Robert Bales Massacred 16 Afghans, and This Drug May Be to Blame


Staff Sgt. Robert Bales has rendered a guilty plea in response to charges of executing 16 Afghan civilians on March 11, 2012. He will be sentenced following a hearing that began Tuesday. By pleading guilty to the massacre, Bales has avoided the death penalty, but could receive a sentence of life in prison with no parole. Defense attorneys will ask for leniency based on several factors including multiple deployments, Traumatic Brain Injury (TBI), possible PTSD, and the antimalarial drug Lariam.

The 39-year-old Ohio native had been well regarded in his hometown where residents still remember him as friendly and respectful. Something happened in the early morning hours of that March morning that belied all the things people thought they knew about Sgt. Bales.

It’s likely the defense will focus on Lariam (mefloquine hydrochloride), which has a spotty history and is specifically contraindicated for patients who have suffered brain injury (as Bales apparently did in Iraq). The manufacturer of Lariam, Hoffman-LaRoche, has provided warnings of possible serious side effects for years.

The Food and Drug Administration (FDA) recently upgraded the warning on mefloquine packaging to one of its most serious. Known as the Black Box Warning, the new packaging of the drug will include a declaration that administering the drug could cause psychiatric side effects that can last for many months after the patient stops taking the drug.

When my son deployed to Afghanistan in 2002, he was also ordered to take Lariam, but refused because of the known side effects which seemed to offer a far greater downside than the risk of contracting malaria.

There is no doubt that Robert Bales committed a horrible crime and should receive substantial jail time. My hope, though, is that this case puts a spotlight on all of the issues suspected of contributing to his behavior, including TBI, PTSD, Lariam, and the ready access to other drugs and alcohol which may have played a role in his behavior. Far from excusing his behavior, which it won’t, further attention may help prevent other members of the military from going off the deep end. And it could save lives.