In the last decade the American military pioneered a programme designed to dull the moral sensibilities of American soldiers in combat on the imperial frontiers: "Pentagon, Big Pharma: Drug Troops to Numb Them to Horrors of War". This attempt to peddle magic pills to chase away the horrors of war is just one front in a long-term, wide-ranging "warfighter enhancement program" ~ including the neurological and genetic re-engineering of soldiers' minds and bodies to create what the Pentagon calls "iron bodied and iron willed personnel": Tireless, relentless, remorseless, unstoppable.
Combat veterans with PTSD
and Traumatic Brain Injuries are suffering from skyrocketing rates of
addiction, alcoholism and suicide. Thirty-five years after Vietnam, is America
creating another lost generation?
November 16, 2011
“Multiple tours and violent conflict generate PTSD. Add to that the worst economy since the Great Depression, traumatic brain injury, and suicide and divorce rates that are off the charts ~ there is going to be a tsunami of addiction, alcoholism and homelessness.”
Every war has its
“signature” wound. In the Civil War, it was gangrene; in World War I, it was
lungs shredded by mustard gas attacks; in World War II, shrapnel. In Iraq and
Afghanistan, it's Traumatic Brain Injury, or TBI. With armored Humvees and new
body protection, soldiers are surviving massive IED blasts that send huge shock
waves through their bodies. The concussive force of five artillery shells
exploding beneath a vehicle damages a soldier's brain in ways researchers are
just starting to understand.
The symptoms of TBI are
similar to those of post-traumatic stress disorder (PTSD); one of the main
commonalities is, of course, increased alcohol and drug use. Take First
Sergeant Hector Matascastillo, a warrior’s warrior. He finished top of his
class in Ranger training, and had boots on the ground in 57 countries with a
whopping 13 combat deployments in an 18-year career in the military.
Seven years ago he was on
a “house cleaning” operation in Iraq, sweeping room to room, a pistol in each
hand, ferreting out enemy combatants. “My training had taught me that when
faced with an armed enemy to kill him,” he says.
This house was clear, but
as Matascastillo stepped outside, an enemy stood directly in front of him with
his gun raised. Matascastillo’s weapons were at his sides. He was wondering why
the man hadn't instantly fired when, inexplicably, the enemy began backing away
with his gun raised. Then he tripped on a curb. Matascastillo raised his
sidearm and just as he was about to open fire, he heard his wife screaming
behind him.
Suddenly, he realized he
was standing in front of his modest home in Lakeville, Minnesota. Police lights
were flashing all around him. He emerged from a nightmare to a life marked by
increased drinking, to nights when he had to "Nyquilize" himself to
sleep. This time, a late-night fight with his wife had led to this moment, an
extreme manifestation of the damage of Post Traumatic Stress Disorder..
Matascastillo is one of
thousands of vets who've dealt with the harrowing transition from combat to
civilian life and the complications of substance abuse. Unlike Hector, though,
most remain silent, and countless go untreated. The consequences are grave: A recent study
reported that a veteran commits suicide every 80 minutes; another determined that
in 2009, 1,868 veterans from the wars in Iraq and Afghanistan tried to kill
themselves. Clearly, not enough is being done to help.
Defense attorney Brock Hunter has
made a study of the relationship between soldiering and booze. “PTSD and
alcohol have gone together for as long as there has been war,” he says. “There
are clear images of combat soldiers using alcohol going back to Homer and The
Iliad.” Alcohol works well for soldiers trying to manage the flashbacks,
insomnia, anger and anxiety of PTSD and TBI, Hunter says.
“Some veterans have told me that their prescriptions for PTSD are not as effective as alcohol at managing nerves and anxiety. Alcohol is by far the most popular and widely abused [drug in the military] ~ and the most likely to get them in trouble with the police.”
Hunter specializes in
representing veterans who get into legal scrapes, mostly due to PTSD and
related alcohol and drug use. And he has seen a dramatic spike in caseload in
the last six months. “It's scary,” he says. “I am getting three or four calls a
day.”
"If PTSD and depression go untreated or are under-treated, there's a cascading set of consequences: Drug use, suicide, marital problems and unemployment."
Veteran’s advocates like
Hunter expect the percentage of veterans suffering from PTSD to be far higher
than during previous wars.
“The United States has the smallest military in our history and we are fighting the two longest wars. Two or three combat tours are commonplace, with some serving as many as eight deployments. And the combat is brutal: face-to-face, hand-to-hand in the street in an urban civilian environment.”
