Substance Abuse and Addiction in the Army

Key Takeaways

• Substance use in the Army is a significant issue, with alcohol misuse being particularly pervasive and linked to behavioral problems and increased suicide risk.
• Tobacco use has decreased among active-duty personnel, but it remains a concern, especially with financial implications for healthcare costs.
• Prescription drug misuse, especially opioids and sedatives, is a challenge, though recent data suggests a decline in self-reported use.
• Substance use often co-occurs with mental health disorders like PTSD, requiring integrated treatment approaches.
• Stigma and low referral rates to treatment services are obstacles to effective care for substance use disorders (SUDs).
• Substance use has far-reaching consequences, affecting physical and mental health, and can lead to career repercussions for Army personnel.
• The Army Substance Abuse Program (ASAP) is a key initiative for prevention and treatment, aiming to enhance combat readiness by addressing substance misuse.
• ASAP provides education, early detection, and intervention, along with treatment services tailored to individual needs.
• Army policies on substance use include strict regulations and consequences for misuse, with an emphasis on prevention and maintaining readiness.
• Recent legislative developments indicate a focus on tracking drug overdoses and providing access to antidotes like naloxone within the military.

Substance use within the Army is a significant concern, impacting both the health of personnel and the effectiveness of military operations. The prevalence of substance use disorders (SUDs) among Army personnel is influenced by a complex interplay of factors, including the stress of deployment, combat exposure, and the challenges of reintegration into civilian life. 

Commonly Abused Substances

Alcohol

Alcohol misuse remains a pervasive issue, contributing to a range of behavioral health problems, misconduct, and an increased risk of suicidal behaviors. In fact, up to 50% of suicides, sexual assaults, and intimate personal violence incidents in the Army are alcohol-related. Studies indicate that untreated alcohol problems severely undermine unit morale and readiness.

Tobacco

Despite a decrease in smoking rates among active-duty personnel, tobacco use remains a concern, with nearly 14% of service members reported as current cigarette smokers. The financial implications of tobacco use are substantial, with considerable costs incurred by the Veterans Health Administration for smoking-related health care. 

Prescription Drugs

Prescription drug misuse also presents challenges, particularly with opioids and sedatives, although recent data suggests a decline in self-reported use. The co-occurrence of SUDs with mental health disorders like PTSD is notably higher in military populations compared to civilian populations, underscoring the need for integrated treatment approaches.

Preventative measures and treatment programs are in place within the Army to address SUDs. These include the Army Substance Abuse Program (ASAP) and evidence-based practices advocated by the Department of Defense. However, stigma and low referral rates to SUD treatment services still need to be addressed for effective care. The Army is working to reduce the stigma associated with seeking help and to promote mental health care access, reflecting a commitment to the well-being of its service members.

Prevalence of Substance Abuse Among Army Personnel

The prevalence of substance use within the Army is a multifaceted issue, with various studies indicating both a decrease in certain types of substance use and ongoing concerns about the rates of alcohol and prescription drug misuse. 

• Tobacco Misuse: According to the National Institute on Drug Abuse, there has been a notable decrease in smoking rates among military personnel, from 24% in 2011 to lower rates in 2015, with a significant number of service members starting to smoke after enlisting. The Department of Defense has implemented smoking cessation programs and aims for tobacco-free installations.
• Alcohol Misuse: However, the challenges of military life, including deployment and combat exposure, have been linked to an increased risk of substance use disorders (SUDs). A 2017 study found that veterans were more likely to use alcohol heavily compared to non-veterans. Moreover, veterans entering treatment programs report alcohol as the most frequently misused substance, which is nearly double the rate of the general population. 
• Prescription Drug Misuse: Prescription drug misuse is also a concern, with over 4% of active-duty service members reporting misuse in the past year.

Research indicates that service members, particularly those deployed to combat zones, are at a higher risk for developing SUDs. The co-occurrence of post-traumatic stress disorder (PTSD) and substance use is common, complicating the treatment and recovery process. Despite higher rates of substance use, there is a noted low rate of referral to SUD treatment services, often due to stigma.

While certain types of substance use have decreased among Army personnel, the prevalence of alcohol and prescription drug misuse remains a significant concern, particularly among veterans and those who have experienced combat or trauma.

Substance Abuse Trends Among Army Personnel

Substance use within the Army is a multifaceted issue, with a range of substances being misused by personnel. 

Tobacco Misuse

Tobacco use is prevalent, with a notable decrease in smoking rates from 24% in 2011 to 14% in 2015 among service members, yet nearly 40% of smokers began after enlisting. Tobacco cessation programs and policies, such as the ban on tobacco use in medical facilities, are in place to counteract this trend. Veterans show higher tobacco use rates compared to non-veterans, with financial implications for the Veterans Health Administration (VHA).

