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The Exact Opposite of Countercultural
February 15, 2011 11:30 AM   Subscribe

The Prozac, Paxil, Zoloft, Wellbutrin, Celexa, Effexor, Valium, Klonopin, Ativan, Restoril, Xanax, Adderall, Ritalin, Haldol, Risperdal, Seroquel, Ambien, Lunesta, Elavil, Trazodone War New York Magazine's Jennifer Senior writes on prescription drug (ab)use among soldiers and veterans of Iraq and Afghanistan.

Extended excerpt:
The first time I meet David Booth, a 39-year-old former medic and surgeon’s assistant who retired this past spring after nineteen years in the active Army Reserve, I make the awkward mistake of proposing we go out to lunch. It seems a natural suggestion. The weather is still warm, and he has told me to meet him in the lobby of his office downtown, so I assume he wants to go out, not back to his desk, when I show up around noon. But it turns out that in the six months he has been at his job, Booth has never left his office in the middle of the day, except to run across the street, and he is simply too polite to say so. From the moment we step outside, it’s clear how unusual this excursion is for him. As we walk, he hews close to the buildings on his right (“If a building’s to my right, no one is going to walk by me on my right”), and when we arrive at the restaurant, he quietly takes a seat at the table closest to the door, his back against the wall. His large brown eyes immediately start darting around.

“How’s your sleep?” I ask him.

“I don’t,” he answers.

Depending on the war, post-traumatic stress can have many expressions, but this war, because of its omnipresent suicide bombers and roadside explosives, seems to have disproportionately rendered its soldiers afraid of two things: driving and crowds. Movie theaters, subway cars, densely packed spaces—all can pose problems for soldiers, because marketplaces are frequent targets for explosions; so can any vehicle, because IEDs are this war’s lethal booby trap of choice. Booth manages his driving anxieties by leaving his Long Island home every morning at 4:30 a.m., when there’s no risk of traffic (especially under bridges, which militants in Iraq are always blowing up), and avoiding the right lane (in Afghanistan and Iraq, one generally drives in the middle of the road to avoid setting off IEDs). Once he gets to the city, Booth parks around the corner from his office and has managed to arrange his life so that he never encounters more than a handful of people. The only real logistical challenge is lunchtime, which he handles by ordering in, picking up from a grill across the street, or skipping entirely. I ask if he goes to restaurants in the off-hours. “Not very much,” he answers, pointing to two sets of scars, one near his jugular and the other stretching down his spinal column. “I reach for a glass, and I can’t feel pressure, so I’ll knock the glass over. It’s hard not to feel self-conscious.”
posted by l33tpolicywonk (50 comments total) 25 users marked this as a favorite

 
Yeah. If you want to begin to get a sense of what this war puts soldiers through, psychologically -- though, of course, you can't get a sense, not really -- I can't recommend Jim Frederick's Black Hearts strongly enough.

Among other things it may make you want to punch Brian De Palma in the mouth for Redacted (which I liked at the time).
posted by eugenen at 11:51 AM on February 15, 2011


Well, I'm going to guess that in previous wars it was the Johnny Walker, Jim Beam, Jack Daniels, case of Miller, Gordons gin, Mohawk Vodka, prescription pain killers, 3 packs of chesterfields a day war.
posted by spicynuts at 11:56 AM on February 15, 2011 [1 favorite]


Well, I'm going to guess that in previous wars it was the Johnny Walker, Jim Beam, Jack Daniels, case of Miller, Gordons gin, Mohawk Vodka, prescription pain killers, 3 packs of chesterfields a day war.

Grandpa?
posted by thsmchnekllsfascists at 12:10 PM on February 15, 2011 [3 favorites]


Uppers and downers have been around since WW2' at least.
posted by Ideefixe at 12:17 PM on February 15, 2011 [1 favorite]


Yeah, post-traumatic stress... Just imagine how many Iraqi civilians have the same problem.
posted by anarch at 12:19 PM on February 15, 2011 [11 favorites]


yes they have... Ideefixe - reminded me of this.
posted by zenwerewolf at 12:20 PM on February 15, 2011


Well, I'm going to guess that in previous wars it was the Johnny Walker, Jim Beam, Jack Daniels, case of Miller, Gordons gin, Mohawk Vodka, prescription pain killers, 3 packs of chesterfields a day war.