Soldiers returning from
the Vietnam War with PTSD led to a wholesale reform of how vets are treated.
Veteran’s advocates like Hunter and Shad Meshad, founder of National
Veterans Foundation, made sure vets kept benefits if they sought
help for mental illness, worked to get services like alcohol treatment programs
at VA hospitals, and devised ways to fill holes in VA services ~ resources like
the Vets Clinic, or Military OneSource, a VA
facility that protects confidentiality of its patients. .
Hunter wants to build on
that. In response to the cases he has in Minnesota, he has helped establish a
“Veteran's Court” in Hennepin County, Minnesota. He and Meshad are writing a book for
other attorneys to help them represent veterans better in the legal system.
Says Meshad,
“These men and women deserve therapy first; the violence is a result of their PTSD, and they are trained killers.”
Meshad has worked with
veterans for over 40 years, helping soldiers from World War I on. He has
appeared on Dateline and been quoted in the New York Times, and
he was also once held hostage by a disgruntled vet for hours (he later made the
veteran a partner in one of his organizations; they're close friends today). He
has slept on the streets with homeless vets and testified before Congress.
Meshad is not easily rattled, but this time around, with these wars, he's
afraid. He says:
“Multiple tours and violent conflict generate PTSD. Add to that the worst economy since the Great Depression, high incidence of traumatic brain injury, and suicide, violence and divorce rates that are off the charts ~ there is going to be a tsunami of addiction, alcoholism and homelessness.”
According to Meshad,
“Los Angeles has the largest homeless population in the country and a third are veterans. It took 15 years for the Vietnam vets to start showing up under the 405 bridge. The Iraq and Afghanistan kids are up there now.”
A Pew Research report
published on October 5th, 2011 supports
Meshad's point. While over 90% of veterans are proud of their service, 44%
report they have had difficulties readjusting to civilian life, 37% say they
have suffered PTSD (whether or not formally diagnosed), 48% felt strains in
family relationships, and 47% frequently feel irritable or angry.
The report states,
“Among all post-9/11 veterans who report having had traumatic experiences during their time in the military, 72% say they have had flashbacks, repeated distressing memories or recurring dreams of those incidents. Among post-9/11 combat veterans, the share is slightly higher ~ 75% of those who say they had traumatic experiences while they were in the service also say they've had flashbacks or nightmares related to those incidents.”“The military is issuing prescription meds like anti-anxiety and pain medications to troops in combat to keep them from breaking down.”
In 2008, the New York Times
reported that
Iraq and Afghanistan veterans had committed 121 homicides, but most of the
crimes were related to drugs and alcohol; one in four veterans between the ages
of 18 and 25 met the criteria for a substance abuse disorder, and 18 veterans a
day commit suicide in the United States ~ a casualty rate that will continue
long after the war’s end. The Rand study estimated that returning veterans with
PTSD and depression will cost the nation as much as $6.2 billion in the two
years following deployment.
But the addiction and
alcohol issues are not only due to PTSD. Says Hunter,
“The military is issuing prescription meds like anti-anxiety and pain medications to troops in combat to keep them from breaking down ~ and to keep them functioning.”
Psychologists are unsure
of the impact, but some suggest that by using drugs to keep soldiers
functioning who have already been exposed to multiple traumatic events they
continue to be exposed when they would otherwise have broken down.
“We've got medicated
soldiers fighting because that's all the military has got,” says Meshad. “They
have to recycle the soldiers back to the battlefield.”
Soldiers with battle
wounds are given Oxycontin and fentynal. “Pain medications are a big deal,”
Hunter reports.
“Vets get addicted and then their prescription ends and they have go out and get it illegally.”
The VA, to its credit,
has far better services for soldiers suffering from PTSD than it did for
Vietnam era veterans. Yet despite the improvements, the VA is a vast
bureaucracy facing a flood of mental health issues. Funding for veterans
services requires annual appropriations from Congress, making the survival of
vets' programs a constant political football. The biggest problem is that
soldiers with PTSD don't go into the VA and ask for help.
First Sergeant Hector
Matascastillo lost his family and went to jail after
having his flashback. Still, he resisted the idea that he was suffering from a
mental health disease.
He says about seeking
help:
“The stigma is still very much out there. “As I was realizing that I was not well, I thought if I can't handle this, my superior won't move me forward. The quick, easy way to deal with flashbacks was to numb it by drinking or even 'Nyquilize' myself so I could sleep.”
