||Meds for PTSD
||Soldier Breaks Into Restaurants
Paragraph 17 reads: "Pace contends a desire to "feel a rush" -- like being at war -- drove his Oct. 3, 2008, restaurant break-in. He thinks medication for PTSD might have influenced his "stupid" decision. And alcohol did the rest."
SSRI Stories Note: The Physicians Desk Reference states that antidepressants can cause a craving for alcohol and can cause alcohol abuse. Also, the liver cannot metabolize the antidepressant and the alcohol simultaneously, thus leading to higher levels of both alcohol and the antidepressant in the human body. Also, the most commonly given drug for PTSD is an antidepressant. The full plethora of drugs for PTSD are: antidepressants, antipsychotics, mood stabilizers, benzodiazepines and pain killers.
From combat to lockdown: Vets in troubleTrading military uniforms for prison attire
By Matthew D. LaPlante
The Salt Lake Tribune
Updated: 04/24/2010 01:24:39 PM MDT
John Pace stumbled to his car, slipped Johnny Cash's "Folsom Prison Blues" into the compact disc player and turned the key.
From half a century away, one Air Force veteran crooned to another:
When I was just a baby, my mama told me, 'Son,
Always be a good boy, don't ever play with guns.'
Five years as a military police officer, including a stint in South Korea, a tour of duty in Afghanistan and multiple deployments in Iraq, had all come to this: a drunken 23-year-old combat vet behind the wheel, determined to find another bottle to empty onto his pain.
Pace pulled into the dark parking lot of a TGI Friday's restaurant in Riverdale, broke a window and crawled inside. He took one bottle, then another. Then he decided to empty out the entire bar.
More than 2 million American military members have served in the nation's ongoing conflicts, and many are returning home deeply troubled by their experiences. About a third suffer from post-traumatic stress disorder (PTSD), traumatic brain injury, depression or other mental illness. At least a fifth struggle with drug or alcohol dependency.
Mental illness and substance abuse are the greatest predictive factors for incarceration in America. And that has put thousands of veterans on a collision course with the nation's criminal justice system.
But no one has a handle on the extent of the problem because most police agencies, prosecutors and prisons aren't tracking who, among the accused and the convicted, has served in the military.
That lack of information is hampering criminal justice officials and social workers who are making an initial push to help veterans in Utah get the support they need before they wind up behind bars - especially if, like Pace, they have not committed a violent crime. But most vets in trouble with the law today will complete their sentences before help arrives.
'I let it get to this point' » Pace, who grew up in Atlanta, yearns for home. But he blames himself for where he is instead: the Central Utah Correctional Facility in Gunnison.
"I let it get to this point," he said. "I made the decisions that resulted in my being here."
Still, he adds, "I've got to give the military some credit, too. I can say with 100 percent certainty that I wouldn't be here if I hadn't gone to war."
Pace knew when he joined the Air Force, right after high school, that he was likely to be called into the fights in Afghanistan or Iraq. But his first tour of duty involved far less action. "In Korea, when we weren't working, we were drinking," he said. "That's just the way it is there."
Ultimately, Pace did deploy to Iraq -- where he manned combat checkpoints, stood watch on guard towers and ran convoys on bomb-laden roads, he said. Among his duty stations: Balad Air Base, not-so-fondly known as "Mortaritaville" for the frequency of mortar and rocket attacks, and Camp Bucca, where U.S. military police keep watch over thousands of Iraqi prisoners suspected of terrorist acts and other crimes.
He still has a hard time talking about his experiences, which left him troubled, confused and angry. "I started hitting the bottle as soon as I got out," Pace said.
Pace contends a desire to "feel a rush" -- like being at war -- drove his Oct. 3, 2008, restaurant break-in. He thinks medication for PTSD might have influenced his "stupid" decision. And alcohol did the rest.
For reasons he can't fully explain, most of the stolen bottles were at the bottom of a ravine near the Pineview Dam in Ogden Canyon within hours of the burglary.
'To see him like this is sad.' » It was Pace's first crime, and records show he cooperated with investigators who arrived on his doorstep the next morning. "I just wanted to avoid going to jail," he said.
"You've got to feel bad for the guy," said Riverdale Police Chief Dave Hansen. Pace had "a drinking problem -- and that certainly could be related to his time in the war," he said.
