Defense Department and National Institutes of Health Take on Substance Abuse in the Military

By Ian Graham
Special to American Forces Press Service

June 29, 2009 - Improved recognition, treatment and prevention of substance abuse among servicemembers is the focus of a recent collaboration between the Defense Department and the National Institute on Drug Abuse, a senior defense official said. "Readiness for the military mission is always our primary reason for existence," said Dr. Michael Kilpatrick, the Military Health System's director of strategic communications. "The health of our men and women in uniform is really critical to sustain that readiness."

Kilpatrick spoke about department programs to prevent substance abuse, provide counseling and study the causes for substance abuse in the military during a June 24 audio webcast, "Armed With Science: Research and Applications for the Modern Military."

Dr. Timothy Condon, deputy director of NIDA, joined the show to discuss a NIDA initiative to study substance use and abuse in U.S. military personnel, veterans and their families.

NIDA hosted a public, multi-agency meeting in January to assess understanding and knowledge of substance abuse in the military environment. The agencies identified knowledge gaps, opportunities and possible complications regarding behavioral research and study in the military, Condon said.

"I think this was a very enlightening experience for both those who were part of the armed forces as well as those who were part of the academic community," he said. "There really was a meeting of the minds."

NIDA plans to release a Request for Applications in the next few months, hoping to attract partners interested in studying abuse prevention in the military and among veterans and their families. The request also aims to determine best practices for prevention and treatment of substance abuse and other conditions that may accompany it, such as depression, post traumatic stress disorder, and traumatic brain injury. Substance abuse includes alcohol, tobacco, illicit drugs, and misuse of prescription drugs.

Over the past six years, the military has seen an increased operational tempo and increased health screenings before and after deployment. As a result, Kilpatrick said, there is "a larger number of servicemembers taking all types of medications, ... so we have to be very focused on how to prevent misuse" of those drugs.

Each service has its own program tailored to work best for its members. For example, the Army has Army Substance Abuse Program, or ASAP; the Air Force has Alcohol and Drug Abuse Prevention and Treatment, or ADAPT. Both programs emphasize the importance of readiness and servicemembers' personal responsibility to their mission.

Condon noted that because of large number of National Guard and reserve troops being deployed to combat zones, treatment programs offered to active-duty members aren't always available to those returning from war.

A larger problem, he said, is those seeking help often don't share the "whole picture" with their doctor because of stigmas and fear attached to seeking help.

In response to those stigmas, Kilpatrick said, the department has introduced "Real Warriors," a program designed to encourage people to reach out when they need help, rather than hide their problems for fear of being considered weak or unfit for duty.

"One of the issues we need to move past is the stigma that we associate with people who become addicted to drugs," Condon said. "We need to recognize that it's not just weak will and moral fiber, but that there may be some underlying vulnerabilities there."

Kilpatrick stressed the importance of early detection of health issues, both mental and physical. Early detection leads to better outcomes, he said, because it circumvents the desire to self-medicate with drugs or alcohol.

"What [self-medication] does is delay the individual from getting to appropriate treatment for the underlying medical problems," Kilpatrick said. "It certainly complicates the situation for everyone."

But the effort is one to be shared by all members of the military – leadership, families and individuals.

"Because the military is a community, medical readiness is a shared responsibility of the military commanders, the military medical personnel and the individual servicemembers," Kilpatrick said. "I like to call it a partnership for health. Each person, each side of that partnership, needs to play its role and work together."

(Ian Graham is attached to the Emerging Media Directorate of the Defense Media Activity.)