According to Assistant Secretary of Defense for Health Affairs, William Winkenwerder Jr, the Pentagon will appoint a panel to design a study that will investigate whether or not an anti-malaria drug developed by the Army could be causing a recent spike in the suicide rates, one month after stating that the drug could not be a factor in the increase.
In late February, Wikenwerder stated that the Army could confirm 21 suicides in the Iraqi Theatre, which translates to a rate of 15.8 per 100,000 soldiers. This rate, slightly above the typical 9.1 to 14.8 range occuring between 1995 and 2002, is not significantly higher than the average according to Wikenwerder. The number does not include suicides among returning veterans, according to the Pentagon. At least six apparent suicides have occurred in this population. Another five deaths are also being investigated as potential suicides.
The drug, Lariam, developed by the Walter Reed Army Institute of Research, is used by soldiers in the Middle East to defend against malaria. The coming hot, moist summer months make getting this deadly disease more likely. According to the Food and Drug Administration, Lariam can cause not only thoughts of suicide, but also psychosis, paranoia, depression and aggression. No direct link has yet been established between the drug and actual suicides, though rare suicide reports amongst Lariam users do occur.
Only four of the 21 suicide victims came from units taking Lariam, and only one tested positive for it in the blood, according to Pentagon health officials. According to LTG James Peake, the Army Surgeon General, a soldier with a history of depression gets an alternate anti-malaria drug. Once mosquitoes in Iraq are tested for malaria, the Central Command surgeon will make the decision whether or not to use anti-malaria drugs in the region at all. They may, in fact, determine that the malaria risk does not justify use of a vaccine. This summer, the daily anti-malaria drug Chloroquine, instead of the more effective Lariam, may be given to soldiers in Iraq should a need for a drug be determined.
According to Col Thomas Burke, program director for mental health policy for the Assistant Secretary of Defense (Health Affairs), overall military suicide rates have remained constant for over a decade. Army rates may look higher, due to the relatively large Army footprint in the Iraq theatre, Burke said. all of the services are now taking a much more integrated approach to not only suicide prevention, but also to mental health care. In 2003, the Army sent over 500 soldiers from Iraq to mental health treatment facilities. Service members now get much needed support not only before and during deployments, but also receive evaluation and care upon their return home.
In addition to the leadership oriented military suicide prevention programs, co-workers, family members and military leaders can all help troubled service members before they make a decision to follow thru with suicide. Burke pointed out that military leaders should also be stressing that there's no stigma attached to getting help with mental health issues. In fact, a recent Marine Corps statistic shows that 75 percent of Marines who had committed suicide had not seen a mental health care provider within the year preceding their death, according to Burke.
United Press International. DOD Now Eyes Lariam in Suicides. Military.Com, February 26th, 2004
Triggs, Marcia SFC. Army Study to Dispel Lariam Suicide Myths. Health.mil. February 26th, 2004.
Gilmore, Gerry J. 'No Epidemic' Number of Soldier Suicides in Iraq. Health.mil. February 26th, 2004.
Labbe, Theola. Suicides in Iraq, Questions at Home. The Washington Post. February 19th, 2004.
Copyright Association of Military Surgeons of the United States Spring 2004
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