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Jason Leopold and I have written an investigatory report for Truthout on the mass administration of the controversial antimalarial drug mefloquine (brand name Lariam) to all Guantanamo detainees through 2005. The drug was applied without regard to whether or not a detainee had malaria, and despite the fact there was no malaria in Guantanamo.
Mefloquine has been a controversial drug since it received FDA approval in 1989, as evidence grows regarding its neurotoxicity and propensity to cause very serious neuropsychiatric side effects. “Adverse events” associated with mefloquine include depression, suicidal thoughts and behaviors, intense rage, paranoia, hallucinations and anxiety. An Army public health physician told us that use of the drug was akin to “pharmacologic waterboarding.”
The article has evidently struck a nerve with DoD and/or members of Congress, as one of the key documents in our story, a September 2002 letter from Deputy Secretary of Defense William Winkenwerder to the Chairman of the House Armed Services Committee, was scrubbed from government servers. The original PDF URL was http://armedservices.house.gov/comdocs/reports/pdfs/02-10-04Mefloquine.pdf. If you click there now, unlike just a day ago, you get a message “the page cannot be found.” The document itself is still available through Google docs cache, and is also being posted at Truthout servers.
Winkenwerder’s letter notes that “malaria is not a problem at Guantanamo,” and makes other statements that undermine DoD’s insistence that treating hundreds of detainees presumptively with a treatment dose of mefloquine was a mere public health measure.
What does mefloquine do to people? Here’s some testimony gathered by the website lariaminfo.org, which is a treasure trove of information on the drug:
“After taking Lariam … I [developed] rapid heartbeat, paranoia, and panic. I have since had episodes of severe panic, depression, sleep disturbances, shaking, flushing and feeling of foreboding … This is by far the worst thing that has ever happened to me. The psychotic episodes were nearly unbearable.”
“I was not warned of the dangerous side effects … ended up in a mental hospital by the end of the trip because no one could explain my manic behavior. My brother flew down from the States to get me because I called home several times stating that my boyfriend was trying to drug me and kill me.”
“I served in Somalia in 1993 for 5 months. I took Lariam once a week for the entire tour. That was 8 years ago. I have been diagnosed with PTSD [Post Traumatic Stress Disorder] by the VA and received 100% disability. I have attempted suicide 10 times and have shot myself twice. I suffer from severe depression. I learned about Lariam on the Internet about 3 years ago but was just too depressed to do anything about it.”
And this is what they were giving to the detainees? The primary story is out for all to read, and it is my hope that this will help lift the lid off the secrecy that still permeates U.S. government torture of the “war on terror” detainees. A Seton Hall report, “Drug Abuse? An Exploration of the Government’s Use of Mefloquine at Guantanamo,” will be released in the next day or two, and will expand on the legal repercussions of using this dangerous drug on detainees.
UPDATE, 12/4/2010, 7:10 am PST: The September 2002 document, including the letter from Winkenwerder, appear to be back online now, for whatever reason, at their original URL. They were not there as late as yesterday.
UPDATE, 12/20/2010, 5:10 pm PST: It’s gone again.
52 Comments
So much important information always gets left out of an article like this. We’re working on a follow-up story, and I’ll have my own personal take and contributions to make here in coming days.
I think with the scrubbing of the docs — so ironic given the current Wikileaks story — is an indication that we hit a sensitive spot.
I’ve always thought drugs and experiments was this government’s weak spot. Now we have something hard to move on.
Thanks, Jeff. It’s hard to imagine that DoD wasn’t intentionally going for the pyschoactive effect of the drug. True evil.
we are supporting ghettos in gaza and the west bank, torturing and experimenting on detainees, how much longer until…?
Not too many ways to spin it:
Malpractice? Pure cruelty? Stupidity? Experiment on antimalarials? Experiment in torture? Or some combination…
I think by starting to scrub the docs, DoD has tipped their hand. They think it’s bad, and they want a cover-up.
