THE GENERAL'S DRUG PROBLEM

His Story Is a Warning About Use of Painkillers

TAMPA - Standing before a packed hall of 700 military doctors and
medics here, the deputy commander of the nation's elite special
operations forces warned about an epidemic of chronic pain sweeping
through the U.S. military after a decade of continuous war.

Be careful about handing out narcotic pain relievers, Lt. Gen. David
Fridovich told the audience last month. "What we don't want is that
next generation of veterans coming out with some bad habits."

What Fridovich didn't say was that he was talking as much about
himself as anyone.

For nearly five years, the Green Beret general quietly has been
hooked on narcotics he has taken for chronic pain -- a reflection of
an addiction problem that is spreading across the military.
Hospitalizations and diagnoses for substance abuse doubled among
members of U.S. forces in recent years. This week, nurses and case
managers at Army wounded care units reported that one in three of
their patients are addicted or dependent on drugs.

In going public about his drug dependency during interviews with USA
TODAY, Fridovich, 59, echoes the findings of an Army surgeon general
task force last year that said doctors too often rely on handing out
addictive narcotics to quell pain.

An internal Army investigation report released Tuesday revealed that
25% to 35% of about 10,000 soldiers assigned to special units for the
wounded, ill or injured are addicted to or dependent on drugs,
according to their nurses and case managers. Doctors in those care
units told investigators they need training in other ways to manage
pain besides only using narcotics.

"I was amazed at how easy it was for me or almost anybody to have
access and to get medication, without really an owner's manual," says
Fridovich, deputy commander of the nation's roughly 60,000 Green
Berets, Army Rangers, Navy SEALS and secretive Delta Force teams.

For such a high-ranking military officer, publicly acknowledging drug
dependency was unprecedented.

Retired Army major general Paul Eaton, a former commander in Iraq,
says Fridovich has now joined a small cadre of senior military
leaders willing to discuss publicly personal struggles, such as
living with post-traumatic stress disorder. Such admissions are
difficult professional decisions, Eaton says.

"Nobody wants to show weaknesses. You want to be perceived as
perfection," he says. "But sometimes moral courage kicks in where
moral courage is demanded."

Fridovich agreed in recent weeks to talk openly about his reliance on
drugs as part of what he says is a personal commitment to push the
Army into better addressing pain management and drug addiction.

"Here's my story," he says. "I feel like there is some real value --
maybe cathartic, don't know -- but really, more than anything else,
how can you help people?"

His own experiences are his bona fides on the issue, Fridovich says,
and others agree.

"This is huge for Fridovich to be willing to talk about this as a
three-star general," says Gen. Peter Chiarelli, Army four-star vice
chief of staff. "We're finally coming clean and admitting at all
levels this is an issue."

Fridovich says narcotics altered his personality, darkened his mood
and management style and strained his 35-year marriage.

When Fridovich finally went through treatment and detoxification to
reduce his drug reliance in 2008 -- he still relies on weaker doses
of narcotics to combat pain -- his wife, Kathy, hid or destroyed more
potent pain pills so he could not use them.

"I was fighting the pain. And I was fighting the injury. And I was
fighting the narcotics," he says. "We have an obligation to the
soldiers to look them in the eye and say, 'I know what you're going
through. You don't want to be like this for the rest of your life.
You don't have to be.' "

Pentagon statistics show the number of pain-relief prescriptions
given to troops, including narcotics, growing 86% from 2001 to 2009,
when 3.7 million doses were handed out. That dipped last year to 3.5
million prescriptions, the data reveal, but is still more than any
year prior to 2009.

From 2005 to 2009, the number of troops diagnosed each year with
substance abuse disorders jumped 50% to nearly 40,000, the Pentagon
says. And substance abuse hospitalizations increased from 100 troops
per month in 2003 to more than 250 per month in 2009.

"The abuse is getting higher and higher and more and more," Fridovich
says, "and that leads to a very dark, deadly, dangerous place."

Narcotics entered Fridovich's life in May 2006, after he severely
injured his back exercising between trips to war zones. At the time
he was a two-star general in command of all special operations forces
- -- Green Berets, Navy Seals and Army Rangers -- operating in the Pacific.

Fresh from a trip to Iraq and slated to go to the Philippines, he was
in a Marine base gymnasium on Oahu leg-pressing 400 pounds when lower
vertebrae shattered. Doctors later said his back was brittle from
decades of soldiering and scores of parachute drops.

He said he felt a twinge at the time and worked through it,
continuing a regimen of weight-lifting, handball and racquetball for
several days.

But by Memorial Day, he awoke barely able to stand. "All I could do
was just lie in bed and writhe," Fridovich recalls, describing pain
radiating from his lower back down his left leg.

"It felt like someone had taken a baseball bat from here to here,"
Fridovich says, gesturing from waste to kneecap.

