Wednesday, March 27, 2024

On Trump's watch, the White House became a virtual drug bazaar, with stimulants and sedatives taken without prescriptions or in dangerous combinations

The White House became a drug den on Trump's watch

Part Two

Stimulant drugs, which helped make the Donald Trump White House awash in Speed and Xanax, often were not taken as prescribed, and that could have left staffers facing serious (even  deadly) health consequences, such as addiction, heart attack, and stroke. Part One of this series showed the White House Medical Unit routinely handed out the stimulant modafinil to staffers during the Trump administration.

That's from a report at Rolling Stone (RS), and RS now provides history on Modafinil, a drug that fueled the Trump White House, but likely is not well-known to the American public. Write reporters Noah Shachtman and Asawin Suebsaeng:

MODAFINIL WAS DISCOVERED in the 1970s by French scientists and was first handed out to pilots to help keep them awake and on task in the 1991 Gulf War. The U.S. military started to use modafinil in earnest around the 2003 invasion of Iraq. At the time, it was heralded as a massive improvement over previous stimulants: stronger and more effective than caffeine, less physically addictive than amphetamines. “These medications aren’t stimulants like the old military ‘go pills,’ there are few if any side effects when taken as prescribed. They simply stave off drowsiness until the medication wears off, then you naturally fall asleep,” one knowledgeable source writes. 

But that “taken as prescribed” caveat is crucial. When handed out willy-nilly, outside a doctor’s supervision, modafinil can pose serious risks, notes Dr. Rachel Teodorini, a researcher at London South Bank University’s division of psychology who has examined the drug and its effects. “If people have cardiovascular problems, heart problems, or blood pressure issues, it could cause things like strokes or heart attacks,” she tells us. And while modafinil doesn’t appear to physically hook patients, “there’s an element of at least psychological dependence. Tolerance builds up, and you need more and more.” 

As a recent study at the journal Military Medicine notes, “Although modafinil was initially said to comprise no risk for abuse, there are now indications that modafinil works on the same neurobiological mechanisms as other addictive stimulants.” 

And just like with other stimulants, the overuse of modafinil can lead to the perceived need for anti-anxiety medications like Xanax. “Effectively, you’re using one drug to get you up and another to get you down,” Teodorini said.

Some former Trump staffers tell Rolling Stone they didn’t get these drugs directly from the White House Medical Unit. One former Trump White House aide concedes they “borrowed” some modafinil from “a friend,” who said they’d gotten it from the unit. “I had a lot going on in my life and I wanted some,” they say. 

In other administrations, modafinil was used “99 percent of the time” for jet lag, one source notes. The Trump White House was a free-for-all. Two other sources each independently compared the White House during those years to college campuses where students cramming for finals or pulling all-nighters would pass around Adderall and other drugs, prescriptions be damned. But it wasn’t just the administration’s junior staffers — the recent college grads — who partook. The sources add that mid-level and certain senior officials — including those who reported to then-President Trump and First Lady Melania Trump — came to rely on modafinil, as well. The sources and former senior Trump officials, who all requested anonymity to discuss sensitive matters, recall instances of staff casually slipping the medical unit-provided stimulant to one another, in efforts to stay focused and help navigate the exhausting chaos of the Trump presidency.

One source told Rolling Stone that "The War on Drugs" was being fought outside the White House, but not on the inside:

It is “ironic” that Trump’s White House was “one place the war on drugs wasn’t being fought,” one of the former officials sardonically notes, given Trump and many of his lieutenants’ zeal for waging the international war on drugs

NEARLY EVERY SOURCE INTERVIEWED for this story traced the problems with the White House Medical Unit back to Dr. Ronny Jackson. Jackson, who joined the team during the George W. Bush administration and became physician to President Barack Obama in 2013. Before then, he was known as an eccentric. Afterward, he became a menace, as several Defense Department investigations detail. 

