DRUG CHIARELLI MEMO PDF

Army commanders aren't punishing for discharge or demanding treatment for soldiers testing positive for substance abuse, a top Army official said. In a memo, Gen. Peter Chiarelli , the Army's vice chief of staff, said hundreds of soldiers involved in "substance abuse-related misconduct," including multiple drug-test failures, weren't processed for possible discharge, USA Today reported Thursday. He also said many weren't referred to the Army Substance Abuse Program, either. During a meeting this week with Army officials, Chiarelli said he was most concerned that "commanders feel a requirement to keep their numbers up" for combat deployments, the newspaper said. He said learned of this attitude when he visited Army installations to examine strain on soldiers and address the record number of suicides reported in the Army.

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By Bob Brewin. This is the first story in an ongoing series. Army leaders are increasingly concerned about the growing use and abuse of prescription drugs by soldiers, but a Nextgov investigation shows a U. Central Command policy that allows troops a or day supply of highly addictive psychotropic drugs before they deploy to combat contributes to the problem. Drug formulary includes drugs like Valium and Xanax, used to treat depression, as well as the antipsychotic Seroquel, originally developed to treat schizophrenia, bipolar disorders, mania and depression.

Read the entire Broken Warriors series. Although CENTCOM policy does not permit the use of Seroquel to treat deploying troops with these conditions, it does allow its use as a sleep aid, and allows deployed troops to be provided with a day supply, even though the drug has been implicated in the deaths of two Marines who died in their sleep after taking large doses of the drug.

The Army endorsed Seroquel as a sleep aid in the May report of its Pain Management Task Force, which, among other things, called for a reduction in the number of prescription drugs given to troops.

An appendix to that report recommended taking Seroquel in either or milligram doses for sleep disorders. Grace Jackson, a former Navy psychiatrist, told Nextgov she resigned her commission in "out of conscience, because I did not want to be a pill pusher.

Peter Breggin, an Ithaca, N. The Army implicated prescription drugs as contributing to suicides in a July report , which said one-third of all active-duty military suicides involved prescription drugs.

When the suicide report was released, Gen. Peter Chiarelli, the Army's vice chief of staff, said the service needed to develop better controls for prescription drugs. Carol Labadie, pharmacy program manager in the Directorate of Health Policy and Services for the surgeon general, said soldiers are supplied with up to days of medications because they "serve in remote areas without easy access to pharmacies.

It is important that soldiers on chronic medications do not run out of them during combat operations, because not taking the medications can be as dangerous as taking too much medication.

Abuse of prescription drugs, Stasinos and Labadie said, can be prevented by improved communication among health care providers, soldiers and commanders. Comprehensive reviews of soldiers' medication profiles by pharmacists are another way to prevent abuse, they said. The statement from Stasinos and Labadie added that it is possible that troops could receive a day supply of more than one psychotropic medication. Navy Lt. He said the drug-supply policy for deployed troops was "established to ensure personnel who required these medications had an adequate supply before deployment to last through pre-deployment activities and training as well as travel to theater and initial deployment phase.

He added, "Some of these medications can cause duty-limiting side effects if they are withdrawn abruptly [i. This policy prevents that from occurring. Speaks said, "Abuse is always a possibility the prescribing clinician must consider The Army's suicide report drew a link between a significant increase in prescription drug use among troops and the service's rising suicide rate.

It also raised serious concerns about troops trafficking in prescription drugs. Jackson, the former Navy psychiatrist, now has a civilian practice in Greensboro, N. She said at least one drug on the CENTCOM formulary -- Depakote, an anticonvulsant, which military doctors prescribe for mood control -- carries serious physical risks for troops.

Depakote is toxic to certain cells, including hair cells in the ears, and can lead to hearing loss. Troops in a howitzer battery who already run the risk of hearing loss should not take Depakote, she said. The medication also can cause what she calls "cognitive toxicity," also known as Depakote dementia, impairing a person's ability to think and make decisions.

