White House Down (and Up)

January 24, 2024 7:07 AM

The White House has its own pharmacy—and, boy, was it shady under Trump [Ars Technica]

From the article: "[A]ccording to a recent investigation report from the Department of Defense’s Office of the Inspector General[PDF]... [f]or years, the White House Medical Unit, run by the White House Military Office, provided the full scope of pharmaceutical services to senior officials and staff—it stored, inventoried, prescribed, dispensed, and disposed of prescription medications, including opioids and sleep medications. However, it was not staffed by a licensed pharmacist or pharmacy support staff, nor was it credentialed by any outside agency."

Among the meds handed out like candy on Halloween were Provigil and Ambien. Former White House doctor Ronny Jackson, the subject of his own investigation and currently a congressman from Texas, was not mentioned in the report.

posted by Halloween Jack (61 comments total)

There's no evidence that White House residents and staff were actively dealing pills on the street during That Guy's time in office, but there's no evidence that they weren't, either.
posted by Faint of Butt at 7:36 AM on January 24 [10 favorites]

What the actual fuck?
posted by medusa at 7:38 AM on January 24 [10 favorites]

Ambien is a terrible drug, and when it was popular you'd hear all sorts of stories about people who have taken it doing all sorts of wild things they didn't remember. I once cared for a patient who had taken it, and then when he didn't fall asleep decided to get out his Sawzall and cut off a cast on his arm. He ended up cutting into his arm, luckily only superficially, but needed something like 100 staples to repair the wound.

It is particularly dangerous in older patients because of their lower clearance rates.

Combining Ambien with Provigil is a cocktail for psychosis.
posted by betaray at 7:42 AM on January 24 [24 favorites]

It sounds like they were getting just high enough to be...(takes off sunglasses) above the law. YEEEEEEEAAAAAAHHHHHH!!!
posted by zaixfeep at 7:45 AM on January 24 [54 favorites]

It's fascinating, in a perverse way, just how true the maxim is that no matter how bad we think it is with Donnie, it's always worse. And this is just even now -- in the fullness of time, when the civil wars are over, the generations following us are going to see some truly wild shit.
posted by Capt. Renault at 7:53 AM on January 24 [24 favorites]

> Ambien is a terrible drug, and when it was popular you'd hear all sorts of stories about people who have taken it doing all sorts of wild things they didn't remember.

"Not now Ambien Walrus, I'm trying to lose my car keys."
posted by genpfault at 7:56 AM on January 24 [32 favorites]

Kind of shocked TBH no mention of Viagra, etc, in the article or the report. JFK would not have put up with this lack of horniness.
posted by meehawl at 7:57 AM on January 24 [8 favorites]

I'm beginning to suspect that this Trump guy may not have the best interest of the American people at heart.
posted by dogbusonline at 7:59 AM on January 24 [32 favorites]

Ambien is a terrible drug, and when it was popular you'd hear all sorts of stories about people who have taken it doing all sorts of wild things they didn't remember.

I took Ambien once after drinking a bunch of wine, and I ended up going on Chatroulette and making fun of all of the dudes who had their weenies out. It was kind of awesome.
posted by grumpybear69 at 8:01 AM on January 24 [33 favorites]

Dr. Ronny Jackson is the one who gave Trump his cognitive test.
posted by dances_with_sneetches at 8:02 AM on January 24 [7 favorites]

And we scoffed when Roseanne Barr claimed racism was a side effect of Ambien.
posted by DirtyOldTown at 8:02 AM on January 24 [13 favorites]

More Ambien Walrus.
posted by zenon at 8:14 AM on January 24 [11 favorites]

People say all sorts of ridiculous things to me when I say I'm an anarchist.
Thing is, they're also anarchists, but in their minds "appropriate anarchism" only extends to the very rich and powerful.
posted by Baby_Balrog at 8:24 AM on January 24 [1 favorite]

Biden staff on cocaine, Trump staff on provigil, that's not the way I would have guessed things would fall out.
posted by dis_integration at 8:26 AM on January 24 [4 favorites]

"The White House has its own pharmacy—and, boy, was it shady under Trump"

This is my 'surprised' face.
posted by AsYouKnow Bob at 8:31 AM on January 24 [4 favorites]

It's too bad they weren't given more antipsychotics
posted by whir at 8:32 AM on January 24 [7 favorites]

JFK and Dr Feelgood.
posted by lalochezia at 8:51 AM on January 24 [3 favorites]

Superficially and 100 staples are not words that should share a sentence.

