This editorial will appear in Friday’s print edition.
The military might employ some of the world’s most up-to-date weapon systems, but it’s stuck in the past when it comes to preventing and treating substance abuse.
That’s the conclusion of a new Institute of Medicine report released this week. It says that abuse of alcohol and prescription drugs among service members and their families is a “public health crisis” and contributes to the record rate of suicide within the ranks. But the services are often dealing with that crisis in outmoded ways.
For instance, materials the U.S. Navy uses for counselor training haven’t been updated since 1984. The military is reluctant to use medication that can curb cravings and to employ other modern strategies for combating substance abuse. And its drug-testing – created in the years after the Vietnam War – focuses on drugs that aren’t the main problems today.
As in the civilian population, prescription drug abuse is rising in the military – but at an even faster rate. Between 2005 and 2008, the most recent year for which statistics were available, abuse of prescription pain medication in the military rose from 2 percent to 11 percent. It’s almost certainly even higher now after four more years of war and multiple deployments.
Among the report’s recommendations: better policing of drinking by underage service members, routine screening for excessive alcohol use and bans on selling alcohol at base package stores at much lower prices than off-base. Easy access to cheap booze is a factor in the military binge drinking rate rising from 35 percent in 1998 to 47 percent a decade later.
Some of the military’s problem with substance abuse – particularly of alcohol – is cultural. The tough soldier or sailor is supposed to be able to hold his liquor. There’s been a stigma attached to those who can’t that might discourage them from seeking help – particularly if they think their superior officer will be notified. But even when they do seek help for substance abuse, often those programs are understaffed or, as the report mentioned, out of date.
Other factors in rising substance abuse rates – besides the pressure prolonged war places on service members – could be linked to who has enlisted in recent years. In order to address wartime recruiting needs, the Army had lowered its standards and accepted applicants it probably would have rejected in previous years. That includes recruits with minor criminal records.
The Army in particular is dealing with a high suicide rate, which has been linked to the stress of war. But not all those who attempt suicide or succeed in killing themselves are combat veterans, suggesting that the military’s substance abuse problem might be as least as much to blame. If the Army is to make headway against suicide, it also needs to more effectively address abuse of drugs and alcohol.