Substance Abuse in the U.S. Military: Causes and Impact

Introduction

The United States military faces considerable difficulty related to substance abuse among its personnel. It is important to note that these substance abuse issues affect both active-duty personnel and veterans. Among the many challenges the military faces, one is the evolving nature of substance abuse in the 21st century. Whereas such abuse has traditionally centered on alcohol and illegal narcotics, there is now a stronger emphasis on the misuse of prescription medication. This abuse, in addition to binge drinking (Institute of Medicine, 2015, p. 243), has considerable consequences for military personnel. Active-duty members face situations in which their readiness and ability to engage in combat is impaired by over-consumption of drugs and alcohol, while veterans must contend with a decreased quality of life and reduced ability to successfully reintegrate into society because of the same problems.

Consequence of War

One of the most critical dimensions of the military's current substance abuse predicament pertains to its timing. There has been a surge in binge drinking and over-consumption of prescription medication since the War on Terror began; individuals deployed in both Afghanistan and Iraq have been involved in both forms of substance abuse (Institute of Medicine, 2015, p. 243). A parallel appears to exist between the intensive combat situations in both of these war theaters and the incidence of substance abuse, suggesting that military personnel are attempting to cope with the former through the latter.

Although a number of programs have been employed — with varying degrees of success — to curb such behavior, relatively little research exists on the correlation between this behavior and overall military training and conduct in both combat and peacetime environments. The military environment may not provide conditions in which two of the major themes for substance abuse recovery — "a search for self, a search to belong" (Gazda, 1998, p. i) — are achievable. Rather than focusing solely on the output of this situation — in which high rates of military personnel abuse legal substances, including "the nonmedical use of prescription drugs" (Manchikanti et al., 2010, p. 401) — this problem may point to larger issues within the overall professional and social framework that exists within the military and all of its branches.

Overarching Military Implications

Some case studies indicate that the current problem with substance abuse among military personnel may actually reflect broader issues with life in the military. Although each individual's decision to turn to over-consumption of alcohol or prescription drugs is his or her own, certain recurring themes emerge in the incidence of such behavior. An analysis of patients in the military's ASAP Triage program — a confidential treatment program for substance abuse issues — illustrates this point. The program represents one of the more modern approaches the military is using to address its contemporary substance abuse challenges. Its confidential nature is telling, as is the fact that patients can choose to enroll voluntarily rather than being compelled to participate.

Many of the patients in ASAP are there for drinking problems (Furuya and Slobodzien, 2015, p. 1), and some have expressed dissatisfaction with their daily activities in the military. Patient B.E.G., for instance, who was deployed in Afghanistan and has had multiple incidents involving drinking — including drinking to the point of losing consciousness — articulated anger problems that partly stem from his work environment and tension with co-workers (Furuya and Slobodzien, 2015, p. 3). These emotional issues, possibly linked to his alcohol abuse, suggest that aspects of daily military life — particularly peer interactions, work assignments, and deployments — contribute to an environment in which substance abuse functions as a means of escape.