Outdated approaches to preventing and treating substance abuse, barriers to care, and other problems hinder the U.S. Defense Department's ability to curb substance use disorders among military service members and their families, says a new report from the Institute of Medicine. Service members' rising rate of prescription drug addiction and their difficulty in accessing adequate treatment for alcohol and drug-related disorders were among the concerns that prompted members of Congress to request this review.
"We commend the steps that the Department of Defense and individual service branches have recently taken to improve prevention and care for substance use disorders, but the armed forces face many ongoing challenges," said Charles P. O'Brien, Kenneth Appel Professor and vice chair, department of psychiatry, and director, Center for Studies of Addiction, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, and chair of the committee that wrote the report. "Better care for service members and their families is hampered by inadequate prevention strategies, staffing shortages, lack of coverage for services that are proved to work, and stigma associated with these disorders. This report recommends solutions to address each of these concerns."
About 20 percent of active duty personnel reported having engaged in heavy drinking in 2008, the latest year for which data are available, and binge drinking increased from 35 percent in 1998 to 47 percent in 2008. While rates of both illicit and prescription drug abuse are low, the rate of medication misuse is rising. Just 2 percent of active duty personnel reported misusing prescription drugs in 2002 compared with 11 percent in 2008. The armed forces' programs and policies have not evolved to effectively address medication misuse and abuse, the committee noted.