Thursday, January 04, 2007

We are climbing 
Jacob's ladder

One of the many lifesaving items of equipment soldiers take into combat are drugs that keep them alert after long hours in a combat zone. This fatigue problem has existed for a long time, and has become particularly acute in the last century or so, as battles became endurance contests, with forces engaged for days on end. In the last few decades, as long range bombers, and refueling in the air, became common, pilots have had to face the same problem during very long (30 hours or more) missions.

For over a century, the solution has been amphetamines ("speed"). However, this drug can impair judgment, making the user more aggressive, for example. In the last decade, kinder and gentler medications have become available. The most effective of these has been Modafinil (sold as Provigil). This stuff is described as "a mood-brightening and memory-enhancing psychostimulant which enhances wakefulness and vigilance." Tests showed that user performance was degraded 15-30 percent, versus 60-100 percent for those who took nothing at all after 24 hours of being awake. While the Modafinil did a pretty good job, the dextroamphetamine was still a bit better. So amphetamines remained competitive.

I've never seen extensive use of amphetamines among American troops - but there is still a level of confidentiality that is maintained between battalion surgeons, who can prescribe them, and troops. Commanders have a limited ability to pierce that veil, if there is a compelling interest for the command to know.

If I were a commander, and one of my troops were taking amphetamines, I'd definitely want to know about it.

I've always thought someone should write a story on the use of prozac and other antianxiety meds in a combat zone, though.

Splash, out


I'm not that worried about what the battalion surgeons do, it's the undocumented stimulants that worry me. I'm aware of stories of some SF guys way back in the way back used tiny slivers of LSD blotters to stay awake in hide sites for long periods of time. I mean spreading out the use of one 'tab' or dose over the period of a week, shaving off and ingesting a sliver every day. The problem with it is that while they maintain decent enough mission effectiveness for a tactical surveillance or ambush, after an extended period of no rest and low dosing with a psychotropic (7 to 14 days without sleep), psychotic episodes can occur. One SF vet told me that he witnessed a pretty horrifying incident.

Personally, I always carried a baggie of Nescafe instant coffee and used it as a sublingual, or dipped. It is damned hard to go to sleep with a double dose of Copenhagen in your mouth. At least if you don't like waking up 10 minutes later, vomiting.
Didn't the F-16 pilots, in the blue-on-blue incident that killed the Canadian troops in Afghanistan, raise the issue of "go-pill" use (as having impaired their judgement, etc.)?

This is also just begging feelgood-leftist opponents of the war and the press (redundancy alert) to start talking about our troops as "drug-addled" as well as uneducated dupes.

Amphetamines have been around since the twenties; IIRC, they saw extensive use in WWII, particularly by the Germans on the Eastern Front. (If I'm cold, starving, undersupplied and outnumbered,amphetamines are just what the doctor ordered....)

Plus, I'm all for useful drugs - especially antibiotics and painkillers - but I wonder what, if any, non-pharmaceutical methods have been investigated for overcoming the effects of sleep deprivation?

There are a number of proven, millenia-old breathing and visualization techniques that, while no subsitute for sleep, refresh and sharpen the mind and take only minutes learn and to perform. (What *did* warriors do before caffiene and tobacco?)

Inquiring minds, etc.
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