As one reads the article, and puts together all the pieces (the elimination of prisoner protections in experiments, the waivers for epidemiological research, etc., the past history of such research, the lies and secrecy), I think the argument for an experiment is overwhelming. But that’s me.
Wow, Jeff! You promised something BIG. Interesting that they’re already scrubbing at DoD.
Great Work, both of you.
I guess that if there are no grounds to hold prisoners on when they arrive, USG has to scramble their brains while they’re at Gitmo, so then they become too dangerous to release. Meanwhile, they might just hallucinate the ‘right’ false confession.
My theory, and it is only a theory, is that they administered the mefloquine to everybody. They got approximately 15-40 or 50% with crazy-making side effects. Then they made a note of that and passed it to interrogators, who could call on the drug then, and not have to wait for the effects of longer-term “softening up” (read “brutality”) or isolation, sleep deprivation and stress positions to take effect. Instant derangement at your fingertips. And I also believe other drugs were tested and/or used as well.
Grisly stuff, I know. But to figure this out you have to think like a torturer. Or simply follow the patterns of their behavior as revealed in histories and documents lo these past 50-60 years.
Additionally, there is an entire controversial history regarding experiments upon prisoners. The article notes (1st time reported in any news source) that mefloquine was initially tested on prisoners who were deliberately inoculated with malaria.
If this treatment was preventative, were the guards treated as well?
I have been sitting here for 5 minutes just staring at the screen slack jawed and horrified.
where is the god damn bottom for this country ?
Jeff Kaye thank you for all you do
Questions to ask.
If they claim it was prophylaxis for malaria. Did the US troops also receive :Lariam? Why not?
Based on the completely out of control atrocities already documented we know the likely answers. I could never in my life time believe I would live to see the government of my country doing these things.
Our posts crossed. Yes.those are questions to ask.
Real Mengele stuff. Why am I not surprised. Horrified (well, I was at the outset) but no longer surprised.
I know about the Milgram experiments intellectually, but I am the one who would say no. Or at least I fancy myself in that stubborn role vis-a-vis authority and have a history that suggests I could be the one, while never having been tested in the extreme ways that the Gitmo torturers were. So I have a hard time understanding it emotionally. I just don’t understand how most humans are wired to torture another human being because an authority figure told him to do so.
One correction. This was not prophylaxis for malaria. Prophylaxis is given a week or so before exposure to a malaria area, and for mefloquine consists of one 250mg pill administered one time a week.
They gave the detainees 1250mg of mefloquine in one day (in divided doses, first 750mg followed 12 hours later by 500 mg). This is the treatment dose you give someone who has malaria already. The side effect profile, a research paper as far back as 1991, is 60 times higher for this dosage.
They gave what is called “mass presumptive treatment” to all the detainees. Since there was no medical reason for this (despite what they say), I can only think on this one fact alone that it was an experiment on the effects of mefloquine. We know from a document we did not quote in this article that a DoD review of mefloquine’s effects was already underway in 2001, due to concerns over its effects.
And, btw, U.S. troops were not administered mefloquine at Guantanamo.
Watch for follow-up articles…
I’ll second that. This topic is impossible for me to deal with, so I admire those who have the fortitude to take it on. It is valuable work.
I feel better taking on this material. For my own part, I don’t know how I could live with myself if I only took this in but felt I could do nothing about it. This is about empowerment, and defeating the torturers’ own goal, which is control over the tortured, and the society that witnesses or is aware of it. The torture victim is an example of their power fantasy over everyone. I won’t stand for it. And I know the tortured find some solace from knowing they are not alone and forgotten.
Bless you.
Yes, I guess one reason why I cannot understand torture emotionally is because I don’t understand power emotionally. I have no desire to have power over anyone.
I am doing everything in my power not to post something to upset the mods.