Alcohol Misuse

Alcohol remains the most commonly misused substance, with 56.6% of veterans reporting use within a one-month period. Heavy alcohol use is reported at 7.5%, and for those entering treatment, 65% identify alcohol as their primary substance of misuse. 

Prescription Drug Misuse

Prescription drug misuse is also a concern, with over 4% of active-duty service members reporting misuse in the past year. The military has seen a significant number of prescriptions for pain medication, which has raised concerns about the potential for opioid use.

Illicit Drug Misuse

Illicit drug use is less common due to strict military policies and deterrents like urinalysis testing. However, marijuana is noted as the second-most commonly misused substance among veterans. 

The high rates of co-occurring Post-Traumatic Stress Disorder (PTSD) and Substance Use Disorders (SUDs) underscore the need for integrated treatment approaches that address both mental health and substance misuse concurrently.

Substance use in the Army not only affects individual health but also has broader implications for unit morale, readiness, and financial costs to military health systems. Prevention and treatment programs are essential to address these issues, including evidence-based practices and trauma-informed care interventions tailored to military personnel.

Consequences of Substance Abuse Among Army Personnel

Substance use within the Army has far-reaching consequences that affect the physical and mental health, as well as the career trajectory of service members. 

Psychological and Physical Consequences of Substance Misuse

The psychological impact of military operations can amplify substance use, with deployment often leading to increased mental health and social functioning issues. Alcohol use, in particular, is intertwined with military culture and has been associated with a range of negative outcomes, from health issues to misconduct.

Excessive alcohol consumption and other forms of substance use can lead to serious health complications, including:

• Cognitive impairments
• Psychological disorders
• Physical injuries

The presence of negative emotionality, impulsivity, and symptoms associated with depression, PTSD, and traumatic brain injuries are higher among personnel who misuse substances. Moreover, substance use has been linked to a domino effect of negative consequences, including reduced unit morale and an increase in incidents of suicide, sexual assaults, and intimate personal violence.

Career Implications

From a career standpoint, substance use can have detrimental effects on service members’ military careers. Research indicates that those who seek mental health treatment, which may include substance use treatment, are more likely to be discharged from service. This highlights the complex relationship between substance use, mental health, and career sustainability in the military. The transition from military to civilian life can also be a critical period where substance use persists or escalates, further impacting veterans’ post-service lives.

Health Complications from Substance Abuse in Army Personnel

Substance use within the Army has significant repercussions on the physical health of service members. The misuse of substances such as alcohol, tobacco, and prescription drugs can lead to a range of health complications that impair both individual well-being and overall military readiness. Studies indicate that up to 50% of suicides, sexual assaults, and incidents of intimate personal violence in the military are alcohol-related, highlighting the gravity of the issue.

Smoking and Tobacco Use Complications

Smoking, a prevalent habit that often commences after enlistment, contributes to the financial burden on military healthcare systems, with costs associated with smoking-related care estimated at billions of dollars. Furthermore, the stressors unique to military life, such as deployment and combat exposure, increase the risk for substance use disorders (SUDs), which can exacerbate conditions like PTSD, depression, and anxiety.

Consequences of Prescription Drug Misuse

Prescription drug misuse, particularly of pain medications, has been a focal point of concern, especially during transitions to medical discharge. The over-prescription and subsequent dependency on opioids for pain management have been noted. However, recent trends suggest a decrease in self-reported misuse of prescription opioids and sedatives among active-duty personnel. However, chronic pain remains a common condition among those with polysubstance use, necessitating the integration of interdisciplinary pain management to improve treatment outcomes.

Substance use in the Army not only affects the individual’s health but also has broader implications for unit morale and the force’s effectiveness. Prevention and treatment strategies must continue to evolve to address the multifaceted nature of substance use and its impacts on Army personnel.

Mental Health Consequences of Substance Abuse in Army Personnel

Substance use within the Army has significant psychological ramifications that extend beyond the immediate effects of the substances themselves. Mental health disorders such as anxiety, depression, post-traumatic stress disorder (PTSD), and other stress-related issues are prevalent among service members with a history of substance use. 

Studies have shown that military personnel who have experienced traumatic events, including combat, are at an increased risk for developing substance use disorders (SUDs), which can exacerbate existing mental health conditions or trigger new ones.

