Psychotropic Medications and Associated CENTCOM Restrictions - pdf

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http://pec.ha.osd.mil/files/CENTCOM%20CNS%20MEDICATIONS%2011052010.pdf

> >> > http://www.nextgov.com/nextgov/ng_20110118_8944.php?oref=spotlight> >> > Military's drug policy threatens troops' health, doctors say> >> > By Bob Brewin 01/18/2011> >> > > >> > 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.S. Central Command policy that allows troops a 90- or 180-day> supply of highly addictive psychotropic drugs before they deploy to> combat contributes to the problem.> >> > The CENTCOM Central Nervous System> > â 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 180-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 2010 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 25- or> 50-milligram doses for sleep disorders.> >> > A June 2010 internal report from the Defense Department's> Pharmacoeconomic Center at Fort Sam Houston in San showed that> 213,972, or 20 percent of the 1.1 million active-duty troops surveyed,> were taking some form of psychotropic drug: antidepressants,> antipsychotics, sedative hypnotics, or other controlled substances.> >> > Dr. Grace , a former Navy psychiatrist, told Nextgov she> resigned her commission in 2002 "out of conscience, because I did not> want to be a pill pusher." She believes psychotropic drugs have so many> inherent dangers that "the CENTCOM CNS formulary is destroying the> force," she said.> >> > Dr. Greg , who runs the Los Angles-based Comprehensive Pain> Relief Group, which treats chronic pain and prescription drug abuse> through an integrative medical approach called the Nutrition,> Emotional/Psychological, Social/Financial and Physical program, said he> was shocked by CENTCOM's drug policy for deployed troops. "If I was a> commander I'd worry about what these troops would do," as a result of> their medications, said.> >> > Dr. Breggin, an Ithaca, N.Y., psychiatrist who testified before> a House Veterans Affairs Committee last September on the relationship> between medication and veterans' suicides, said flatly, "You should not> send troops into combat on psychotropic drugs." Medications on the> CENTCOM CNS formulary can cause loss of judgment and self-control and> could result in increased violence and suicidal impulses, Breggin said.> >> > The Army implicated prescription drugs as contributing to suicides in> a July 2010 report, which said one-third of all active-duty military> suicides involved prescription drugs.> >> > When the suicide report was released, Gen. Chiarelli, the Army's> vice chief of staff, said the service needed to develop better controls> for prescription drugs. "Let's make sure when we prescribe that we put> an end date on that prescription, so it doesn't remain an open-ended> opportunity for somebody to be abusing drugs," Chiarelli said.> >> > But when it comes to the CENTCOM CNS formulary -- which for some drugs> allows a 180-day supply when troops deploy, followed by a 180-day refill> in theater, according to an October 2010 update to the psychotropic drug> policy -- neither the Army nor CENTCOM sees a need for change.> >> > In an e-mailed statement to Nextgov, Col. Stasinos, chief of> > â addiction medicine for the Army surgeon general, and Col. Carol> Labadie, pharmacy program manager in the Directorate of Health Policy> and Services for the surgeon general, said soldiers are supplied with up> to 180 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 180-day supply of more than one psychotropic> medication.> >> > Navy Lt. Cmdr. Speaks, a CENTCOM spokesman, echoed comments> from the Army. 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.e. if the individual runs> out]. This policy prevents that from occurring."> >> > Speaks said, "Abuse is always a possibility the prescribing clinician> must consider ... demonstration of clinical stability, medication> quantity limits and in-theater review of prescriptions reduces the> potential for abuse."> >> > Suicide and Drug Abuse> >> > 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.> >> > , the former Navy psychiatrist, now has a civilian practice in> Greensboro, N.C. 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. 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.> >> > The antidepressant Wellbutrin, also on the CENTCOM formulary, likely> poses a long-term risk of Parkinson's disease, especially for older> troops, said , author of Drug-Induced Dementia: A Perfect Crime> (AuthorHouse, 2009).