How horrifying and disgusting. Why do the two major parties seem hell-bent on establishing the Fourth Reich? Obama won’t prosecute. Democrats are openly hostile to progressives, let alone Republicans. We imprison without cause, torture without conscience and experiment on the innocent. We can’t help our citizens find a decent job but we’ve got trillions for bankers and bomb makers. Our State Department conducts espionage and our operatives assassinate without trial or declaration of war. Our Constitution is under attack by the very men and women who swear oaths to protect it and they smirk about it. It’s a badge of honor for them to replace our democracy with their fascist oligarchy.
Great work. I hope the people who authorized and administered this are punished as severely as the crack dealer on the corner they can’t wait to get shackled to a gurney.
The government is injecting psychotic drugs into innocent people so they could be better softened up for torture. How has it come to this?
Since 9/11/2001, we are no different than NAZIs.
Mengele is right. This is some seriously sick behavior. Someday you will have to tell us how you originally discovered this Jeff. I hope that someday you will have the opportunity to testify against our home-grown monsters.
We never were different than Nazi’s, we embraced them, it was German manufacturing and industrial engineering superiority we hated. Next we’ll be harvesting organs for transplantation from live prisoners like the chinese do.
I hope that day comes, too, shekissesfrogs.
We don’t know they injected mefloquine into anybody. It is supposed to be administered only in pill form. It was thought among experts we consulted that there was no experience with injectible mefloquine, it having been determined early on that injections were too painful for practical use.
But then the experts weren’t thinking the way torturers might think. Also, it turns out there has been research on creating a injection-ready mefloquine. See “Submicron oil-in-water emulsion formulations for mefloquine and halofantrine” at link.
[Quote]
The mefloquine-loaded emulsions with charge inducers were active at 10 mg kg(-1) for dicetylphosphate, 17 mg kg(-1) for phosphatidylserine, 23 mg kg(-1) for oleic acid and 27 mg kg(-1) for stearylamine, again after subcutaneous administration. This work has enabled the formulation of stable emulsions, incorporating drugs with high antimalarial activity, which are proposed for parenteral delivery of these fairly soluble drugs.
[End Quote]
“Parenteral” refers to injection forms of a drug, vs. oral.
But to conclude, we really don’t know if injections of mefloquine took place. Someone mentioned it could be delivered via IV, as well.
Kind of got into the weeds on this story.
Wow, just when I think we’ve hit bottom in terms of revelations about what our country has become, BAM. There’s a new reason to sit here, gobsmacked, at what’s been done in my name.
Horrifying.
Jeff, do you know if the US personnel are also taking mefloquine (or malarone or other antimalarials)?
Although malaria does appear to occur regularly in Cuba (Guantanamo?), the risk doesn’t appear to be high.
http://www.ajtmh.org/cgi/content/abstract/s1-22/6/587
A nice mosquito repellent would work just as well, wouldn’t cost taxpayers nearly as much, and would also protect prisoners against dengue–which IS prevalent in Cuba.
http://www.fco.gov.uk/en/travel-and-living-abroad/travel-advice-by-country/north-central-america/cuba
Utterly depraved behavior! And yet the nation’s chief law-enforcement officer looks forward, not back.
“And this is what they were giving to the detainees?”
It’s “prisoners,” dagnabbit: “prisoners.” Guantanamo is a prison. They are not free to leave. They are prisoners.
Having delivered my semantic rant, I now wish to ask: If this sort of thing was wrong for Mengele, isn’t it wrong for us?
And the people who went along with Josef Mengele …..
In a disgraceful expose on how deeply into propaganda our former free press has sunk, Good Morning America and many other news shows issued glowing reports (mainly from press releases) about how great President Bush’s anti-malaria program in Africa is, spreading Mefloquine and DDT across the continent.
On GMA, courageous reporter Chris Cuomo was assigned to congratulate First Lady Laura Bush on the accomplishment. Instead he immediately questioned her about the DDT-coated tents her program touted. He started pointing out its danger, possibly building up to the Mefloquine, then the earphone must have ordered him to shut up, which he did. Laura Bush ignored him. He’s not with the show anymore.
