January4, 2007: One of the many lifesaving items of equipment soldiers take into combat are drugs that keep them alert after long hours in a combat zone. This fatigue problem has existed for a long time, and has become particularly acute in the last century or so, as battles became endurance contests, with forces engaged for days on end. In the last few decades, as long range bombers, and refueling in the air, became common, pilots have had to face the same problem during very long (30 hours or more) missions.

For over a century, the solution has been amphetamines ("speed"). However, this drug can impair judgment, making the user more aggressive, for example. In the last decade, kinder and gentler medications have become available. The most effective of these has been Modafinil (sold as Provigil). This stuff is described as "a mood-brightening and memory-enhancing psychostimulant which enhances wakefulness and vigilance." Tests showed that user performance was degraded 15-30 percent, versus 60-100 percent for those who took nothing at all after 24 hours of being awake. While the Modafinil did a pretty good job, the dextroamphetamine was still a bit better. So amphetamines remained competitive.

A new stimulant, apparently superior to dextroamphetamine and Modafinil, is being tested. This is CX717. Another approach, and another new drug, Gaboxadol, make small amounts of sleep provide the same effect as a full nights sleep. Thus a soldier or pilot could nap for an hour or less, and be ready for another full day of action.

Wakefulness can be a potent weapon, especially for commandos, or troops engaged in prolonged combat (like the Battle of Fallujah in 2004). Without these wakefulness drugs, you would have to either pull troops out of action so they could rest, or leave them in and risk having them make fatal mistakes. Either way, you have a problem, because there are never enough troops to get the job done. But with the wakefulness medications, you can solve the problem, for a few days, anyway. Prolonged use of these drugs is not healthy. But neither is being drowsy during combat.