Substance Abuse in the Army

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Updated 03/06/2024

Key Takeaways

  • Substance use in the army is a significant issue, with a higher prevalence among military personnel than civilians.
  • Factors contributing to substance use include genetic predisposition, environmental influences, psychological conditions, and military-specific stressors like combat exposure.
  • Alcohol, prescription drugs, and tobacco are among the most commonly used substances in the army.
  • Substance use can lead to severe health consequences, including addiction, depression, and increased risk of suicide.
  • The Army Substance Abuse Program (ASAP) aims to prevent and treat substance use to maintain combat readiness and unit cohesion.
  • ASAP includes mandatory drug testing, educational campaigns, and treatment and rehabilitation services.
  • Despite efforts, challenges such as stigma and the need for integrated treatment approaches for co-occurring disorders like PTSD remain.
  • The effectiveness of substance use programs is critical for the health and readiness of military personnel, requiring ongoing research and evidence-based strategies.

Substance Abuse Prevalence Among Army Personnel

The prevalence of substance use in the military, particularly among army personnel, is a significant concern, with various studies highlighting the extent and nature of the issue. Data indicates that service members, including those who have been deployed to combat zones, are at an increased risk of developing substance use disorders (SUDs) compared to civilian populations. For instance, research suggests that individuals recently deployed to Iraq and Afghanistan are 1.36 times more likely to develop an alcohol use disorder and 1.14 times more likely to develop a drug use disorder than their non-deployed counterparts.

Moreover, the National Institute on Drug Abuse (NIDA) reports that nearly 9% of military service personnel were current cigar smokers, and nearly 13% used smokeless tobacco as of 2015. Additionally, 65% of veterans entering treatment programs report alcohol as the substance they most frequently misuse. These statistics underscore the need for targeted prevention and intervention strategies within military settings.

One of the contributing factors to the high rates of substance use is the common co-occurrence of post-traumatic stress disorder (PTSD) and SUDs within military populations, which is higher than in the general population. The Department of Defense has implemented policies and programs aimed at addressing substance use, including smoking cessation programs and the prohibition of tobacco use in medical facilities. Furthermore, the integration of treatment for SUDs and PTSD has shown promise in recent clinical studies, highlighting the importance of trauma-informed care interventions.

Despite these efforts, there are still challenges in effectively addressing substance use in the army. Stigma associated with seeking help for SUDs and mental health issues often leads to low rates of referral to treatment services. This indicates an ongoing need for the military to enhance its substance use prevention and treatment initiatives, reduce stigma, and support service members in overcoming these challenges.

Commonly Abused Substances in the Army

Substance use within army ranks is a significant concern, particularly given the unique stressors military personnel face. Alcohol, prescription drugs, and illicit substances are the primary categories of substances commonly misused by army members. Alcohol use disorder (AUD) is prevalent, with a substantial number of veterans entering treatment programs reporting alcohol as their most frequently misused substance. This is nearly double the rate of the general population, highlighting the acute issue of alcohol misuse in military life.

Prescription drug use also mirrors civilian patterns, with pain medications being a notable concern. The military’s high prescription rate for pain medication has drawn attention, especially considering the potential for misuse during transitions to medical discharge. Illicit drug use, while lower due to stringent military policies and deterrents like urinalysis testing, still occurs. Tobacco use, including cigarette and smokeless tobacco, is another substance commonly used by military personnel, with many starting after enlistment. This has led to the implementation of smoking cessation programs and policies aimed at reducing tobacco use within the ranks.

Substance use in the army is exacerbated by factors such as the co-occurrence of post-traumatic stress disorder (PTSD) and the military culture that often normalizes drinking. The combination of PTSD and AUD can have severe mental health consequences, necessitating integrated treatment approaches that address both issues concurrently.

Contributing Factors to Substance Abuse Among Army Personnel

The occurrence of substance use in the army is influenced by a complex interplay of factors. High-pressure environments, repeated deployments, and the psychological impact of combat can significantly contribute to substance use among military personnel. Prolonged deployments, particularly those with multiple tours, often correlate with increased medication use to manage combat-related stress, leading to potential substance use issues. Studies have shown that service members on their third or fourth deployments report more problems than their first or second.

Psychological distress is a prominent factor, with service members facing the ‘invisible wounds’ of military service, including post-traumatic stress disorder (PTSD), depression, and traumatic brain injury (TBI). Rates of depression among military personnel are notably higher than in the civilian population, and substance use often becomes a maladaptive coping mechanism in the absence of adequate mental health support. Furthermore, the military culture itself can play a role; drinking is frequently seen as an integral part of bonding within the unit, leading to increased alcohol consumption and potential misuse.

Prescription medication misuse is another concern, with rates similar to the civilian population despite a zero-tolerance policy for illicit drug use. The prescription of pain medications, particularly during the transition to medical discharge, has been a subject of much discussion due to the risk of developing substance use disorders. Recognizing risk factors and implementing evidence-based practices across the continuum of care is crucial for effectively addressing these issues.