Whatever else it may be, it is certainly criminal, and internationally (i.e. the Hague) indictable. I won’t hold my breath. The PTB won’t turn on their own.
Guess where I am emotionally?
My husband does geology field work at a Naval weapons testing grounds. When I discovered the cover up regarding uranium munitions, I not only realized he was exposed to deadly uranium, but so was I. All of us were, He was bringing it home with him.
The government is in complete denial about the toxicity of uranium. Now none of them speak to me, bearers of ugly truths just do not keep any popularity.
At some point the truth about our government is so toxic that even the best relationships are damaged and destroyed by it.
I sure miss him and I worry about him too, all of them. I believe they don’t talk to me because they are afraid of the government. I think you would have to be crazy to not be afraid of it. Look what it does to people.
I sure appreciate it. Thank you.
Me too.
Are they ILLEGAL prisoners?
I’ve been trying to figure out how to flip the ‘illegal’ people label back onto those who have been wielding it so well and often to mow brown people down with. I think you may have just pitched it to me, let’s hope I can get a hit.
I forgot, is politics supposed to be a game of chess, football, quidditch or calvinball?
I’m not quite clear about the rules …
I’d say the Zimbardo Prison Experiment is even more disturbing than Milgram’s work, a prison being a total institution which absorbs its inmates and its overseers. The total institution can and often does turn the human capacity for social interaction into a machine which produces human degradation as its primary output.
http://en.wikipedia.org/wiki/Stanford_prison_experiment
http://en.wikipedia.org/wiki/Total_institution
Given Gitmo’s nature and goals, it’s unremarkable that the US military attempted to poison the individuals interred at that Gulag. What is remarkable is America’s willingness to tolerate an institution such as this one.
We owe much thanks to Jason Leopold and Jeff Kaye for bringing this situation to public attention.
Ditto. Many blessings to both of you for pursuing this story and publishing it.
Thank you for all that you do.
“pharmacologic waterboarding” … yes.
Thank you, Jeff, as always, for not allowing this country’s descent into maddness to go unremarked.
The treasonous behavior, it is nothing less … or else, of the ruling classes, including making it very clear that the “government” views those it supposedly “represents”, the people of the nation, as threasts asnd enemies, suggests that the “natural elite” who are “in charge” consider that the “government” is like a corporation in that its existence is more important than it ostensible “reaason” for existing. When a “government” views the people as a threat to its existence, such a government has lost its legitimacy entirely and has become a menace to conscience and a severe threat to life itself, especially now, and especially with the world-destroying and life-destroying “technology” the government claims it may use with impunity.
DW
“At some point the truth about our government is so toxic that even the best relationships are damaged and destroyed by it. ”
You said a mouthful there for sure.
I’ve posted about the ugly reality of DU ammunition for years. I contend that the manufacture and use of DU ammunition, at its core is simply a technique to turn a dangerous and inconvenient hazardous waste liability problem into a profit center.
DU isn’t really good for anything and it’s a liability to own, and costly to dispose of. That is until the MIC found a way to turn that problem into an expensive ‘product’.
Everywhere I have posted, the conversation is suppressed by the effects of an omnipresent and obviously well organized network of counter-posters who cite studies that say DU is not dangerous, but fail to mention those studies are funded by the DOD.
The general message is “Any sensible person knows that DU is harmless unless you happen to be inside an enemy tank.” and if that doesn’t kill the thread then eventually you’ll be called a ‘tin-hat conspiracy theorist’.
As you say, DU dust is carried about by anyone who has been in the polluted environs, and that means millions of middle-easterners and of course our own soldiers.
Some are calling DU the ‘Agent Orange of Kosovo.
I’m sad to hear of your own contact with the stuff and hope the impact will not prove severe.