In the emergency room at Tripler Army Medical Center in Honolulu,
X-rays showed shattered bones and pinched nerves. Motrin and morphine
were the first medications, followed by fistfuls of fast-acting
roxicet and longer-lasting Oxycontin, both listed by the federal
government as highly addictive with significant potential for abuse.

Doctors wanted him to wait on surgery to gauge progress. "That was a
little bit more than wishful thinking," Fridovich says now.

Eager to quell pain and resume command, Fridovich during one 24-hour
period swallowed five dozen Oxycontin pills. His calculus was simple,
he says: If the drugs were for pain relief, more drugs must equal more relief.

But the price was a disturbing fogginess of mind and dark,
frightening thoughts. Fridovich recalls contemplating, almost
irrationally, whether he should simply have his stricken left leg
amputated and be done with it.

He says he pulled out the written warnings about narcotics and
realized he was in treacherous territory. "That scared the hell out
of me, (the) anxiety, depression, real bad thoughts," he recalls. "I
got scared so bad that I stopped."

Fridovich says he immediately cut his consumption of pills
drastically -- but not entirely. Instead, Fridovich fell into a
lifestyle he now concedes was a mistake -- ingesting two to four pain
pills daily, even as he continued commanding troops and moving up
through the ranks.

The demands of his job, the need to travel by plane and helicopter
around the globe and stay functional, meant that the roxicet and
Oxycontin pills would be part of his daily diet.

"Somebody should have challenged me," he says. "I should have
challenged myself and said, "Wow, I'm on this stuff way too long.
What's the deal?' "

His wife, Kathy, the college sweetheart he married on the eve of
joining the Army in 1976 -- the couple have one child, a daughter --
found herself in a dilemma. She could see her husband was in chronic
pain, but she hated the medication.

"I don't like the drugs," says Kathy Fridovich. "I knew he was taking
a lot. I read all the little fine print. Drugs are scary."

She became her husband's conscience, urging him to find a way off the drugs.

For a time in Hawaii, Fridovich sought out acupuncture and managed to
reduce his intake of narcotics.

He received his third star in July 2007, and an assignment as
director of the Center for Special Operations. He and Kathy moved to
Tampa, where Special Operations Command headquarters are located and
the acupuncture treatment ended. Special Operations troops have
played a central role in the Iraq and Afghanistan wars since 9/11 and
the pressure on Fridovich to remain fully functional meant that the
pain had to be kept in check. The easiest way was the pills, he says.

"Starting a new job and wanting to do well, he just worked as hard as
he could, and they helped him get through," Kathy Fridovich says.
"(But) I kind of wondered about the quality of what he was doing."

"I did, too," echoes Fridovich.

The drugs were altering his personality. Fridovich found himself
becoming cross with colleagues and less tolerant of new ideas. "I
found myself being, in some ways, very isolated, very combative," he
says. "It's not what I wanted to be known for. I wanted to build
teams. I wanted to bring people together."

Doctors at Walter Reed Army Center in Washington, D.C., finally
decided to operate on Fridovich's back in January 2008. The surgery
removed shattered bone and fused vertebrae. It would provide some
long-term relief, but for a while the pain intensified.

Oxycontin and roxicet no longer were enough. He was given morphine.

Within a few weeks back in Tampa, doctors finally advised the
three-star general that he had a long-standing dependency on
narcotics. He needed some way of managing his pain without relying
only on drugs.

At the time, Special Operations doctors were facing the same issues
with soldiers suffering chronic pain, dependency or addiction. They
found the Andrews Institute for Orthopedics and Sports Medicine, a
Pensacola-based center that provides an array of services including
surgery, rehabilitation and pain management.

Fridovich would be the test subject.

For four weeks, doctors, therapists and rehab specialists worked with
Fridovich through physical training, psychological counseling and
nutrition to train his body in more natural ways to deal with pain.
They also put him through detoxification.

He was placed on a weaker narcotic, buprenorphrine, less amenable to abuse.

Detoxification left Fridovich physically and emotionally wrung out,
he says, suffering the shakes, sweats, aches and nausea. "It's the
most sickening feeling that racks your entire body," he says.

Fridovich -- who was named deputy commander of Special Operations
Forces in May 2010 -- says the therapy, detox and reduction in
narcotics cleared his head, eased his temperament and brightened his
outlook on life. "I should probably take an ad out in a national
newspaper apologizing for everything I've said or done, because I'm a
different person," he says with a grin.

He hopes one day to leave narcotics behind entirely.

When the Army's surgeon general office developed a plan last year to
institute service-wide some of the same holistic methods that helped
Fridovich, the general was part of the campaign.

"I want to be involved," Fridovich says. "I want to listen to where
this is going and see if my playing a part would lend any sense of
urgency or importance -- get it moving in a way that we start getting
things done."

He says Army medicine must be better prepared to treat pain with
aggressive monitoring of medication, drug education, acupuncture,
nutrition and proper exercise. "We ask great things of (soldiers).
Don't we owe them great things as well?" Fridovich says. "It's about
the human expense."