But charges were up to prosecutors, who filed two felonies against Pace in 2nd District Court. Five weeks later, Judge Ernie Jones - a retired lieutenant colonel in the Army Reserves - sentenced Pace to 36 months of probation for the theft.
A month later, Pace was back before Jones for hitting a parked car while driving drunk. Jones sent him to jail for 90 days with the admonition to use the time to sober up.
A few months after he got out of jail, police were called to an altercation between Pace and a female roommate. Pace wasn't charged in the incident, but he admitted he had been drinking -- a violation of the terms of his probation. On Feb. 11, Jones ordered Pace to prison for up to five years.
Pace said he's still trying to figure out how he went from being a military policeman to being an inmate in the Utah State Prison. "It boggles my mind," he said.
His younger brother, U.S. Marine Miller Pace, also struggles with his brother's downfall. "John was one of the major reasons I joined the military," he said. "To see him like this is sad for me."
But after two combat tours in Iraq's volatile Anbar province, Miller Pace believes he recognizes his brother's pain in the lives of some of his brothers in arms. "I've seen alcohol ruin a lot of these guys' lives," he said. "I've lost a lot of good buddies to this same thing."
'The services they need' » A pilot program in Utah's capital city will offer a different path to some veterans who, like Pace, are accused of crimes related to addiction or mental health.
Starting this month, Salt Lake City prosecutor Sim Gill will allow some vets to stay out of jail or reduce their sentences if they access treatment and other services through the Department of Veterans Affairs.
While all offenders must be held accountable, Gill said, "we also have to get them the underlying help they need. And there really isn't another entity that has a better understanding of what these men and women have been through, and what they need to get better, than the VA."
U.S. District Judge Paul Warner agrees. The retired Army colonel in the National Guard was saddened by the stream of veterans, charged with minor violations, he saw cycling through his courtroom. "I was seeing people who were veterans who were being picked up for being drunk or disorderly," Warner said. "Some of them were in their 80s. Others were from Vietnam. And I was starting to see some from Iraq and Afghanistan."
He asked other judges in Salt Lake City's federal courthouse to watch for vets and send them to his court. Once Warner has them, he works with the VA to arrange housing, mental health services and addiction counseling.
The beauty of both solutions, Gill and Warner agree: "We're not reinventing anything," Gill said, "we're just connecting veterans to the services they need."
But the two programs will help only a small number of veterans -- those who find themselves in trouble in Salt Lake City or who commit violations on federal land in Utah. It could be years before similar programs are implemented to help veterans statewide.
Gill's initiative was inspired by his volunteer work with the "Homeless Veterans Stand-down," an outreach event at the Salt Lake VA Medical Center, where he met veterans who had spent decades moving in and out of incarceration. When the wars in Afghanistan and Iraq began, Gill said, he wanted to prevent others from falling into the same cycle.
One major obstacle: No one was asking accused criminals whether they were veterans.
'I started using right away' » On the battlefields of southern Iraq on Feb. 27, 1991, two groups of American M-1A1 Abrams tanks mistook each other for the enemy. Before the fog of war had cleared, six soldiers from Ray Lara's unit, the 2nd Armored Division, were dead.
"It wasn't easy for me to deal with," the heavily tattooed former soldier said.
Lara left the service three years later, ending a 16-year commitment to the Army in a haze of alcohol and drug abuse. "I started using right away, and I just never stopped," he said.
After years of trouble in California, Lara moved to Utah -- but didn't leave his problems behind. In 2004, he was cited for misdemeanor assault. In 2006, he was arrested for possessing drugs. And in 2009, he was picked up for dealing meth near a school while carrying a gun. He's serving up to 15 years in Gunnison.
These days, Lara said, he doesn't feel worthy of the uniform he once wore, but he wonders what his life might look like today if his service had been a ticket to help. Once he'd fallen into addiction and crime, he said, no one ever asked if he was a veteran.
"I went from hero to zero in no time at all," he said.
Veterans are less likely to be incarcerated in the United States than non-vets. But in a nation with the largest prison population in the world, federal researchers believe nearly a quarter-million veterans are locked up. About 400,000 are on probation and 75,000 or more are on parole, according to estimates from Bureau of Justice Statistics, based on surveys done early in the wars in Iraq and Afghanistan.
But most individual veterans, advocates say, are invisible in the justice system.
"Most jails don't even ask whether someone has served in the military," said Amy Earle, a VA justice outreach coordinator in Salt Lake City. "And even if it is a question in the intake process, nobody is keeping the data."