> >> > 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.> >> > Breggin, author of Medication Madness: The Role of Psychiatric Drugs> in Cases of Violence, Suicide and Crime (St. 's , 2009),> called Xanax "solid alcohol" and said all the benzodiazepines on the> CENTCOM formulary "amount to a prescription for abuse." He also said> there is no rationale for prescribing multiple psychotropic drugs to> troops.> >> > 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."> >> > noted Seroquel has the addictive potential of opioids, such> heroin.> >> > CENTCOM's allowance of Seroquel as a sleep aid also seems to fly in> the face of a high-level Defense policy set in November 2006. In a memo> titled "Policy Guidance for Deployment Limiting Pyschiatric Conditions> and Medications," 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." They added while other> sleep medications are on the CENTCOM formulary, none appears to relieve> nightmares as effectively as Seroquel.> >> > Woodin, a spokeswoman for the U.S. division of London-based> AstraZeneca, which makes Seroquel, said the drug is not approved by the> FDA as a sleep aid or to treat post-traumatic stress disorder. But, she> added, mental health professionals often prescribe it to treat> conditions not approved by the FDA. "Like patients, we trust doctors to> use their medical judgment to determine when it is appropriate to> prescribe medications," Woodin said.> >> > Nightmare> >> > Stan White, a retired high school teacher who lives in the small town> of Cross Lanes, W.Va., has observed the effects Seroquel can have. When> his son returned from a tour in Iraq with the Marine Reserve 4th> Combat Engineer Battalion in 2007, 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.> >> > VA started on 25 milligrams of Seroquel a day and upped the> dose to 1,600 milligrams a day (the CENTCOM-approved dose is 25> milligrams a day). White died in his sleep Feb. 12, 2008, six> months after seeking help.> >> > White said 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 for. White said Seroquel> did not diminish '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> had only a few such sessions, primarily with a local veterans'> peer therapy group. It was not until the week 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."> > Sent via BlackBerry by AT & T> >>

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http://pec.ha.osd.mil/files/CENTCOM%20CNS%20MEDICATIONS%2011052010.pdf

> >> > http://www.nextgov.com/nextgov/ng_20110118_8944.php?oref=spotlight> >> > Military's drug policy threatens troops' health, doctors say> >> > By Bob Brewin 01/18/2011> >> > > >> > 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.S. Central Command policy that allows troops a 90- or 180-day> supply of highly addictive psychotropic drugs before they deploy to> combat contributes to the problem.> >> > The CENTCOM Central Nervous System> > â 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 180-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 2010 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 25- or> 50-milligram doses for sleep disorders.> >> > A June 2010 internal report from the Defense Department's> Pharmacoeconomic Center at Fort Sam Houston in San showed that> 213,972, or 20 percent of the 1.1 million active-duty troops surveyed,> were taking some form of psychotropic drug: antidepressants,> antipsychotics, sedative hypnotics, or other controlled substances.> >> > Dr. Grace , a former Navy psychiatrist, told Nextgov she> resigned her commission in 2002 "out of conscience, because I did not> want to be a pill pusher." She believes psychotropic drugs have so many> inherent dangers that "the CENTCOM CNS formulary is destroying the> force," she said.> >> > Dr. Greg , who runs the Los Angles-based Comprehensive Pain> Relief Group, which treats chronic pain and prescription drug abuse> through an integrative medical approach called the Nutrition,> Emotional/Psychological, Social/Financial and Physical program, said he> was shocked by CENTCOM's drug policy for deployed troops. "If I was a> commander I'd worry about what these troops would do," as a result of> their medications, said.> >> > Dr. Breggin, an Ithaca, N.Y., psychiatrist who testified before> a House Veterans Affairs Committee last September on the relationship> between medication and veterans' suicides, said flatly, "You should not> send troops into combat on psychotropic drugs." Medications on the> CENTCOM CNS formulary can cause loss of judgment and self-control and> could result in increased violence and suicidal impulses, Breggin said.