After having some overnight thoughts, I had exactly the same thought as Teddy. Just as you think you’d heard every evil of the USG, a new one comes up to hit you. I’m aware of this in a general way* and constantly alert to “you ain’t heard nothing yet” wrt politics, so I’m rarely surprised when the pols plumb new bottoms. But wrt torture, the W admin successfully buried new revelations after the release of the Abu Ghraib torture pics, O has managed to suppress any revelations of ongoing torture, and I have such emotional difficulties with torture, that I had forgotten that it would also be the case there. I now imagine that there are many other, more horrifying, tortures still to come to light.
*Decades ago, during the 1980s, an investment banking friend specializing in Latin America, had a hard time finding a suitable position. It was the aftermath of the second oil crisis, when many LA countries were in such trouble. So he finally took a job as prez of a bankrupt bank; it was a workout situation. I forget its nationality. Might have been Argentine. No dummy he, he thoroughly investigated its financials before he accepted. Several years later, I asked him if it were better, same, or worse that he anticipated. He looked at me, shook his head, and answered: “Worse. Much much worse.” It taught me an important lesson, which I have never forgotten, but don’t always think of when I should.
Our govt also gave this to our troops – mr dks, a major at the time, got a nice dose during our invasion of Panama to get Noriega. He was always cold after that little exercise – still piles on the blankets at night and still wears sweats in the Texas summer.
The inprocessing form in 693 & 760′s med file says PO after the mefloquine 1250 mg dose – that means taken orally. At least suggests it’s pill form.
Thanks Jeff. I suspected this was the case, I have no doubt it was a medical experiment. to study its use as torture in interrogation. I have not kept up with the controversies surrounding Lariam but have the sense they won’t give up on trying to find a use for it.
My cousin contracted malaria in Africa some years ago and can tell anyone Lariiam is torture.
Keep on keeping on my friend.
I wonder, is this why detainee Omar Khadr developed cataracts in his early 20s?
(One of the side effects of long-term use of the drug is lens opacity.)
I know this is probably EPU-ed, but I wanted to reply anyway. I totally agree with Jeff and pretty much all of you that first, unnecessary medical treatment is unethical, and unnecessary treatment that is likely to cause harm, particularly on those that cannot refuse, is at best illegal, and in this case seems sadistic and evil.
However, I’m less comfortable generalizing to necessary medical treatment. On the order of a million people die of malaria each year, and while there are a lot of passive things that people can do to control mosquitoes (eliminate standing water, window screens, etc.) there is a place for active treatment. We can and should debate whether the costs (human, ecological, and economic) of a particular treatment or tool are worth the benefits. We (human beings) can only benefit from a full discussion of the facts; we may decide that this medication is too toxic for the benefit, or to reserve it only for treatment of otherwise resistant cases. Only the corporations benefit from keeping us in the dark, informed only by press releases.
URL to site with info on malaria (where did the hyperlink tool go)
http://www.vpwa.org/kick-malaria-out-2009-campaign
BTW I took Lariam prophylactically for about two months in the early 90′s when traveling through S and SE Asia. The word at the time was that it could cause strange and vivid dreams, though I didn’t experience any. I don’t recall any major side effects except the horrible taste which would stay in your mouth for hours after taking it, though this does not discount the stories of others as people have subtly different biochemistries that can react differently to a given substance.
You are right to stress the dangers and horrific human cost in lives and suffering of malaria. I know I take it very seriously, and so did the medical professionals to which I spoke. It was the medical problems with using the drug in this way to supposedly treat a malaria issue that got them incensed in the first place.
If you read the story, we describe the different reasons why the use of mefloquine in this instance was medically contraindicated. Of course, the story can be that this was just a medical decision and people can disagree on such decisions. But I believe the evidence is overwhelming that this was more than just a medical decision. Why did the AF Epidemiological Board hide evidence of this treatment from their own panel of experts at the time (as mentioned in the story)? Why were they worried about malaria when only a handful of detainees showed up in Guantanamo with the infection, and other kinds of situations similar, not least the Haitian refugee situation in Guantanamo only ten years earlier (when there were even less concerns about mefloquine) treated without mass presumptive treatment.
