That's disturbing enough, but military officials make even tracking potentially disqualifying medical histories difficult — if not impossible — by failing to use all the resources at their disposal. The DoD keeps a pharmacy database for military personnel and their families (through its TRICARE health-care program), but doesn't use it to identify deploying service members who are using medications that would disqualify them from service — a practice that's been criticized by medics and field doctors.
In addition, the Army's combat health-support management system, MC4 (Medical Communications for Combat Casualty Care), was designed to harness a state-of-the-art network of handheld devices, laptops, and software and share medical information in the field. Yet while MC4 could, in the event of an emergency, be used to alert field commanders and medical personnel to a soldier's pre-existing conditions — such as PTSD — this too isn't being done with any consistency. As a result, many combat troops are being unnecessarily mis-prescribed at the worst of all possible times — during battle.
Complicating matters further is the assortment of mandatory medications — including the anthrax vaccine ABthrax, as well as other drugs to fight off local ailments — given to all military personnel serving in Iraq. Drugs used to treat mental conditions aren't necessarily problematic on their own, but when combined with one of these mandatory medications, they can be dangerous — and even fatal.
In Pogany's case, for example, the problem wasn't the Ambien he was given as a sleep aid, but, he says, his acute reaction to the Army-issued Lariam. While effective in treating malaria (American tourists often take a dose before traveling to Third World countries), it can have severe repercussions when used as a preventative measure by people with depression, anxiety disorder, psychosis, or schizophrenia. Consider that it can present hazards to a backpacker who takes it just once or twice while on vacation, then imagine how it can have exponentially more severe consequences for a soldier who takes it once a week (or more) for years at a time.
Four years ago, Dr. Geoffrey Dow and his team at Walter Reed Army Institute of Research in Rockville, Maryland, found that not only is Lariam a neurotoxin that ate away the brain stems of test creatures, but that it causes psychiatric effects — including dizziness, depression, acute anxiety, mania, aggression, rage, psychosis, confusion, and memory loss — in nearly a quarter of the people who take it, as the World Health Organization asserted in 1995.
"These are people running around with big guns who are supposed to be alert," says Jeanne Lese, co-director of non-profit health organization Lariam Action USA. "They're supposed to be shooting people, but they're also supposed to be in control of their weapon, and if their brain has taken away their ability to control their balance, what's wrong with this picture?"
The military has stood by its assertion that weekly doses of Lariam are safe, and more effective at preventing malaria than daily doses of cheaper and less potent alternatives, such as doxycycline, which was suggested as a Lariam alternative by the Army Surgeon General this past month. However, Pogany and other military personnel who have had acute reactions to Lariam to whom the Phoenix spoke say that it has made them feel suicidal, which should outweigh any potential benefit as a preventative medication.