Substance Use Disorders in the U.S. Armed Forces


Book Description

Problems stemming from the misuse and abuse of alcohol and other drugs are by no means a new phenomenon, although the face of the issues has changed in recent years. National trends indicate substantial increases in the abuse of prescription medications. These increases are particularly prominent within the military, a population that also continues to experience long-standing issues with alcohol abuse. The problem of substance abuse within the military has come under new scrutiny in the context of the two concurrent wars in which the United States has been engaged during the past decade-in Afghanistan (Operation Enduring Freedom) and Iraq (Operation Iraqi Freedom and Operation New Dawn). Increasing rates of alcohol and other drug misuse adversely affect military readiness, family readiness, and safety, thereby posing a significant public health problem for the Department of Defense (DoD). To better understand this problem, DoD requested that the Institute of Medicine (IOM) assess the adequacy of current protocols in place across DoD and the different branches of the military pertaining to the prevention, screening, diagnosis, and treatment of substance use disorders (SUDs). Substance Use Disorders in the U.S. Armed Forces reviews the IOM's task of assessing access to SUD care for service members, members of the National Guard and Reserves, and military dependents, as well as the education and credentialing of SUD care providers, and offers specific recommendations to DoD on where and how improvements in these areas could be made.




Assessing Fitness for Military Enlistment


Book Description

The U.S. Department of Defense (DoD) faces short-term and long-term challenges in selecting and recruiting an enlisted force to meet personnel requirements associated with diverse and changing missions. The DoD has established standards for aptitudes/abilities, medical conditions, and physical fitness to be used in selecting recruits who are most likely to succeed in their jobs and complete the first term of service (generally 36 months). In 1999, the Committee on the Youth Population and Military Recruitment was established by the National Research Council (NRC) in response to a request from the DoD. One focus of the committee's work was to examine trends in the youth population relative to the needs of the military and the standards used to screen applicants to meet these needs. When the committee began its work in 1999, the Army, the Navy, and the Air Force had recently experienced recruiting shortfalls. By the early 2000s, all the Services were meeting their goals; however, in the first half of calendar year 2005, both the Army and the Marine Corps experienced recruiting difficulties and, in some months, shortfalls. When recruiting goals are not being met, scientific guidance is needed to inform policy decisions regarding the advisability of lowering standards and the impact of any change on training time and cost, job performance, attrition, and the health of the force. Assessing Fitness for Military Enlistment examines the current physical, medical, and mental health standards for military enlistment in light of (1) trends in the physical condition of the youth population; (2) medical advances for treating certain conditions, as well as knowledge of the typical course of chronic conditions as young people reach adulthood; (3) the role of basic training in physical conditioning; (4) the physical demands and working conditions of various jobs in today's military services; and (5) the measures that are used by the Services to characterize an individual's physical condition. The focus is on the enlistment of 18- to 24-year-olds and their first term of service.




War and Drugs


Book Description

War and Drugs explores the relationship between military incursions and substance use and abuse throughout history. For centuries, drugs have been used to weaken enemies, stimulate troops to fight, and quell post-war trauma. They have also served as a source of funding for clandestine military and paramilitary activity. In addition to offering detailed geopolitical perspectives, this book explores the intergenerational trauma that follows military conflict and the rising tide of substance abuse among veterans, especially from the Vietnam and Iraq-Afghan eras. Addiction specialist Bergen-Cico raises important questions about the past and challenges us to consider new approaches in the future to this longest of US wars.




