neither will the individual giving his social, political, and economic destiny to a some collectivist, statist bureaucrats. Yes, in regards to an individualistic, and practical working democracy, I am most reactionary. I defend the Constitution, and the rule of law, not the agenda of a world order “rational planning”, heavy on the “class-struggle” (what is class identification in America? Is it merely of the “corporate” and the rest of us? Might I suggest you read Frederick Hayek’s, “Constitution of Liberty”, or Karl Popper’s ‘The open society and its enemies”- both volumes being a most enjoyable and enlightening read.

  4. franco_american1962 said on August 3rd, 2010 at 1:15pm #

    I have to remember that I tend to be a sloppy typist! I trust that what I shared might add and not detract from any debate over the ameliorative.

  5. franco_american1962 said on August 3rd, 2010 at 1:24pm #

    Sorry, dude, I thought I was responding to another one of my posts. Now I really feel stupid. I cannot nor will not try to answer your emotional response, as there is just too much for me to respond to in kind-and my pain meds are muddling my thinking. I can say this, however. If you look at your “faith” in psychiatry as you would, say, of a religious faith, you and I could not conceivably touch base on any commonality of view and outlook. I suggest that if you are really steeped in the myth of mental illness, and you persist in seeing “problems in living” as that of a diseased “mind” (a verbal, by the way), then you have every right to ascribe to this moral view; after all, true liberty demands that you follow your conscience!

  6. franco_american1962 said on August 3rd, 2010 at 1:30pm #

    Or how about the person suffering from a bipolar “problem in living” who during the manic phase simply doesn’t want to solve their “problem” because they feel so good- despite the fact they’ve spent away their life savings, caught a few STDs as a result of promiscuous sex, and engaged in risky behavior like using IV drugs during their episode.
    So where is the disease in all this, other than the obvious, physical ones? This is morality, passing as medical. I suspect that someone as this would be “subject” to treatment, under the “right to treatment” law? The latter would most certainly be a logical conclusion to draw, especially if this person’s behavior is troubling and troublesome…to others.

  7. BartFargo said on August 3rd, 2010 at 3:47pm #

    Uh, no, it’s not morality masquerading as medicine, since there is obvious, objective damage done when someone is left bankrupt, infected with gonorrhea or chlamydia or potentially something far more serious, and has taken the first steps toward developing a dependence on IV drugs (which carries all sorts of other objective health risks like addiction, Hep B, HIV, endocarditis) following a prolonged manic episode. I should also mention that during manic episodes patients may go out of their way to break the law, committing brazen acts of theft and violence because they feel invincible. Depending on how mania manifests itself in an individual, a patient could easily become a danger to himself and others, and in that case any doctor or psychiatrist who is acting in that patients’ best interest should intervene before more harm can be done- just as needs to be done for a suicidal patient.

  8. franco_american1962 said on August 3rd, 2010 at 6:42pm #

    I am personally acquainted with the anti-seizure medications used as anti-depressants. As for your response in kind, you obviously missed the entire thrust of my argument. Good luck with your personal weltanshauung.

  9. BartFargo said on August 4th, 2010 at 5:31am #

    Then you’re acquainted with bad science and bad medicine, because none of the anti-seizure drugs are approved as anti-depressants. Some of them are approved only as mood-stabilizing drugs, which is a far different from having an anti-depressant effect. Keep tilting at windmills, since you obviously have no idea what you’re talking about.

  10. BartFargo said on August 4th, 2010 at 5:39am #

    And it’s easy to miss the thrust of your argument because you don’t have one- it’s just a bunch of hand-waving and pseudo-intellectual vocabulary. When you’re confronted on the nonsense, you say the obvious, logical truth is just inconsistent with your “enlightened” (hah!) worldview. Give me a break.

  11. franco_american1962 said on August 7th, 2010 at 11:08am #

    This discussion does not concern itself, as you seem to believe, with any scientific worthy discussion. The real discussion of institutional psychiatry in modern culture, is more so a moral discussion, passing off as medical. The latter is truly what I allude to as psychiatry as the social and political tranquilizer. I would not dare or care to lower my moral outlook on psychiatry to suit your medicalizing the moral and social.