Substance Abuse in the Military - Creative Care

Substance Abuse in the Military

Substance abuse among military personnel has been on the rise in the last 20 years, as it has been for the rest of society. Although use of illicit drug use is lower than that of civilians, alcohol and prescription drug use has  become much more prevalent. Some of the reasons can be attributed to the stresses of wartime deployment and the army’s unique culture, as well as the zero tolerance policy. The general stigma of being in the military tends to stop many from seeking treatment. The zero tolerance policy, though, has also led to lower statistics: compared to the 12% of civilians who abuse drugs, the number of military personnel is 2.3%. Those 18 to 25 years old in the military is 3.9, compared to a civilian average of  17.2%.

Those with multiple deployment and the stress surrounding it are more apt to abuse drugs, as well as going on drinking and drug binges while not on duty. The number of those on behavioral medications (psych meds) is obviously very high. Again, the abuse of prescription medications is the biggest issue. In 2008, it was reported that 11% of military personnel abuse prescription drugs, which is a 4% rise from 2005; this is largely compromised of opiate-based medications, such a Oxycontin and Vicodin. The larger accessibility of these medications and ease in acquiring prescriptions for them may be a factor to their growing abuse by service members. Pain reliever prescriptions written by armed forces physicians quadrupled between 2001 and 2009—to almost 3.8 million. Combat-related injuries and the damage from carrying heavy equipment during multiple deployments likely play a part in this development.

Alcohol use is also elevated among men and women in military service than among civilians. Almost half of active duty service members (47 percent) reported binge drinking in 2008—up from 35 percent in 1998. In 2008, 20 percent of military personnel reported binge drinking every week in the past month; the rate was significantly higher—27 percent—among those with elevated combat experience.

There is also the issue of personnel returning from active duty. Service members often bring psychological and physical injuries of their military incidents with them into succeeding civilian life. In one study, one in four veterans returning from Iraq and Afghanistan conveyed symptoms of mental or cognitive disorder, one in six reported symptoms of post-traumatic stress disorder (PSTD). These syndromes are clearly associated with substance abuse and/or dependence, as are other problems such as sleep disturbance , traumatic brain injury and domestic violence in relationships.

Suicide statistics in the military were customarily lower than between civilians in the same age range, but in 2004 the suicide rate in the U.S. Army began to rise, exceeding the civilian rate in 2008. Substance use is relevant in many of these suicides. The 2010 report of the Army Suicide Prevention Task Force found that 29 percent of operational duty Army suicides from 2005 to 2009 involved alcohol or drug use; and in 2009, prescription drugs were involved in nearly one third of them.

Branches of the military have currently taken steps to control prescription drug abuse. The Army, for instance, has put into operation adjustments that include limiting the extent of prescriptions for opioid pain relievers to 6 months and having a pharmacist scrutinize a soldier’s medications when multiple prescriptions are being used. A 2012 report prepared for the Department of Defense by the Institute of Medicine (IOM Report) suggested ways of addressing the issue of substance use in the military comprise increasing the use of evidence-based deterrence and treatment interventions and increasing access to care. The report recommends expansion of insurance coverage to comprise effective outpatient treatments and better outfit healthcare providers to distinguish and screen for substance use issues so they can refer patients to appropriate, evidence-based care when needed. It also recommends procedures like limiting access to alcohol on bases. It also finds that attending to substance use in the military will necessitate greater than ever confidentiality and changing a cultural atmosphere in which drug problems are stigmatized and evoke fear in people suffering from them.

The zero tolerance policy was initiated in 1982, and is enforced by increased random drug testing. For those service personnel who deliver positive drug tests, they face dishonorable discharge and possible criminal prosecution. Due to the current state of the economy and poor job market in the United States, the fact that many young people choose a military career due to economic circumstances rather than straight patriotic considerations make it even more of a slippery slope.