[NYTr] Sleepless in Iraq: Rx for Disaster

[All the News That Doesn't Fit]

[Speed Kills. So do soldiers. An interesting report on drugs,
exhaustion, PTSD and the war in Iraq. -NYTr]

Counterpunch - Aug 22, 2007
http://www.counterpunch.org/levy08222007.html

RX for Disaster

Sleepless in Iraq

By MARC LEVY

"RAMADI, Iraq: Troops swallow diet pills and slurp can after can of
Red Bull, fighting to stay awake as they peer from armored Humvees into
the pre-dawn darkness. Twangy country music pours from some vehicle
sound systems, angry rap from others." -Associated Press, December 8,
2006

"Exhaustion and combat stress are besieging US troops in Iraq as
they battle with a new type of warfare." -The Observer, August 12, 2007

 

DAV in Gloucester, MA 2004

It's 7p.m. I'm sitting at the monthly Disabled American Veterans
meeting, held in a wide open room with a low ceiling, big tables and
cheap chairs. Our chapter is composed of twenty-five Vietnam, Korean
and World War II vets. All have seen combat. Tonight we focus on what
to send the troops in Iraq. The men deliberate, then settle on Girl
Scout cookies. "Boys, boys," says the burly chapter president.
"Everyone chips in twenty bucks we can send a hundred boxes." He pauses
a moment. "All in favor..."

Standing up, I say, "Hold on a second. The troops want flea shampoo,
insect repellent, sun screen, foot powder. And tampons. That's right.
They haven't got enough bandages for gun shot wounds." I speak loud and
clear to this well meaning but straight-laced bunch. "That's what they
want. Not your damn cookies." Silence. Then from the back of the room,
a Nam vet shouts, "They need condoms to stretch over the 50-cal machine
gun barrels to keep the sand out. When the shooting starts they fire
straight through them."

You'd think that would bang the nail home but the president is adamant.
"Too much trouble, too expensive," he says. "And besides, the Girl
Scouts know where to send the packages. Let's keep it simple, boys.
Let's keep it simple. All in favor..." "Wait!" I pipe up. My voice is
not pleasant. "At least have the damn Girl Scouts send the damn condoms
with their goddamn cookies." Only one man chuckles. Later I heard they
thought I was strange.

Phnom Penn 1995

A dozen years ago I backpacked in Southeast Asia and Indonesia. In
Singapore, Thailand, Laos, Vietnam, in both busy and remote market
places, rows of small brown bottles touted increased energy. Cambodia's
crushing heat lead me to pay seventy-five cents for a bottle with two
red bulls on the label. Sugar, B vitamins, caffeine, and extract of
nicotine were the main ingredients. It tasted like candy but in twenty
minutes I could walk, hitch, bike or ride buses and not eat for hours.
And I felt great. Back in the US, I found and bought Red Bull in New
York's Chinatown. Same label, same taste but no soothing rush from the
tobacco extract. All that remained was the caffeine kick.

Iraq 2007

Thanks to an impressive PR campaign, energy drinks are doing
exceptionally well in the United States and throughout the world.
Demand is especially high in poor, bombed out, bullet ridden, kidnap
addled, socially disintegrating and otherwise despoiled Iraq. And
Afghanistan. The customers: the American army.

Mark Brinkley, a staff writer for Army Times, put it this way, "They're
certainly getting enough of the amber energy cocktail, buying more than
138,000 cans each month from the 54 military exchanges supporting
Operations Iraqi Freedom and Enduring Freedom. All told, four of the
top eight sellers in combat exchanges are human rocket fuels. Either
snazzy energy drinks or super-sweet shots of cold, condensed coffee.
Not since Popeye put back the spinach has such a big boost been
promised from such a tiny package." High demand has led Bawls Guarana,
a high-caffeine soft drink that packs twice the punch of Pepsi or Coke,
to develop The Bawls Military Gift Pack. Regarding the muster for Red
Bull, Monster Energy Drink, Bawls et al, Brinkley posits, "Maybe it's
sleep deprivation."