> >> > The Army implicated prescription drugs as contributing to suicides in> a July 2010 report, which said one-third of all active-duty military> suicides involved prescription drugs.> >> > When the suicide report was released, Gen. Chiarelli, the Army's> vice chief of staff, said the service needed to develop better controls> for prescription drugs. "Let's make sure when we prescribe that we put> an end date on that prescription, so it doesn't remain an open-ended> opportunity for somebody to be abusing drugs," Chiarelli said.> >> > But when it comes to the CENTCOM CNS formulary -- which for some drugs> allows a 180-day supply when troops deploy, followed by a 180-day refill> in theater, according to an October 2010 update to the psychotropic drug> policy -- neither the Army nor CENTCOM sees a need for change.> >> > In an e-mailed statement to Nextgov, Col. Stasinos, chief of> > â addiction medicine for the Army surgeon general, and Col. Carol> Labadie, pharmacy program manager in the Directorate of Health Policy> and Services for the surgeon general, said soldiers are supplied with up> to 180 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 180-day supply of more than one psychotropic> medication.> >> > Navy Lt. Cmdr. Speaks, a CENTCOM spokesman, echoed comments> from the Army. 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.e. if the individual runs> out]. This policy prevents that from occurring."> >> > Speaks said, "Abuse is always a possibility the prescribing clinician> must consider ... demonstration of clinical stability, medication> quantity limits and in-theater review of prescriptions reduces the> potential for abuse."> >> > Suicide and Drug Abuse> >> > 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.> >> > , the former Navy psychiatrist, now has a civilian practice in> Greensboro, N.C. 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. 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.> >> > The antidepressant Wellbutrin, also on the CENTCOM formulary, likely> poses a long-term risk of Parkinson's disease, especially for older> troops, said , author of Drug-Induced Dementia: A Perfect Crime> (AuthorHouse, 2009).> >> > 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.> >> > Breggin, author of Medication Madness: The Role of Psychiatric Drugs> in Cases of Violence, Suicide and Crime (St. 's , 2009),> called Xanax "solid alcohol" and said all the benzodiazepines on the> CENTCOM formulary "amount to a prescription for abuse." He also said> there is no rationale for prescribing multiple psychotropic drugs to> troops.> >> > 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."> >> > noted Seroquel has the addictive potential of opioids, such> heroin.> >> > CENTCOM's allowance of Seroquel as a sleep aid also seems to fly in> the face of a high-level Defense policy set in November 2006. In a memo> titled "Policy Guidance for Deployment Limiting Pyschiatric Conditions> and Medications," 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." They added while other> sleep medications are on the CENTCOM formulary, none appears to relieve> nightmares as effectively as Seroquel.> >> > Woodin, a spokeswoman for the U.S. division of London-based> AstraZeneca, which makes Seroquel, said the drug is not approved by the> FDA as a sleep aid or to treat post-traumatic stress disorder. But, she> added, mental health professionals often prescribe it to treat> conditions not approved by the FDA. "Like patients, we trust doctors to> use their medical judgment to determine when it is appropriate to> prescribe medications," Woodin said.> >> > Nightmare> >> > Stan White, a retired high school teacher who lives in the small town> of Cross Lanes, W.Va., has observed the effects Seroquel can have. When> his son returned from a tour in Iraq with the Marine Reserve 4th> Combat Engineer Battalion in 2007, 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.> >> > VA started on 25 milligrams of Seroquel a day and upped the> dose to 1,600 milligrams a day (the CENTCOM-approved dose is 25> milligrams a day). White died in his sleep Feb. 12, 2008, six> months after seeking help.> >> > White said 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 for. White said Seroquel> did not diminish '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> had only a few such sessions, primarily with a local veterans'> peer therapy group. It was not until the week 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."> > Sent via BlackBerry by AT & T> >>