In WWII, a lot of soldiers learned to love the morphine that came in the first aid kits.
posted by Thorzdad at 12:22 PM on February 15, 2011 [1 favorite]


Yeah I guess what I was getting at is that previously the coping methods were just as destructive as the problems. Opinions aside about over-reliance on psych meds for the general population, doctor supervised use of mood stabilizers have got to be a step in a good direction on this stuff. I have not, as yet, finished the article though.
posted by spicynuts at 12:26 PM on February 15, 2011 [1 favorite]


Haldol is not a recreational drug. A psychiatric ER doctor I know decided to try it, after having prescribed a lot of it like everyone else. He almost completely stopped prescribing it after that.
posted by StickyCarpet at 12:30 PM on February 15, 2011 [3 favorites]


Yeah, post-traumatic stress... Just imagine how many Iraqi civilians have the same problem.

Sure. We could even have an FPP about them, if you'd like to step up and write one.
posted by fairytale of los angeles at 12:44 PM on February 15, 2011 [7 favorites]


StickyCarpet... especially intramuscular haldol... a "how did I wake up here?" drug.
posted by nutate at 12:45 PM on February 15, 2011 [1 favorite]


“At 24 years of age,” says a striking footnote on page one of the Army’s suicide report, “a Soldier, on average, has moved from home, family, and friends and resided in two other states; has traveled the world (deployed); been promoted four times; bought a car and wrecked it; married and had children; has had relationship and financial problems; seen death; is responsible for dozens of Soldiers; maintains millions of dollars’ worth of equipment; and gets paid less than $40,000 a year.”
posted by nutate at 12:53 PM on February 15, 2011 [6 favorites]


I think George W Bush was a horrible president.
posted by Daddy-O at 12:55 PM on February 15, 2011 [1 favorite]


By the far the drug most abused by WW II veterans was alcohol.
posted by clavdivs at 12:58 PM on February 15, 2011 [1 favorite]


nutate: “At 24 years of age,” says a striking footnote on page one of the Army’s suicide report, “a Soldier, on average, has moved from home, family, and friends and resided in two other states; has traveled the world (deployed); been promoted four times; bought a car and wrecked it; married and had children; has had relationship and financial problems; seen death; is responsible for dozens of Soldiers; maintains millions of dollars’ worth of equipment; and gets paid less than $40,000 a year.”

A lot of that would be pretty common among people of that age group.
posted by Mitrovarr at 1:01 PM on February 15, 2011


A lot of that would be pretty common among people of that age group.

Cept the 40k.
posted by thsmchnekllsfascists at 1:09 PM on February 15, 2011 [2 favorites]


at 24 I was finishing college.
posted by Shit Parade at 1:13 PM on February 15, 2011


thsmchnekllsfascists: Cept the 40k.

I bet nearly 95% of people are making less than 40k at 24. The only exceptions I can think of would be engineers and particularly successful IT people.
posted by Mitrovarr at 1:17 PM on February 15, 2011 [2 favorites]


"At 24 years of age,” says a striking footnote on page one of the Army’s suicide report..."

This cited passage is not remotely indicative of anything. It's pretty much how all young people from working-class families (the exact same demographic that attracts enlisted military) live with a few differences that are pretty obvious to anyone thinking of enlisting.

At 24 years of age a Soldier, on average, has moved from home, family, and friends and resided in two other states; has traveled the world (deployed);
That's pretty much what everyone expects. You join the military, you get sent other places that are not of your choosing.

been promoted four times
Great. Whatever.

bought a car and wrecked it
That's what young men do when they have disposable income. They all want cars, and men in their late teens/early 20s drive recklessly. The friends in their little hometowns have done the same thing except it was probably a truck.

married and had children
This is what people in the demographics that the military attracts do at that age, especially when they have a steady income. Again, their civilian friends back home have done the same thing (but probably without getting married)

has had relationship and financial problems
Just like their friends back home. They're generally from modest backgrounds that don't teach them to handle money. And early marriages statistically lead to more strife.

seen death
They joined an organization where you train with weapons and get sent to hostile countries and they've SEEN DEATH? That sounds pretty incredible. Assuming it's true, they probably had no idea that would happen despite the past eight years of foreign occupation that the US military has been involved in.

is responsible for dozens of Soldiers; maintains millions of dollars’ worth of equipment
Did they enlist hoping to not advance? Were they forced to take the position despite only wanting to oversee a couple soldiers and a Dremel? I think most people enlist hoping to further their leadership skills and responsibilities.

and gets paid less than $40,000 a year.
Or about twice what their high school friends back home are making at the Wal Mart distribution center. And the friends don't have access to health care.
posted by Mayor Curley at 1:18 PM on February 15, 2011 [4 favorites]


Mitrovarr: My buddy in Afghanistan has seen death in ways I never will.

