Substance Abuse and Addiction in Air Force Personnel

Key Takeaways

• Substance use in the Air Force includes alcohol, prescription drugs, and tobacco, with a notable prevalence of alcoholism among veterans.
• Military personnel, especially those deployed to combat zones, are at higher risk for substance use disorders (SUDs) compared to civilians.
• There is a significant co-occurrence of post-traumatic stress disorder (PTSD) and SUDs within the Air Force, requiring integrated treatment approaches.
• Stigma and cultural factors contribute to the underutilization of SUD treatment services among Air Force personnel.
• The Air Force’s ADAPT program emphasizes early self-identification and treatment for substance misuse to enhance force readiness.
• Substance use impacts unit cohesion and operational readiness, negatively impacting individual health and job performance.
• Prevention and treatment efforts in the Air Force include education, standardized treatment protocols, and intensive outpatient programs.
• Despite lower rates of heavy drinking in the Air Force, the transition to civilian life post-service can lead to an escalation in drinking behaviors among veterans.
• Mental health conditions, particularly PTSD, are closely linked to substance use, with veterans more likely to have SUDs.
• Substance use poses challenges to the Air Force’s mission, necessitating ongoing prevention and treatment strategies.

Substance Abuse Prevalence in the Air Force

The occurrence of substance use among Air Force personnel is a significant concern, with research indicating that military service members, including those in the Air Force, face a heightened risk of developing substance use disorders (SUDs) compared to civilian populations. 

Alcohol and Substance Use

While the Air Force has the lowest rates of heavy drinking among military branches, there is a notable prevalence of alcoholism, especially among veterans post-separation. Approximately 24.5% of servicemen and 6.3% of servicewomen in the Air Force engage in heavy drinking. In terms of alcoholism, veterans are the most affected group, with a significant number seeking treatment for alcohol use disorder (AUD) also meeting the criteria for post-traumatic stress disorder (PTSD).

Impact of Deployment

A substantial factor contributing to this risk is deployment to combat zones. Studies show that individuals deployed to recent conflicts 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. Furthermore, the prevalence of SUDs co-occurring with post-traumatic stress disorder (PTSD) is notably high, with a considerable percentage of individuals seeking treatment for alcohol use disorder also meeting the criteria for PTSD.

Underutilization of Treatment Services

Despite the elevated risk and prevalence of substance use, there is a notable underutilization of SUD treatment services among deployed personnel. This is caused by two different factors:

• Stigma: There is notable underutilization of SUD treatment services among deployed personnel, often due to stigma. 
• Cultural Factors: Cultural factors within the military environment also exacerbate substance use issues. 

The Air Force, like other service branches, employs its own programs for SUD treatment, and there is a continued emphasis on integrating treatment for both PTSD and SUD symptoms.

Smoking and Prescription Drug Misuse

Statistics from the National Institute on Drug Abuse (NIDA) reveal a decrease in certain types of substance use, such as smoking, among military personnel in recent years. However, the rates of prescription drug misuse, particularly opioids, remain a concern, with military policies aiming to reduce these rates through education and stringent regulations. Additionally, the Air Force has reported lower rates of heavy drinking compared to other military branches, yet veterans may experience an escalation in drinking behavior post-separation.

In summary, while the Air Force has implemented measures to mitigate substance use, the prevalence remains an issue of concern, highlighting the need for ongoing prevention and treatment efforts tailored to the unique challenges faced by Air Force personnel.

Commonly Abused Substances in the Air Force

Substance use within the Air Force encompasses a range of substances, with alcohol, prescription medications, and tobacco being the most commonly reported. Studies indicate that the stringent zero-tolerance policy for illicit drugs has resulted in a lower prevalence of illicit drug use among military personnel compared to civilians. However, the high-stress environment and unique challenges faced by Air Force members contribute to a notable consumption of legal substances.

• Alcohol: Alcohol use disorder (AUD) is prevalent, with many individuals seeking treatment for AUD also meeting the criteria for post-traumatic stress disorder (PTSD), highlighting the comorbidity of these conditions.
• Prescription Medications: The misuse of prescription drugs, particularly opioids for pain management, has been a growing concern, though recent efforts have been made to reduce reliance on these medications.
• Tobacco: Tobacco use, including cigarette smoking and smokeless tobacco, remains a significant issue, with many service members initiating use after enlisting.

Efforts to address substance use in the Air Force include prevention programs and treatment services tailored to the needs of service members, including those with co-occurring conditions such as PTSD. The integration of treatment for SUDs and PTSD has shown promise in improving outcomes for affected individuals.

Factors Contributing to Substance Abuse in the Air Force

Substance use within the Air Force is influenced by a complex interplay of factors, ranging from individual psychological struggles to broader systemic issues. Sociodemographic, psychological, and contextual elements are significant predictors of substance use among military personnel, with studies indicating that these factors can inform the development of targeted interventions. 