Indeed, a stunning report by Peter Beaumont (The Observer, August 12,
2007) paints a bleak portrait of US troops, pushed to their physical
limits and exhausted. A desperate low tech way to prop the eyelids open
until the day's tense patrol, the night's careening convoy, or the
checkpoint guard shift ends, is to chug can after can of Red Bull, Rip
It, or Bawl's, and cat nap when possible. Only after the worn out,
sleep-deprived soldier is back at base is there a chance for
undisturbed slumber. But the cumulative effect of multiple and extended
tours, extreme over-work and sleep deprivation appears to be a growing
army of none, with no end in sight.

Ranger in a Strange Land

Elite military forces have long used certain drugs to increase combat
effectiveness. My best friend, a heavy combat Army Ranger (see
http://www.counterpunch.org/levy02162007.html) relates that prior to
missions in Vietnam, he and his men were issued Dexedrine and paregoric
tablets. The former increased self-confidence, concentration, risk
taking, and reduced pain, hunger, thirst, and the need for shuteye. The
latter induced constipation. Think about it: men who do not defecate
cannot be tracked by the scent of their shit, and can walk, march,
crawl or lay in wait for hour and hours. Three days or three weeks
later, once back at base, they crashed, drank, smoked pot,
decompressed. A week later they choppered out; the cycle began again.
Thirty-seven years later, my Ranger pal does not sleep well. Broken
sleep, he calls it. And his nightmares are not pleasant. But Rangers
are a self-selective bunch. Their training is ferocious. Through
interrupted sleep, brutal physical training, and fearsome harassment,
the Army does its best to physically and psychologically break a man
down. Those who graduate have extraordinary endurance. The same cannot
be said for the average American soldier in Afghanistan or Iraq.
Patriots who think otherwise are just plain wrong. And one more thing.
Returned home, my Ranger pal went through a long period of being
short-tempered, violent, prone to taking extreme risks, did ten years
hard time, but most importantly, to this day feels that he cannot
accept the moral wrongfulness of his actions in war and afterwards.
Why? Because the US government ordered him to take amphetamines, the
better to do his dirty work.

The Pilots of Penzance

In the 19th century the Germans invented methamphetamine. By the Second
World War the German army was using it widely. In 2002, Air Force
pilots Major Harry Schmidt (call sign 'Psycho') and Major William
Umbach misidentified a target in Iraq. After the mission, they
complained of exhaustion. They felt the "common-sense" rule of 12 hours
off between flights was being ignored.

They were advised to shut up and see the flight surgeon for "go/no-go"
pills, i.e. Dexedrine. Days later Schmidt and Umbach dropped a
precision bomb on Canadian troops, killing four, wounding eight.
Court-martialed, each was charged with negligent manslaughter,
aggravated assault, and dereliction of duty. Their lawyers blamed Air
Force issued Dexedrine. Umbach's case was dismissed. Schmidt was found
guilty of dereliction of duty, fined nearly $6,000, and reprimanded.

In a subsequent news conference, Air Force physician and pilot Dr. Pete
Demitry said, "Air Force has used Dexedrine safely for sixty years"
with "no known speed-related mishaps." The need for amphetamines,
Demitry noted, "is a life-and-death issue for our military." (Wired Feb
10, 03).

But John Pike, director of Globalsecurity.org, thought otherwise.
"Better bombing through chemistry," he said. "I think enquiring whether
amphetamine use had a role in the bombing errors is an obvious question
to ask. I am surprised that the question has not been asked
before." (The Independent, August 3, 2002)

The English are equally prudent. In March 2003, an A-10 Thunderbolt,
co-piloted by National Guard Lt. Colonel Gus Kohntopp (call sign 'Popov
36'), killed Lance Corporal Matty Hull of The Blues & Royals, in Iraq.
After an American cover-up and British expose, Air Marshal and MP Lord
Garden hoped further investigation would consider possible drug use on
the part of the A-10 pilots. (Scotland On Sunday, 11 Feb 2007).

