Fentanyl has taken a record toll on the Army. Families demand answers
The parents of Sgt. 1st Class Ronald Conley Jr. want to know how many days their son lay dead on his bathroom floor from fentanyl poisoning without the Army noticing. Kue Vue's brother questions how the straight-laced sergeant turned to drugs. Spec. Ari McGuire's parents wonder why he wasn't immediately sent to treatment when he suffered withdrawal symptoms in a training exercise.
None of the families expect they will get all the answers about how the men died from fentanyl, a lethal synthetic opioid that has hit the Army the hardest among military branches and caused a record number of fatal overdoses among soldiers in 2021, the last complete year of data available, according to new figures obtained by The Washington Post.
The emerging scope of drug abuse in the military has alarmed lawmakers, who in late May introduced a bill to compel the Pentagon to publicly release overdose data each year, as well improve treatment for personnel suffering from addiction. The proposed legislation comes as experts say the services have done a poor job tracking overdoses, which have increased among active duty troops in the last two years. And many families contend that preventive measures, including urinalysis tests and rehabilitation, fall short.
Sen. Edward J. Markey (D-Mass.) and five other lawmakers who introduced the bill pointed to rising overdose deaths at Fort Liberty, N.C., and other Army posts, warning that "hundreds of service members have lost their lives to overdose and thousands more nearly did." Rep. Seth Moulton (D-Mass.), a veteran who signed onto the bill, called the overdoses across the entire military "an institutional failure and a threat to our national defense."
The lack of clear data is further complicated by the emergence of fentanyl, which poses an especially acute threat because of its deadly potency and its tendency to be blended with other drugs or disguised as prescription pills.
The Army lost 127 soldiers to fentanyl between 2015 and 2022, according to casualty records obtained by The Post through the Freedom of Information Act. That's more than double the number of Army personnel killed in combat in Afghanistan during that same period.
At least 27 soldiers died from fentanyl in 2021, the Army's deadliest year yet. But in February, when asked by senators for statistics on fentanyl overdoses, Pentagon officials reported a number that was half of the figure contained in the records obtained by The Post. When asked about the discrepancy, Pentagon spokeswoman Jade Fulce blamed an accounting mistake.
In total, the Pentagon told lawmakers in a letter that fentanyl has claimed more than half of the 332 service members who died from drugs between 2017 and 2021, a shorter time period than what The Post sought for data. More than 15,000 troops overdosed but survived during that timeframe, according to the letter.
In addition to the personal toll, experts emphasized that drug abuse in the military ranks can weaken unit readiness and cohesion. The Pentagon had acknowledged drug use is an issue for the military, and the Army says it is focused on addressing it.
"Taking care of people, including the prevention of misuse of prescription or illicit drugs, is a priority for the Army. One drug overdose is one too many," Army spokeswoman Heather Hagan said in response to questions from The Post.
A number of families told The Post that they believe their loved one did not have a drug habit until joining the Army. For many families, drug abuse is especially painful because they trusted the military to nurture their children and offer a bright future, a promise that has been central to the Army's pitch as it struggles to meet recruiting quotas.
Carole DeNola, whose son, Ari McGuire, died from a fentanyl overdose in 2019, has been pushing military officials to intervene sooner when they learn of drug abuse. An Army investigation into her son's death said his commanders should have taken "more aggressive steps to seek rehabilitation" when he told his superiors about his issues. DeNola contrasted that lack of preventive care to the nonprofit USO's attentiveness in walking her and her husband through "every step" after her son's death, from airport arrangements to planning a military burial.
"Why can't that kind of energy and care go into the military's research and prevention and treatment?" she said. "We appreciate all they did, but he's dead. What about the living?"
North Carolina is a hotspot
The Department of Defense maintains that the rate per 100,000 service members dying from any kind of drug overdose is still below the national rate for civilians. Yet, in some hotspots, like North Carolina and Washington state, the rate of drug deaths among service members was close to the rest of the state. Texas, home to about 17 percent of the Army's enlisted members, has a higher rate of death among soldiers than the state population generally.
Fort Liberty, home to the storied 82nd Airborne Division and Army Special Operations Command, suffered more overdoses than any other Army installation. At least 29 soldiers assigned to that post died from fentanyl from 2015 to 2022, according to the data The Post obtained. The scope of the crisis at the North Carolina base first became public when a Rolling Stone report found that at least 14 overdose deaths occurred there. (The Army post was formerly known as Fort Bragg.)
When Theresa Conley read that story about drug deaths at Fort Liberty, it was already too late to warn her 35-year old son, Ronald, who was based there.
After tours in Afghanistan and Iraq had left him with PTSD symptoms, Ron said he was seeking mental health support would reflect poorly on his record, so he sought the help of an Army chaplain, Theresa said. While he was attending leadership training at Fort Lee, Va., in 2022 he suddenly went silent. A weekend would pass before her son's body was discovered slumped in his hotel room bathroom, after he didn't show up for class. He had taken a fentanyl variant, according to his toxicology report, but his parents have no idea how he came to possess it. The Army has not finished an investigative record in his case.