Does everyone know that cocaine is a prescription drug? At least in Canada it is. It's a vascodilator commonly used in nasal surgery.

Be interesting to see if it was handed out to any of the people not eligible for care.

White House Medical Unit senior officials estimated that its Executive Medicine clinic has 60 enrolled patients, but it provided care for 6,000 employees, potentially billing the DoD.

It not to often you see corruption two orders of magnitude greater than the legitimate service.
posted by Mitheral at 8:58 AM on January 24 [11 favorites]

Got that WMD here!
posted by McBearclaw at 9:01 AM on January 24 [14 favorites]

White House Medical Unit: We're too small to be a pharmacy
Report: Additionally, at the WHCA clinic, we observed a sign that read “Pharmacy” outside a room housing the MedSelect unit.
posted by misskaz at 9:01 AM on January 24 [4 favorites]

The report does repeatedly stress that they requested records for 2014-2018 for dispensed controlled substances, and only 2017-2019 were available from the White House Medical Unit and Walter Reed. The auditor for the medical unit has been the same since 2014. Page 34 summarizes some top-flight buck-passing about which agency oversees the unit, with the conclusion that there is no oversight above the level of the White House Military Office. They looked at transcripts of interviews with staff who served back to 2009. So while the records they have are for the Trump administration and there's no paper trail establishing that previous administrations were, say, swimming in amphetamines, it does raise some questions.
posted by figurant at 9:17 AM on January 24 [12 favorites]

Cocaine is a potent vasoconstrictor. So, in addition to its anesthetic properties, it's also good at stopping bleeding.

While cocaine will fuck up your nose, this vasoconstriction is particularly hard on your lungs because they are sacs of blood vessels. This creates a condition called "crack lung." I remember the first time I saw that in an intensivist's documentation.

I was going to say that it usually comes in solution and not as a powder in plastic baggies. However, the article says they were putting their little speed-ball kits in plastic baggies, so who knows?
posted by betaray at 9:18 AM on January 24 [3 favorites]

It not to often you see corruption two orders of magnitude greater than the legitimate service.

I guess the thing here is that we see it, not that it doesn't happen often.
posted by 43rdAnd9th at 9:22 AM on January 24 [2 favorites]

I'm not not licking toads.
posted by kirkaracha at 9:29 AM on January 24 [10 favorites]

Toads lick me for the hallucinogenic effects.
posted by dances_with_sneetches at 9:36 AM on January 24 [9 favorites]

TIL I learned about Ambien Walrus and I am delight

I also kinda want to try Ambien now and I don't think that that is the comic's intended effect
posted by Kitteh at 9:39 AM on January 24 [11 favorites]

Looking forward to "shooting at TV screens" and "dying on the toilet" as the next phase, bonus points for sequined jumpsuit.
posted by symbioid at 9:43 AM on January 24 [6 favorites]

Trump wants Ambien Walrus to run as VP

or so the machine elves sing to me
posted by MonsieurPEB at 9:44 AM on January 24 [7 favorites]

Can you imagine all the racist dog whistling if this had taken place under Obama?
posted by brundlefly at 9:46 AM on January 24 [15 favorites]

Whenever you lick a toad, you're licking every MeFite that toad has licked.
posted by Riki tiki at 9:52 AM on January 24 [3 favorites]

[Cocaine is] a vasodilator commonly used in nasal surgery.

A number of derivatives of cocaine in use as local anesthetics are fairly potent vasodilators.