“Right, a guy admit he's weak,” he says. “They'd be on him like jackals.”
So the soldiers won't
talk to caseworkers, psychologists, or even writers for The Fix. But
PTSD, alcoholism and addiction are family diseases, and the wives do talk ~ but
only off the record, and even then only through the relative anonymity of the
Internet. Sites like FamilyOfaVet.com, a non-profit
organization dedicated to helping heroes and their families survive and thrive
after combat, are avenues of hope for isolated wives and family.
When I posted on one site for this story, emails trickled into my inbox. The wives want to talk, but they're guarded, suspicious and maintain anonymity.After all, living with a husband suffering from PTSD is a form of combat in itself, and the disease is contagious.
One woman wrote,
“I am glad to contribute as long as none of my personal info is used… I am rarely away from my husband and he doesn't want me talking to anyone about him. My husband was diagnosed with PTSD during his first tour…TBI during his 2nd tour. After he…came home…he was very stand offish, going out to our garage…alone…in the middle of the night and just sit in the dark. He started sleepwalking…crazy mood changes…an explosive temper…he is…an almost daily drinker…his mind going 24/7. He wants something to block that even if just for a short time.”
She continued,
“We cope the only way we can, we laugh as much as possible…at his crazy memory loss, we laugh when his brain can't form the right words. We talk, seriously, on those days when he is doing 'good' so he understands what I am feeling and going through. I give him his space on the days when he is doing 'bad.' I try to treasure all the good days.”
“I am seeing these guys
drinking or shooting heroin so they don't have the anxiety attacks or
flashbacks,” wrote one wife, who's a nurse at a VA psych ward. “One of the main
things we do is detox a lot of really young guys.” Two of her patients have
overdosed on heroin.
Another woman called and
said, “Addiction is a huge problem.” Her voice was even and quiet, the struggle
and turmoil beneath her words like a great weight. “I left my husband at the
end of March,” she said. “PTSD turns you into a beast…he was
self-medicating…drinking all the time. I am pregnant with his child and he
doesn't know and with him using I am not sure what to do.”
One woman takes care of
her husband and also works as a nurse on a VA psych ward. “What I am seeing is
these guys are drinking or shooting heroin so they don't have the anxiety
attacks or flashbacks,” she wrote. “One of the main things we do is detox. We
are detoxing a lot of really young guys.” Two of her patients have overdosed on
heroin in the last few years.
None of the wives would
allow their names to be used. Only a hero like Hector Matascastillo, brave in
both battle and civilian life, has stepped forward to speak on the record. The
wives understand anonymity. Says one,
“I have secondary trauma issues, and it is hard to talk about. Surrounding the military is the stigma that you can't admit to being mentally weak [which] is preventing people from seeking help. The military has trouble recognizing PTSD and they don't communicate that you can seek help without repercussions.”
I pressed the wives,
asking them why it was impossible to find a veteran beyond Matascastillo that
was willing to talk about his PTSD and struggles adjusting to life after war.
One woman had a startling view. “PTSD changes your brain,” she says. “It makes them angry and kinda jerks; they lose their sympathetic response [where they would normally be] willing to help out with something like this."
Milan Christianson is a
veteran who works as a psychologist, human relations and family life specialist
and teaches at North Dakota State. He sees a need for groups like FamilyOfaVet.
Christianson wrote the book for the Air Force that helps Chaplains help
families deal with a major deployment and the return of their soldier. Said
Christianson:
“The VA needs to be more connected with the civilian portion, that piece beyond diagnosis and prescribing medication. The military needs to train soldiers and their families to deal with family issues right at boot camp. They (families and soldiers) have not been trained, and they do not know what they are up against.”
The “militaristic
culture” of this war, says Christianson, is so much less than in previous wars.
During World War II, for instance, with over half of all military aged males
serving, the military culture was very much a part of mainstream culture.
Not so for Iraq and
Afghanistan, with only about 1% of military aged males serving. In
addition, World War II Veterans returned to a booming economy and free
education in the form of the GI Bill.
Said Christianson, “The number one thing we could do for these veterans is to give them a job or education.”
Congressman Tim Walz, a
retired National Guard Command Sergeant Major, elected in Minnesota’s First
Congressional District in 2006, agrees. Congressman Walz has become a national
leader on veterans’ issues, serving on the House Veterans Affairs Committee and
working to make reintegration easier for veterans and their families. Says
Walz,
“You need to have a comprehensive approach. From being able to get a good paying job to support your family when you return home, to getting the physical and mental health care you need and have earned, to getting the support your family needs as you reintegrate to civilian life ~ none of these things happen in a bubble. They are all interconnected and it’s important we approach our work that way.”