At least he's on facebook, though.
posted by nutate at 1:20 PM on February 15, 2011


I bet nearly 95% of people are making less than 40k at 24. The only exceptions I can think of would be engineers and particularly successful IT people.

Which is why I said it. It's extremely uncommon for people that age to make more than that. Most of the other stuff is more common.
posted by thsmchnekllsfascists at 1:21 PM on February 15, 2011




"At 24 years of age,” says a striking footnote on page one of the Army’s suicide report..."

This cited passage is not remotely indicative of anything. It's pretty much how all young people from working-class families (the exact same demographic that attracts enlisted military) live with a few differences that are pretty obvious to anyone thinking of enlisting.


I find it very indicative, and i'm not sure if you're lacking imagination or if language has neutered your emotions. For one, working-class families is a great euphemism for poor or impoverished.

It has been said before, but having a professional military class, whose vast majority comes from the bottom 5th, in a democracy which has been at war for nearly a decade cannot be beneficial for our democracy.
posted by Shit Parade at 1:29 PM on February 15, 2011 [3 favorites]


Oh man, Ativan. That stuff is the amazing for making it so you can deal with anything. Nothing touches you on that stuff. You could watch your family burn in front of you and not feel a thing. The bad part is when you come off of it. The withdrawl is fast and harsh and makes everything THE WORST THING IN THE WORLD AND YOU CAN'T HANDLE IT.

I've done my share of psychotropic drugs in a recreational setting. Recently, after a hospital visit (respiratory failure, whee), they thought I had a sezure and put me on some anti-seizure meds. The psychotropic effects of Dilantina and Topomax were eerily similar to LSD, MDMA, and low grade speed that I had done when I was younger, only the effects were random and not consistent. I can't imagine why anyone would want to function like that, aside from someone who likes being screwed up in their head constantly and not have any control over their emotional states. Though I guess it's one of those "man, people will try anything to stay in an altered state as much as possible."
The worst part about it was the doctor that prescribed these drugs to me, a neurologist, wanted to put me on more and more of these drugs because of the supposed seizure. I've never had seizures nor do I have any of the symptoms of seizure disorders, yet he wanted to put me on a cocktail of insanely powerful medication, simply because I lost consciousness during a hypoxic episode (respiratory failure = blood oxygen level dropping below 70%). I'm still fighting with them to prove I don't have a seizure disorder.

Also, our military is kind of strange in how it deals with drugs use. Pilots are prescribed "Go Pills", basically medical grade speed. Prolonged use of those drugs is a surefire way to make someone mentally unstable. And then they prescribe more drugs to counteract the damage done from that. Somehow I don't think that's a good solution.

As for treating PTSD with some of these drugs. Yikes. I know the pills are cheaper than training and paying for good counseling, but I seriously doubt people will ever truly understand just how fucked up in the head a young person can get when they are exposed to death and violence as their job. I have a friend who served in Iraq and Afghanistan on 4 tours, and he came back a completely different person. He spent several years after he got out of the military at the bottom of a bottle. Then several more years trying to rebuild his own self image to that of someone who could function in civilian society. He failed at that and is now trying to join up with any private security firm that will send him overseas again. I somehow doubt he's going to live to see 30.
posted by daq at 1:38 PM on February 15, 2011 [6 favorites]


I bet nearly 95% of people are making less than 40k at 24.

I think that was the point of the statement: the soldiers are getting 40k, unlike their non-military peers.
posted by Civil_Disobedient at 1:38 PM on February 15, 2011


By the far the drug most abused by WW II veterans was alcohol.

