WASHINGTON—DoD needs to acknowledge that the current levels of substance use and misuse among military personnel and dependents constitute a “public health crisis,” a new study says.

The IoM report, Substance Use Disorders in the U.S. Armed Forces, noted that about 20% of active duty personnel reported having engaged in heavy drinking in 2008 and binge drinking increased from 35% in 1998 to 47% in 2008. 

The report noted that while rates of both illicit and prescription drug abuse are low, the rate of medication misuse is rising.  Just 2% of active duty personnel reported misusing prescription drugs in 2002 compared with 11% in 2008, according to an IoM written statement on the report.

Military leadership and providers have an important role in addressing the problem, according to the report.

“The IOM asserts that the highest levels of military leadership must acknowledge these alarming facts and combat them using an arsenal of public health strategies, including proactively attacking substance use problems before they begin by lim­iting access to certain medications and alcohol,” according to a report brief. “Additional structural changes involve pre­scribers, who should routinely check local pre­scription drug monitoring programs before dis­pensing medications with high abuse potential. Health care professionals also should be trained to recognize worrisome patterns of prescrip­tion drug use and medication-seeking behaviors and should be given clear guidelines for refer­ral to specialty providers.”

The report also stated that the agency needs to update outdates policies and practices that hinder it from effectively tackling the problem.

“The continuum of care for substance misuse in the Military Health System (from prevention through intervention and aftercare) has not been modified to accord with current understanding of factors that motivate individuals to seek help, settings in which care or interventions can be delivered most effectively, training/skills required by key staff, and medications that have proven useful in achieving or maintaining abstinence.”

Charles P. O'Brien, chair of the committee that wrote the report, said in a written statement that the committee commends “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.”

The report was sponsored by DoD.