Health Officials Discourage Aspirin Use by Troops in Combat Zones

By Gerry J. Gilmore
American Forces Press Service

April 30, 2009 - The Defense Department is directing servicemembers and government civilians deployed in overseas war zones to refrain from taking aspirin unless under a doctor's orders, a senior military physician said here today. "Aspirin use for reasons other than medical indications is discouraged," said Army Col. (Dr.) Tony Carter, director for operational medicine and medical force readiness under the deputy assistant secretary of defense for force health protection, a component of the Office of the Assistant Secretary of Defense for Health Affairs.

Military medical authorities also advise that troops slated for deployment to combat zones should cease taking aspirin at least 10 days before departure, Carter told Pentagon Channel and American Forces Press Service reporters.

Aspirin is "a platelet-inhibitor," Carter explained. Platelets are small cells floating in the blood that induce hemostasis -- the process that causes bleeding to stop through the forming of blood clots. Low amounts of blood platelets can lead to excessive bleeding.

"Those platelets serve an important role in stopping bleeding once it occurs," Carter said.

Then-Assistant Secretary of Defense for Health Affairs Dr. S. Ward Casscells III signed a March 12 memorandum that noted aspirin use by troops deployed in contingency areas could contribute to excessive bleeding in the event of wounding or injury.

Blood loss is the most common cause of preventable death associated with combat injuries, the memorandum said.

Carter recalled Casscells asking his staff if the military was discouraging aspirin use by people deploying to combat zones where they stood risk of injury. The answer at the time was no, Carter said.

The subsequent memorandum, Carter said, also directed the cessation of "over-the-counter access" to aspirin through Army and Air Force Exchange Service outlets or morale, welfare and recreation activities in war zones. AAFES has jurisdiction over Army post exchanges and Air Force base exchanges.

AAFES is complying with the Health Affairs-issued memorandum, noting in a news release that its "operations in contingency locations are removing all products containing aspirin from their shelves."

The intent of the new policy, Carter said, is to "discourage the inadvertent use of aspirin" in combat zones. People who routinely take small doses of aspirin per doctor's orders to maintain vascular health should be all right, he said, but they should consult their physician.

Servicemembers and civilians could substitute over-the-counter, non-aspirin-based medications – such as Tylenol or Motrin -- for treatment of colds, fever, muscle aches and other maladies, Carter said.

"I think we should take every measure possible to make sure that we minimize blood loss," Carter said. "And, not taking aspirin, unless you need to take it, is one of those mechanisms that we want to use."