The British Are Going! The British Are Going!

Brit combat troops serve 6 months at war, then 24 off. A 4:1 ratio. By
contrast, American soldiers serve a 4:5 ratio of 15 months in combat,
with less than a year's rest. The British high command believes
anything over a 4:1 ratio could "break the army." (The Guardian, August
13, 2007). It seems it will not get better soon. Army Times reports
that 15 month deployments will hold until the Army can switch to one
year of combat, one year at rest. "The only way shorter tours will be
possible is when demand for combat power drops...12 months of boots on
the ground will not happen overnight," a senior Army official said.
(Army Times August 13, 2007). Even with an ultimate goal of one year
deployed, two years at home, that ratio may "break the army."

All Aboard The Chew Chew Train

According to Army Times, Dr. Gary Kamimori is a research physiologist
at Walter Read Army Institute of Research. Tasked to chew on the
problem of sleep deprivation and combat effectiveness, Kamimori
discovered that after forty-eight sleepless hours a combat soldier is
kaput. Not exactly post-doctoral material but Kamimori's most recent
unpublished government study concludes that caffeine, delivered by
chewing gum, is an excellent way to ward off zzzz's. Here is the back
story:

In 1998 Wrigley's launched "Stay Alert Gum." The product fizzled but it
caught Kamimori's eye. In 2000 Congress funded the initial research,
which showed quick absorption rates of the stimulant, which lead to
testing the gum as an antidote for sleep deprivation in combat. The
results were encouraging: "Alertness, marksmanship (both simulated and
live fire), vigilance on observation and reconnaissance tasks, and
physical performance during simulated operations was either maintained
or improved as compared to those soldiers receiving a placebo chewing
gum."

Stay Alert could be optimally dosed: at 200mg every two hours, for up
to eight hours straight, though after 68 hours the caffeine lost its
effect.

The gum was recently approved for use in First Strike Rations, an
experimental meal for Special Operation Forces (Army News Service,
January 17, 2006). In the meantime Jolt Gum (which sold 64,000 packs in
war zones in one year) is sold in US military exchanges and combat
outposts. By comparison, approximately 30,000 cans of Red Bull are sold
in Iraq and Afghanistan each week. Kamimori notes that until Stay Alert
is officially available, combat commanders can purchase it by
contacting the company at (800) 826 2526 or by visiting
www.stayalertgum.com. "It's been like gold for them," said Kamimori,
about the units that have field-tested Stay Alert in the Middle East.
"This is something that's going to help the average soldier." Perhaps.
Perhaps not.

Rx for Disaster: 100mg = 1 cup

Dr. Kamimori suggests that combat troops chomp the equivalent of one
cup of coffee an hour for eight hours straight. But according to
MayoClinic.com, six cups of coffee a day constitutes heavy intake. And
many GIs may drink Red Bull and smoke cigarettes. After a break (not
specified by Kamimori) the caffeine cycle begins again. Prolonged and
repeated caffeination translates to extended stay-awake time but the
price is severe loss of sleep, which kicks in when an individual gets
less than 8 straight hours of sleep in a 24 hour period.

Call It Sleep

The National Sleep Foundation states, "Sleep experts say most adults
need between seven and nine hours of sleep each night for optimum
performance, health and safety." Inadequate sleep has been linked to
"obesity and high blood pressure, negative mood and behavior, decreased
productivity, and safety issues in the home, on the job, and on the
road."

The US Army War College Guide to Executive Health and Fitness confides,
"Sleep sustains effectiveness. Sleep deprivation, whether total or
partial, impairs the ability to stay awake, under boring or non
stimulating conditions. Even under highly stimulating or challenging
conditions, sleep deprivation impairs complex mental operations,
including the ability to judge one's own mental level of effectiveness.
(Barko, Vaitkus et al 2000).

