Friday, May 2, 2008

Of necessity, the Pentagon strikes "Question 21" from the Security Clearance questionaire

As the war in Afghanistan grinds on toward the seven-year mark, and the war in Iraq is almost two months into the sixth year, the effects on our military forces have been overwhelming. Last month the RAND corporation released a study that pulled the curtain back on the horrors of what our Soldiers, Sailors, Airmen and Marines are being forced to deal with and should have served as a wake-up call for the homefront - and the Pentagon. It also compliments and confirms an Army study on mental health that was released by the Joint Chiefs earlier this month that pegged the number of soldiers suffering from PTSD after one deployment at 12%, after two deployments at 18.5% and after three deployments at 28%.

Many units have deployed multiple times, and as the studies showed, the members of those units are suffering horribly. The more times they deploy, the worse they suffer.

Until yesterday, many of those who are suffering the effects of repeated combat rotations suffered in silence...because of "Question 21."

Anyone wo has ever gone through the process of getting a security clearance knows what it is..."Have you consulted a mental health professional in the past seven years for issues other than martial problems or grief?" A "yes" required excruciating details of the reason treatment was sought, and the treatment method(s) employed. This usually raised other questions and led to closer scrutiny.
John E. Fortunato, chief of Fort Bliss' Restoration and Resilience Center, which treats soldiers returning from combat with post-traumatic stress disorder, called Thursday's announcement an important first step.

Fortunato, who has treated 37 soldiers since his center opened nearly a year ago, said commanders have taunted troops and told them to "soldier on" when they complained of combat stress.

Soldiers have "paid such a high price for PTSD," Fortunato said.

The cost of treating a soldier is far less than pushing him or her out of the Army, Fortunato added. He estimated it costs his center roughly $20,000 to treat someone with post-traumatic stress disorder, compared to the hundreds of thousands of dollars the military would have to spend to replace the discharged soldier.

"The measure (of mental health treatment) success is retention," he said.

During his visit, Gates said the military must lift the stigma on mental health care and encourage troops to see it as equal to physical care.

"The most important thing for us now is to get the word out as far as we can to every man and woman in uniform to let them know about this change, to let them know the efforts that are under way to remove the stigma and to encourage them to seek help when they are in the theater or when they return from the theater," Gates told reporters here as he announced the change.

"The department considers it a mark of strength and maturity to seek appropriate health care, whenever required," James Clapper, the undersecretary of Defense for Intelligence, and David Chu, the undersecretary of Defense for Personnel and Readiness, wrote in a letter announcing the change.

It is a welcome change that is long overdue, but truly - it's better late than never.


It's a welcome step--but will they really strike the question and not hold that against someone when they are adjudicating a clearance renewal? Because that's what this essentially affects. A soldier who reclasses into an MOS or job specialty that requires a clearance after an initial tour shouldn't be penalized, and those who already had clearances shouldn't be penalized for getting PTSD counseling. So you need to strike that question for the FIRST application for a clearance and then for the 5 year periodic updates.

MORE IMPORTANTLY--they strike Question 21, but did you know--Questions 27, 28, and 29 are about ANY kind of "illegal drug use" and the number one item detailed is marijuana? Did you know that Question 30 asks about alcohol and whether or not use of alcohol led to any kind of counseling?

Seems to me, they can strike Question 21, confident they will catch anyone who has PTSD who "self-medicates" with marijuana or alcohol, and as we know from the data, sufferers of PTSD have to self-medicate with whatever they can find while they await treatment in a very slow system and while they go through a phase of getting their various life issues under some kind of control.

The medications that go with that treatment have always been of interest on the clearance paperwork as well--meaning, if you were prescribed valium or some other form of legitimate drug for treatment, you had to disclose that in detail as well. So I hope they end the scrutiny of counseling AND they end the scrutiny of asking what medications were used to treat the PTSD.

As it sits right now, forget about medical marijuana for an active duty soldier. If an active duty soldier legitimately needs it to calm down, the tests hot on a urinalysis, their career is essentially over if they've been in longer than 36 months. This reform is welcome, but the treatment of PTSD often conflicts with what they allow, culturally, in the military, and that's a nearly zero level of tolerance for anything relating to marijuana. If a person who has separated from service needs it, that is less complicated. And if someone is a reservist or guardsman, their testing regime might be less often than for the active duty, but they're in jeopardy of testing positive and facing UCMJ.

A mature and considered debate awaits--do we treat these men and women with medical marijuana or not? And if we do, then THAT should not endanger their clearances nor should it end their careers. So, it's all well and good to strike Question 21 if they then know they can turn around at get someone on the other questions, which ask about use at any time since the age of 16, use while holding a clearance, manufacturing and distribution, and whether use of alcohol led to ANY kind of counseling or treatment. Those questions would surely catch quite a few people who might have answered in the affirmative on Question 21.

Blue Girl adds -

Pale Rider raises a damned good issue. Medical marijuana would, in my (medical) opinion, be preferable to long-term use of any of the anti-anxiety drugs in the benzodiazapine family. They are highly addictive, and highly intoxicating. They also have a long half-life, which means that the drug builds up in the system, and tolerance from intoxication takes a long, long time to kick in. Frequently, by the time it does, an addiction has set in, and abuse soon follows. Benzos should only be used for short periods of time for this reason. But PTSD is not a short-term disorder. It takes a long time to treat.

Marijuana, too, has a long half life, but it stores in the fat cells and doesn't have an amplified intoxication effect.

And by the way, it's bullshit to say it can't be regulated and dosed, because it sure as hell can. By one of the oldest and most effective methods of extracting active ingredients from medicinal herbs...tincturing. Tinctures can be tested for efficacy by batch via chemical assay, and graded by a system something akin to proofing of alcohol. We don't have to distribute two-finger bags and rolling papers at sick call.

And we might need to have a serious discussion about what is best for those in need and forget what gets the authoritarians, hippie-haters and conservatards in a lather. Stop even paying attention to those whack-jobs. They have been wrong about everything and that is never going to change, it's a hallmark of the species. The sooner we get past trying to placate those implacable mouth-breathers and marginalize them to the degree they so richly deserve, the better off we'll be as a society.

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