On a trip to Argentina in March 2016, one of those reports notes, Jackson’s “intoxicated behavior in the middle of the night, pounding on [a female subordinate’s] hotel room door, screaming, yelling, and overall loud behavior in his hotel room exhibited less than exemplary workplace conduct while on official travel to provide medical care for the President.” The Pentagon interviewed 60 of Jackson’s former subordinates; 56 “experienced, saw, or heard about [him] yelling, screaming, cursing, or belittling subordinates.” During a six-week stretch in 2018, a Defense Department hotline received 12 complaints” about Jackson. (Jackson’s office did not respond to a request to comment on this article.)

His nomination to become Secretary of Veterans Affairs that same year was derailed over accusations he handed out pills to White House staffers like a “candyman.” (In one case, a Senate report noted, medical staffers fell “into a panic” because he had given such “a large supply” of Percocet pain pills to a member of the White House Military Office.)

Jackson briefly returned to the White House as Trump’s “chief medical adviser” in 2019 before running for Congress. But no matter what position he held, several sources tell us, his influence dominated medical care at the Trump White House, and Jackson’s “minions” and “loyalists” ran the White House Medical Unit in his stead. “Any practices existing at that time were all set up by Jackson, who’d been there for a dozen years. Though the med unit was led by an administrator, little happened without his say-so,” one of those sources say.

The source adds, “Unit leadership did slowly start making appropriate changes, but due to [the] complicated nature of missions, individual expectations within the organization, a self-imposed cone of silence, and fear of being held liable for "sins of the father," it took a long time to find the right way forward.”

Rolling Stone's interest in the Trump-administration drug story started with a document that makes the White House sound like a broken-down drug house -- an illicit den for the addicted. From the RS report:

OUR INTEREST IN THIS STORY was sparked, in part, by a handwritten ledger reprinted on page 14 of the January inspector general’s report: a tracking form for the controlled substances ordered by the White House Medical Unit. In addition to the thousands of pills of Ambien and Provigil listed are even more potent sedatives and pain pills: morphine, hydrocodone, diazepam and lorazepam (better known by their brand names, Valium and Ativan), fentanyl, and even ketamine. 

We invite you to reread the above paragraph, highlighted in blue. Among the drugs making their way around the White House staff were Ambien, Provigil, Morphine, Hydrocodone, Valium, Ativan, Fentanyl, Ketamine . . . Good grief, it's a miracle someone didn't die. And it makes you wonder about the "leadership abilities" of the man in charge of this dangerous sideshow. Here is more from RS:

Jackson, now a Republican congressman from Texas, told the Washington Post that his team prescribed narcotics “less than five times” across his tenure. And according to the paper’s sources, drugs like fentanyl were “kept on hand for extreme emergencies — such as a White House fence jumper impaling themselves on a spike.” 

That’s a ridiculous example, a well-placed source tells us. “Someone just made up something. If there was a jumper, someone would call 911,” the source says. The jumper would then be transferred to a nearby civilian hospital.

It sounds as if Jackson, like his boss in those days, had a tortured relationship with the truth -- at least some of the time. From RS:

There was a grain of truth to the idea that the medical unit retained fentanyl and the like for extreme events. In the wake of the wars in Iraq and Afghanistan, there was a desire to bring the advances in battlefield medicine to the White House. If the president or vice president were to get shot in a remote location, far from any hospital, the unit’s physicians wanted to be able to insert a breathing tube into the VIP almost instantaneously, a process known as “rapid sequence induction and intubation.” Doing that requires sedating the patient in a hurry with powerful drugs.

“The unit employed the world’s standards in pre-hospital trauma care, as directed by the DoD’s Joint Trauma System & Committee on tactical-combat casualty-care guidelines. That includes the use of ketamine, fentanyl, etc. for pain management,” a second knowledgeable source writes. “The whole mission is contingency planning for providing most/best possible care for the worst/craziest scenarios.”

Needless to say, they never encountered a scenario that nuts. And we didn’t uncover any evidence that ketamine or fentanyl were handed out to White House staff the way Xanax and Provigil were.

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