Cultural and Psychological Factors

• Military Culture: Military culture and attitudes towards substance use, stigma, and barriers to behavioral health treatment seeking also contribute to substance use trends within the Air Force. The Air Force culture may differ from other military branches in its approach to substance use, potentially affecting the prevalence and management of substance use. 
• Co-occurring PTSD: The co-occurrence of post-traumatic stress disorder (PTSD) and substance use disorders is prevalent, with many veterans seeking treatment for alcohol use disorder also meeting the criteria for PTSD, necessitating integrated treatment approaches.

Environmental Stressors

Environmental stressors unique to military life, such as the challenges of reintegration into civilian life and the management of chronic pain, further exacerbate the risk of SUDs. The Air Force’s zero-tolerance policies and prevention programs aim to address these issues. Still, the need for effective treatment and rehabilitation remains critical, as noted in the Air Force’s leaders’ guide on substance use.

Work-Related Stress and Substance Abuse in the Air Force

Work-related stress within the Air Force is a significant factor that can contribute to substance use among service members. The demands and pressures of military duties often lead to physical, behavioral, and emotional responses that, if not addressed, can result in fatigue, poor health, and injury. These stresses can also exacerbate domestic issues, creating a cycle that may drive some individuals toward substance misuse as a coping mechanism. 

High-Stress Environments

Research has shown that high-stress environments can increase the likelihood of substance use, including the misuse of alcohol and prescription medication. The Air Force upholds a strict “zero tolerance” policy for illicit drug use, which extends to the misuse of prescription drugs. Despite this, the unique challenges of Air Force service, such as high-stakes responsibilities and the potential for prolonged separation from family, can lead to ‘at risk’ or ‘heavy’ drinking behaviors as defined by Air Force guidelines. These behaviors are characterized by consumption that exceeds two drinks on any day or fourteen per week for men and one drink on any day or seven per week for women.

Transition to Civilian Life

While the Air Force has the lowest rates of heavy drinking compared to other military branches, the transition to civilian life post-service can see an escalation in drinking behaviors among veterans. The Military Health System recognizes the need to address substance use proactively, as evidenced by a rise in substance misuse numbers in recent years.

Mental Health Conditions and Substance Abuse in the Air Force

Mental health conditions are a critical factor contributing to substance use among Air Force personnel. Research indicates that service members may develop substance use disorders (SUDs) as a way to self-medicate symptoms of mental health issues such as post-traumatic stress disorder (PTSD), depression, and anxiety. 

Co-occurring Conditions

Studies have shown that veterans with mental health disorders, particularly those with PTSD, have a higher incidence of SUDs. For instance, a study on veterans found that those with PTSD were more likely to have substance use issues. Moreover, mental health conditions can also arise as a consequence of substance use, creating a vicious cycle that can be difficult to break.

Air Force Initiatives

The Air Force has recognized the importance of addressing mental health to prevent and treat substance use. Initiatives include:

• Screening: Screening for depression and SUDs, which are correlated with increased suicide risk.
• Stigma Reduction: Implementing programs to reduce the stigma associated with seeking help for mental health conditions. 

However, challenges such as a shortage of mental health workers and long wait times for appointments can hinder the effectiveness of these efforts.

Integrated Treatment Approaches

Addressing the dual diagnosis of SUDs and mental health conditions requires an integrated treatment approach. Studies suggest that treatment that simultaneously addresses PTSD and SUDs can lead to improvements in substance use, though it may be less effective for alleviating PTSD symptoms. This underscores the need for comprehensive, interdisciplinary strategies that consider the complex interplay between mental health and substance use within the Air Force community.

Consequences of Substance Abuse on Air Force Personnel and Operations

Substance use within the Air Force has far-reaching implications that affect not only individual airmen but also the operational readiness and effectiveness of the entire force. The use of substances, including alcohol and drugs, can lead to a range of adverse outcomes, such as impaired judgment, decreased performance, and increased risk-taking behaviors. These issues may manifest as mood and behavior changes, slurred speech, and the smell of alcohol on one’s breath, which are clear indicators of potential substance misuse.

Effects of Substance Abuse on Health and Job Performance in Air Force Personnel

Health Impacts

Substance use among Air Force personnel significantly affects individual health and job performance. The use of tobacco products, including cigarettes and smokeless tobacco, is prevalent, with close to 40% of smokers starting after enlistment, highlighting the need for targeted prevention strategies. Data shows that veterans are more likely to use alcohol and tobacco than non-veterans, with implications for the Veterans Health Administration (VHA) in terms of increased healthcare costs and the need for specialized treatment programs.

Exacerbation of Conditions

Substance use disorders (SUDs) can exacerbate existing medical conditions and mental health issues like depression and post-traumatic stress disorder (PTSD), increasing the risk of suicide. Furthermore, the misuse of prescription drugs, particularly pain medications, poses a challenge, especially during the transition to medical discharge. 

