Friday, November 27, 2009

The war. On drugs: the Pentagon wants to keep soldiers awake indefinitely. For now, they're using pills. Soon, they may have something Petter. USA, LLC

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In the beginning, there was speed. Cheap speed, Dexedrine, about the same as diet pills. Too much made the soldiers nauseated, too little just made them grind their teeth, but it was all they had, so they ate it and powered through the night. And when civilians complained that it was wrong and dangerous to juice the troops with amphetamines, when news reporters criticized the practice, well, nobody paid any mind to that nonsense. A man who has never spent fourteen hours in the enemy sky, who has never had to land a B-1 on a rough-hewn dust strip in the Persian Gulf at 4:00 A.M. without lights, a man who has never had to dig his nails into his cheeks to stave off fatigue in the face of incoming fire, well, this is not a man whose opinion on warfare counts. The men who did count took speed, and they were thankful for it.

But Afghanistan changed the equation. With Special Ops leading the charge, longer missions and constant night fighting brought soldier fatigue to new heights, and five milligrams of Dex wouldn't cut it anymore. They doubled the dose to ten milligrams, but that only deepened the problem. Sure, they stayed awake longer, but they also suffered more. The headaches became like timpani, the nausea debilitating. Sometimes, after a major operation, they couldn't even eat for a day. It was clearly time for a better pill, but nobody knew which one. Until they discovered modafinil.

Maybe you've heard of modafinil. A stay-awake drug of epic proportions, it has already been approved by the FDA as a treatment for narcolepsy (it's marketed in the U.S. as Provigil), and psychiatrists are also prescribing it for attention deficit disorder and depression. A growing number of career obsessed overachievers have even begun popping the pills recreationally. But unlike speed, it doesn't get you high or deliver euphoria, and aside from the increased productivity, it isn't especially fun. It simply keeps you awake.

All of which makes modafinil, at least on the surface, seem like a perfect solution to the problem of soldier fatigue. It's an order of magnitude better than Dexedrine: Two hundred milligrams can not only heighten your alertness level, it can keep it there for forty hours or more. Modafinil isn't a member of the amphetamine family, and the side effects are almost nil--a couple good nights of sleep and you're right back on track. To most soldiers, it's about as close to a wonder drug as you can get, and as troop activity surged after 9/11, so did the use of modafinil.

Only a few units would admit to using the stuff, like the brash pilots of the Army's 160th Special Ops Aviation Regiment, but others, like the bomber and fighter pilots in the Air Combat Command of the Air Force, snarfed it up behind closed doors. It was the new magic of the Afghan theater--and would surely become prevalent in Iraq--but nobody particularly wanted to sing its praises in public. That's because commanders knew there was at least one problem with modafinil: that they didn't fully understand how it worked, or quite why it worked, only that it did work--that somehow, in the cryptic recesses of a man's brain, modafinil went to win" against fatigue and modafinil won. Even the drug's U.S. maker, Cephalon Inc., admits on "The precise mechanism of action of Provigil is unknown." At the end of the day, the decision whether or not to use the mysterious pills fell on a soldier's own shoulders, and those who took the gamble weren't exactly eager to brag about it.

But even as military doctors struggled to understand modafinil better, scientists at one military lab were hard at work to find something better. To the soldiers, forty hours of waking time might have sounded like a lot, but to the men and women of the Defense Advanced Re search Projects Agency (DARPA), it just wasn't enough. They had a mandate from the Pentagon to find a way to keep soldiers awake for a week or more, and they didn't want to riddle the brain with additives doing it. They were looking for a more incisive kind of fix, something that wouldn't wear off or dissipate. They were looking at genetics.

As DARPA notes on its Web site: "The major limiting factor for operational dominance in a conflict is the warfighter."

So at the beginning of last year, the DARPA sleep group initiated a set of bold experiments, separating into teams and studying the physiologies of other animal species, searching for clues as to how those species avoid fatigue. One team studied migratory songbirds that can stay awake for up to three weeks of flight. Another team studied the female dolphin, which stops sleeping for several weeks after giving birth. But the most promising experiments came from DARPA's fruit-fly team.

The fruit-fly team had a slight advantage over the others. Scientists had only recently produced the first map of the fruit-fly genome, and after comparing it with the human-genome map, they announced that humans and fruit flies share about 60 percent of the same genes. That meant that if the DARPA scientists could find a way to modify fruit-fly genes and eliminate the need fur flies to sleep, there was a good chance they could do the same thing in humans. So the DARPA team set about tinkering with fruit-fly genetics, hoping that somehow, among the countless possible mutations, they would stumble upon a sleep gene.

"It was like looking for a needle in a haystack," admits John Carney, director of the DARPA sleep project. "But we found the needle. We did a gazillion knockouts--like ten thousand different kinds of fruit flies--and we have now created a fly that can be sleep deprived for twenty-four hours with no behavioral deficit."

But DARPA is famous for its brisk (critics say reckless) pace of work, and already scientists there have moved on to mammals. As it happens, the DNA of mice is even more similar to the DNA of humans (there's a 99 percent overlap), so Carney and his team have begun tinkering with the mouse genome, hoping to apply the same kind of genetic fix they found in the fruit fly. After that, with a little luck, they'll move on to primates. "We've been given a four-year timetable," Carney says. "But we should know within a year whether there's light at the end of the tunnel. We're betting on the dark horse. We have strong reason to believe that the solution to sleep is here."

Source Citation
Hylton, Wil S. "The war. On drugs: the Pentagon wants to keep soldiers awake indefinitely. For now, they're using pills. Soon, they may have something Petter." Esquire Feb. 2003: 116+. General OneFile. Web. 27 Nov. 2009. .

Gale Document Number:A96378867

Disclaimer:This information is not a tool for self-diagnosis or a substitute for professional care.

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