America's Chemically Modified 21st Century Soldiers

Amphetamines and the military first met somewhere in the fog of WWII, when axis and allied forces alike were issued speed tablets to head off fatigue on the battlefield.

More than 60 years later, the U.S. Air Force still doles out dextro-amphetamine to pilots whose duties do not afford them the luxury of sleep.

Through it all, it seems, the human body and its fleshy weaknesses keep getting in the way of warfare. Just as in the health clinics of the nation, the first waypoint in the military effort to redress these foibles is a pharmaceutical one. The catch is, we're really not that great at it. In the case of speed, the U.S. Drug Enforcement Agency itself notes a few unwanted snags like addiction, anxiety, aggression, paranoia and hallucinations. For side-effects like insomnia, the Air Force issues "no-go" pills like temazepam alongside its "go" pills. Psychosis, though, is a wee bit trickier.

Far from getting discouraged, the working consensus appears to be that we just haven't gotten the drugs right yet. In recent years, the U.S., the UK and France -- among others -- have reportedly been funding investigations into a new line-up of military performance enhancers. The bulk of these drugs are already familiar to us from the lists of substances banned by international sporting bodies, including the stimulant ephedrine, non-stimulant "wakefulness promoting agents" like modafinil (aka Provigil) and erythropoietin, used to improve endurance by boosting the production of red blood cells.

As the chemical interventions grow bolder and more sophisticated, we should not be surprised that some are beginning to cast their eyes beyond droopy eyelids and sore muscles. Chief among the new horizons is the alluring notion of psychological prophylactics: drugs used to pre-empt the often nasty effects of combat stress on soldiers, particularly that perennial veteran's bugaboo known as post-traumatic stress disorder syndrome. In the U.S., where roughly two-fifths of troops returning from combat deployments are presenting serious mental health problems, PTSD has gone political in form of the Psychological Kevlar Act, which would direct the Secretary of Defense to implement "preventive and early-intervention measures" to protect troops against "stress-related psychopathologies."

Proponents of the "Psychological Kevlar" approach to PTSD may have found a silver bullet in the form of propranolol, a 50-year-old beta-blocker used on-label to treat high blood pressure, and off-label as a stress-buster for performers and exam-takers. Ongoing psychiatric research has intriguingly suggested that a dose of propranolol, taken soon after a harrowing event, can suppress the victim's stress response and effectively block the physiological process that makes certain memories intense and intrusive. That the drug is cheap and well tolerated is icing on the cake.

Propranolol has already been dubbed the "mourning after pill," largely by those who argue that its military use amounts to medicating away pangs of conscience. For the time being, though, we can set aside our dystopian visions of zombies with guns, since the tranquilizing effects of beta-blockers are unlikely to permit their widespread use on the battlefield. But pharmacology moves more swiftly with each passing year -- especially when helped along by defense-research dollars -- and we may need to revive those visions sooner than we think.

The Mediated Soldier

In the new model army, brute force and viscera are out. Cutting edge gadgetry, omniscient surveillance and precision long-distance termination is in. What motivates it all is the type of war we fear we'll be fighting.

On this, the strategists have spoken: with Iraq and Afghanistan as the testing grounds, the conflicts of the future will be guerrilla wars, open-ended, with no battle lines, no rules of engagement and ambivalent or openly hostile civilian populations in which any man, woman or child can turn combatant.