Military personnel from different countries are operating in war zones around the world and remaining awake night and day. Due to advanced military research into tablets designed to keep them alert and functional for up to and more than 40 hours straight, absent the hyper hangover and/or crashing letdown. In many past conflicts soldiers required to remain alert as a life or death necessity used stimulants to stay awake. These worked but came at the price of adverse reactions such as edginess, making bad decisions, and the requirement for additional sleep when the pill popping was ended.
The military studied the drug modafinil as a means to keep their forces awake over short stretches of time. In the U.S military research showed that on average recruits were able to remain awake and operational for 40 hours and grab eight hours of sleep then remain awake for a further 40 hours and not have their cognitive ability prejudiced in any way as it would have with the previous “uppers” that were in use.
This kind of envelope pushing by the military is frightening some medical experts that claim modafinil, or marketed in Canada as Alertec and in the U.S as Provigil, could have adverse health effects on those trying the limits of the drug. It was originally produced as a treatment for sleep disorders such as narcolepsy, assisting these patients to keep awake. Some people are using modafinil for to fight symptoms of multiple sclerosis [MS]. Off labeling of modafinil is rampant and the military is just taking it to the next level.
This medication is not physically addictive though some have reported a psychological requirement and feeling of anxiety if they begin to run out of modafinil. When ordinary citizens begin to feel the need to remain awake for extended periods of time to complete assignments or perform better at work and begin to abuse modafinil as a lifestyle drug will the sequence just carry on? Off labeling of eugeroics or “good feelings” medications are becoming more popular in society. One hundred fifty thousand people are prescribed modafinil to treat narcolepsy but 250,000 people are using it and many without a medical sleep condition.
The U.S. manufacturer of modafinil published some patient observations to its web domain and it showed that a quarter of the users suffered from narcolepsy, some had multiple sclerosis while others were plagued by depression. The concerning thing is that there was a substantial number of users who listed their condition as “Other”. Now, overall there may be legitimate reasons for individuals other those fighting for our freedom to be taking modafinil, but there is little doubt that a large number of modafinil users are taking the drug simply because they want to stay awake. Drugs that fall into the “lifestyle” category always run the risk of being abused to some extent and this makes it difficult for those who have a definite medical need for the drug. The medication may not necessarily hurt these casual users overtly, they may suffer eventually and cause harm to themselves due to a lack of sleep.
Simply stated there are too many questions revolving around the use of modafinil in general to understand all the eventualities from sleep deficiency. However, we do understand that a lack of sleep will make people lethargic. Their ability to respond to stimulus will be decreased. They will become accident prone. Anyone who drives while in a sleep deficient state will perform as poorly behind the wheel as someone who is under the influence of alcohol.
There is a noted spike in car accidents reported between the hours of 2:00 am and 5:00 am due to the number of sleep deprived people behind the wheel at that hour. There are diabetic like numbers when blood glucose levels are tested in people who are exhausted due to no sleep. Experts fear that the pressure to perform that is placed on many in society will place pressure on some individuals to succumb and begin taking modafinil for non medical reasons. Modafinil is not alone in this practice.
It is impractical from a health standpoint to stay awake and fight the body’s natural tendency to require sleep. One could likely drink copious amounts of coffee or caffeine laden drinks and get the same wakeful result but feel lousy afterward. Experts urge people if at all possible to get a good night’s sleep for the overall health benefits it will bring. One of the first questions my own doctor asks me is “am I getting enough rest?” He asks me this because of my tendency to work at odd hours due to the nature of my work and my clientele being in different time zones.
Hen modafinil is evaluated against more popular stimulants like Dexedrine and Ritalin, there is a marked difference in the way it metabolizes through the system and the adverse reactions are different from a recovery stand point especially. There is no hypertension associated with using it and never a feeling of being “wired” afterwards, these common nervous system effects, just are not present. Yet the risk is still present.
No one really understands yet what the chemical reaction is in the brain, what is it actually working on in there? There should be more oversight given to purposely stimulating someone’s system and brain for no apparent medical reason when there is so much research data still to be rooted out.