This is true of the population as a whole, though, even today.
posted by something something at 1:46 PM on February 15, 2011 [1 favorite]


The thing that gets me about all this is how military psychiatrists are tasked with getting a trouble soldier functional enough to go back and fight. Not being able to engage in war is somehow indicative of illness that needs medical redirection, instead of a natural defense mechanism. Nothing really new, there, but still infuriating to me.
posted by Burhanistan at 1:55 PM on February 15, 2011 [7 favorites]


I think that was the point of the statement: the soldiers are getting 40k, unlike their non-military peers.


"...gets paid less than $40,000 a year."
posted by dersins at 1:55 PM on February 15, 2011 [1 favorite]


Mitrovarr: "thsmchnekllsfascists: Cept the 40k.

I bet nearly 95% of people are making less than 40k at 24. The only exceptions I can think of would be engineers and particularly successful IT people.
"

You know what; no one is shooting at or blowing up IT people (as a matter of their day-today); so this is pretty miserable right here. By all means pay them (soldiers) better than me or my other keyboard jokey brethren.
posted by NiteMayr at 2:04 PM on February 15, 2011 [2 favorites]


NiteMayr: You know what; no one is shooting at or blowing up IT people (as a matter of their day-today); so this is pretty miserable right here. By all means pay them (soldiers) better than me or my other keyboard jokey brethren.

My point was purely that it wasn't unusual for someone at 24 to make less than $40,000, no matter who they are. I didn't state an opinion on whether they deserve to or not.
posted by Mitrovarr at 2:11 PM on February 15, 2011


[Comment removed. Please find some way to make your point that doesn't involve HA HA I'M BEING IRONIC chucking of slurs around.]
posted by cortex at 2:19 PM on February 15, 2011


two Ps from the article:

The nature of this conflict is also quite unusual. As in Vietnam, the enemy blends in with civilians, rendering everyone a potential threat; but unlike in Vietnam, this war is fought in cities as much as in the hinterlands, which means soldiers are never allowed to mentally decompress. There’s no front in this war, and no rear either, which means there’s no place to go where the mortar rounds aren’t. “I was up at Walter Reed the other day,” Chiarelli tells me on the airplane, “and I ran into a young kid who lost both his legs, wayyyyyy up. I asked him, ‘How did it happen?’ You know what he said?” He pauses, looks at me intently. He’s big and barrel-chested, with crow’s feet so pronounced they look like they’ve been stamped into his temples with a fork. “He said, ‘Sir, I was standing in line at the PX to get shaving cream, and a 120-millimeter mortar came in and took off both my legs.’ ”

And on top of this unremitting combat anxiety, our soldiers have to cope with unremitting domestic anxiety of a sort that previous generations never knew, because these soldiers are Skype-ing with their families several times a week, even from the mountains of Afghanistan. At first, the Army believed this constant contact might help mitigate loneliness. Now, Chiarelli frankly acknowledges, he’s not so sure, “because technology just drags you back home, where your 22-year-old wife is having trouble finding a job and has a couple of kids she’s taking care of on her own.” Many soldiers are also addicted to Facebook, whose tagging function is proving a mixed blessing. “Soldiers are seeing pictures of their loved ones in bars, pictures of their loved ones in outrageous behaviors with sexual overtones,” says Colonel Kathy Platoni, a clinical psychologist in the Army Reserve who’s been deployed four times. “Everything they’re hanging on to is demolished. What’s sustaining them is torn away.”

posted by Shit Parade at 2:30 PM on February 15, 2011 [4 favorites]


A while back I saw one of those "let's follow this soldier through his training and deployment and so on for a while" features called "Ian Fisher, American Soldier", and it was very eye-opening for me. As per the discussion above, maybe not for others, but...

Besides his serial girlfriend-engagement thing (a few times, when he gets a girlfriend, they become engaged almost instantly, probably a reflection of that "in the now" moment), what really struck me was that this guy was a walking pillbox - they had him on a half-dozen, for all sorts of things. I was just very surprised to read this.

I got to see all the oscar nominated documentaries/short films over the weekend, and in one called Poster Girl this fact rose up, that this PTSD veteran was on, at one point, something like 30 different prescriptions.