Moreover, stigmas associated with mental health within the military may serve as barriers to seeking help. The army needs to provide comprehensive support and treatment options, considering the unique challenges military personnel face.

Effects of Substance Abuse on Military Personnel and Operations

Substance use within the Army has profound implications, not only for the individual soldiers but also for military operations and overall readiness. Studies have shown that up to half of suicides, sexual assaults, and incidents of intimate personal violence in the Army are related to alcohol misuse. Moreover, substance use disorders (SUDs) can create a domino effect, negatively impacting unit morale and leading to behavioral health issues, misconduct, and high-risk behaviors that threaten the well-being of service members and the efficacy of military operations.

Deployment and combat exposure are significant risk factors for initiating substance use and exacerbating existing SUDs. Research indicates that veterans of Iraq and Afghanistan experience high levels of extreme stressors and injuries, which can lead to increased substance use and hinder their reintegration into civilian life. The presence of co-occurring mental health disorders, such as PTSD, depression, and anxiety, is common among veterans with SUDs, further complicating treatment and recovery.

On an operational level, substance use can lead to lost duty days, reduced unit cohesion, and compromised mission capability. The Department of Defense has recognized the need for evidence-based practices in SUD treatment and the integration of care for co-occurring conditions like PTSD and SUDs. Policies are in place to deter substance use, including stringent alcohol and drug use prohibitions and preventive measures like urinalysis testing programs. Nevertheless, despite these efforts, the challenge of substance use in the military persists, necessitating ongoing research and development of effective prevention and treatment strategies.

Health Consequences of Substance Abuse in the Army

Substance use can lead to a host of physical and mental health issues that are particularly concerning within the context of military service. Addiction, depression, and suicidal tendencies are among the most severe consequences that can arise from substance misuse. Addiction is a complex disorder characterized by compulsive drug use despite harmful consequences, and it can lead to significant brain changes affecting judgment, decision-making, learning, memory, and behavior control. Depression is another common outcome, with substance use often worsening the symptoms of pre-existing mental health conditions or triggering new ones.

Substance use in the army can also have unique physical health consequences due to the demanding nature of military duties. Long-term misuse of substances can lead to chronic health problems, including liver disease, heart disease, and respiratory issues. Furthermore, the use of illicit drugs or the misuse of prescription medications can impair physical performance, reaction times, and decision-making, potentially jeopardizing missions and the safety of fellow soldiers.

The mental health of army personnel is particularly vulnerable, as high-stress environments and trauma exposure can exacerbate substance use issues. Recent studies indicate that stress and anxiety are key factors driving individuals towards substance use as a coping mechanism. However, this can create a vicious cycle where substance use further deteriorates mental health, leading to an increased risk of addiction and other mental health disorders such as PTSD. In severe cases, this cycle can culminate in suicidal ideation or attempts, underscoring the critical need for effective prevention and treatment strategies within military settings.

Addressing the complex interplay between substance use and mental health in the army requires comprehensive approaches that include prevention, education, and access to mental health services. By understanding the multifaceted impact of substance use on both physical and mental health, the army can better protect its personnel and maintain operational readiness.

Operational Impact of Substance Abuse in the Military

Substance use within military ranks has significant repercussions on the effectiveness and efficiency of operations. The Department of Defense (DoD) actively operates programs focused on the prevention, treatment, and research of substance use, recognizing its impact on service members’ mental and physical readiness. Substance use trends in the military reflect a need for stringent measures to maintain operational integrity, especially given the high-stress environments and unique challenges military personnel face.

Substance use can lead to a decline in readiness and performance, affecting critical areas such as acquisitions, contract management, cybersecurity, and overseas contingency operations. The DoD Office of the Inspector General (OIG) emphasizes the importance of evaluating program performance, cost efficiency, and effectiveness to mitigate these risks. Furthermore, the Military Health System (MHS) strives to provide medically ready forces and ready medical forces, acknowledging that substance use counters these objectives.

Research indicates that military personnel may have higher rates of substance use compared to civilian peers, driven by factors like the challenges of war, self-medication for physical and mental health issues, and coping with traumatic events. Substance misuse has been linked to psychiatric disorders, suicides, and other deaths, underscoring the urgency of addressing this issue within the military context. Effective management and prevention strategies are vital to maintaining unit cohesion and operational readiness, which are essential for military success.

Army Initiatives to Combat Substance Abuse

The Army Substance Abuse Program (ASAP) is a central component of the US Army’s efforts to maintain a healthy and combat-ready force. The program’s mission is to prevent the misuse of legal substances and the use of illicit drugs and to mitigate any negative impacts on individual soldiers, unit cohesion, and overall combat readiness. ASAP is critical to upholding the Army values and the high standards of performance, discipline, and readiness essential to the Army’s mission.

