ARMED FORCES ALCOHOL AND DRUG ABUSE PROGRAMS

Combat readiness, the combination of materiel, logistics, personnel, and training factors that determines a unit's ability to enter combat, is influenced by a host of human behavioral problems. Illicit drug use, heavy drinking, and tobacco use can jeopardize mission readiness, impair work performance, and put lives at risk.

Since the mid-1960s the Department of Defense (DOD) has kept drug abuse statistics and developed policies for prevention, counseling, and the elimination of drug abuse within the Armed Forces. In the 1960s marijuana was believed to be the primary drug of abuse. However by 1970 it was evident that large quantities of heroin were being used by service members in Vietnam. As much as one-half of all U.S. personnel were using illicit drugs; over one-third were addicted. In response, DOD policy was revised to offer amnesty to encourage voluntary identification and drug abuser enrollment in treatment programs; nonpunitive military rehabilitation programs were developed with a focus on treatment. The Armed Forces began identifying narcotics users as they left Vietnam, detoxifying identified abusers prior to their return to the United States, and providing a minimum of 30 days of treatment in military facilities. As policy was refined, a systematic, random drug testing program was established for active duty military personnel. Those who volunteered for treatment could not be discharged under other than honorable conditions. It was only a matter of time before a drug-related incident erupted.

For the U.S. Navy this proved to be an accident on board the aircraft carrier USS Nimitz. On May 26, 1981, flight personnel using illicit drugs caused an aircraft accident that resulted in 7 planes destroyed, 11 planes damaged, 14 personnel killed, and 48 additional personnel injured. Autopsies revealed traces of THC in six of the personnel killed. The Chief of Naval Operations declared a zero tolerance policy for illicit drug use. Military-wide, the strong push for punitive action for drug use was adopted and a White House commission developed guidelines for a forensically solid, DOD unified testing program.

In 1986 the DOD established a formal, integrated health promotion policy designed to improve and maintain military readiness and the quality of life of personnel. Alcohol and tobacco were finally identified as real targets for behavioral change. Specific objectives of the policy included reducing heavy drinking by military personnel (heavy drinking is defined as having five or more drinks per typical occasion at least once a week), reducing alcohol-related motor vehicle crash deaths, and reducing illicit drug use by military personnel. Emphasis was placed on those most at risk: junior enlisted men, single personnel, and personnel with high school education or less.

In addition to DOD-wide policy implementations, such as nonsmoking regulations and deglamorization of alcohol, all branches of the military have responded with their own comprehensive programs. These have incorporated aggressive education and training, leadership support, involvement and responsibility at every level, and group peer pressure. The Navy's Personal Responsibilities and Values: Education and Training (PreVent) program emphasized individual responsibility concerning alcohol and drugs, as well as violence and sexual harassment, fitness and readiness, and financial management. The Marine Corps' Semper Fit program is based on the "whole health" picture and promotes health awareness at the local command. The focus is on the personal choices that each marine can make to feel and perform his or her best. Army's Installation Prevention Team Training (IPTT) brings together multi-disciplined teams from Army posts to develop collaborative, installation-wide prevention programs. One component of this program is the Soldier Risk Reduction Program, a process of identifying, targeting, and preventing high-risk problem behaviors that can directly effect individual and unit combat readiness.

Today the Department of Defense Demand Reduction Program, in support of the National Drug Control Policy, consists of activity in three areas: randomized testing—unpredictable and without a discernible selection system—for Active Duty Military, the DOD civilian, and National Guard and Reserves; Anti-Drug Education and Training for DOD military and civilians, military dependents, and others through outreach programs; and treatment and rehabilitation to restore the individual to effective duty. The latest Department of Defense Survey of Health Related Behaviors Among Military Personnel, conducted worldwide among all military services every three years, speaks to the success of the program. The 1998 survey results show that self-reported use of any illicit drugs within the past 30 days of the survey date is at 2.7 percent, down over 90 percent in the 18 years since the survey began. Use of legal substances, however, remains a concern; nearly one in six military personnel engages in heavy drinking. Cigarette smoking also remains common, affecting almost one in every three active-duty military personnel. While obvious progress has been made since the 1980s there is room for improvement. With a focus on concerted leadership and those values which maintain that alcohol and other drug abuse is incompatible with military service, the Armed Forces can work toward inculcating a positive culture that may help to effect behavior change.

Mallary Tytel

(see also: Addiction and Habituation; Alcohol Use and Abuse; Domestic Violence; Marijuana; Smoking Cessation; Substance Abuse; Tobacco Control; Violence )

Bibliography

Army Center for Substance Abuse Programs (1996). Installation Prevention Team Training. Washington, DC: Author.

—— (1998). Unit Prevention Leader Urinalysis Collection Handbook. Washington, DC: Author.

Bray, R. M.; Sanchez, R. P.; Ornstein, M. L.; Lentine, D.; Vincus, A. A.; Baird, T. U.; Walker, J. A.; Wheeless, S. C.; Guess, L. L.; Kroutil, L. A.; and Iannacchione, V. G. 1988 Department of Defense Survey of Health Related Behaviors Among Military Personnel (RTI/7034/006-FR). Research Triangle Park, NC: Research Triangle Institute.

Department of Defense Directives 1010.1, 1010.2, 1010.3, 1010.4, 1300.11. Washington, DC.

Department of the Navy (1997). PreVent 2000, Personal Responsibility and Values: Education and Training. Washington, DC: Author.

Department of the Navy and Marine Corps (1993). Semper Fit 2000. Washington, DC: Author.

Tytel, M. (1997). Diffusion and Adoption of Health Promotion Practices and Processes within the U.S. Army Community. Ph.D. Diss., The Union Institute.