Concurrent Treatment of PTSD and Substance Use Disorders Using Prolonged Exposure (COPE)


Book Description

Concurrent Treatment of PTSD and Substance Use Disorders Using Prolonged Exposure (COPE) is a cognitive-behavioral psychotherapy program designed for patients who have posttraumatic stress disorder (PTSD) and a co-occurring alcohol or drug use disorder. COPE represents an integration of two evidence-based treatments: Prolonged Exposure (PE) therapy for PTSD and Relapse Prevention for substance use disorders. COPE is an integrated treatment, meaning that both the PTSD and substance use disorder are addressed concurrently in therapy by the same clinician, and patients can experience substantial reductions in both PTSD symptoms and substance use severity. Patients use the COPE Patient Workbook while their clinician uses the Therapist Guide to deliver treatment. The program is comprised of 12 individual, 60 to 90 minute therapy sessions. The program includes several components: information about how PTSD symptoms and substance use interact with one another; information about the most common reactions to trauma; techniques to help the patient manage cravings and thoughts about using alcohol or drugs; coping skills to help the patient prevent relapse to substances; a breathing retraining relaxation exercise; and in vivo (real life) and imaginal exposures to target the patient's PTSD symptoms.




Combating Tobacco Use in Military and Veteran Populations


Book Description

The health and economic costs of tobacco use in military and veteran populations are high. In 2007, the Department of Veterans Affairs (VA) and the Department of Defense (DoD) requested that the Institute of Medicine (IOM) make recommendations on how to reduce tobacco initiation and encourage cessation in both military and veteran populations. In its 2009 report, Combating Tobacco in Military and Veteran Populations, the authoring committee concludes that to prevent tobacco initiation and encourage cessation, both DoD and VA should implement comprehensive tobacco-control programs.




Shooting Up


Book Description

Pharmacologically enhanced militaries -- Alcohol -- From pre-modern times to the end of the Second World War -- Pre-modern times: opium, hashish, mushrooms and coca -- Napoleon in Egypt and the adventures of Europeans with hashish -- The Opium Wars -- The American Civil War, opium, morphine and the "soldiers' disease"--The colonial wars and the terrifying "barbarians"--coca to cocaine: the First World War -- The Second World War -- The Cold War -- From the Korean War to the war over mind control -- In search of wonderful new techniques and weapons -- Vietnam: the first true pharmacological war -- The Red Army in Afghanistan and the problem of drug addiction -- Towards the present -- Contemporary irregular armies empowered by drugs -- Intoxicated child soldiers -- Drugs in the contemporary American Armed Forces -- Conclusion -- Epilogue: war as a drug




Department of Defense Survey of Health Related Behaviors Among Active Duty Military Personnel


Book Description

For more than 20 years, the DoD has collected information regarding behavioral and health readiness of active duty military personnel through the Survey of Health Related Behaviors Among Military Personnel (Survey). In 2005, DoD initiated the ¿Dept. of Defense Lifestyle Assessment Program,¿ which incorporates the active-duty health behaviors study and expands the scope to include the National Guard and Reserves, as well as other special studies, the first of which will examine unit-level influences on alcohol and tobacco use. The 2005 Survey has two broad aims for active duty military personnel: (1) to continue the survey of substance use; and (b) to assess progress toward selected ¿Healthy People 2010¿ objectives. Charts and tables.




Substance Abuse


Book Description

The premier text on substance abuse and addictive behaviors is now in its updated and expanded Fourth Edition, with up-to-the-minute insights from more than 150 experts at the front lines of patient management and research. This edition features expanded coverage of the neurobiology of abused substances, new pharmacologic therapies for addictions, and complete information on “club drugs” such as Ecstasy. New sections focus on addiction in children, adolescents, adults, and the elderly and women’s health issues, including pregnancy. The expanded behavioral addictions section now includes hoarding, shopping, and computer/Internet abuse. Includes access to a Companion wesbite that has fully searchable text.




Returning Home from Iraq and Afghanistan


Book Description

Nearly 1.9 million U.S. troops have been deployed to Afghanistan and Iraq since October 2001. Many service members and veterans face serious challenges in readjusting to normal life after returning home. This initial book presents findings on the most critical challenges, and lays out the blueprint for the second phase of the study to determine how best to meet the needs of returning troops and their families.




Military Psychiatry


Book Description