[Guest guest]

http://pec.ha.osd.mil/files/CENTCOM%20CNS%20MEDICATIONS%2011052010.pdf

> >> > http://www.nextgov.com/nextgov/ng_20110118_8944.php?oref=spotlight> >> > Military's drug policy threatens troops' health, doctors say> >> > By Bob Brewin 01/18/2011> >> > > >> > 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.S. Central Command policy that allows troops a 90- or 180-day> supply of highly addictive psychotropic drugs before they deploy to> combat contributes to the problem.> >> > The CENTCOM Central Nervous System> > â 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 180-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 2010 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 25- or> 50-milligram doses for sleep disorders.> >> > A June 2010 internal report from the Defense Department's> Pharmacoeconomic Center at Fort Sam Houston in San showed that> 213,972, or 20 percent of the 1.1 million active-duty troops surveyed,> were taking some form of psychotropic drug: antidepressants,> antipsychotics, sedative hypnotics, or other controlled substances.> >> > Dr. Grace , a former Navy psychiatrist, told Nextgov she> resigned her commission in 2002 "out of conscience, because I did not> want to be a pill pusher." She believes psychotropic drugs have so many> inherent dangers that "the CENTCOM CNS formulary is destroying the> force," she said.> >> > Dr. Greg , who runs the Los Angles-based Comprehensive Pain> Relief Group, which treats chronic pain and prescription drug abuse> through an integrative medical approach called the Nutrition,> Emotional/Psychological, Social/Financial and Physical program, said he> was shocked by CENTCOM's drug policy for deployed troops. "If I was a> commander I'd worry about what these troops would do," as a result of> their medications, said.> >> > Dr. Breggin, an Ithaca, N.Y., psychiatrist who testified before> a House Veterans Affairs Committee last September on the relationship> between medication and veterans' suicides, said flatly, "You should not> send troops into combat on psychotropic drugs." Medications on the> CENTCOM CNS formulary can cause loss of judgment and self-control and> could result in increased violence and suicidal impulses, Breggin said.> >> > The Army implicated prescription drugs as contributing to suicides in> a July 2010 report, which said one-third of all active-duty military> suicides involved prescription drugs.> >> > When the suicide report was released, Gen. Chiarelli, the Army's> vice chief of staff, said the service needed to develop better controls> for prescription drugs. "Let's make sure when we prescribe that we put> an end date on that prescription, so it doesn't remain an open-ended> opportunity for somebody to be abusing drugs," Chiarelli said.> >> > But when it comes to the CENTCOM CNS formulary -- which for some drugs> allows a 180-day supply when troops deploy, followed by a 180-day refill> in theater, according to an October 2010 update to the psychotropic drug> policy -- neither the Army nor CENTCOM sees a need for change.> >> > In an e-mailed statement to Nextgov, Col. Stasinos, chief of> > â addiction medicine for the Army surgeon general, and Col. Carol> Labadie, pharmacy program manager in the Directorate of Health Policy> and Services for the surgeon general, said soldiers are supplied with up> to 180 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 180-day supply of more than one psychotropic> medication.> >> > Navy Lt. Cmdr. Speaks, a CENTCOM spokesman, echoed comments> from the Army. 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.e. if the individual runs> out]. This policy prevents that from occurring."> >> > Speaks said, "Abuse is always a possibility the prescribing clinician> must consider ... demonstration of clinical stability, medication> quantity limits and in-theater review of prescriptions reduces the> potential for abuse."> >> > Suicide and Drug Abuse> >> > 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.> >> > , the former Navy psychiatrist, now has a civilian practice in> Greensboro, N.C. 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. 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.> >> > The antidepressant Wellbutrin, also on the CENTCOM formulary, likely> poses a long-term risk of Parkinson's disease, especially for older> troops, said , author of Drug-Induced Dementia: A Perfect Crime> (AuthorHouse, 2009).> >> > 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.