It’s great that the military, the VA, and the mainstream media are giving more attention to the awful mental health problems plaguing soldiers and veterans. What's not so great -- in fact, awful -- is their continuing failure to recognize the role played by the military’s own toxic anti-malaria drug.
Until that occurs, the toll will continue to rise.
The federal government has a long and sorry record of ignoring, suppressing, and covering up the truth about the drug, called mefloquine and also known by the brand name Lariam. You can almost hear the silence as the Pentagon holds its collective breath in hopes that Sgt. Robert Bales, who allegedly went on a rampage last month in Afghanistan, killing 17 villagers and setting some of them, including children, on fire, was not prescribed the drug.
That answer will emerge in time, though many have wondered why the Army won't say so if he simply didn't take it. Either way, the renewed attention from the Bales case should not be allowed to pass without reprising the military’s unconscionable history with the drug it invented and licensed to Roche pharmaceuticals, and the role of other federal agencies, in particular the FDA and CDC, in approving and recommending it. This is important because the effects are far worse and far more frequent than the military cares to admit (just check the official product label for “suicide,” "hallucinations," "psychotic or paranoid reactions," and “aggression”), and because (also per the label) they can last “long after” someone stops taking it. In many cases, that means forever. What was once a problem for deployed soldiers is now a problem for more and more reservists and veterans every day.
It is also important because the failures surrounding this drug go straight to the issue of pattern and practice -- whether the federal government is doing its job in protecting citizens from unsafe medicines. (The drug's manufacturer, Swiss-based Roche, has much to answer for as well. It stopped distributing it in the U.S. a couple of years ago but a generic remains available.)
Mefloquine has been damaging U.S. troops often enough for long enough – since the Somalia action in the early 1990s, soon after the drug was hurriedly approved in 1989 – that there are now thousands of veterans with very clear mefloquine toxicity ranging from chronic dizziness to psychosis to unrelenting depression. Some of them – an undetermined but not insubstantial number – are now dead, and some of those have taken with them family, friends, and bystanders who happened to get in the way of a full-blown mefloquine rage.
Now the VA is adding hundreds of psychiatrists to help veterans with their mental health nightmares. Nicholas Kristof of the agenda-setting New York Times has called attention to the veteran suicide rate of one every 80 minutes. The drugging of service members with everything from Adderall to Prozac is being recognized for the problem it is. But a widely prescribed pill that can cause suicide and homicide? It is still strangely absent from this discussion.
The military will tell you it’s been on the case, but that is just spin. Yes, it dialed back on (but did not eliminate) the use of the drug in 2009; yes, it reminded medical officers earlier this year to follow prescribing information (and the Army followed up with an urgent memo just days after the Bales incident that looks a little suspicious).
But these concerns were clear years earlier, when the Army dug a deep hole and buried them. The low point came when it covered up – the right word – the role Lariam played in the murder-suicides at Fort Bragg in the summer of 2002 involving elite Special Operations soldiers returning from Afghanistan.
Within a couple of years, as tens of thousands more soldiers were ordered to take mefloquine in Iraq and Afghanistan -- and some started returning home -- the problems escalated. At United Press International, Mark Benjamin and I (teaming up with CNN) wrote on September 7, 2004:
“A startling pattern of violence and suicide by America's most elite soldiers has followed their use of a controversial anti-malaria drug, an investigation by United Press International and CNN has found.
In response, Sen. Dianne Feinstein said: "The Department of Defense, and all other government agencies that give this drug to their employees, should immediately reassess their decision to use Lariam and look for alternatives that can protect our troops without causing dangerous side effects."
But as we reported in the same article, the Army defended the drug “as both highly effective and safe for soldiers to take. Army medical officials declined requests for an interview but said in a written statement, ‘We have no data that indicate that Lariam was a factor in any Army suicides in Operation Iraqi Freedom and Operation Enduring Freedom (Afghanistan).’
“Instead, the Army said, the deaths were linked to ‘failed personal relationships, financial crises, legal difficulties and mental problems like depression and psychosis’ -- the same factors that trigger suicide in the general public, magnified by ready access to guns.”
Blame the victim, in other words. The worst case of that came in 2003, as The New York Times reported on November 5: "Not since the Vietnam War has the Army punished a soldier for being too scared to do his duty. But on Friday, Sgt. Georg Andreas Pogany will appear in front of military court here to face charges he was a coward." That was punishable by death, but after it was established he took Lariam and suffered a psychotic break as a direct result, Pogany fought the Army to a standstill, got the charges dropped and received an honorable discharge for medical reasons. He went on to fight for other soldiers and vets.
The truth was as obvious a decade ago as it is now. A drug that can make people kill should not be given to soldiers. It should not be given to anyone. Way back in 2002, we talked to Gerald F. Meyer, former deputy director of the FDA's Center for Drug Evaluation and Research.
"I do not know of any product that would be allowed to generate a psychosis that could stimulate someone to commit murder and be an approved drug," said Meyer, who was not familiar with Lariam but an expert on drug safety. "I do not know of any, and I cannot imagine one."
Dan Olmsted is Editor of AgeofAutism.com and co-author, with Mark Blaxill, of The Age of Autism – Mercury, Medicine, and a Man-Made Epidemic. With Mark Benjamin, he wrote a series of articles on mefloquine side effects for UPI from 2002 to 2004. Their investigation of the drug’s impact on U.S. soldiers was named Best Wire Service Reporting by the National Mental Health Association. [email protected].