Earle is helping to change that in Salt Lake County, where new inmates are now asked whether they have served in the United States military. Veterans' names are sent to Earle, who evaluates what services they might receive -- after release.
Under federal law, veterans aren't permitted to access VA services while they are incarcerated. Those suffering from PTSD and other combat-related mental health issues must make do with the care that jails and prisons can provide.
'I ask God to help me' » Utah Department of Corrections therapist Ross Williams runs a support group every Thursday for veterans in Gunnison. He can include no more than 20 inmates at a time -- and it's the only program of its sort for more than 500 veterans in the state prison system. . There is no similar program at the state's main prison in Draper.
The department does not offer effective treatment for PTSD, said Williams, a former Navy chaplain.
"The priority here is safety and security, not treatment,'' Williams said. "We do enough to keep people stable and healthy enough to do their time. We don't do enough to get people healed and well."
Veterans advocate Tom Tarantino believes prison is "the absolute worst place" for veterans with PTSD. "Combat would actually be a better situation for a lot of these guys," said the Iraq war veteran from Washington, D.C., who frequently testifies about veterans' health issues before Congress.
Lara agrees. The slamming doors, uniformed guards, shouting prisoners and seething hostility -- all bring back unwanted memories. "I just go to my higher power," he said. "I ask God to help me get through it."
Tarantino, a legislative liaison for the nonprofit Iraq and Afghanistan Veterans of America, said there's one relatively easy and immediate way to help incarcerated vets: Allow them to get VA treatment.
But so far, he said, no one has stepped up to lift the ban.
Lynn Jorgensen, an incarcerated veterans re-entry specialist with the VA, said the ban means "all I can do is send them some information -- and wait."
Since the state parole board decides when convicts will be released, "I have to put the responsibility on the inmate," Jorgensen said. "I say, 'Mr. Inmate, you have to let me know when you are six months shy of being released.'"
Many do, but some are released suddenly due to overcrowding and have little time for correspondence. "Some will get lost in the system," Jorgensen acknowledged. "But we're trying very hard to make sure that everyone has a chance to access our help."
'If someone ... had intervened ...' » Walter Smith was loading a shotgun, apparently intent on killing himself, when Pleasant Grove police confronted him in 2004.
Friends say it was a cry for help that should have propelled the former Marine, recently returned from Iraq, into intense treatment for PTSD. Instead, Smith was released after two days in a mental health facility with instructions "to find counseling," they say.
A year and a half later, Nicole Speirs, the mother of Smith's infant twins, drowned in a bathtub at her Tooele home. The death remained a mystery until Smith confessed eight months later. Prosecutors charged Smith with murder, but later agreed he could plead guilty to the lesser charge of manslaughter -- - reasoning that jurors might have found he was suffering from extreme emotional distress during the slaying. He'll serve up to 15 years at the prison in Draper.
Tarantino believes the Smith case is one of an epidemic of missed chances.
"If someone had deduced what was going on with him and intervened," he said, "you might not have seen the horrible consequences that happened."
Darin Farr, an outreach specialist for the Utah Department of Veterans Affairs, said officials have "learned a lot" since Smith's first encounter with police and are less likely to miss warning signs.
Troubled vets often cross paths with police many times before they commit a crime serious enough to draw a jail sentence, Farr said, "and every one of those instances is an opportunity."
Ron Bruno wants officers to make the most of those opportunities. As a crisis intervention instructor, the Salt Lake City police detective teaches officers statewide how to deal with people who are mentally ill.
He wants to increase the veteran-specific section of the training, which is limited to a few hours. For now, officers talk with a veteran who has PTSD, and they work through a scenario in which they encounter a veteran suffering a flashback.
Bruno said about 11 percent of Utah's public safety officers have taken the course. He'd like to double that rate.
But Tarantino would like every police officer to be trained to deal with veterans. With tens of thousands of new combat veterans created every year, he believes the criminal justice system needs to be better prepared to confront the consequences of war.
"In a lot of cases, these aren't people who chose to live a life of crime," he said. "A lot of these individuals are in the situation they're in as a result of their service to this country. Their inability to cope within the norms of society, the lack of treatment, the lack of understanding, the self-medication -- it all leads them to where they are."
The reporting of this story was supported in part by the Center on Media, Crime and Justice at John Jay College in New York, and the Harry Frank Guggeneim Foundation.