Matascastillo is proof
that there is life after PTSD. He was finally able to get treatment, and he
dove into individual therapy the way he did everything: balls-to-the-wall.
“I did intensive therapy for a year, and pilot programs at the VA like spiritual healing, which was awesome.”
During therapy,
Matascastillo was able to identify the thing that haunted him, the event from
his 13 combat missions that put him on edge: he was in Kosovo in the late
1990s, on a hilltop to witness events and report back to command and ordered to
take no action.
He watched through his riflescope as the genocide unfolded, as
soldiers rounded up and shot the all the men in a village and then raped the
women. One woman had her baby torn from her arms and Matascastillo was forced
to watch as they shot her child in front of her and then raped the mother. His
eye was to the scope of a weapon that could end her misery, protect her child,
and bring justice. But his orders were to do nothing and so, impotent, he
watched. The horror never left him.
During his trial, many of
the officers who Matascastillo had served under came forward. He was able to
avoid jail time. He may have lost his wife and home, but not his career. In
fact, after his therapist suggested a remarkable way for him to heal himself ~ by
going back into the breach ~ he was able, with the help of supportive officers
and his sterling record, to convince the army to send him back to Iraq in
command of a full company of men as their Staff Sergeant.
He knew what these men
faced and was relentless in training. “My men hated me,” he says. “I needed to
train them hard so that they all came back and could hate me for the rest of
their lives.”
They were sent to Al
Anbar during the surge and saw heavy action. Matascastillo barely slept during
that time ~ his energy was intense, his mind racing a million miles an hour.
“It was a crucible,” he says.
“But I brought them all home. Some purple hearts
and shattered minds but all alive. Back home we went on parade and read the
roster. I turned them all back to the commander and said, 'They are all here.'”
And then he collapsed. He
wept. He allowed his racing mind to quiet and the demons to depart. Just two
years shy of his pension, he retired and left the military. He got his degree
as a psychotherapist and clinical social worker. Now he spends his life trying
to help other vets navigate their battle related PTSD, TBI, drinking and
drugging. “We do a lot of reality therapy to overcome that stigma,” he says.
“We try to re-frame that stigma by being realistic.” His record is such that
the jackals don't dare bite, so, like Audie Murphy, the most decorated warrior
in American history who broke the code of silence during the Vietnam War,
Matascastillo is carrying the message. “It is easier,” he says, “to live the
rest of my life without worrying about what the military thinks.”
There is hope, and it is
at the VA, warts and all. “The VA is a very frustrating system,” says
Matascastillo. “But there you will find the warriors that have gone before you.
The Vietnam era broke down a lot of barriers and guys need to be persistent and
ask for help.”
One of the women's
husbands saw a speech therapist that gave him an iPod to help him break free of
flashbacks. Apps reminds him of appointments and to-do lists, Cozi.com sends
him reminders from his wife for his family calendar, and a special watch given
to him by the VA vibrates against his wrist every 10 minutes, reminding him to
come back to the “now” if he is slipping into flashback.
According to one of the
wives,
“Veterans need to register. All benefits depend on registry. The VA doesn't advertise. Soldiers can get five years of health care, and there's the post 9/11 caregiver program ~ you can apply for it if your husband was severely wounded post 9/11 and you get support and a stipend every month.”
The second thing vets
should do, she says, is to make an appointment with the transition clinic. If
they don't feel like they can come to the VA, there are other resources. She
urges the men and their wives to speak out, if only anonymously. “The more
exposure we give to PTSD, the less stigma there will be,” she says. “The less
stigma, the less self medicating. The less self medicating, the less dependence
and addiction and broken families and legal problems.”
One of the wives perhaps
best sums up the situation we find ourselves in when she says,
“This war has come home to all of us. Now it is being fought in homes across the country. We are in the fight of our lives.”
The Huffington Post
Impact has compiled a list of organizations that seek to help veterans like the
ones mentioned here. You can read more about those groups, and ways you can
help, here.
Jeff Forester is a writer
in Minnesota. His book, Forest for the Trees: How
Humans Shaped the North Woods, an ecological history of his state's famed
Boundary Waters, came out in paperback in 2009. He has also written about sober high schools and
relapsing addiction counselors, among
many other topics, for The Fix.
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