In a comment some time ago I made the opposite mistake of assuming that because cocaine was such a good vasoconstrictor, those local anesthetics would be as well.

The mechanism for the difference might be as simple as cocaine activating a receptor which produces vasoconstriction, while the derivatives share cocaine's affinity for the receptor but don’t activate it, and are therefore good at blocking vasoconstriction, but I don’t know that to be the case.
posted by jamjam at 9:55 AM on January 24

I mean when you're rich, you can pay a doctor to prescribe just about anything. I worked with some Clinton WH staff post their days in office, and angels they weren't.

I hate Trump with a red hot passion, but I'm not surprised that people working under that heavy workload trying to defraud the US and destroy democracy were popping pills. I'm just surprised they did it under any actual government imprimatur rather than just having their lawyers or actual medical doctors give them whatever they wanted. They're so incredibly dumb with their methods, how do they keep getting away with shit?
posted by Abehammerb Lincoln at 10:02 AM on January 24 [6 favorites]

Kind of shocked TBH no mention of Viagra, etc, in the article or the report. JFK would not have put up with this lack of horniness.
posted by meehawl

You don't need Viagra when you're separating families at the border or front-loading the court system with hard-core sycophants.

"Stop! I can only get so erect!" --Dr Krieger
posted by zaixfeep at 10:03 AM on January 24 [7 favorites]

I thought I read somewhere that President George HW Bush, James Baker and other members of that administration were heavy users of Ambien as a means to cope with the irregular sleep schedules of the Presidency and all the international travel. I’m pretty sure this practice of handing out stimulants and sleep drugs goes back a long time before Trump.
posted by interogative mood at 10:06 AM on January 24 [6 favorites]

I take Ambien sometimes and all it does is help me sleep. I'm glad I don't get the exciting side effects, but also feel a little bit left out from the fun ones (versus the "try and cut off your own arm" cases).
posted by Dip Flash at 10:08 AM on January 24 [2 favorites]

I took Ambien to help me sleep, and it was very effective until it completely wasn't. I no longer take Ambien. Didn't have any wacky side effects either (that I know of).
posted by May Kasahara at 10:11 AM on January 24

Metafilter: Whenever you lick a toad, you're licking every MeFite that toad has licked.
posted by Catblack at 10:16 AM on January 24 [7 favorites]

A GP gave me Ambien on a daily dose to help suppress anxiety. Then I moved to another region and didn't get it anymore. Cold turkey off Ambien is real crazy town. I became a serious danger to myself and others. I would suggest being very careful with dosages and if you eventually stop using, make sure you have medical support.
posted by Abehammerb Lincoln at 10:17 AM on January 24 [6 favorites]

Combining Ambien with Provigil is a cocktail for psychosis.

Daily Provigil user here (18 years and counting): can confirm it does not pair well with Ambien.

I have some stories that I've posted to Metafilter:
The Frog Fort
Non-figuratively coming out of the closet
Channeling Edward Longshanks

When it works Ambien is amazing - no cognitive impairment the next day, subjectively feels like natural sleep in a way nothing else ever does. But if you stay awake longer than 20 minutes after taking it, you are going to trip bad, you will do and say things that are not just smashed-on-booze "your worst self" but full on "somebody else entirely," and when you wake up you will have zero memory of any of it. Not even the faintest glimmer of familiarity. Subjectively it is as close to self-induced possession as one could possibly hope for.

Provigil is 12+ hour caffeine without jitters, and if taken to excess a very mild anti-depressant. I take it every morning to counter the 15+ hour sleep requirement side effect of Lamotrigine. To its credit, Provigil has a very interesting natural anti-addictive property: because it only prevents your sleep cycle from activating (by walling off the ventrolateral pre-optic nucleus, IIRC) but does absolutely nothing to address the physiological symptoms of sleep deprivation, if you try to push past 24 hours you subjectively feel much worse than if you just tried to stay awake without Provigil. The more you abuse it, the shittier you feel (technically: the more you are aware of how shitty you feel physically, because you remain in a state of mental focus and clarity).