"I would like to know every possible thing that I could," Theresa said, "but I know I never will."
The Army has tried to address soldiers' fears of potential career consequences if they seek treatment. In December, the service put out an ad campaign with the tagline "Let's talk, I'm listening," to raise awareness about their evolving approach to addressing addiction and overdoses. Charles Milliken, director of the Army's Substance Use Disorder Clinical Care program, said that while a soldier's illicit drug use will be reported to their command, if they proactively seek treatment, they are protected from that information being used for legal prosecution.
"When a soldier's substance use does not respond to treatment, the commander, with [clinical] input, makes the decision about continued service," Milliken added.
The high number of overdose deaths at Fort Liberty, Conley's home base, has elicited scrutiny on social media, from news outlets and Army officials. Earlier this year, a dozen Army Special Operations soldiers were questioned as part of an investigation of illegal drug activity, Army officials said at the time, but few other details have been made public. "The investigation is still ongoing," said Army Criminal Investigation Division spokesman Jeffrey Castro. "No further details will be released at this time."
Court cases show prosecutors have gone after dealers suspected of giving deadly drugs to soldiers. And Hagan, the Army spokeswoman, said Army investigators run a "proactive and robust counternarcotics program" aimed at "curtailing drug distribution on and around Army installations."
A vast majority - 98 percent - of those who have died from drugs in the Army are enlisted personnel, not officers, according to a Post analysis of death records. Most of those dying from fentanyl are young, White men. Of the 127 fentanyl victims reported in these records, the average age was just below 26. Sixteen were Black, and 17 were Hispanic or Latino.
The Post obtained the data after an inquiry in September led by Markey. In response to senators' questions, Gilbert Cisneros Jr., the undersecretary of defense for personnel and readiness, said that addressing addiction and overdoses had to be "a high priority" for the Pentagon after active duty drug deaths increased in 2020 and 2021.
Cisneros said the department is currently improving overdose data collection and monitoring, messaging and treatment options.
"We share your concern that drug overdose is a serious problem and must be addressed for the safety of those at Fort Bragg, North Carolina; Fort Bliss, Texas; West Point, New York; and the safety of all who serve," Cisneros wrote in a Feb. 10 letter to the senators.
Katherine Kuzminski, a senior fellow at the Center for a New American Security, said that while a civilian organization might view drug use from a more compassionate lens, it is more difficult for the military services to acknowledge because it is a break in the rigorous standards they must maintain for uniformity and security reasons.
"It comes down to a readiness issue," Kuzminski said. "If someone is using illicit drugs in the military, that affects their performance, if they die of an overdose or even if there's a traumatic event that they survive, the impact on the unit is pretty intense."
'Not an agenda item for leadership'
After Staff Sgt. Kue Vue, 25, died from cocaine laced with fentanyl on March 28, 2022, his family wondered whether his death could have been prevented if the Army had drug tested him more frequently at Fort Hood, now renamed Fort Cavazos. Hagan, the Army spokeswoman, said the service has "an aggressive drug-testing program" and soldiers are tested annually, with 10 percent of troops tested monthly at random.
"Drug testing can be helpful on a broader scale," said Tom Gillard, the Army's substance abuse program manager. For instance, he said, the Army tracks testing and will respond "when there are multiple positive drug tests in the same unit of the same kind of drug."
The overall active duty drug-positive rate through urinalysis testing was 0.79 percent in 2021, according to the Pentagon. Twenty-three service members out of 332 who died had a positive drug test before overdosing.
"They told us that they just do it randomly and some soldiers don't get chosen within a year," said Vue's brother Chee. "I don't know, maybe that's a good protocol to them, but to me, I just don't think that's good enough protocol when you got soldiers basically risking their lives for the United States."
The bill introduced last week, called the Department of Defense Overdose Data Act, would require the Pentagon to start annual reporting of fatal and nonfatal overdoses among active-duty service members and military families, engage with an independent entity that will research barriers to accessing care and develop standards to promote education and prevention.
"The information we received from the Department of Defense is a call to action to address this epidemic's impact on service members and their families and to institute systemic reform to prevent overdose, improve access to treatment, and reduce the stigma of asking for help," Markey said in a statement.
Also signed onto the bill were Senators Lisa Murkowski (R-Alaska), Elizabeth Warren (D-Mass.), and Mike Braun (R-Ind.), and Representatives Moulton and Nancy Mace (R-S.C.).
Understanding the data is an important part of developing solutions that could counter drug use on military installations, said Jaime Earnest, an epidemiologist who has studied substance abuse and served as a contractor at the Pentagon. But drawing attention to the problem can be difficult for optics.