Like I said, I am sure some people in here will rise up and go "of cuss, of cuss" and point out how long they new it, but that's been one of the most surprising things to me, the extent and breadth of pharmacological propping up of soldiers.
posted by jscott at 2:40 PM on February 15, 2011


posted by Shit Parade at 2:30 PM

Eponyster...uh, eponypressing.
posted by anarch at 3:36 PM on February 15, 2011


Have nothing to add to this conversation except to say that Ambien is great -- if you make yourself stay awake and write poetry on it. You will write some deep, penetrating shit. But never in my life would I use it for its intended purpose, unless I wanted to spend half of next day as an ambien zombie. Fuuuuuck that.
posted by Afroblanco at 4:06 PM on February 15, 2011


Mitrovarr wrote: "I bet nearly 95% of people are making less than 40k at 24. The only exceptions I can think of would be engineers and particularly successful IT people."

Nearly any profession (meaning that at some point you have to get a professional license) that has you working behind a desk will start at $40,000 right out of school. You have to remember that a soldier at 24 has likely been in the service for 6 years already.

It's a great gig, if you don't have to go fight in some godforsaken country and you get housing on base. Otherwise, not so much. Hell, even then it's not very nice, since you routinely hear of your buddies getting their appendages blown off or being killed. No, it's pretty much the worst kind of shit work imaginable this side of a third world slum and they get paid shit to boot. And there's not exactly the best job prospects if you decide to leave and go do something else.

It's like being a cop, only a hundred times worse on the fucked-up scale. (cops also see all kinds of fucked up shit, although they at least aren't as likely to die or be dismembered)
posted by wierdo at 4:35 PM on February 15, 2011


Afroblanco: "But never in my life would I use it (ambien) for its intended purpose, unless I wanted to spend half of next day as an ambien zombie. Fuuuuuck that."

Except it doesn't do that to everyone; like many (most?) other psych drugs, YMMV. For some people ambien is like pez candy, for others it's what you describe, for others in between. Not a cut at you at all Afroblanco -- I love to read what you write -- but even saying this might cause someone to not take or stop taking a medication that would help them, at least without qualifying that it's not for you but might be just fine for someone else.

Not wanting to be on these drugs, you betcha, no one wants it, there's so much societal shame around ANY sort of mental weaknesses or needs or whatever you want to call it. Someone has diabetes, people would say / will say that they would be / are not thinking clearly at all if they were to decide to not use insulin as prescibed, a medication which will let them live, and maybe live with some balance even.

And no one would ever even dream of trying to get off of it, or cutting down the dose once they establish a healthy baseline through taking the drug. But watch people respond to anti-depressants (and/or most any psych medications) and then want to get off them because they don't want to "lean on a crutch". Total bullshit but damned if it isn't deeply cut into society, and maybe every society, might take some time for humans to overcome this backwards idea...
posted by dancestoblue at 4:46 PM on February 15, 2011 [3 favorites]


Ok, why is it supposed to be surprising that soldiers with PTSD, depression and chronic pain are on meds? Why does taking a list of drugs similar to the list found in a celebrity OD scene mean anything— obviously, when someone overdoses, they are going to have a lot of drugs in them but that doesn't mean that taking multiple types of drugs always or even often produces overdose. Dose matters! Effectiveness matters! Correlation is not cause, etc.

If you are taking 20 different drugs and still have chronic pain, depression and can't sleep, maybe the problem isn't that you are taking 20 different drugs but that you aren't being given *the right* drugs. People are terrified of painkiller addiction— but you can't become an opioid addict unless you misuse the drugs [dependent yes, addicted no].

Addiction is much more likely to develop with undertreated and mistreated pain. People who are on a steady dose that works aren't likely to overdose— in fact, unless they add something new to the mix, their tolerance makes this quite difficult to achieve. On the other hand, people whose pain isn't being helped have incentive to take extra stuff on top and to commit suicide, whether it gets labeled that way or as an "accidental" overdose.

Meanwhile, however, doctors are free with antipsychotics which you can take exactly as prescribed and develop diabetes, obesity and/or permanent movement disorders.

