Throughout history, there is evidence of armed groups – both state and non-state – seeking to advance the physical and mental limits of human performance.
Despite significant advances in military technology, war remains a fundamentally human endeavour. People, not machines, fight wars, and people have remained largely the same. They need to sleep, eat, rest and recover, they feel trauma, and are constrained by the extent of the body’s physical and mental capabilities. Throughout history, there is evidence of individual soldiers and entire armies seeking to advance these limits of human performance. To give just a few examples, the Ancient Greeks used opium; Viking Berserkers took hallucinogenic mushrooms; Inca warriors chewed coca leaves; and the Wehrmacht used a forerunner of crystal methamphetamine (informally known as crystal meth).
In 1776, during the American War of Independence, General George Washington ordered all of his troops in the Continental Army to be vaccinated against smallpox, to enhance their immunity to the disease which he described as a greater threat ‘than the sword of the enemy’. Historically, disease was the real enemy in war. Contagion traditionally killed more soldiers in war than enemy action, and vaccination programmes have become a routine part of military service, as governments owe a duty of care to protect their soldiers from such foreseeable exposure. This has not been without controversy, however, and later in this paper the experience of Gulf War veterans provides a useful parallel from which to consider the ethical considerations of pharmacological enhancement.
The context of total war during the Second World War relaxed the moral boundaries regarding the use of performance-enhancing drugs, and they became widely used by both the Allied and Axis forces. Wehrmacht troops were issued with methamphetamine, or crystal meth, to keep them awake on long missions, and the popularity of its use by Panzer tank crews earned it the nickname ‘Panzerschokolade’ (tank chocolate). By increasing the rate of metabolic processes, amphetamines boost energy and physical strength, improving stamina and eliminating the need for soldiers to sleep. In the UK, the Royal Air Force (RAF) provided aircrews with amphetamines during the war, in the form of Benzedrine ‘wakey-wakey pills’, to promote wakefulness when sleep was a threat to performance. The British Army also provided amphetamines to its soldiers for their ‘consciousness-altering properties’, which were found to lift the mood and improve the courage and determination of troops, allowing them to fight harder. Historians have also recorded the use of amphetamines during the Second World War by Australian, Finnish, Italian, Japanese and US troops, with the Soviet Union seemingly being the only notable exception as regards adopting the practice, preferring instead to dispense vodka to its troops.
Unsurprisingly, it was in the so-called ‘swinging Sixties’ when experimentation with drugs became prolific in conflict, reflecting changing trends in their use across wider society at that time. The Vietnam War became the first true ‘pharmacological war’, so called because of the unprecedented consumption of drugs by the US military during the conflict. American troops in Vietnam were issued with medical kits containing painkillers, codeine (an opiate) and amphetamines, and before departing on long-range patrols soldiers received injections of anabolic steroids. A 1971 US government report revealed that 225 million tablets of stimulants, mostly the amphetamine Dexedrine, had been provided to US armed forces in Vietnam between 1966 and 1969. In addition to those prescribed by the military, American soldiers in Vietnam also ‘self-prescribed’ a cocktail of illicit drugs including marijuana, hallucinogens (mainly LSD) and heroin.
Illicit drug use among combatants continues to be a feature of present-day conflicts, most notably where irregular armed groups seek to counter the technical superiority of Western militaries. Drug use has been reported among members of ISIS, Al-Qaeda and the Taliban, as well as among Chechen fighters, Somali militants and rebel groups in Liberia, Sierra Leone, Uganda and the Democratic Republic of the Congo, where combatants make use of psychoactive substances in an attempt to compensate for inadequate military training and technology. These non-state armed groups use drugs to embolden and stimulate fighters, as in the case of the Pakistan-based militant group Lashkar-e-Taiba (LeT), which carried out a protracted series of terrorist attacks across Mumbai in November 2008. LeT fighters were found to have used steroids and cocaine to sustain them during the 60-hour siege, with one individual continuing to fight despite suffering serious injury. Drugs are also used by these groups to reward good combat performance, and to overcome poor living conditions; they are used to recruit new fighters, and to promote fearlessness and dependency, most disturbingly in child soldiers. In this way, by intoxicating combatants, drugs present irregular armed groups with a mechanism to potentially enhance their human capability, and their prospects of success in asymmetric warfare.
Drugs are also used by non-state armed groups to reward good combat performance, and to overcome poor living conditions; they are used to recruit new fighters, and to promote fearlessness and dependency, most disturbingly in child soldiers.
The armed forces are not the only profession to have resorted to drugs in order to enhance performance. The use of banned substances by professional athletes is well documented, with particularly infamous cases from the worlds of athletics and cycling. However, the occupational use of drugs is more prevalent than some may think. For example, beta blockers are reportedly used by some classical musicians to alleviate the anxiety of ‘stage fright’, while students and their professors may take ‘smart drugs’ such as Ritalin (commonly prescribed in cases of attention deficit hyperactivity disorder – ADHD), to help them focus and study. Meanwhile, Modafinil, a drug licensed for the treatment of narcolepsy, has had many occupational uses, such as combating fatigue in shift workers and regulating astronauts’ sleep, and has recently has been trialled to investigate whether it can help reduce errors by tired doctors.
This overview of historical drug use in warfare, and of its professional applications in contemporary society, illustrates just some of the ways in which individuals have sought to improve their performance through pharmaceutical technologies. It also points to two key interrelating factors in the acceptance of such technologies. First, there is the importance of societal opinion in shaping the policy and motivations for drug use. This can be seen in the variety of contemporary applications of performance-enhancing drugs across society, reflecting a growing medicalization of Western culture, and an increasing acceptance of prescription medication in general. Almost half of all UK adults now take prescription drugs on a regular basis, and the threshold for providing them has lowered. Second, advancements in medical technology have increased our understanding of the side effects and safety of drugs. And with greater government oversight regulating the standards of safety for their approval, the public have better assurances that harmful medical products will not receive licence approval. The question then remains, if these technologies are considered safe, is there any reason to reject their use by soldiers?
