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Toronto Star August 1, 2002

U.S. pilots stay up taking 'uppers'

William Walker

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PERFORMANCE MAINTENANCE During Continuous Flight Operations A GUIDE FOR FLIGHT SURGEONS - NAVMED P-6410 - 1 JAN 2000 -- Intermittently since Vietnam up through Desert Storm the Air Force has used both amphetamines and sedatives in selected aircraft for specific missions. USAF pilots during Desert Storm stated that 5 mgs of dextro-amphetamine (Dexedrine) helped maintain alertness without causing other changes in mood or perception.
WASHINGTON - U.S. jet fighter pilots, responsible for at least 10 deadly "friendly fire" accidents in the Afghanistan war, have regularly been given amphetamines to fly longer hours.

Then when they return to base, the pilots are given sedatives by air force doctors to help them sleep, before beginning the whole cycle again on the next mission, often less than 12 hours later.

The exact drugs pilots are given and how they're taken is outlined in a 24-page document obtained by The Star, produced by the Top Gun fighter training school and the Naval Aerospace Medical Research Laboratory in Pensacola, Fla.

A spokesperson for the U.S. Air Force Surgeon-General's Office in Washington confirmed pilots are given the stimulant Dexedrine, generically known as dextroamphetamine, to stay alert during combat missions in Afghanistan.

Pilots refer to Dexedrine as "go-pills." The sleeping pills they are given, called Ambien (zolpidem) and Restoril (temazepam), are referred to as "no-go pills."

"When fatigue could be expected to degrade air crew performance, they are given Dexedrine in 10 mg doses," air force spokeswoman Betty-Anne Mauger told The Star.

It is not known whether Dexedrine was involved in the friendly fire incident in which an American fighter jet dropped a 500-pound laser-guided bomb that killed four Canadian soldiers early on April 18. But the possibility did come to the mind of one defence analyst.

"Better bombing through chemistry," remarked John Pike, director of Globalsecurity.org, a Washington-area defence policy think-tank.

"This was certainly one of my first thoughts after the Canadian friendly fire accident," he said in an interview. "The initial depiction made it seem as if the pilot was behaving in an unusually aggressive fashion."

Illinois Air National Guard Maj. Harry Schmidt was piloting the F-16 supersonic fighter that dropped the bomb. Maj. William Umbach was flying with him in another F-16 that night.

"I don't know the answer," Schmidt's lawyer, Charles Gittins, responded last night about whether Dexedrine was involved. "I never asked my pilot if he was medicated. But it's quite common. He's on vacation now, so I'll check with him about it when he gets back."

Pike said there's little controversy among politicians or the American public about the use of amphetamines by the air force because "I don't think anybody even knows about it.

"The aviation community and the air force community certainly don't like to talk about so-called `performance enhancing' drugs," he said.

There have been reports that Schmidt and his fellow pilots - originally deployed to patrol the U.S.-enforced no-fly zone over southern Iraq from an American base in Kuwait - had complained of fatigue since they were also ordered to fly combat missions over Afghanistan. Gittins said he was not aware of such complaints.

Schmidt and his fellow pilots had to fly for three hours to arrive at the combat zone. An F-16 mission to Afghanistan from Kuwait routinely takes nine hours including three hours over the target area plus the trip back. Pilots also attend pre-flight briefings and debriefings after they return.

Mauger said Dexedrine is commonly used by pilots on missions of more than eight hours' duration, or when pilots get less than the recommended 12 hours' rest between missions, as was the case for the pilots on double duty from the Kuwait air base.

The 24-page Top Gun document, entitled Performance Maintenance During Continuous Flight Operations, reports that in an anonymous survey among pilots who flew in Desert Storm, the 1991 Persian Gulf War, 60 per cent said they used Dexedrine. In units that saw the most frequent combat missions, usage was as high as 96 per cent.

During that war, Dexedrine was administered in doses of 5 mg each, as opposed to the 10 mg pills now offered to pilots in Afghanistan.

So far, amphetamine use has not been mentioned in the summaries made public of either the Canadian or U.S. probes into the accident, which killed Princess Patricia's Canadian Light Infantry soldiers Sgt. Marc Léger, Pte. Nathan Smith, Pte. Richard Green and Cpl. Ainsworth Dyer.

But according to a leaked transcript of radio communications, Schmidt - after reporting that he was being fired at from the ground but being told by air controllers to "hold fire" - suddenly declared he was "rolling in" and dropped the bomb.

It was only after Schmidt hit his target that he asked the controllers to confirm he was being fired at. The dispatcher responded: "You're cleared. Self-defence."

The U.S. military appears to view pilots as machines. Under the heading "Basic Principles" in the Top Gun document, it says: "We manage maintenance, we manage fuel and weapons; we can also manage fatigue."

Pilots are allowed to "self-regulate" the amounts of Dexedrine they take. They carry the pills in the single-person cockpit of their F-16s and take them as they wish.

As one unidentified Desert Storm squadron commander said of his pilots in the document: "You must give them guidelines and then let them self-regulate. If you can't trust them with the medication then you can't trust them with a 50 million dollar airplane to try and go kill someone."

Retired Col. Richard Graham of Plano, Texas, who logged 4,600 hours of flight time in the U.S. Air Force, including 210 combat missions in Vietnam, said pilots in that war routinely took Dexedrine. The air force approved its use in 1960.

"We would be tested for uppers and downers and if we tolerated them okay, we went forward," he said in an interview. As long as nobody is abusing it, I think it's okay.

"I'm not a big fan of anybody taking medication in the flight business, but sometimes situations call for it in combat. I never had any bad effects from it and it served me well."

But medical literature indicates that amphetamines can have severe side effects. The worst is called "amphetamine psychosis." It causes hallucinations as well as paranoid delusions.

"Dexedrine also leads a person to build a tolerance level for the drug and when higher doses are offered, anything at that level develops addictive tendencies among those who continue to use it regularly," said Dr. Joyce A. Walsleben, director of the Sleep Disorder Centre at the New York University School of Medicine. "The threat of abuse and addiction is definitely higher with Dexedrine."

Pilots, after being tested for drug tolerance, are also asked to sign a consent form, which was also obtained by The Star.

Entitled "Informed Consent For Operational Use of Dexedrine," it begins by saying: "It has been explained to me and I understand that the U.S. Food and Drug Administration has not approved the use of Dexedrine to manage fatigue ... (and) I further understand that the decision to take this medication is mine alone."

Air force insiders say the pilots really do not have a choice in taking the drug. The form states that "should I choose not to take it under circumstances where its use appears indicated ... my commander, upon advice of the flight surgeon, may determine whether or not I should be considered unfit to fly a given mission."

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