Pentagon Finally Stops Hiding Military Overdose Epidemic
The U.S. Army Special Forces, better known as the Green Berets, has a serious problem with substance abuse and fatal drug overdoses. The same is true of the Army’s two most important infantry divisions: the 101st Airborne Division and the 82nd Airborne Division.
That’s the takeaway of data released by the Pentagon this week to a group of five U.S. senators, led by Massachusetts Sen. Edward Markey. Markey, Massachusetts Sen. Elizabeth Warren, and others grew concerned about rising drug use in the military after reading a report in the September issue of Rolling Stone that at least 14 and as many as 30 American soldiers had died in 2020 and 2021 of overdoses at Fort Bragg, North Carolina. Fort Bragg is the headquarters of the Special Forces, as well as the top-secret Joint Special Operations Command, the “black ops” component of the military.
The senators wrote a letter to Secretary of Defense Lloyd Austin in late September requesting detailed statistics, going back five years, on accidental overdoses in the ranks. “We share your concern that drug overdose is a serious problem,” the Pentagon’s undersecretary for personnel and readiness wrote in response this week. “We must work to do better.”
A total of 15,293 American soldiers, sailors, airmen, and Marines overdosed on illicit drugs from 2017 to 2022, according to a compendium of data and analysis enclosed with the letter. Of those, 332 cases were fatal.
Consistent with Rolling Stone’s recent reporting, the data showed a rising long-term trend, followed by a sharp spike in overdose deaths among active-duty military men in 2020 and 2021. Fentanyl was by far the biggest killer, accounting for more than half of the casualties. “The number of OD deaths involving fentanyl has more than doubled over the past five years,” the Pentagon disclosed.
“With hundreds of fatal overdoses reported on U.S. military bases in recent years,” Markey writes in a statement to Rolling Stone, “the toll is mounting. We can and must curb this tragic trend.”
The demographics of those hardest hit paralleled the opioid crisis in the civilian population. The overwhelming majority of fatal overdoses in the military occurred among white male soldiers between the ages of 18 and 33. Notably, 96 percent of OD victims were enlisted personnel, as opposed to commissioned officers. In the civilian population, too, people without college degrees have suffered the most from the scourge of opioid addiction.
The Pentagon’s letter to Markey and his colleagues pointedly noted that in 2020, the rate of fatal overdoses across the entire Department of Defense was 5.0 per 100,000 — much lower than the comparable civilian rate of 28.3 per 100,000 for Americans in general. However, the geographic breakdown of the data showed that there are certain installations where the overdose rate is significantly higher than the civilian base line. What’s more, nearly all of those locations have dense concentrations of Army infantrymen, Green Berets, and other elite soldiers. This is likely no coincidence, as these formations, together with the smaller Naval Special Warfare Command, have borne nearly all of the brunt of the past decade of war in Afghanistan and a half-dozen other countries.
“Damaged people self-medicate,” says Dr. Jaime Earnest, an epidemiologist and expert on behavioral health and substance abuse who has worked on staff at the Pentagon. “It’s what they do.”
She described the overlap between “moral injury and PTSD” and substance abuse as “like peanut butter and jelly.”
“Moral injury” is a term often used in the context of veterans’ health care to refer to the complex of symptoms arising from a damaged conscience, typically involving profound feelings of guilt, shame, and anger. Military personnel who participate directly in combat are most at risk of suffering this form of trauma, which is distinct from the heightened feelings of alertness and stress that characterize PTSD. “Pretty much all of these moral injury, anxiety, and mood-based disorder states are very frequently comorbid with substance abuse,” Earnest says.
The Pentagon data makes clear that Fort Bragg — the beating heart of America’s global special-operations complex — is far and away the site of the most drug overdoses, both in absolute terms and per capita, with 31 confirmed OD’s since 2017, a rate of 36.0 per 100,000 soldiers. That is a significant disclosure, because for as long as I have been reporting this story, since early 2021, Fort Bragg officials have insisted that while they do admittedly have something of a drug problem, it isn’t nearly as bad as the civilian population from which the Army draws its personnel. The data released this week belies that line of reasoning.
Besides North Carolina, the only other state with a major military population where service members died of overdoses at a significantly higher rate than the civilian populace was Washington state, home of Joint Base Lewis-McChord, the headquarters of the 1st Special Forces Group. Eleven soldiers have fatally overdosed at JBLM since 2017. That is much fewer than at Fort Bragg, but still comes out to an annual rate of 29.5 per 100,000.
Though the military population in Kentucky is small, the overdose rate among that group was very high, the data showed. From 2017 to 2022, the annual rate was 50.4 per 100,000, more than double the national rate — and that is saying a lot, because the national rate has been steadily rising for decades and is at a historic high. The biggest military base in Kentucky is Fort Campbell, home of the famed 101st Airborne Division, the 5th Special Forces Group, and the covert, night-flying 160th Special Operations Aviation Regiment. These are organizations that have been embroiled in continuous low-level wars fought in near-total secrecy over the past 10 years, in remote countries like Mali, Yemen, Syria, Somalia, and Niger.
“We like to characterize SOF-ambitious soldiers as lacking in empathy,” Earnest says, referring to soldiers who aspire to join the Special Operations Forces. “But they’re not, they’re human.” She gives the example of a Special Forces soldier who starts using cocaine “because it makes you feel braver. And like a big man, you can handle the pressure of your job, when you actually feel kind of scared inside, or deeply morally injured because you’re not a robot automaton, and you’re having nightmares about the people you shot.”
Against the stereotype of elite soldiers as coldblooded, hardhearted killers, she says, “everybody has a different personality, characteristics, and cognitive architecture, which facilitates them being able to do that job and wanting to be ambitious in that career track.”
The government trains these men to kill and then sends them into war zones to do exactly that. “We expect moral injuries to be a consequence of combat,” Earnest says. “Particularly when there’s been a traumatic event. And we cannot abdicate our ethical responsibility as an organization, as the U.S. federal government, when we put people in occupational situations that we know cause collateral psychological damage,” to properly care for their mental health in the aftermath.
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The Pentagon’s letter to Markey and his colleagues makes reference to a great deal of programs and protocols in use in the military to deal with substance abuse and associated mental health issues, and throws out a dizzying array of acronyms including MPDATP, DDRP, “SMART” testing, OPSS, SUDCC, ADAPT, and MAT. “The Army loves its policies and programs,” Earnest says. “The massive size and organizational structure of the DOD and the military health system is mind-boggling. There are a million links you can click, text alerts, phones you can jingle, hotlines with three numbers, chat apps.” Nevertheless, she says, “our duty of care to these soldiers is not being fulfilled,” because so many of these processes are not designed to actually heal an individual human being, but to coldly assess whether or not he or she is “operationally deployable.”
Other barriers to reducing drug addiction, overdoses, and suicide in the Special Forces include a lack of highly trained psychologists qualified to deal with complex cases, plus the cultural and occupational stigma of seeking help, Earnest says. In addition, “the Army’s commitment to optics management is in direct conflict with its ethical duty of care to its soldiers. You cannot pretend that everything is OK and make managing optics your priority. You cannot put people and optics first. It has to be people first. And that actually has to mean something.”