> >> > Breggin, author of Medication Madness: The Role of Psychiatric Drugs> in Cases of Violence, Suicide and Crime (St. 's , 2009),> called Xanax "solid alcohol" and said all the benzodiazepines on the> CENTCOM formulary "amount to a prescription for abuse." He also said> there is no rationale for prescribing multiple psychotropic drugs to> troops.> >> > 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."> >> > noted Seroquel has the addictive potential of opioids, such> heroin.> >> > CENTCOM's allowance of Seroquel as a sleep aid also seems to fly in> the face of a high-level Defense policy set in November 2006. In a memo> titled "Policy Guidance for Deployment Limiting Pyschiatric Conditions> and Medications," 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." They added while other> sleep medications are on the CENTCOM formulary, none appears to relieve> nightmares as effectively as Seroquel.> >> > Woodin, a spokeswoman for the U.S. division of London-based> AstraZeneca, which makes Seroquel, said the drug is not approved by the> FDA as a sleep aid or to treat post-traumatic stress disorder. But, she> added, mental health professionals often prescribe it to treat> conditions not approved by the FDA. "Like patients, we trust doctors to> use their medical judgment to determine when it is appropriate to> prescribe medications," Woodin said.> >> > Nightmare> >> > Stan White, a retired high school teacher who lives in the small town> of Cross Lanes, W.Va., has observed the effects Seroquel can have. When> his son returned from a tour in Iraq with the Marine Reserve 4th> Combat Engineer Battalion in 2007, 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.> >> > VA started on 25 milligrams of Seroquel a day and upped the> dose to 1,600 milligrams a day (the CENTCOM-approved dose is 25> milligrams a day). White died in his sleep Feb. 12, 2008, six> months after seeking help.> >> > White said 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 for. White said Seroquel> did not diminish '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> had only a few such sessions, primarily with a local veterans'> peer therapy group. It was not until the week 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."> > Sent via BlackBerry by AT & T> >>

[Guest guest]

http://pec.ha.osd.mil/files/CENTCOM%20CNS%20MEDICATIONS%2011052010.pdf

> >> > http://www.nextgov.com/nextgov/ng_20110118_8944.php?oref=spotlight> >> > Military's drug policy threatens troops' health, doctors say> >> > By Bob Brewin 01/18/2011> >> > > >> > 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.S. Central Command policy that allows troops a 90- or 180-day> supply of highly addictive psychotropic drugs before they deploy to> combat contributes to the problem.> >> > The CENTCOM Central Nervous System> > â 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 180-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 2010 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 25- or> 50-milligram doses for sleep disorders.> >> > A June 2010 internal report from the Defense Department's> Pharmacoeconomic Center at Fort Sam Houston in San showed that> 213,972, or 20 percent of the 1.1 million active-duty troops surveyed,> were taking some form of psychotropic drug: antidepressants,> antipsychotics, sedative hypnotics, or other controlled substances.> >> > Dr. Grace , a former Navy psychiatrist, told Nextgov she> resigned her commission in 2002 "out of conscience, because I did not> want to be a pill pusher." She believes psychotropic drugs have so many> inherent dangers that "the CENTCOM CNS formulary is destroying the> force," she said.> >> > Dr. Greg , who runs the Los Angles-based Comprehensive Pain> Relief Group, which treats chronic pain and prescription drug abuse> through an integrative medical approach called the Nutrition,> Emotional/Psychological, Social/Financial and Physical program, said he> was shocked by CENTCOM's drug policy for deployed troops. "If I was a> commander I'd worry about what these troops would do," as a result of> their medications, said.> >> > Dr. Breggin, an Ithaca, N.Y., psychiatrist who testified before> a House Veterans Affairs Committee last September on the relationship> between medication and veterans' suicides, said flatly, "You should not> send troops into combat on psychotropic drugs." Medications on the> CENTCOM CNS formulary can cause loss of judgment and self-control and> could result in increased violence and suicidal impulses, Breggin said.