Closer to home is the May 2006 Patient Handbook, Post Traumatic Stress
Disorder Program, VA Medical Center, Northampton, MA: "If you are
drinking more than 4-5 cups of coffee daily, you probably are addicted
to caffeine. Symptoms of caffeinism include anxiety, "restless legs,"
insomnia, and bowel and stomach problems. Caffeinism and other dietary
or lifestyle issues may worsen PTSD symptoms. Try reducing your daily
coffee (and other caffeine drinks such as tea and soft drinks) to less
than four cups daily."

The Army's Field Manual 7-93 Long-range Surveillance Unit Operations is
compellingly simple. Appendix C, Geographic Environments, Section C-2,
Desert Operations states: 1) Soldiers must avoid alcohol, tobacco
products, and caffeine. These substances cause dehydration. 2) Soldiers
need at least 6 hours of sleep each day. (Headquarters Department of
the Army Washington, Dc, October 3, 1995).

GIs once read the eponymous and wildly errant Stars and Strips. Today,
the Military Times Media Group (publisher of Army, Marine, and Navy
Times) shoots straight from the hip. "Soldiers' abilities to think
clearly, make smart decisions compromised by fatigue" blares the
headline of a recent full page article. "Working long hours on little
sleep is common for troops in Iraq and Afghanistan. Some Army medical
specialists and leaders, however, say that sleep deprivation is
dangerous and unnecessary." A final quote: "Sleep deprived subjects
take longer to make the correct moral judgements," said Dr. Balkin,
Chief, Behavioral Biology, Walter Reed Army Institute of Research.
"What would be affected would be your ability to determine if it was a
friend or a foe."

Over There

Multiple and extended combat tours without adequate down time. Command
encouraged or enforced sleep deprivation. Ordinary soldiers
inadequately trained for such demands. Wired, trigger-happy pilots. The
likelihood of increased friendly fire incidents and non combat
accidents. Scarce, broken or sub par equipment. Missing, stolen or
black-marketed weaponry. Desertions. AWOLs. Rumors of mutiny. Civil
war. Mass civilian wounded and dead, refugees in the millions. A litany
of failed promises. An army of occupation caught in a quadruple cross
fire of Shiites and Sunnis, armed tribes, criminals, Al Qaeda. This is
not a happy picture.

Send The Word

Drag an ill-equipped Army into a chosen war. Disregard all signs that
speedy triumph equals rose-petal fantasy. Over and over inform the
weary civilians that war is hell but we're almost done. And what does
the Pentagon propose to uplift the sagging brows and soul dead spirits
of overworked, brain shaken, caffeinated and RPG'd troops in times of
arid slaughter? After much time, financial expense and young blood
spilt, what bold curative, what magic bullet is thus pronounced?
Coffee. Combat coffee. Good god, what next? Kevlar donuts? Girl Scout
Cookies?

Say A Prayer

Have pity for the broken and quartered army whose commander in chief
lies asleep at the wheel. Bring them home. Bring them home. And compel
our Lord High Executioner to view at length the horrid morgues of
Baghdad, to walk its bloody streets. Then demote and promote him to
Chief of Ground Crew, Arlington National Cemetery. Make him see what he
has wrought.

n.b. DAV

This writer contacted Gumrunner's (http://www.gumrunners.com) makers of
Jolt caffeinated chewing gum. "Absolutely," said amiable sales rep
Maurice Green. Gumrunner's would gladly offer the Disabled American
Veterans a hefty discount off the $1.49 retail price if bought in bulk
and sent to Iraq. "Just ask for the pallet price," said Maurice. So
much for cookies.

[Marc Levy was an infantry medic with the First Cavalry in Vietnam and
Cambodia. Email him at silverspartan at gmail.com ]