ASAP’s objectives include increasing individual fitness and overall unit readiness by providing proactive and responsive services to the Army’s workforce. These services emphasize education and initiatives to prevent alcohol and other drug use. The program also involves guidance and leadership on non-clinical alcohol and other drug policy issues, developing, establishing, administering, and evaluating non-clinical alcohol and other drug use prevention programs. ASAP’s approach is comprehensive, aiming to strengthen the overall fitness and effectiveness of the Army’s workforce, thereby enhancing soldiers’ combat readiness.

Initiated in 1971, the Army’s policy mandates that all soldiers be tested for substance use at least once per year at random, emphasizing the seriousness with which the Army approaches substance use. The program also includes educational campaigns, like ‘Too Much To Lose,’ designed to inform service members about the risks associated with prescription drug misuse and illicit drug use, including marijuana. Education campaigns play a vital role in prevention efforts.

Army Substance Abuse Prevention Strategies

The United States Army has implemented a comprehensive approach to prevent substance use among its personnel, recognizing the significant impact such misuse has on individual readiness, unit cohesion, and overall operational effectiveness. The Directorate of Prevention, Resilience and Readiness oversees the development of policies and resources aimed at enhancing the resilience of soldiers and leaders. One of the key components of the Army’s prevention efforts is the Sexual Assault Prevention and Response (SAPR) Program, which includes measures to prevent substance use.

The Army Substance Abuse Program (ASAP) is another cornerstone of the Army’s preventive strategy. ASAP’s mission is to prevent the misuse of legal substances and the use of illicit drugs, which are inconsistent with Army values and readiness. This program includes mandatory drug testing and educational initiatives that highlight the risks associated with substance use. The Employee Assistance Program (EAP) provides support services such as screening, referral, short-term counseling, and follow-up services to help maintain the workforce’s fitness and effectiveness.

Furthermore, the Army’s approach to substance use prevention includes ongoing training and awareness programs, such as those offered through the Joint Knowledge Online platform, which educate personnel on the dangers and costs of substance use, including the impact on health, productivity, and crime.

Army Substance Abuse Program: Treatment and Rehabilitation Services

The Army Substance Abuse Program (ASAP) provides comprehensive treatment and rehabilitation services to Army personnel dealing with substance use issues. The Substance Use Disorder Clinical Care (SUDCC), formerly known as ASAP-Rehab, is the Army’s model for outpatient substance use disorder treatment. It offers a range of behavioral health care services designed to support soldiers in overcoming substance use and returning to duty with full capability.

ASAP’s mission is to enhance combat readiness by offering guidance and leadership on non-clinical alcohol and other drug policy issues, developing and administering prevention and education programs, and ensuring the provision of responsive services to meet the needs of the Army’s workforce. The program emphasizes alcohol and drug use deterrence, education, and the promotion of healthy lifestyles.

Services under ASAP include prevention education, suicide prevention, urinalysis testing, risk reduction, and counseling for civilian employees. The program’s objectives are to increase individual fitness and overall unit readiness. The comprehensive policy of ASAP, as outlined in AR 600-85, aims to prevent and treat substance use among Army personnel and civilians. This policy is available for review in an official PDF document, which details ASAP’s objectives, procedures, and services.

ASAP is crucial to maintaining the health and wellness of Soldiers, Family Members, and DOD Civilians and retirees. It operates with the understanding that the misuse of legal substances and the use of illicit drugs are inconsistent with Army values and can negatively impact performance, discipline, and readiness. The program’s services are designed to sustain mission readiness and support the Army’s overall fitness and effectiveness.

Evaluating the Effectiveness of Army Substance Abuse Programs

The effectiveness of Army Substance Abuse Programs (ASAP) is a critical aspect of maintaining the health and readiness of military personnel. The Comprehensive Plan on Prevention, Diagnosis, and Treatment of Substance Use Disorders outlines the framework for addressing substance use within the armed forces. ASAP’s mission is to enhance the overall fitness and effectiveness of the Army’s workforce, with a focus on the prevention, education, and treatment of substance use disorders (SUDs).

ASAP initiatives include confidential counseling, training for employees and supervisors, and leadership on non-clinical alcohol and other drug policy issues. The program’s success is evident in the reported decrease in tobacco use among service members and the implementation of smoking cessation programs. However, challenges remain, such as the high prevalence of tobacco use among veterans and the need for integrated treatment approaches for those with PTSD and co-occurring SUDs.

Recent studies have emphasized the importance of interdisciplinary approaches in treatment, particularly for those with chronic pain, to reduce reliance on long-term opioid therapy. Despite higher rates of substance use among deployed personnel, there is often a low rate of referral to SUD treatment services, partly due to stigma. The Department of Defense advocates for evidence-based practices across all service branches, and clinical studies have shown promise in trauma-informed care interventions that focus on both PTSD and SUD symptoms concurrently.

While ASAP and other military substance use programs have made strides in addressing SUDs, ongoing research and adaptation of evidence-based strategies are necessary to improve the effectiveness of these programs and support the transition of military personnel to productive civilian lives.

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