Oh Good

Who, exactly, thought this was a good idea?

he government is testing drugs with severe side effects like psychosis and suicidal behavior on hundreds of military veterans, using small cash payments to attract patients into medical experiments that often target distressed soldiers returning from Iraq and Afghanistan, a Washington Times/ABC News investigation has found.

In one such experiment involving the controversial anti-smoking drug Chantix, the Department of Veterans Affairs (VA) took three months to alert its patients about severe mental side effects. The warning did not arrive until after one of the veterans taking the drug had suffered a psychotic episode that ended in a near lethal confrontation with police.

Appalling.

Comments

Who, exactly, thought this was a good idea?

With the current crowd, are you really that surprised? This fits pretty well with a mentality of torture, secrecy, and totalitarianism.

Posted by live | June 17, 2008 10:36 AM

With the current crowd, are you really that surprised? This fits pretty well with a mentality of torture, secrecy, and totalitarianism.

And the sacrifice of people over profit.

Posted by TDE | June 17, 2008 10:43 AM

But we have to support the troops by keeping them exposed to military action!

Posted by Dave | June 17, 2008 10:49 AM

C'mon! You libruls just don't "support the troops". You're whining about experiments with potential horrible mental health side effects on vets who just got pulled from about the most high stress situation you can imagine, but you probably don't even have a yellow ribbon on your SUV's.

Posted by LFC | June 17, 2008 10:50 AM

But remember, Jeremiah Wright is a demagogue for suggesting that the US government might be conducting tests on its citizens.

Posted by sniper fire | June 17, 2008 11:15 AM

But remember, Jeremiah Wright is a demagogue for suggesting that the US government might be conducting tests on its citizens.

Posted by sniper fire | June 17, 2008 11:17 AM

before all of you get riled up why don't you take a step back and look at what drug they are talking about.

chantix is a new drug that was developed to help people quit smoking. it looks promising, and passed through the regular FDA process. it is a different type of drug and has had good success in helping people quit smoking. better than any other single agent to date. through the FDA phases there is no evidence of the psychotic symptoms that this article is talking about. this drug was approved in 2006 here and in the u.s. after the drug was approved there were some reports of depression and suicidal thoughts and these were in people with previous mental health issues. the european medical agency looked at the drug and said that there was no relationship. the british drug agency and the FDA are now looking into it. pfizer says that these symptoms are due to the nicotine withdrawal, which it could be. in britain out of some 20,000 people 16 reported suicidal thoughts.

so let's put this into context then. you have a new drug to help stop smoking. smoking causes a whole myriad of problems. you have veterans who are heavy heavy smokers and who have trouble quiting. so the v.a. tried to try the new drug out. this wasn't an example of some evil agency trying to harm their veterans. this may be one of two things. one, the drug combined with the nicotine withdrawal exacerbates PRE-EXISTING mental health problems which you would have no way of knowing until the drug was prescribed widely, and two there is no connection whatsoever.

please take these sorts of stories with a tablespoon of salt.

Posted by skeptical m.d. | June 17, 2008 11:24 AM

And exactly how does this differ from medical experimentation not involving veterans, or from past policy?

You do not know that the psychotic episode referred to was caused by the drug. Anyway, using a high-risk population to test for side effects is actually a conservative strategy with respect to overall risk of the drug, as it magnifies the effects. Think of it the other way - would it make sense to test for harmful effects on a population which is known to have a low propensity for these effects?

One reason that veterans are preferred for tests is that they have relatively complete medical records - this can actually make it easier to screen out unsuitable subjects. I believe that veterans have been used in many previous tests.

Making subjects aware of specific possible side effects demonstrably increases the reported incidence of such effects. Is it a good idea to make people think they going crazy (or whatever) if they are really not? Of course subjects must be made aware of the possibility of side effects, but unless they are assured that there will be no side effects any sentient potential subject should already know that there are risks in taking experimental drugs.

There are lots of moral issues involved in human (and animal) testing, but it is not clear that this particular program is qualitatively different from others, or that some particular political faction is responsible for it.

Posted by skeptonomist | June 17, 2008 11:27 AM

What I love about this story is Matt being appalled, but then, entering into the cognitive dissonance zone by continuing to believe that government run health care would be a good thing. If they can't manage the small-ish military population, what makes you think they can handle all of us?

