WASHINGTON, Jan. 28 (UPI) -- The number of suicides by soldiers serving in Operation Iraqi Freedom dropped last year by at least half -- a decline that helped lower significantly the Army's overall suicide rate.
Nine soldiers' deaths in Iraq in 2004 have been ruled suicides, compared with 24 in 2003, the Army told United Press International. Three other deaths in 2004 are being investigated as possible suicides.
Suicide rates are expressed as the number of suicides per 100,000 individuals per year. By that measure, the Army suicide rate in Iraq dropped from 18 per 100,000 in 2003 to 7.9 in 2004.
For the Army as a whole, the number of suicides fell from 77 in 2003 to 58 in 2004, dropping the suicide rate from 12.8 per 100,000 in 2003 to 9.5 in 2004.
A cluster of suicides by U.S. troops in Iraq in the summer of 2003 alarmed military commanders in Iraq. In response, the Pentagon sent a team from the Army surgeon general's office to investigate and recommend improvements in mental healthcare.
Asked why the suicide rate fell so much, spokeswoman Martha Rudd said: "It's really not possible to tell. We think some of the efforts we've made over there are paying off, but also that the news coverage of the issue last year really elevated the level of attention paid to this." She said the military's efforts included putting mental-health workers closer to troops, training soldiers to spot those at risk for suicide and installing a countrywide coordinator to deal with combat stress.
Others point to a different possibility. Last year the Army largely quit using an anti-malaria drug called Lariam in Iraq that has been linked to depression, hallucinations, psychosis and rare reports of suicide. It was widely prescribed in Iraq in 2003.
An advocacy group, Lariam Action USA, said the suicide statistics implicate Lariam.
"The obvious external factor was the administration of Lariam in 2003 and the withdrawal of the drug in 2004," said Susan G. Rose, the group's legal adviser. "Lariam clearly played a role in the increased rate of suicides in 2003. Unfortunately, due to the Department of Defense policy of not recording anti-malarial medication in troops' medical records, the extent of Lariam's role cannot be established."
Eleven of the 24 confirmed suicides in Iraq in 2003 were by soldiers in units where the drug, known generically as mefloquine, was prescribed to at least some soldiers. Only one soldier tested positive for the drug at autopsy, the Army said.
The number of soldiers who have taken Lariam in Iraq is unclear, but the U.S. military dispensed about 45,000 prescriptions worldwide in the year that ended in October 2003. The Pentagon said its policy is to record all prescribed drugs on a soldier's record, but UPI found widespread instances where that did not happen with Lariam.
Since 2002 the Food and Drug Administration has strengthened the drug's official product label to warn about suicide reports and added a statement that mental problems have been reported to last "long after" someone stops taking it. The FDA also mandated that anyone prescribed the drug be told in writing about the risks -- one of fewer than 20 drugs for which a written warning is required.
The Pentagon announced last February that it is investigating whether there is a link between the drug and any soldier suicides. But it defends Lariam as both highly effective and safe for soldiers to take. In September the Army said in a statement, "We have no data that indicate that Lariam was a factor in any Army suicides in Operation Iraqi Freedom and Operation Enduring Freedom (Afghanistan)."
Instead, the Army said, the deaths were linked to "failed personal relationships, financial crises, legal difficulties and mental problems like depression and psychosis" -- the same factors that trigger suicide in the general public, magnified by ready access to guns.
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