A growing group of veterans and their family members are hoping legal action will bring answers and an acknowledgement that an anti-malarial drug used by the Canadian Forces left them with life-altering, long-term side effects.
“I wanted somebody to be accountable. I wanted somebody to acknowledge that maybe things weren’t done right,” Sherri Elms told Global News.
Elms is one of eight people who filed three lawsuits against the federal government this spring over the military’s use of mefloquine, alleging the Canadian Armed Forces (CAF) administered the drug in a negligent manner, leaving them with long-term health issues. The number of claimants is expected to grow exponentially in the next few months, according to Paul Miller, one of the lawyers representing the claimants. The government has yet to file a defence to the lawsuits.
Meanwhile, some Conservative MPs are calling for an independent inquiry into the drug’s military use in a dissenting opinion to a veterans affairs committee report tabled in the House of Commons on Wednesday.
Mefloquine is an anti-malarial drug used by the CAF since 1992 in deployments including Somalia, Congo, Rwanda and Afghanistan.
The manufacturer currently warns there could be negative mental and nervous system side effects including anxiety, depression, hallucinations, suicidal thoughts, restlessness, confusion, unusual behaviour, dizziness, vertigo, loss of balance, tinnitus, seizures and insomnia.
It also reads that some of the mental side effects can last months or years.
Troops first took mefloquine in Somalia
Elms’ husband, Capt. Brad Elms, first took mefloquine in 1992 in Somalia, before the drug was licensed. In the years that followed, he was diagnosed with tinnitus and suffered from memory loss, anxiety and depression before he died by suicide in 2014.
“Things just got more and more difficult,” Elms recalled. “He couldn’t remember anything, couldn’t hear anything. He was frustrated with his mood and why couldn’t he enjoy life.
“He couldn’t fix it.”
Capt. Elms is one of the soldiers named in a set of lawsuits on the military’s use of mefloquine.
Elms started researching mefloquine after Brad died. A pharmacist by trade, Elms said she was shocked at what she learned. She said soldiers like Brad were given the unlicensed drug as part of a clinical trial and wouldn’t have been able to say no.
“It boggles the mind that one could enroll an entire group of men in a clinical trial and then not do any due diligence, not monitor them, not get informed consent,” she said.
While there might be other factors influencing her husband’s health issues, Elms said she believes mefloquine — which he also took in Haiti and Afghanistan — played a role.
Approximately 18,000 prescriptions have been written for CAF members, according to the military’s surgeon-general. CAF now uses mefloquine as a drug of last resort, with only three prescriptions written in 2018.
Other filed statements of claim allege that side effects of mefloquine have led to employment issues, divorce, familial estrangement, homelessness, criminal activity, suicidal thoughts and suicide.
Mefloquine runs right through the middle: veteran said drug changed his life
Maj. (Ret’d) Christian Glauninger divides his life into two distinct halves — before mefloquine and after.
“You have numbness in your feet, your extremities. You have trouble sleeping. It affects everything in your life,” he said.
“You’re not the same and what’s really upsetting is they kept giving it to us.”
Glauninger had already served for decades before he deployed to the Congo in 2003 and was prescribed mefloquine. He said strange things started to happen immediately including nightmares, difficulty sleeping and some anger issues.
He chalked it up to conditions in the Congo, but the symptoms continued when he returned home. Then came the anxiety, tinnitus and hallucinations. Glauninger’s wife was diagnosed with cancer at the same time so he figured everything was due to stress.
Then he heard about mefloquine’s side effects at a Legion information night. Glauninger started to research the drug and realized the issue went beyond his own experience.
“That’s what the lawsuit is all about. It’s having them own up to what they’ve done to us,” Glauninger said, who expects his lawsuit to be filed soon.
The disputed evidence on mefloquine’s long-term effects
Defence Minister Harjit Sajjan wouldn’t comment on the matter before the courts but did say: “When it comes to looking after our Canadian Armed Forces members, we take this very seriously and make all the decisions based on the appropriate science and we have a surgeon general who looks at matters like this.”
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The CAF surgeon general studied mefloquine in 2017 and concluded it is not consistently associated with an excess risk of adverse effects, nor is there evidence for the long-term adverse effects.
Brig.-Gen. Andrew Downes reiterated the position recently at the veterans affairs committee last month.
“Our assessment of the literature is that there remain many unanswered questions around this hypothesis. The evidence supporting it is insufficient and has been challenged by many experts,” the surgeon general told parliamentarians, adding the military is focused on helping to treat members’ health issues regardless of whether they took mefloquine or not.
Tropical disease specialist Dr. Michael Libman also testified at the committee. He said major retrospective studies comparing soldiers who have taken mefloquine with soldiers who have taken other anti-malarials have not been able to show causality when it comes to long-term side effects.
“Nobody could show in retrospect that the mefloquine did anything worse than other anti-malarials,” Libman said. “Either it’s not the mefloquine at all or all anti-malarials are the same. Either way you, can’t pin it specifically on the mefloquine.”
Elms said the military’s view of the evidence is too narrow.
“There’s people that need help and just acknowledge there is something there,” she said. “Maybe it’s not everything, but there’s something significant there.”
Other physicians who testified pointed to evidence that mefloquine’s effects could be chronic for some people.
“The major problem with this drug is that when given to perfectly healthy individuals, sizeable minorities experience what can be lasting neuropsychiatric adverse effects,” said Dr. Remington Nevin, a former American military physician who studies the effects of mefloquine.
Nevin, who has been retained by the law firm representing claimants, said the drug shouldn’t be used in military settings because the symptoms are easy to confuse with the stress of deployment. He said the drug doesn’t affect everyone, but those who are affected should stop taking it immediately.
Elms is now doing her PhD in medication safety. She said the Department of National Defence should have done a better job monitoring the drug and recording adverse effects.
“We have a brand-new drug, and you’re using it in a very difficult situation and you have all kinds of strange things happening. The assumption should not be that there’s something wrong with the people,” she said.
“The clinical assumption should be maybe there’s something going on here and it should have been investigated.”
MPs seek recognition of forthcoming American mefloquine study
The House of Commons veterans affairs committee’s main report recommends the government recognize the findings of a major forthcoming American scientific study, and if the study supports it, possibly implement a screening program for CAF members who took mefloquine. It also calls on the government to acknowledge the possibility that short-term mefloquine effects could have “indirectly” led to permanent disabilities.
A dissenting report from Conservatives on the committee seeks an independent inquiry.
“Admit to the fact that this is an issue of toxicity. It’s an issue where veterans are dealing with troubling issues and to do the proper inquiries into this and make sure we get to the bottom of it,” said Conservative Phil McColeman.
The NDP are seeking a study into treatments and a cure for long-term mefloquine effects.
“Acknowledge we don’t know everything but there is enough of a trend there that something needs to change,” said NDP MP Rachel Blaney.
Elms would welcome future help for veterans, but she also hopes any past wrongs can be righted.
“It would just be nice for someone to admit we didn’t do the best that we could have by these men,” she said.
WATCH BELOW: Politicians on the military’s use of mefloquine