Jackson said that while Depakote has been investigated as an adjunct therapy for cancer, its use has been limited due to the drug's effects on cognition. Jackson and Breggin both expressed deep concerns about Xanax, perhaps the most addictive of all benzodiazepines, a class of depressant medications used to treat anxiety, on the CENTCOM formulary. Smith said he was "flabbergasted" that military doctors prescribed Seroquel as a sleep aid, as the Food and Drug Administration has not approved such a use and other drugs are more effective.

Breggin agreed, calling Seroquel "very dangerous, expensive and not proven to be more beneficial than other drugs. In a memo titled "Policy Guidance for Deployment Limiting Pyschiatric Conditions and Medications," William Winkenwerder, then assistant secretary of Defense for health affairs, said psychotropic medications that would prohibit troops from deployment included those used to treat chronic insomnia. Asked if prescribing Seroquel to aid sleep violated this policy, Stasinos and Labadie said in an e-mail, "Seroquel is not prescribed for chronic insomnia.

Lower doses have been used to aid soldiers with troubled sleep for anxiety-related nightmares. Laura Woodin, a spokeswoman for the U. But, she added, mental health professionals often prescribe it to treat conditions not approved by the FDA.

Stan White, a retired high school teacher who lives in the small town of Cross Lanes, W. When his son Andrew returned from a tour in Iraq with the Marine Reserve 4th Combat Engineer Battalion in , he was diagnosed with post-traumatic stress disorder and was prescribed three psychotropic drugs, including Seroquel, by the Huntington Veterans Affairs Medical Center, White said. Andrew White died in his sleep Feb. White said Andrew was so befuddled by his drug cocktail, which included Klonopin, a benzodiazepine, and hydrocodone, an opiate, that his wife, Shirley, had to dole them out forAndrew.

White said Seroquel did not diminish Andrew's nightmares at even such a high dosage. While talk therapy is widely viewed as one of the most effective treatments for some mental health problems, including PTSD, White said Andrew had only a few such sessions, primarily with a local veterans' peer therapy group.

It was not until the week Andrew died that a VA psychiatrist decided to begin intensive sessions with him. Stan White says his mission in life today is to expose the dangers of Seroquel. The drug, he said, "turns people unto zombies. I cannot imagine going into battle on Seroquel. Correction : A sidebar that originally appeared with this story mistakenly identified three monoamine oxidase inhibitors as drugs on the CENTCOM formulary. Those drugs are not on the formulary. The sidebar, which described how military field rations could interfere with the drugs' performance, has been removed.

Subscribe Events About. Featured eBooks. By Bob Brewin , Editor at Large. By Bob Brewin January 18, In an e-mailed statement to Nextgov , Col. John Stasinos, chief of addiction medicine for the Army surgeon general, and Col. Share This:. Nextgov uses cookies for analytics and personalization. By continuing to use this site, you agree to our use of cookies. Read our Privacy Policy to find out more.

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Army memo: Substance abuse reaction lax

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Military's drug policy threatens troops' health, doctors say

Installations are reporting that hundreds of soldiers who have engaged in substance abuse have not been pushed to seek treatment, according to the Army vice chief of staff. Peter Chiarelli wrote in a May 8 memo to Army leaders that soldiers involved in "substance abuse-related misconduct including multiple positive urinalyses " were not processed for possible discharge as required under the regulations, USA Today first reported on Thursday. Many soldiers also were not sent to the Army Substance Abuse Program for help. The memo said that there is a shortage of qualified counselors at the installation level and pressed commanders to speed up hiring. A military spokeswoman said that among a group of 1, soldiers who tested positive for drugs at one installation, had failed the same drug test previously.

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By Bob Brewin. This is the first story in an ongoing series. Army leaders are increasingly concerned about the growing use and abuse of prescription drugs by soldiers, but a Nextgov investigation shows a U. Central Command policy that allows troops a or day supply of highly addictive psychotropic drugs before they deploy to combat contributes to the problem. Drug formulary includes drugs like Valium and Xanax, used to treat depression, as well as the antipsychotic Seroquel, originally developed to treat schizophrenia, bipolar disorders, mania and depression.

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