Introduction
Abuse of alcohol and prescription drugs is a nettlesome problem, as its incidence has risen since the beginning of the century. Long-term regular alcohol abuse sooner or later leads to alcohol dependence, mental shock, nervous system and internal organs diseases. Despite the commonly held belief, active-duty personnel in the military are not quite as tough as to be completely immune to the substance abuse problems that blight civilian populations. However, the exact number of the alcohol abusers is very difficult to determine because people tend not to share this information. Thus, the numbers among civilians are very rough as many individuals reject to answer this question due to their right for privacy. In contrast, such numbers in the army forces are more accurate and close to reality because specifics of the army institution. In other words, civilian organizations do not monitor their employees as closely as military due to employee's rights to privacy. Unlike Civilian organizations that infrequently test their employees; the Army's commitment to invest in soldier's readiness is dependent upon alcohol and drug abuse prevention and control in the military. This paper will examine the problem of substance abuse among military personnel, the origin of the issue, the causes and subsequences, and the measures that are currently being implemented to tackle the problem.
The prejudices about alcohol abuse in military
Despite the popular belief that discipline in army forbids any kind of drug consumption, the alcohol abuse in the armed forces is impressive. Moreover, people usually tend to think that civilians due to their expanded freedom are more prone to different kinds of psychostimulators than military men. Thus, it is very common when these civilians think about themselves as more free. However, as studies show, the level of alcohol consumption among civilians is not only higher than among military, but sometimes troops now seem to be abusing alcohol more than civilians do. Thus, according to statistics adduced by the National Institute on Drug Abuse, the percentage of active-duty personnel having problems with binge drinking increased from an estimated 35% in 1998 to 47% in 2008, with 20% of them binge drinking every week in the past month (2013). In the meantime, the associations between alcohol abuse and alcohol-related incidents on the barracks for active-duty service members as well as associations between alcohol abuse and domestic violence and driving under the influence for veterans have also heightened (US Department of the Army, 2012). Although some of the above-cited sources suggest that the prevalence rates of alcohol abuse in the military have reached a plateau of sluggish growth, the problem is nonetheless persistent and demands reinvigorated attention. Thus, notwithstanding the popular opinion, the alcohol consumption in the forces is higher than among civilian.
The problem of alcohol abuse in the army cannot be underestimated as currently it is one of the most urge issues in the army that requires solution. Alcohol became the ultimate ground for communication in the army when every non-formal meeting are inevitable accompaniment of the alcohol consumption. It is very unpopular knowledge as there is a myth of army forces with high level of discipline that ultimately excludes the alcohol consumption that is usually ascribed to the civilians way of living. However, using prevalence rates as the main yardstick, heavy alcohol consumption appears to be the most persistent form of substance abuse in the military. In his 2012 interview with The Stars and Stripes, sergeant Brennan intimated that it was not a rarity to see a bunch of Marines “partying, having a good time, getting ready to war” on the catwalks or in the barracks when he arrived to his first duty station several years before (Hlad, 2012, p. 1). Hlad (2012) even speaks of the alcohol-soaked culture in the military, which presumes service members getting together wherever and whenever they can to hoist several beers or several shots of some stronger liquor to allegedly enhance “camaraderie and esprit de corps” (p. 1). Essentially, all venues frequented by troops, such as drinking parlors on the territory of military towns, hotel rooms, living quarters of noncommissioned officers, officers pubs and even war zones, are awash in alcohol. Appallingly enough, the problem has been exacerbating lately, not least because of America’s continuous military involvement in the Middle East. However, some may claim that the drinking rates among military are exaggerated, the statistics shows that the alcohol abuse in the army is comparatively high (in case of comparison to civilians). Thus, the problem of excessive alcohol abuse undermines the prestige of the army in general, and therefore, cannot be left without proper attention.
The problem with drug abuse in the military is not as unambiguous, however, and serious steps has been already implemented in order to eliminate the issue. It goes without saying that discipline in the army does not allow alcohol consumption. On the one hand, the widely accepted and strictly enforced policies of no tolerance towards illicit drug abuse have engendered an atmosphere of repulsion at illicit drugs. Indeed, ever since this policy was implemented in 1982, prevalence rates of illicit drug abuse in the military have seldom approached the levels of illicit drug abuse among the civilian population (Marion & Oliver, 2014). For example, in 2008, the most recent year for which statistics is readily available, the rate of illicit drug abuse among US service members was just 2.3%, whereas it stood at 12% among civilians (National Institute on Drug Abuse, 2013). Again, this stark discrepancy is not surprising given the harsh regulations within the armed forces. After all, a positive result in random drug testing implemented within the frameworks of the policy of zero tolerance is fraught with the risks of ignominious discharge and even criminal litigations.