And like dancestoblue says, why do we believe there's an inherent problem with needing a psych med to function when we have no problem with this when the problem is physical? Yes, polypharmacy can be a problem. Yes, it's better not to be dependent than to be dependent if it's possible to avoid it. But it seemed to me that the main guy in the story was doing pretty well given what he'd been through.
posted by Maias at 5:02 PM on February 15, 2011


What I would like to see is full disclosure. Full disclosure to all recruits coming through the door. They should be made to sit through a couple of hours of videos explaining what the life of a soldier amounts to these days - with regular updates, because times change and conditions change. Then they should be sent away with reading/study materials about this. Then, when they come back, they should be made to go through a test to see if they absorbed the material. Then they should be sent away for a month to think about this. If they come back and still want to sign up, fine.

I'm pretty hardcore about "you signed up for it, you live it" wrt. military service during peace time. But I also think that many 18 year olds are sadly not equipped to make a decision about signing up. It's only fair that they know what they are in for.

And fuck the chickenhawk politicians.
posted by VikingSword at 6:20 PM on February 15, 2011 [2 favorites]


I just joined the military with a job labeled "Mental Health Specialist". The intent is that people with my job will help people with the really scary jobs come back and reintegrate into society with a minimum level of damage. I truly, truly hope that I and others like me can make a difference. Watching this thread.
posted by Night_owl at 7:57 PM on February 15, 2011 [16 favorites]


Huge faves to you, Night_owl. Good luck, and here's me truly, truly hoping you make a difference.
posted by Ahab at 8:34 PM on February 15, 2011 [1 favorite]


seems to have disproportionately rendered its soldiers afraid of two things: driving and crowds. Movie theaters, subway cars, densely packed spaces...

I wonder what effect this will have on funding for communal and public spaces. These soldiers will grow up and become voters, and if they're afraid of public spaces, I'm guessing they'll be less likely to fund things like parks and public transportation.

I feel horrible about the traumatic impact these wars have had on our soldiers and the citizens of these countries, but the future impact is also concerning too.
posted by formless at 9:13 PM on February 15, 2011


You are clearly an optimist. Because if the lasting damage of these wars on our society is merely less funding for communal and public spaces, we will have gotten away with much more than we deserved.
posted by Bobicus at 11:42 PM on February 15, 2011 [1 favorite]


> I wonder what effect this will have on funding for communal and public spaces. These soldiers will grow up and become voters, and if they're afraid of public spaces, I'm guessing they'll be less likely to fund things like parks and public transportation.

Interesting thought, but I would wager the effect will be nil. The ratio of so-called "war fighters" to general military personnel is pretty low, and there ratio of military personnel to general voting population is even lower.
posted by Burhanistan at 7:25 AM on February 16, 2011 [1 favorite]


"if they're afraid of public spaces"

...and yet, statistically, veterans are far more likely to live in them.
posted by jaduncan at 8:10 AM on February 16, 2011 [1 favorite]


I can't believe I never realized some of this: for example, that soldiers back from Iraq or Af/Pak would be petrified of crowds and public places. That is one hell of a disability.

I mean, my generation came back from Vietnam mostly fucked up, although perhaps not as much due to the lack of redeployment, but at least they didn't have PTSD triggers like rice farmers or jungles to worry about.
posted by kozad at 11:53 AM on February 16, 2011 [1 favorite]


Not just crowds and public spaces, but trash by the road. Could be an IED.
posted by Burhanistan at 12:05 PM on February 16, 2011 [1 favorite]


If they're afraid of leaving their house, then they're not going to vote in the first place.
posted by autoclavicle at 3:20 PM on February 16, 2011


Where I live it's 'vote by mail' and you can register as an absentee voter other places.

But to get back to stuff that is likely to un-nerve returning veterans of the wars the US is in now, wouldn't they be at least a little twitchy around visibly Muslim
people?

A lot of major cities have large numbers of Muslims. Some smaller towns as well.

My town basically had like three Muslims when I moved here. Then the wars came and we wound up as an area where people who helped the US got resettled.

This is also a town that has a large military base and many soldiers call my town their home town.
posted by Katjusa Roquette at 3:46 PM on February 16, 2011


These soldiers will grow up and become voters, and if they're afraid of public spaces, I'm guessing they'll be less likely to fund things like parks and public transportation.

I'm honestly baffled that this is your response to the article. Soldiers are already voters, for one. And there are less than two million veterans of Iraq and Afghanistan. That's not even a percent of the population. I don't think you need to worry about parks and public transportation being defunded because of them.
posted by lullaby at 4:03 PM on February 16, 2011 [2 favorites]


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