Prevention Strategies to Combat Substance Abuse in the Army

The Army has implemented several initiatives to combat the stigma associated with seeking help for mental health and substance use issues. Programs such as the Real Warriors Campaign and the Defense Centers for Public Health-Aberdeen aim to foster a supportive culture that encourages service members to seek the necessary care. These efforts are critical in a system where up to 60% of veterans who would benefit from treatment do not seek it due to stigma. Efforts to educate military leadership and change the culture around mental health care are ongoing to improve access to and participation in mental health and substance use treatment services.

Furthermore, the presence of embedded Behavioral Health teams within Army units has increased the availability of mental health professionals, promoting positive attitudes toward seeking help. Intervention and treatment resources are available to service members and their families, aiming to address SUDs before they result in severe consequences, such as increased suicidal risk behaviors and impaired unit morale. The intertwining of substance use with mental health issues presents a complex challenge that the Army continues to address through these multifaceted approaches.

Career Consequences of Substance Abuse in the Army

Substance use within the Army has significant career-related consequences for personnel. The use of alcohol or drugs can lead to a range of negative outcomes that impact both the individual service members and their units. Alcohol misuse, for instance, is linked to approximately 50% of suicides, sexual assaults, and incidents of intimate personal violence, which can profoundly affect unit morale and cohesion. These issues not only compromise the well-being of Army personnel but also threaten the overall readiness and effectiveness of military operations.

Service members struggling with substance use disorders (SUDs) may face disciplinary actions, which can include:

• Demotion
• Loss of security clearance
• Discharge from service. 

The stigma associated with seeking help for substance use can deter individuals from accessing available resources. Moreover, untreated mental health issues like post-traumatic stress disorder (PTSD) and depression, often associated with substance use, can impair performance and lead to further disciplinary measures or involuntary separation from the Army.

Prevention and treatment programs are crucial in mitigating these career-related impacts. The Army provides resources such as the Army Substance Abuse Program (ASAP) and encourages the use of evidence-based practices to address SUDs. Addressing substance use proactively is essential for maintaining the health and career viability of Army personnel and ensuring the operational readiness of military units.

Prevention and Treatment Strategies for Substance Abuse in the Army

The Army Substance Abuse Program (ASAP) is a key component of the US Army’s efforts to combat substance use among its personnel. ASAP’s objectives are to increase individual fitness and overall unit readiness, providing proactive and responsive services to the needs of the Army’s workforce. These services emphasize the importance of alcohol and other drug use prevention and offer various treatment options to enhance personnel and unit combat readiness.

ASAP’s Comprehensive Approach

ASAP offers a comprehensive approach that includes deterrence, prevention, and treatment components. The program is designed to strengthen the overall fitness and effectiveness of the Army by eliminating alcohol and/or other drug misuse. It includes guidance and leadership on all non-clinical alcohol and other drug policy issues and the development, establishment, and administration of these policies.

ASAP Prevention Efforts

Prevention efforts deployed by ASAP are evidence-based and aim to educate Army personnel on the risks associated with substance use. The program also emphasizes the importance of early detection and intervention to prevent the escalation of substance use issues. Treatment services provided by ASAP cater to the specific needs of individuals, offering support and resources to soldiers struggling with substance use to achieve a ready and resilient force.

Army Substance Abuse Prevention Initiatives

The US Army has implemented comprehensive substance use prevention programs to maintain the health and readiness of its personnel. The Army Substance Abuse Program plays a central role in these initiatives, aiming to enhance combat readiness by addressing non-clinical alcohol and drug policy issues. ASAP’s mission is to strengthen the Army’s workforce, conserve manpower, and enhance combat readiness through prevention and treatment strategies.

ASAP’s prevention efforts include:

• Developing and administering policies and providing guidance and leadership on substance use matters. 
• Evaluating the effectiveness of these strategies to ensure they meet the needs of soldiers. 

The Army Resilience Directorate’s “Ready and Resilient” campaign provides additional support by offering training and resources aimed at personal readiness, which encompasses substance use prevention.

Other Substance Misuse Programs for Army Personnel

Moreover, the Department of Defense (DoD) has long-standing substance use programs focused on prevention, treatment, and research. These programs address alcohol, illicit drug use, and non-medical use of prescription drugs. DoD substance use education campaigns are another critical element, offering resources and support to service members, which health educators and prevention professionals deliver across military commands.

Furthermore, Military OneSource provides a MilLife Guide for service members and their spouses, covering mental health and substance use prevention and care. This guide is part of a broader support network that includes live chats, crisis hotlines, and connections to advocates, all aimed at understanding and addressing substance use problems.

Substance Abuse Treatment Options for Army Personnel

The US Army is committed to the health and readiness of its personnel, and this includes providing comprehensive treatment options for those struggling with substance use. The Army Substance Abuse Program is at the forefront of this effort, offering services tailored to the needs of soldiers and other beneficiaries. 

