In his last months alive, Senior Aviator Anthony Mena rarely left the home without a backpack filled with drugs.
He returned for his second deployment to Iraq complaining of back pain, insomnia, anxiety and nightmares. Doctors diagnosed disorder by post-traumatic stress disorder and prescribed potent cocktail of psychiatric and narcotic drugs.
However his pain only deepened, as did his depression. "I've almost given its hope," said a doctor in 2008, the show's medical records. "I have died in Iraq."
Aviator Mena instead died were in their apartment in Albuquerque, July 21, 2009, five months after leaving the air force in a high medical. A toxicologist found eight drugs prescribed in their blood, including three antidepressant, sedative, a sleeping pill and two powerful painkillers.
However, his death was not suicide, the coroner came to the conclusion. That killed Aviator Mena was not any one drug overdose, but the interaction of many. He was 23.
After a decade to treat thousands of wounded soldiers, the military medical system is awash in prescription drug and the results were sometimes fatal.
According to some estimates, more than 300,000 soldiers had returned from Iraq or Afghanistan with P.T.S.D., depression, traumatic brain injury or a combination of those. The Pentagon has approached the pharmacology to treat these complex problems, following the initiative of civilian medicine. As a result, psychiatric medications have been more widely used by the military than in any previous war.
But these medications with narcotic pain relievers are ever more linked to a rising tide of other problems, including drug dependence, suicides and fatal accidents - sometimes the interaction of the drugs themselves. A report from the army on suicide, released last year documented the problem, saying that a third of the force was on prescription medications at least one.
"Prescription drug abuse is on the rise," said the report, noting that drugs were involved in one third of suicides of record 162 active soldiers in 2009. An additional 101 soldiers accidentally killed the toxic mixture of medicines prescribed from 2006 to 2009.
"I am not a doctor, but there is something inside me said the younger of these things we carry, it would be best," General Peter Chiarelli from w., the vice Chief of staff of the army that has led the efforts on the suicide, said in an interview.
Awareness of the dangers of the overmedicated troops has made to the Department of Defense to improve the monitoring of prescription drugs and restrict its use.
In November, the army issued a new policy on the use of several medications which requires further training for doctors, limits of 30 days on new recipes and General examination of cases where patients are receiving four or more drugs.
The Pentagon is also promoting measures to prevent troops from storage of drugs, a common source of overdose. For example, the Navy that provides medical care for the Marines, has begun to days of "reward" pill in certain databases. In Camp Lejeune, North Carolina, 22,000 expired pills were returned in December.
The army and Navy are also offering more treatments without drugs, such as acupuncture and yoga. And they have sought to expand programs in speech, one of whom, exposure therapy, therapy it is considered by some experts as the only proven treatment for P.T.S.D. But the shortage of mental health professionals has hampered the efforts.
Still, given the depth of the medical problems of combat veterans, well as the strong dependence of the medical system of drug, few experts expect that the widespread use of various medications to decrease significantly in the near future.
The New York Times reviewed in detail the cases of three members of service who was killed by forensic doctors said were toxic interactions of prescription drugs. All were classified as accidents, suicides do not.
Aviator Mena was part of a military police unit that patrols you battle with units of the army in the center of Baghdad. Clean up the remains of bombing victims suicide and he was almost killed by a bomb, display their records.
Christopher Bachus artillery Sergeant had spent virtually all his adult life in the Marine Corps, the deployment in the Middle East in 1991, Iraq during the invasion of 2003, and for a brief tour, Afghanistan in 2005. He suffered from what he calls the survivor guilt and returned as "a ghost," medical, said his brother, Jerry, of Westerville, Ohio.
Cape Nicholas Endicott joined the Marines in 2003 after working as a West Virginia coal miner. He deployed twice to Iraq and once a Afghanistan, where he saw heavy combat. On a mission, Corporal Endicott was injected more than eight feet in the air by a bomb, display medical records. Wine House was plagued by nightmares and memories and rarely left the House.
Given the complexity of the interactions of drugs, it is difficult to know exactly what killed the three men, and the Pentagon refused to comment on their case, citing confidentiality. But there were significant similarities with their stories.
All the men had been deployed several times and finally received diagnoses of P.T.S.D. All of them had five or more drugs in their systems when they were killed, including opioid analgesics and psychiatric drugs alter state of mind, but not alcohol. Everything had changed drug repeatedly, expecting better results that never arrived.
All died in his sleep.
Psychiatry and war
The military medical system has struggled to meet the demand caused by two wars, and today still reports of shortage of therapists, psychologists and psychiatrists. But the drugs have always been available.
Across all branches, spending on psychiatric medication has more than doubled since 2001, to $ 280 million in 2010, according to the numbers obtained by the Defense Logistics Agency by a psychiatrist from Cornell University, Dr. Richard a. Friedman.
Doctors in the health systems of the defense and Veterans Affairs departments say that you for most patients, medications have proven to be safe. "It is important to not reduce the benefit of these medications," said Dr. Robert Kerns, national director of pain management for the Department of Veterans Affairs.
Toby Lyles contributed research.
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