Prescription drugs
It should also be mentioned that the drug abuse in the army is only the echo of the global problem with the prescription drug that currently exists in the United States. The incidence of prescription drug abuse within the army has been steadily rising since the turn of the twenty-first century. Thus, it is estimated that prescription drug misuse had skyrocketed from a negligent 2% in 2002 (National Institute on Drug Abuse, 2013) to nearly 12% in 2008 (Indiana Prevention Resource Center, 2012), while the rates for civilian population had fluctuated at about 4%. Most often, service members are partial to opioid pain relievers, which is unsurprising given the vast variety of injuries inflicted upon troops in the military. Even though alcohol abuse in the military has firm correlations with violence and driving under influence, illicit and prescription drug misuse has associations with an even more worrisome problem: suicide. Indeed, in 2009 alone, nearly 33% of all suicides in the US military were committed by service members abusing drugs (National Institute on Drug Abuse, 2013). In other words, whereas service members sodden with alcohol tend to drive their cars and beat their family members, those abusing illicit and prescription drugs tend to commit suicide. But the tendency works the other way around as well.
Service members themselves often view drinking and consuming drugs as a way to unwind and cope with stress. In fact, drinking oneself into oblivion or using drugs to achieve the same effect is a common response to stress of many people irrespective of their occupation. Yet, it is a matter of conventional wisdom that stresses are more common in the military than in civilian life. This is especially true of those who have been deployed to the battlefield and those awaiting deployment. Attesting to this worrisome correlation is the fact that service members with high combat exposure are at an increased risk of developing substance abuse problems (National Institute on Drug Abuse, 2013). For example, Preidt (2012) argues, some 12% of troops with no previous record of alcohol abuse develop this problem during deployment or afterwards. In this regard, America’s increased belligerence in the early 21st century is only exacerbating the problem. The US has been paring down the number of its troops in both Afghanistan and Iraq and has, in face, committed to withdraw from these countries completely. Yet, many service members are tormented by the fear of being deployed to Syria and, potentially, other hot spots, as tyrannical leaders keep circling the grindstone of violence in the volatile parts of the world and the US is performing the role of an international gendarme. But even those service members who are less exposed to combat often struggle to cope with stresses associated with unique culture of the armed forces – culture of grueling training, rigorous subordination and tense relations with other service members. And then there is the carousing culture of binge drinking, which is often grafted upon newcomers against their will. In these circumstances, it is unsurprising that substance abuse problems are so persistent in the military.
Prevention strategies
The persistently high rates of substance abuse in the military should not be attributed to the lack of actions by the Department of Defense (DoD) and other stakeholders. In fact, as mentioned previously in the text, the military leadership has proved its worthiness in keeping illicit drug abuse at bay by implementing a policy of zero tolerance. Certainly, it cannot copy-paste this policy to address other types of substance abuse in the armed forces. Indeed, initiating criminal prosecution against service members caught drinking would not make sense. The possibility of ignominious discharge is not, perhaps, too menacing to persuade troops to quit binge drinking. Hence, the DoD and its partners have relied on different approaches to confront the problem of alcohol and prescription drug abuse in the military. Yet, instead of taking a comprehensive set of virile measures, it has taken piecemeal, albeit not ineffective, measures.
In its mission statement of the Army Substance Abuse Program, the Department of Army states that it takes cognizance of the risks that substance abuse in the military poses to the nation’s defense capability and, therefore, aims to address the problem (US Army, 2016). It was with this end in mind that the Alcohol and Drug Abuse Prevention and Control Program was founded in 1971 to cover all three major departments of the DoD. Within the framework of this program, the DoD has sought to prevent substance abuse through education and training, deterrence, identification, referral, etc. One recent example of a valuable education and training program was the Comprehensive Soldier Fitness program (Moore & Barnett, 2014). This psychological resilience program was designed to teach troops to withstand stress and tackle emotional issue through lectures and drills.