In fact, I challenge all who doubt to find even one instance where mefloquine was used for mass presumptive treatment of a group of refugees. Other drugs, yes, but not mefloquine, and in part for reasons I’ve stated in other comments above (no injectible form, etc.)
I’m glad you had no bad effects from the mefloquine. The majority did not (at prophylactic doses). About 15-30% did, and we’re talking those not under undue stress. Today, the drug is not even allowed to be administered to anyone who had PTSD. How many of the prisoners had PTSD, having been kidnapped and rendered to Guantanamo, many previously tortured at Bagram or elsewhere? Did DoD even check?
How about a call for release of the medical records? Names could be easily redacted.
Let’s get to the truth.
Press release:
[Begin Quote]
Seton Hall University School of Law’s Center for Policy and Research has issued a report, Drug Abuse: An Exploration of the Government Use of Mefloquine at Guantánamo documenting the medically inappropriate use of a dangerous pharmacological treatment on Guantánamo Bay detainees.
The prophylactic dose of mefloquine is 250 mg. On arrival at Guantánamo, as a matter of standard operating procedure, detainees received 1250 mg of mefloquine. The larger dose of mefloquine was administered without taking a patient history of any kind.
Dr. G. Richard Olds, tropical disease specialist and founding Dean of the Medical School of the University of California at Riverside, commented on the long-lasting effects of the drug: “Mefloquine is fat soluble, and as a result, it does build up in the body and has a very long half-life. This is important since a massive dose of this drug is not easily corrected and the ‘side effects’ of the medication could last for weeks or months”….
The report, Drug Abuse: An Exploration of the Government Use of Mefloquine at Guantánamo, may be found at http://law.shu.edu/ProgramsCenters/PublicIntGovServ/policyresearch/upload/drug-abuse-exploration-government-use-mefloquine-gunatanamo.pdf.
TruthOut.org published an article independent of the Seton Hall Law report. Read it here: http://www.truth-out.org/controversial-drug-given-all-guantanamo-detainees-amounted-pharmacologic-waterboarding6558
[End Quote]
http://law.shu.edu/About/News_Events/releases.cfm?id=171971
Thanks for linking to that, Jeff.
From pg.2:
[quote] This suggests a darker possibility: that the military gave the detainees the drug specifically to bring about the adverse side effects, either as part of enhanced interrogation techniques, experimentation in behavioral modification, or torture for some other purpose.] [end quote]
From Andy Worthington:
“All Guantánamo Prisoners Were Subjected to “Pharmacological Waterboarding””; 12/2/10
[quote] Jason and Jeff have just published another exposé for Truthout, demonstrating how every single prisoner at Guantánamo was forced to “take a high dosage of a controversial antimalarial drug, mefloquine, an act that an Army public health physician called ‘pharmacologic waterboarding.’” The article reveals another chilling aspect of Guantánamo as a laboratory for human experimentation, and also confirms what former prisoners have been stating for many years, although without the detailed evidence unearthed by Kaye and Leopold. [endquote]
Oh, I guess you must already know that, since he cross-posted your article. duh!
I knew he was going to, but didn’t know it was up, so thanks for letting me know, and also the more general reading public. Worthington’s article has corroborative testimony from some Guantanamo detainees about being forced to take injections and pills.
“What is remarkable is America’s willingness to tolerate an institution such as this one.”
Well said. This is truly something it is difficult to get one’s head around.
Yes, the instruction was by mouth. My suppositions are based on the question of whether it could be administered as an injection. As I said, I don’t have any evidence it was, and as you point out, the evidence we do have is that it was given as pills, swallowed orally.