The Pentagon must acknowledge a "public health crisis" in the growing abuse of alcohol and prescription drugs by troops and show stronger leadership in dealing with it, according to a report by a blue ribbon committee released Monday.
The report by an Institute of Medicine panel calls for better policing of underage drinking, reducing access to alcohol on bases and bringing treatment programs -- some of which haven't evolved since the Vietnam War -- into the 21st century.
"I think they're ready to acknowledge that they can do better," Dennis McCarty, a public-health expert on the panel, said of the military. Alcohol and drug abuse are frequently linked to record suicides plaguing the military, a problem that Defense Secretary Leon Panetta told USA TODAY over the weekend requires stronger leadership to address.
The study emerges as new Pentagon figures show the rate of prescription medications handed out by military caregivers has soared since the Afghanistan War began in 2001.
Nearly 5 million prescriptions for pain medication, tranquilizers, muscle relaxants, stimulants and barbiturates were provided to troops last year, up from fewer than a million in 2001, according to Pentagon data.
The panel cites statistics showing opiate pain medication abuse increasing in the military from 2% to 11% from 2005 to 2008, the latest data available.
The problem was worse in the Army, which has borne much of the fighting in Iraq and Afghanistan. There, one in four soldiers admitted in 2008 to abusing prescription drugs during a one-year period. The panel cited data showing that binge drinking --consuming five drinks in one setting -- is 50% higher among servicemembers ages 18-35 than among civilians. Nearly 60% of Marines engage in binge drinking.
Pentagon spokeswoman Cynthia Smith said military health officials "are in the process of analyzing (the committee's) findings and recommendations. But most importantly, we want to do the right thing by the servicemember.
"If there are areas in need of improvement, then we will work to improve those areas," Smith says. "The health and well-being of our servicemembers is paramount."
Some military programs -- such as an Army experiment allowing soldiers access to confidential counseling -- have worked well to encourage soldiers to seek help, the panel says. However, that program exists at only six of 60 Army installations. The committee urges that it be expanded to all bases and adopted by the Navy, Air Force and Marines.
About one in four soldiers who served in Iraq and Afghanistan last year -- or about 63,000 GIs -- admitted they have a drinking problem, according to Pentagon data released this year. The services operate substance-abuse programs with little direction or accountability from the Pentagon and this needs to change, the committee report says.
"Rather than continuing to use a 20th-century workforce to treat (substance abuse disorders, the Pentagon) is challenged to structure and staff treatment services for alcohol and drug use disorders for the 21st century," the report says.
Other problems raised by the panel:
-- Military doctors need better training in recognizing substance abuse and clear guidelines for referring patients to specialists, such as pain-management experts, rather than relying so heavily on dispensing drugs.
-- Service branches should reduce the number of alcohol sales outlets on installations and limit hours of operation.
--The number of servicemembers engaging in substance-abuse programs is far lower than would be expected, suggesting that many are inhibited from doing so because of stigma, availability and other barriers to care.
-- The Pentagon's health care program, TRICARE, does not cover the use of medications that can help reduce a servicemember's dependency on opioid drugs.
-- Substance-abuse programs are lacking for members of the National Guard and Reserve forces.
An investigation into rising drug abuse at the Army's Fort Leonard Wood in Missouri by Democratic Sen. Claire McCaskill in 2008 led to a provision in the 2010 Defense bill authorizing an outside review of military prevention practices. The Institute of Medicine launched the committee early last year.
By Gregg Zoroya
USA Today Monday 17th September 2012.