Yet, lest criticism should appear too gentle to the DoD, the persistently high rates of alcohol abuse and prescription drug abuse indicate that the DoD has failed to fulfill its prevention strategies. Its deterrence capabilities, for example, are eroded by the lack of sufficiently harsh punishment and unwillingness to mete out such punishment. What is more important, the DoD has undervalued the role of prevention strategies. In practice, even though substance abuse programs existed for more than four decades, prevention has not become the main pillar of the DoD’s efforts to tackle substance abuse. By contrast, the DoD has focused on clinical treatment of those abusing alcohol or drugs. But, Bowser (2012) argues, citing a famous 2012 report by the Institute of Medicine, clinical interventions implemented by the DoD are also of low quality. The report lambasts the military’s top brass for using treatment and prevention programs that are divorced from the newest achievements in evidence-based medicine and for failing to put an emphasis on outpatient care (Bowser, 2012). More specifically, Bowser (2012) cites the words of the report’s contributors: “The military needs to understand that modern addiction treatment means using drugs like Suboxone, which has been used successfully in civilian life to treat opiate addiction, and Vivitrol, which reduces a patient’s craving for alcohol or narcotic drugs” (p. 1).
It is imperative, however, that the DoD should put prevention to the cornerstone of its program to address substance abuse in the military, as prevention is the most efficient mechanism to tackle the problem. This means paying reinvigorated attention to the overarching tenets and supporting capabilities of prevention, such as education and training, risk reduction, and deterrence. But this also demands a radical makeover of the prevailing alcohol-soaked culture in the military.
According to official information, the Pentagon spends about $140 million annually to change the way soldiers think about their experiences on the battlefield and in training camps with the ultimate goal of addressing substance abuse (Bowser, 2012). Yet, it is clear that more needs to be done to reverse the adverse trend within the military. The fact that the suicide rate among US active-duty troops outstripped the number of casualties on the battlefield in 2012 demonstrates this point clearly (Bowser 2012). In addition to the recommendations outlined by the Institute of Medicine, the DoD needs to take additional measures. For example, it could broaden insurance coverage for effective outpatient treatment. Emulating the example of the Army, the DoD could also limit the duration of prescriptions for opioid pain medications in other branches of the military (National Institute on Drug Abuse, 2013).
Indeed, given the stresses associated with their service, active-duty personnel and veterans commonly see a drink as a viable strategy of unwinding. Senior officers, too, often regard drinking as an adequate behavior, because they are also exposed to the same stresses. But, apparently, the borderline between alcohol use to unwind and alcohol use to self-medicate for post-traumatic stress disorder, depression and other conditions is fragile. In this environment, casual drinking degenerates into alcoholism. By contrast, illicit and prescription drug use is difficult to address because of the stigma-ridden culture. Indeed, service members using drugs are afraid to seek assistance because of the fear of being stigmatized. Hence, it is vital that this culture should be dismantled by eliminating the stigma and ensuring confidentiality to those applying for therapy. It is equally vital that distribution of prescription drugs should be thoroughly controlled to prevent the problem from occurring.
Conclusion
References
Bowser, B. (2012, September 17). Military not doing enough to curb alcohol, drug abuse,
IOM concludes. PBS Newshour. Retrieved from
http://www.pbs.org/newshour/rundown/militarys-care-for-addicts-outdated-major-
study-concludes/
Hlad, J. (2012, December 26). US military’s alcohol-soaked culture taking toll on service
members. Stars and Stripes. Retrieved from https://www.stripes.com/us-military-s-
alcohol-soaked-culture-taking-toll-on-servicemembers-1.201959
Indiana Prevention Resource Center. (2012, May 21). Military and behavioral health
problems: Substance abuse and problem gambling. Retrieved from
http://drugs.indiana.edu/drug-info/featured-articles/200-military-and-behavioral-
health-problems-substance-abuse-and-problem-gambling
Marion, N., & Oliver, W. (2014). Drugs in American society: An encyclopedia of history,
politics, culture, and the law. Santa Barbara, CA: ABC-CLIO.
Moore, B., & Barnett, J. (2014). Military psychologist’s desk reference. Oxford, UK: Oxford
UP.
National Institute of Drug Abuse. (2013). Drug facts – substance abuse in the military.
Retrieved from https://www.drugabuse.gov/publications/drugfacts/substance-abuse-
in-military
Preidt, R. (2012). Soldiers with post-traumatic stress, depression might self-medicate,
research suggests. Health Day. Retrieved from
http://www.nlm.nih.gov/medlineplus/news/fullstory_122112.html
US Army. (2016). Army substance abuse program (ASAP). Retrieved from
http://jackson.armylive.dodlive.mil/units/usag/dhr/asap/
US Department of the Army. (2012). Army 2020: Generating health and discipline in the
force ahead of the strategic reset, report 2012. Retrieved from
http://usarmy.vo.llnwd.net/e2/c/downloads/232541.pdf
