Academic journal article Air & Space Power Journal

Stimulant Use in Extended Flight Operations

Academic journal article Air & Space Power Journal

Stimulant Use in Extended Flight Operations

Article excerpt

PSYCHOSTIMULANTS, particularly amphetamine, became available in America for clinical use in 1937, and since then have been widely prescribed. More recently, their beneficial effects have been overshadowed by the recognition of a significant abuse potential. Nevertheless, the military services, particularly the Air Force, have recognized the value of psychostimulants under certain conditions. Use of amphetamine, at the direction of the unit commander and under the supervision of the flight surgeon, has been sanctioned by some components of the Air Force since 1960 and by the tactical air forces until 1991. In March 1991, following successful completion of Operation Desert Storm, the chief of staff of the Air Force sent a message terminating the policy of allowing in-flight medications, including amphetamines, by Air Force personnel.

This article briefly outlines the historical development, mechanism of action, and effects of amphetamine on normal personnel. It then discusses the value of these agents in military operations, the safety record, and the concerns that may have been the impetus for banning their use. Finally, it concludes that, in light of their value to mission accomplishment-especially in the absence of demonstrable negative effects-the ban on amphetamines should be rescinded.

Amphetamine is one member of a family of synthetic drugs, similar in chemical structure to the neurotransmitters adrenalin and noradrenalin. Amphetamine is known to enhance the release of naturally occurring neurotransmitters that affect central nervous system neurons (i.e., the brain) and that are involved with peripheral neurotransmission (such as nervous control of muscular contractions). Amphetamine in particular was noted for its striking "central effect"-that of enhanced alertness, with relatively minor physiological effects on blood pressure, heart rate, or gastric motility.1

Amphetamine became commercially available for prescription in 1937. Able to decrease appetite markedly in almost all species, it rapidly found favor as a treatment for a number of conditions, including obesity and narcolepsy.2 Other conditions that occasionally improve with amphetamine usage include hyperactivity in children, depression, and some types of parkinsonism.3 By 1938, amphetamine was a very commonly prescribed medication.4 It was considered very safe and was widely used for a variety of physical and mental disorders. However, within a short time, physicians determined that amphetamine's ability to suppress appetite decreases markedly with continued usage, requiring higher and higher doses to maintain the same effect on food intake. Overdose (usually greater than one hundred milligrams) can cause mood changes.5 They also noted other undesirable side effects that occur with chronic, increasing use, including insomnia, psychosis, euphoria, and paranoia. Additionally, when high doses of amphetamine are ingested, inhaled, or injected, significant mood-altering effects occur, which explains why amphetamine became a drug of choice to abuse in the 1960s and 1970s.6 These undesirable traits led to the strict control of amphetamine drugs, as is the case today.

Some military services recognized the potential of psychostimulants to combat fatigue and boredom. The greatest use of the drug reportedly occurred during World War II by German, Japanese, and English troops.7 Although American troops reportedly did not have access to the drugs, studies were initiated in the late 1940s and 1950s to determine the military significance. The results among healthy subjects were remarkably consistent: in numerous studies using normal, nonfatigued human volunteers-including some military personnel-amphetamine improved performance by about 5 percent on most mental tasks. Reaction time and hand-eye coordination were most significantly improved. Similarly, amphetamine administration restored mental performance of sleep-deprived subjects to nondeprived levels. …

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