"It's not an agenda item for leadership to dig through the dirty laundry of substance abuse," Earnest said. "I think that's a problem endemic to any organization, but certainly within the DOD, facing a recruitment and retention crisis, that probably isn't keen to offer up to the public that there is a drug abuse and substance abuse crisis in its midst."
And although the military produces large amounts of data on personnel, including drug use, the massive bureaucracy has trouble centralizing that information, maintaining databases and providing easy access to it, Earnest said.
"I think a large part of this is a synchronization and coordination issue," she added. "Who has visibility on what, who holds what data? These questions are unclear, even to leaders sometimes."
Earnest said she was fired by consulting firm Saliense, which contracts with the Army directorate that provides behavioral health services to soldiers, two days after speaking with Rolling Stone for the article about drug use at Fort Liberty. She shared the termination letter, which dated two days after the article published. Saliense did not respond to emails or a phone request for comment.
'Tough it out'
At the Army's lowest levels, routine death investigations sometimes call out leadership.
Ari McGuire, 23, enlisted in 2016 to become a paratrooper and appeared to thrive in the 82nd Airborne Division at Fort Liberty, deploying to Afghanistan in 2017 with a goal of attending Ranger School. While preparing for the rigorous course, McGuire became friends with a much older staff sergeant who an Army investigation later said was known to use opioids and had influenced McGuire to use drugs.
The investigation into McGuire's death found that he had sought out help for addiction, raising his issues to "anyone that would listen," including senior soldiers in his chain of command. The investigating officer chided unit leaders for not taking "more aggressive steps to seek rehabilitation" for McGuire "immediately following his confession to drug use and addiction."
Shortly before a July 2019 military exercise in Louisiana, it became obvious that McGuire was suffering from withdrawal symptoms, according to a soldier who spoke on the condition of anonymity because he is still serving in the military.
"I'm trying to be respectful, because I'm still in the Army, but the chain of command at the time was unresponsive," the soldier said. "They kind of just wanted [him] to tough it out."
It was during that time that McGuire also began to open up about his drug use, according to the investigation. He told his peers and leaders that he wanted to get his life together and get away from the staff sergeant who introduced him to drugs.
But not long after McGuire returned to Fort Liberty, fellow soldiers said his bloodshot eyes and trouble staying awake indicated he had relapsed, the report said. A company commander told McGuire that he was being referred to an outpatient substance use disorder program on post.
McGuire's parents said they were told he was "put on a wait list" for inpatient rehab in another state. In the meantime, two sergeants were ordered to conduct wellness checks on him in his barracks room at night.
On a Thursday night in mid-August 2019, while one of the sergeants checked his room for drugs and alcohol, McGuire talked about how he was excited to start rehab. But it did not appear there was a plan to continue checks over the following weekend, the investigating officer wrote in his report on McGuire's death.
At about 9 p.m. that Friday night, McGuire left the barracks in a Lyft car and went to Wood Spring Suites, an extended stay hotel off post. He went inside briefly before taking the same car home. As the driver approached the Fort Liberty gate, he realized McGuire was unconscious.
McGuire later died at a hospital, with his cause of death listed as "fentanyl toxicity." The Army's investigation into McGuire's death concluded that his chain of command should have been checking in on him throughout the weekend.
Since McGuire's death, Fort Liberty officials say they have increased random urinalysis testing, improved prevention training and heightened law enforcement presence on base and at its entries. The installation also offers free naloxone, an overdose-reversing drug.
Army officials say they have about 300 employees across 100 behavioral health clinics who can provide outpatient substance use care. For soldiers who require more intensive care, the service also has 12 intensive outpatient programs to treat addiction and three residential substance use treatment programs.
McGuire's parents, however, have sought more. Last year, they lobbied the office of Rep. Jackie Speier (D-Calif.) to help create an inpatient drug and alcohol rapid response program that intervenes immediately when troops admit drug use, as their son had, though their desired amendment never made it into Congress's annual defense bill.
One military family, who spoke on the condition that their full names not be used to protect their privacy, raised another issue: the denial of survivor benefits because of a drug-induced death.
David M. did not use drugs before he enlisted, according to his wife, Dawn. But during the coronavirus pandemic, his mental health deteriorated when he was restricted to living on the base where he conducted top-secret, challenging operational work, she said.
He was visiting the weekend of his birthday in September 2021, and his son, who was about to turn 5, came into his room to discover his father's body, blue in bed.
Dawn doesn't know e Army was lacking; no one in her family was interviewed.
She applied for military benefits paid to eligible survivors of service members who died in the line of duty or from a service-related injury or disease. But the claim for her and her son was denied.
"Things he was dealing with and seeing at work gave him these issues and then you're gonna punish me and my son for it," she said. "Had he killed himself that night we would get it. If he crashed his car while high that night we would get it. But because that was the cause of death, we don't get any of those benefits."