You can push it out to 72 hours with near-total lucidity if you absolutely have to, but you will hate every fucking second of the last 36 hour half of that. Neat stuff, I wish it were more generally available to the public for "actually I really have to push through some shit" once-a-month time management emergencies, but the 0.8% possibility of triggering Steven Johnson syndrome (DO NOT IMAGE SEARCH, it's effectively your immune system deciding your entire dermal sheath is a bad organ transplant) is not to be fucked with.
posted by Ryvar at 10:18 AM on January 24 [30 favorites]

It's a vascodilator commonly used in nasal surgery.

Definitely gonna start calling the bathroom at my local bar "Nasal Surgery Room 1" lol
posted by We put our faith in Blast Hardcheese at 10:28 AM on January 24 [5 favorites]

> Ambien is a terrible drug, and when it was popular you'd hear all sorts of stories about people who have taken it doing all sorts of wild things they didn't remember.

One evening years ago I received an email from one of the writers of an extremely well-known television comedy. He told me how much he loved my podcast, and he invited me to a table read, and proposed that we work together on a creative project. I try to be open to new opportunities, so I replied, in essence, 'Sure! What did you have in mind?' He replied the next morning that he had been on Ambien and had no recollection of sending the original message, nor what project idea(s) he had been thinking of. Oops, lol.
posted by Hot Pastrami! at 10:35 AM on January 24 [19 favorites]

"What did you do to my legs, you Nazi walrus bastard?!"
posted by Servo5678 at 10:36 AM on January 24

Can you imagine all the racist dog whistling if this had taken place under Obama?

It's incredibly naive to think all the bad stuff just happened to start exactly the same day as the beginning of the data provided by the White House and Walter Reed. Most of the people who actually run things in the WH don't actually work for the current administration and don't get hired nor fired by that administration.
posted by Back At It Again At Krispy Kreme at 10:41 AM on January 24 [10 favorites]

Mitheral: It's a vascodilator commonly used in nasal surgery.

By both the patient and the practitioners!
posted by dr_dank at 10:45 AM on January 24 [1 favorite]

And as far as Ambien goes, I had to take it leading up to some test ten years or so ago, and I was forced to lie to my doctor about having someone at home with me because one of the side effects he was hot about at the time was the possibility I might sleep walk my way into my kitchen and literally eat myself to death without waking up.

So while lots of people (myself included) have zero side effects, at least one person has gone to sleep and never woken up because they ate too much ice cream or whatever, so it's a good idea it's controlled substance.
posted by Back At It Again At Krispy Kreme at 10:47 AM on January 24 [1 favorite]

The brief week I was taking Ambien I woke up with a full smoked turduken in my fridge. I had to piece together via texts what had happened the night before.
posted by lizjohn at 10:51 AM on January 24 [16 favorites]

When it works Ambien is amazing - no cognitive impairment the next day, subjectively feels like natural sleep in a way nothing else ever does. But if you stay awake longer than 20 minutes after taking it, you are going to trip bad, you will do and say things that are not just smashed-on-booze "your worst self" but full on "somebody else entirely," and when you wake up you will have zero memory of any of it. Not even the faintest glimmer of familiarity. Subjectively it is as close to self-induced possession as one could possibly hope for.

See, this is the kind of side effect that frankly sounds kind of fun, but that just hasn't happened to me. I'll take Ambien if I wake up at 3am, then I'll lay there and listen to an audiobook while I try to go back asleep, which can take 30 minutes or more. I don't even lose track of the audiobook, much less get to experience any kind of gonzo flying high.
posted by Dip Flash at 11:07 AM on January 24

Back when the Dr. Ronnie Jackson craziness was being unearth, the Pod Save America guys mentioned that he would prescribe sleep aids and the like during international travel where everyone's sleep schedules were jumbled and they were in day-after-day of all day meetings while constantly changing time zones.
posted by mmascolino at 11:17 AM on January 24 [3 favorites]

I once asked my GP about Ambien when I was having trouble turning my brain off at night during peak dissertation writing stress, and her reply was "Sorry, but I wouldn't prescribe Ambien to my worst enemy."
posted by coffeecat at 11:21 AM on January 24 [4 favorites]

I don't even lose track of the audiobook, much less get to experience any kind of gonzo flying high.

