Military, Drug and Alcohol Abuse in the United States

Drug and alcohol use have historically been common among military personnel. Soldiers have used drugs to reduce pain, lessen fatigue, increase alertness, cope with boredom, or cope with the panic that accompanies battle. During the U.S. Civil War, the medical use of opium resulted in addiction among some soldiers. In the modern U.S. military, drug use became a problem during the Vietnam War in the late 1960s and early 1970s. Approximately 20 percent of Vietnam War veterans reported having used narcotics (such as heroin and opium) on a weekly basis, and 20 percent also showed signs of being addicted. Although few personnel continued using heroin when they returned home, concerns about addiction continued. Since 1981, the military has conducted regular, random drug testing of all personnel. Illicit drug use has declined significantly since the 1970s, and heavy alcohol use has declined slightly among military personnel.

Heavy drinking has long been an accepted custom and tradition in the military. In the past, military authorities believed that alcohol was necessary as a part of servicemen's diet and as a boost for morale, and provided it in the daily rations of sailors and soldiers. More recently, alcoholic beverages have been available at reduced prices to military personnel and during "happy hours" at clubs on military bases. In addition, alcohol has been used to reward hard work, to ease tensions between personnel, and to promote friendship and the cohesion of units.

In the mostly male population of the U.S. military, heavy drinking and being able to "hold one's liquor" serve as proofs of masculinity and strength. A common stereotype has been to characterize hard- fighting soldiers as hard-drinking soldiers.

The U.S. military strongly opposes the abuse of drugs and alcohol because of the negative effects of that abuse on the health and well-being of military personnel. The military also disapproves of drug and alcohol abuse as detrimental to military readiness and the maintenance of high standards of performance and military discipline. In the U.S. military, drug abuse is defined as the wrongful use, possession, distribution, or introduction onto a military installation of a controlled substance (such as marijuana, heroin, or cocaine), prescription medication, over-the-counter medication, or intoxicating substance (other than alcohol). Alcohol abuse is defined as alcohol use that has negative effects on the user's health or behavior, on the user's family or community, on the Department of Defense (DoD), or that leads to unacceptable behavior.

Military Policy

In response to public concern about reports of serious drug addiction among U.S. forces in Southeast Asia, President Richard M. Nixon in 1971 directed the DoD to address the drug problem. The DoD established mandatory urine testing for service members leaving Southeast Asia and mandatory, random urine testing for all U.S. forces worldwide. The program was discontinued for a time because of the difficulties and high costs of running the testing program, and also because of legal challenges to the policy. Some charged that the policy of drug testing violated the Fifth Amendment protection against self-incrimination.

The reaction to the crash of a jet on the aircraft carrier Nimitz in 1981 again focused public attention on the military's drug abuse problem, particularly marijuana use. Autopsies of fourteen Navy personnel killed in the crash showed evidence of marijuana use among six of the thirteen sailors and of over-the-counter antihistamine use by the pilot. As a result, the armed forces again began urine testing for drugs in 1981. Stricter testing procedures overcame earlier legal objections. The DoD maintains that urine tests, conducted either randomly or when a person is suspected of using drugs, are a major tool for detecting and deterring drug use.

Currently, the U.S. military has a zero tolerance policy toward substance use. This means that no exceptions are made for any member of the military found to be using or selling illegal drugs. Automatic dismissal from the military is the standard punishment. Detection and prevention of drug use are high priorities. While drug abusers are discharged, first-time alcohol abusers are given an opportunity for treatment and rehabilitation.

Worldwide Survey Series

To help monitor the extent of drug and alcohol abuse, the DoD began a series of worldwide surveys among active-duty military personnel in the Army, Navy, Marine Corps, and Air Force. Civilian (nonmilitary) researchers first randomly selected a sample of about sixty military installations to represent the armed forces throughout the world. At these installations, they randomly selected men and women of all ranks to represent all active-duty personnel. Participants in the surveys answered questions about their use of illegal drugs (marijuana, cocaine, heroin); about the misuse of prescription drugs (stimulants such as Ritalin or other amphetamines), tranquilizers such as Valium); about the frequency and amount of alcohol use; and about health and other problems resulting from drug or alcohol use.

Trends in Drug and Alcohol Use

Between 1980 and 1998, illicit drug use declined sharply from just under 28 percent in 1980 to about 3 percent in 1998. Heavy drinking declined significantly from approximately 21 percent in 1980 to just above 15 percent in 1998, although the decrease was less dramatic than for drug use. Heavy drinking by itself does not always indicate alcohol abuse, but it does indicate that the person's drinking habits are likely to result in negative consequences.

The Effects of Changes in Who Serves

In the 1990s, military analysts reviewed data that showed declines in drug and alcohol use. They wanted to determine whether the declines were due to military programs and policies or to some other explanation. One possible explanation for the declines in drug and alcohol abuse is a general change in the types of people who served in the armed forces between 1980 and 1998. For example, members of the military in 1998 were more likely to be older, to be officers, to be married, and to have more education than members of the military in 1980. These characteristics are also associated with less substance use.

Military analysts compared the data for 1998 with the data for 1980. They found that the decline in heavy alcohol use was largely a result of changes in the characteristics of the military population. However, the decline in illicit drug use was not a result of these changes.

Comparing the Military to Civilians

Comparing military and civilian populations offers another possible explanation for the downward trends in drug and alcohol use in the military. These trends in the military may simply mirror similar trends among civilians. Survey data for the military were compared to civilian data taken from the 1997 National Household Survey on Drug Abuse, a nationwide survey of drug abuse.

Comparisons showed that military personnel (about 3%) were significantly less likely than civilians (about 11%) to have used any illicit drugs during the past 30 days. However, military personnel (about 14%) were significantly more likely than civilians (about 10%) to have been heavy drinkers. Heavy drinking was nearly twice as high among younger (18 to 25) military personnel compared to younger civilians, but it was about the same among the older age groups (26 to 55). Results of the 2000 National Household Survey on Drug Abuse show a continuing gradual decline in illicit drug use and no change in heavy alcohol use among civilians, but until a more current survey of military personnel is conducted, more recent trends in use of drugs or alcohol cannot be compared between the two populations.

Comparing the two populations indicates that substance use trends in the military do not simply mirror similar changes among civilians. The lower rates of drug use among military personnel than among civilians suggest that the military's policy of zero tolerance for drug use and the urine testing program used to enforce it have been effective. In contrast, the higher rates of heavy drinking by military personnel as compared with civilians suggest that certain aspects of military life may encourage heavy drinking. In addition, it appears that military policies and programs directed at reducing heavy alcohol use have not been as effective as similar efforts among civilians.

Conclusion

The military has made steady progress in combating illicit drug use, but has had less success at reducing heavy drinking. In 1998 nearly one in six active-duty personnel drank heavily, a proportion much higher than among civilians. The military needs to develop a plan to reduce heavy drinking that will be as effective as its policy to reduce drug use.

see also Diagnosis of Drug and Alcohol Abuse: An Overview; Workplace, Drug use in the; Zero Tolerance.