On the same token young people in past wars and present have been and will be offered other pills to stay alert and if it is not this seemingly benign medication than it may well be something we know is dangerous when overused like amphetamines. It should be noted that if someone has a legitimate medical reason to take modafinil or they already have a brain impairment of some kind and require it for treatment, than the difference is obvious when used in this circumstance as opposed to a healthy soldier or the average Joe or Jane.
Certain countries have militaries that are sowing an interest in Modafinil other than the United States Military. Many currently use amphetamines for their troops when they are in a combat role so they remain in an alert and readily prepared state to complete sometimes prolonged operations. The French administration has pointed out that their elite Foreign Legion service has taken modafinil during some undercover actions. The British Governments Defense Ministry has also acknowledged their interest in modafinil for their forces and have invested over £300,000. or approximately $516,000 USD into continuing research about modafinil use in their ranks.
The United States Military has already given the thumbs up to their Air Force to use modafinil particular missions where they feel it is warranted and they are looking into other uses for it. In a certain trial done on helicopter pilots showed that 600 mg of modafinil administered in three dosages was enough to maintain the pilot’s pre drug accuracy levels over a forty hour period with zero sleep. The pilots were able to keep their alertness at peak levels over the extended sleep deprived time period.
There was however, considerable nausea and dizziness experienced. A study that was performed on fighter pilots demonstrated when modafinil was administered in three 100 mg amounts, maintained the flight control ability of sleep deficient F117 fighter bomber pilots to inside roughly 27% of the required accuracy minimums for up to 37 hour and there were no adverse reactions experienced. The military held an 88 hour operations exercise/study in which the participants were given 400 mg daily of modafinil and found it to be only slightly useful in sustaining awareness and adequate function levels in soldiers when evaluated alongside the placebo group. It was decided by the authors of the trial that the amount of medication administered did not meet the needs of those whose tasks were affected by such a dramatic deficiency in sleep.
Modafinil Study and Its Effect on Helicopter Pilots
This was a double blind study that was placebo restricted conducted to determine the effectiveness of maintaining the preparedness and professional accuracy of pilots when using modafinil.
Approved in 1998 by the FDA, modafinil was initially meant to treat the illness narcolepsy, specifically the daytime drowsiness that was associated with it. When discussions began about off label use for sleep deprivation in circumstances where an operator was at the controls of a piece of hardware, military or otherwise, veiled queries arose about the suitability of such drug use. Volunteers put their performance on the line taking modafinil to assist with completing extremely risky assignments in a sleep deficient state.
The primary purpose of the demanding study was to establish the viability of administering adequately preventative amounts of modafinil to sustain a pilot’s standard capabilities and awareness during a couple days and one complete evening deprived of sleep.
Half a dozen helicopter aviators where challenged to two forty hour time frames of nonstop vigilance. During the first phase three 200 mg quantities of modafinil were prescribed and in phase two the same doses of a placebo pill were given to the participants. The aviators took part in helicopter simulation exercises, had their hearts monitored when at rest via EEG’s, and they provided psychological disposition surveys that were assessed by the experts.
The resulting data showed that modafinil did ease the sleep deficit during four of six flying exercises, there was a reduction in slow wave brain monitoring, and fewer self assessed troubles pertaining to disposition and awareness when evaluated alongside the placebo. The majority of adverse reactions appeared to be dizziness, queasiness and loss of balance. This was a trial that revolved around movement so this may have had some bearing on the side effects. There are incidence due to flight simulators referred to as simulator sickness that occurs because of the use of virtual flight equipment instead of the real flying machines. Their also may have been dosages administered that were beyond the 400 mg dosages of modafinil. These explanations remain unverified.
Researchers concluded that modafinil appears to be a capable drug and relatively safe supplement for control based technicians and operators; however further data is required to improve the adverse reactions apparent in this initial trial before it can be utilized by pilots in actual flight.