> >> > The Army implicated prescription drugs as contributing to suicides in> a July 2010 report, which said one-third of all active-duty military> suicides involved prescription drugs.> >> > When the suicide report was released, Gen. Chiarelli, the Army's> vice chief of staff, said the service needed to develop better controls> for prescription drugs. "Let's make sure when we prescribe that we put> an end date on that prescription, so it doesn't remain an open-ended> opportunity for somebody to be abusing drugs," Chiarelli said.> >> > But when it comes to the CENTCOM CNS formulary -- which for some drugs> allows a 180-day supply when troops deploy, followed by a 180-day refill> in theater, according to an October 2010 update to the psychotropic drug> policy -- neither the Army nor CENTCOM sees a need for change.> >> > In an e-mailed statement to Nextgov, Col. Stasinos, chief of> > â addiction medicine for the Army surgeon general, and Col. Carol> Labadie, pharmacy program manager in the Directorate of Health Policy> and Services for the surgeon general, said soldiers are supplied with up> to 180 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 180-day supply of more than one psychotropic> medication.> >> > Navy Lt. Cmdr. Speaks, a CENTCOM spokesman, echoed comments> from the Army. 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.e. if the individual runs> out]. This policy prevents that from occurring."> >> > Speaks said, "Abuse is always a possibility the prescribing clinician> must consider ... demonstration of clinical stability, medication> quantity limits and in-theater review of prescriptions reduces the> potential for abuse."> >> > Suicide and Drug Abuse> >> > 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.> >> > , the former Navy psychiatrist, now has a civilian practice in> Greensboro, N.C. 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. 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.> >> > The antidepressant Wellbutrin, also on the CENTCOM formulary, likely> poses a long-term risk of Parkinson's disease, especially for older> troops, said , author of Drug-Induced Dementia: A Perfect Crime> (AuthorHouse, 2009).> >> > 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.> >> > Breggin, author of Medication Madness: The Role of Psychiatric Drugs> in Cases of Violence, Suicide and Crime (St. 's , 2009),> called Xanax "solid alcohol" and said all the benzodiazepines on the> CENTCOM formulary "amount to a prescription for abuse." He also said> there is no rationale for prescribing multiple psychotropic drugs to> troops.> >> > 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."> >> > noted Seroquel has the addictive potential of opioids, such> heroin.> >> > CENTCOM's allowance of Seroquel as a sleep aid also seems to fly in> the face of a high-level Defense policy set in November 2006. In a memo> titled "Policy Guidance for Deployment Limiting Pyschiatric Conditions> and Medications," 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." They added while other> sleep medications are on the CENTCOM formulary, none appears to relieve> nightmares as effectively as Seroquel.> >> > Woodin, a spokeswoman for the U.S. division of London-based> AstraZeneca, which makes Seroquel, said the drug is not approved by the> FDA as a sleep aid or to treat post-traumatic stress disorder. But, she> added, mental health professionals often prescribe it to treat> conditions not approved by the FDA. "Like patients, we trust doctors to> use their medical judgment to determine when it is appropriate to> prescribe medications," Woodin said.> >> > Nightmare> >> > Stan White, a retired high school teacher who lives in the small town> of Cross Lanes, W.Va., has observed the effects Seroquel can have. When> his son returned from a tour in Iraq with the Marine Reserve 4th> Combat Engineer Battalion in 2007, 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.> >> > VA started on 25 milligrams of Seroquel a day and upped the> dose to 1,600 milligrams a day (the CENTCOM-approved dose is 25> milligrams a day). White died in his sleep Feb. 12, 2008, six> months after seeking help.> >> > White said 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 for. White said Seroquel> did not diminish '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> had only a few such sessions, primarily with a local veterans'> peer therapy group. It was not until the week 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."> > Sent via BlackBerry by AT & T> >>