Substance Use Disorder Clinical Care

Through ASAP, the Army provides Substance Use Disorder Clinical Care (SUDCC), which was previously known as ASAP-Rehab. This outpatient program delivers integrated substance use disorder treatment along with other behavioral health care services.

SUDCC is designed to be accessible and supportive, with services that include assessment, treatment, and aftercare. These are aligned with military units and co-located to ensure convenience and promote recovery within the context of service members’ duties. The program aims to increase individual fitness, preserve manpower, and enhance overall unit readiness.

Other Treatment Options for Army Personnel

In addition to SUDCC, the Army offers educational resources and prevention programs to address substance use before it begins. For immediate assistance, service members can access resources such as Military OneSource, which provides various support options, including a crisis hotline and live chat services. For family members and retired personnel, the Employee Assistance Program (EAP) extends its services, offering counseling and support for dealing with substance use.

These treatment and support programs underscore the Army’s holistic approach to substance use, focusing on the well-being of the individual and the effectiveness of the workforce as a whole.

Army Substance Abuse Policies and Regulations

The US Army enforces strict policies and regulations to prevent and manage substance use within its ranks. The Army Substance Abuse Program is a comprehensive initiative outlined in AR 600-85, which serves as the cornerstone of the Army’s efforts to combat substance misuse. ASAP’s mission is to enhance the combat readiness of soldiers by providing education, prevention, and treatment services related to substance use. The program includes services that are essential for maintaining Army personnel’s overall fitness and effectiveness.

According to the official Army Substance Abuse Program documentation, the program is designed to provide guidance and leadership on all non-clinical alcohol and other drug policy issues. It also aims to develop and administer policies that prevent substance use among soldiers and civilian employees. Soldiers who voluntarily seek alcohol-related behavioral healthcare are not mandated to participate in treatment, allowing them to seek help without the fear of mandatory enrollment in substance use programs. This policy encourages soldiers to seek assistance early without concern for career repercussions.

Department of Defense Efforts to Fight Substance Misuse

Furthermore, the Army’s regulations are aligned with the Department of Defense’s broader efforts to address substance misuse, as seen in the DoD Policy Guidance on Substance Misuse. Penalties for substance use violations can be severe, ranging from administrative action to more serious legal consequences, depending on the nature and severity of the offense. The Army’s approach to substance use is multifaceted, focusing on prevention, treatment, and strict enforcement of policies to ensure the readiness and well-being of its personnel.

Army Substance Abuse Program Policies

ASAP’s mission is to enhance the combat readiness and overall fitness of Army personnel by preventing substance misuse and providing treatment options. ASAP encompasses various strategies, including:

• Guidance on non-clinical alcohol and drug policy issues
• Education
• Initiatives to promote health and wellness among Soldiers, their families, and Department of Defense civilians

Key components of the ASAP include the development and administration of evidence-based prevention and education programs, suicide prevention efforts, and urinalysis testing. The program also offers risk reduction and counseling services for civilian employees. 

The Army’s commitment to substance use prevention and treatment is further outlined in the official regulation AR 600-85, which provides detailed objectives, procedures, and services under ASAP. Furthermore, the Army executes the Department of Defense Prevention Plan of Action and adheres to DoD Policy Guidance on Substance Misuse to ensure a consistent approach across military branches.

Recent policies, such as Army Directive 2021-21, address the use of prescribed medications and controlled substances, indicating the Army’s ongoing efforts to adapt and update its substance use policies in response to evolving challenges.

Consequences of Substance Abuse in the Army

The US Army takes substance use among its personnel seriously, with a range of consequences to deter and address such behaviors. ASAP’s comprehensive initiative focuses on prevention, treatment, and enforcement to maintain the combat readiness and effectiveness of its workforce. According to the ASAP mission statement, the program aims to conserve manpower and enhance combat readiness by eliminating substance misuse.

What Happens When Military Personnel Abuse Substances

When Army personnel are found to be abusing substances, they face various penalties that may include:

• Mandatory referral to counseling services
• Participation in rehabilitation programs
• Administrative actions
• Separation from service

In more severe cases, individuals may face non-judicial punishment or court-martial, depending on the circumstances and severity of the offense.

Recent legislative developments reflect a growing concern over substance use in the military. A 2024 defense bill mandates the Pentagon to compile data on drug overdoses within the ranks and to provide access to opioid overdose antidotes, highlighting the issue’s importance to national security. These steps indicate a dual approach of both punitive measures for substance use and proactive strategies to prevent and treat drug overdoses among military personnel.

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