Alcohol misuse is notable among Air Force members, with interventions such as the Alcohol Misconduct Prevention Program (AMPP) aimed at reducing alcohol-related incidents. However, despite the lower rates of heavy drinking in the Air Force compared to other military branches, the risk of escalation post-separation remains. Overall, the impact of substance use extends beyond individual health, affecting job functioning, unit cohesion, and the operational effectiveness of the Air Force.

The Effects of Substance Abuse on Air Force Unit Cohesion and Readiness

Substance use within the Air Force has significant repercussions on unit cohesion and operational readiness. Research from the RAND Corporation highlights the critical role of unit cohesion in military effectiveness, with programs like UNITE aiming to bolster this through participation in Force Support Squadron Programs. Conversely, substance use can erode these efforts, leading to staffing gaps, reduced morale, and a weakened state of readiness.

Impact on Unit Cohesion and Readiness

According to a Congressional Research Service report, substance use can result in lost duty days, disrupt unit cohesion, and perpetuate a stigma around mental health. The Department of Defense has acknowledged substance use as a significant cause of lost duty days, second only to service member illnesses and injuries.

• Staffing Gaps: Substance use can lead to absenteeism and lost duty days, creating staffing gaps that disrupt unit operations.
• Reduced Morale: The negative behaviors associated with substance misuse can lower morale among unit members.
• Weakened Readiness: Decreased performance and impaired judgment due to substance use undermine operational readiness.

Alcohol use, in particular, has been identified as a public health crisis for the military, with negative impacts on health and readiness. Policies are in place to discourage alcohol and drug misuse, but the prevalence of such behaviors remains a concern. The National Center for Biotechnology Information underscores the military’s stringent policies against drug use. Yet, the existence of substance use disorders (SUDs) indicates a need for more effective prevention and intervention strategies.

Overall, substance use undermines the very fabric of military cohesion and performance, necessitating comprehensive measures to address and mitigate its impacts on the Air Force.

Air Force Substance Abuse Prevention Programs

The Air Force takes a proactive stance on substance use through its Alcohol and Drug Abuse Prevention and Treatment (ADAPT) program. ADAPT’s mission is to promote readiness, health, and wellness by preventing and treating substance misuse among personnel. This comprehensive program is outlined in Air Force Instruction 44-121, which provides detailed policy and operational guidance to Major Commands within the Air Force.

Prevention Efforts

ADAPT focuses on both prevention and treatment, aiming to minimize the negative consequences of substance misuse on individuals, families, and the organization. Prevention efforts include educational programs that advocate for substance misuse awareness, equipping Air Force members with the knowledge to make informed decisions regarding substance use. These initiatives are supported by mental health units across various bases, such as the 325th OMRS mental health unit and the 359th Medical Operations Squadron Mental Health Flight at Joint Base San Antonio-Randolph.

Treatment Services

Treatment aspects of ADAPT involve comprehensive education and rehabilitation services for individuals experiencing substance use issues. The program emphasizes early identification and treatment of substance misuse, offering support through a collaborative approach that involves various Department of Defense, Air Force, and civilian agencies. Through ADAPT, the Air Force strives to maintain a physically and mentally fit force, ready to meet the demands of their duty with the highest level of performance.

Air Force Treatment and Rehabilitation Programs for Substance Abuse

The United States Air Force acknowledges the challenges of substance use among its personnel and has established comprehensive treatment and rehabilitation programs to address this critical issue. The Alcohol and Drug Abuse Prevention and Treatment (ADAPT) program, as outlined in Air Force Instruction 44-121, is the cornerstone of the Air Force’s efforts. ADAPT focuses on early identification, education, and intervention to promote readiness and health among Air Force members.

ADAPT Program Components

ADAPT includes a variety of treatment options tailored to individual needs, ranging from short-term outpatient programs to more intensive interventions. The program aims to integrate personnel into the least restrictive treatment plan possible, which may involve varying lengths of stay and different treatment settings. Some of the key components of the ADAPT program include:

• Comprehensive education on substance misuse prevention.
• Standardized treatment protocols to ensure consistency and compliance across the Air Force.
• Management of the budget allocated for alcohol and drug misuse prevention and treatment.
• An Intensive Addiction Service/Partial Hospitalization program that provides education, treatment, and support groups over a 4-6 week period.

Moreover, the Air Force is proactive in offering support through educational programs and anonymous drug testing to prevent substance misuse. The Intensive Addiction Service at Joint Base Andrews exemplifies the Air Force’s commitment to providing extensive support, including partial hospitalization for individuals requiring a structured treatment environment. By addressing substance use through such comprehensive programs, the Air Force strives to maintain its personnel’s health, wellness, and readiness.

Help for Military Veterans with Substance Use Disorder 

If you’re a military veteran seeking addiction treatment, The Recovery Village Cherry Hill at Cooper is here to help. We are a part of the VA Community Care Network, and we offer a trauma-informed program designed for veterans and first responders. Contact a Veteran Advocate today to learn more or to get started with treatment.