Posted by James Robertson | June 17, 2008 11:27 AM

All the commenters so far seem to think this is something about "the current crowd" or conservatives. That's foolish. There's a certain amount of this that goes on routinely in the uniformed services -- for example there is (I am serious here) a group of soldiers who are exposed to blasts/trauma to look for medical effects there, and a neurologist tells me Ariborne guys suffer certain changes in their grey matter. Whether or not this kind of research is essential or appropriate is an interesting question -- I lean against -- but there's quite a long tradition of it in the uniformed services and here they're extending it to veterans. It's not something Bush/Cheney brought in, and if you want to do something about it -- and you might well -- then you need to understand that or else it'll just continue under a President Obama. This story is unremarkable.

Posted by Sanjay | June 17, 2008 11:30 AM

OK, amend what I said about "all the commenters": when I posted the last comment I saw was by "sniper fire," and in between there and my post all the smart guys came out.

Posted by Sanjay | June 17, 2008 11:34 AM

and another thing

you have to ask yourself is the rate of psychotic episodes among PTSD patients taking chantix higher than that of normal PTSD sufferers.

in the V.A. study in the article they talked about 1 out of a 1000 patients taking chantix. there are studies of much larger patient cohorts that say that up to 50% of PTSD patients experience some sort of psychotic symptoms.

food for thought

Posted by skeptical m.d. | June 17, 2008 11:34 AM

and another thing

you have to ask yourself is the rate of psychotic episodes among PTSD patients taking chantix higher than that of normal PTSD sufferers.

in the V.A. study in the article they talked about 1 out of a 1000 patients taking chantix. there are studies of much larger patient cohorts that say that up to 50% of PTSD patients experience some sort of psychotic symptoms.

food for thought

Posted by skeptical m.d. | June 17, 2008 11:37 AM

This isn't new. Fresh out of basic training at Fort Ord, California, in 1964, some of my recruit buddies went off to volunteer as guinea pigs for LSD and other exciting new substances. As military historian Richard Gabriel documented in his book No More Heroes (1987), the US Army has long experimented with drugs designed to eliminate the fear response--in effect, to turn soldiers into sociopaths.

Posted by Crawford Kilian | June 17, 2008 11:55 AM

Anyone remember Tuskegee?

Posted by ET | June 17, 2008 12:21 PM

Heck, I used Chantix to quit smoking. It's a damn miracle drug. 20 years of smoking, tried everything to quit, this stuff finally did the job.

No side effects.

Posted by wiredog | June 17, 2008 12:25 PM

Evidently, ET _you_ don't remember Tuskegee. Two separate issues there -- the Tuskegee experiments on _civilian_ blacks, and discrimination against the black Tuskegee airmen.

Posted by Sanjay | June 17, 2008 12:29 PM

Sanjay - yes I do know about Tuskegee. I just figured the people on this blog would understand which I was referring to. I guess not.

Posted by ET | June 17, 2008 12:35 PM

I am always amazed how many progressives turn into Luddites when it comes to medical research. How do you think medicine changes over time?

The first question is whether informed consented was obtained from the test subjects.

The second question is whether there is a non-protocol group getting the same treatment. If you do not understand that sentence, you really are not qualified to talk about medical research.

A third question is whether the study is new use for an approved drug, a dosing study, a phase 1 study for developmental drug, or a phase2/3 for a developmental drug.

Posted by superdestroyer | June 17, 2008 12:39 PM

A couple of things, skeptical m.d.
- "1 out of a 1000 patients taking chantix", its actually 1 in 143, or about 7 times more common than you suggested
- "there were some reports of depression and suicidal thoughts and these were in people with previous mental health issues". The study is specifically looking at patients with a pre-existing mental health issue - PTSD.

Chantix may be great at controlling nicotine addiction but its looking like a more and more dangerous drug and putting people with severe psychiatric problems on a relatively new drug that is known to cause suicidality and depression in people with psychiatric problems doesn't seem smart.

Posted by industry researcher | June 17, 2008 4:24 PM

And I suppose you have a better way to develop a corps of mutuant super soldiers?

Posted by Eric Scharf | June 17, 2008 4:52 PM

And I suppose you have a better way to develop a corps of mutuant super soldiers?

Posted by Eric Scharf | June 17, 2008 4:54 PM

I think the point here is not the drug, but that they are testing a drug with suspected bad mental side effects on people...with bad mental side effects already.

That is not smart, no matter what the point of the testing is. It violates any medical ethics I've ever heard of.

The soldiers should be screened first - in fact, it would be better if no troops who have been in a combat theater were selected. That might be hard given the current military situation, but there you are - another "bad side effect" of the wars.

Posted by Richard Steven Hack | June 17, 2008 7:36 PM