Yeah to be clear what I wrote above is true for me: a person with extremely atypical neurochemistry such that it’s usually a coin toss whether the standard dose of any mind-altering substance has one-half-or-less impact vs double-or-more (Provigil is a rare case of doing exactly what it should, at the standard dose). And then both mood stabilizers and a wakefulness agent are added to the mix.

I know many other people experience similarly strange shit with Ambien, but there’s no guarantee. Personally the loss of control was terrifying, and the frog fort was my final straw with Ambien.
posted by Ryvar at 11:54 AM on January 24

was the possibility I might sleep walk my way into my kitchen and literally eat myself to death without waking up.

So while lots of people (myself included) have zero side effects, at least one person has gone to sleep and never woken up because they ate too much ice cream or whatever, so it's a good idea it's controlled substance.
posted by Back At It Again At Krispy Kreme at 1:47 PM on January 24 [+] [⚑]

Now I understand the username.
posted by ricochet biscuit at 12:01 PM on January 24 [8 favorites]

sleep drugs, whatev, give it up on the opioids and amphetamines. are not-pharmacists bound by hipaa? break out.
posted by j_curiouser at 12:12 PM on January 24 [2 favorites]

And as far as Ambien goes, I had to take it leading up to some test ten years or so ago, and I was forced to lie to my doctor about having someone at home with me because one of the side effects he was hot about at the time was the possibility I might sleep walk my way into my kitchen and literally eat myself to death without waking up.

A friend took Ambien and sleep ate, but not in a dangerous way, other than that having a 3rd meal in the middle of the night you don't remember eating is not wise from a calorie counting perspective. He quit taking it after a few weeks.
posted by The_Vegetables at 12:16 PM on January 24

I’m pretty sure this practice of handing out stimulants and sleep drugs goes back a long time before Trump.

George Washington grew hemp
posted by chavenet at 12:16 PM on January 24 [2 favorites]

Not surprised to hear that the government wasn't negotiating prescription drug prices down or using generics...
posted by shenkerism at 12:22 PM on January 24 [2 favorites]

Generic Provigil (Modafinil) was still ~$850 for a month’s supply when I was between insurers for six weeks a few years back. I haven’t had brand name Provigil since the patent expired in 2014, but I want to say the price without insurance was a few thousand USD for 30x200mg.
posted by Ryvar at 12:33 PM on January 24

Cocaine comes in a paste and as confirmed in an AskMe awhile back even though is Schedule II it is expensive and rarely prescribed given how tightly controlled it is. I am surprise actually to not see amphetamines and benzodiazepines on the list. Most high functioning, type-A executive types I know are definitely on a cocktail similar to what WH staffers were doing. Really after 40 it isn’t natural to have the energy and motivation of a 25 year old. That’s just called getting older.
posted by geoff. at 1:01 PM on January 24 [6 favorites]

Tired: The War On Drugs
Wired: The War, On Drugs
posted by credulous at 1:35 PM on January 24 [34 favorites]

For years, the White House Medical Unit, run by the White House Military Office...

Though a draft.... was completed in 2020, it sat under review in the White House Military Office until July 2023.

Fill in the blanks.
Now you heard the story. You will never hear the rest of the story. The story is done.
Done. Dusted. From here on, we can simply sweep it under the rug. Nobody will be prosecuted, nothing will be done; I wouldn't worry about it.
posted by BlueHorse at 5:28 PM on January 24

I guess that answers the "How do they sleep at night?" question.
posted by The corpse in the library at 3:35 PM on January 25 [12 favorites]

Added to the list of common ground with MAGA: That time I blacked out when mixing prescription drugs.
posted by JJ86 at 4:37 PM on January 26