Drug and Alcohol Abuse in the Military Research Proposal

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Army Substance Abuse Program, in terms of the program's history, its employment requirements, and the rationale behind them. It looks at various jobs within the hierarchy of this program, from the commanders responsible for implementing the program on the level of installations or garrisons, to the trained personnel taking urine samples. By way of demonstrating the utility of the continued education requirement even for the personnel collecting urine, the paper notes the existence of such widespread willingness to deceive testing, and then reviews recent peer-reviewed studies with potential relevance for successful implementation of Army Substance Abuse Program theories, curricula, and policies.

Introduction

The Army Center for Substance Abuse Programs was first established in 1971 in response to a law requiring the Secretary of Defense to identify, treat, and rehabilitate members of the U.S. military determined to be dependent upon alcohol or illicit drugs; similar legislation followed to require the same standards for civilian employees of the military. The Army Substance Abuse Program is the result of this overall shift in policy during the era of the Vietnam Conflict, when the addiction to or abuse of alcohol and other drugs by military personnel -- very often as a comorbidity associated with post-traumatic stress disorder, but also as a disease in its own right -- gained a much higher level of visibility for the general public, partly because of the overall visibility given to drug use in that era by the so-called "counterculture." Popular depictions of the Vietnam conflict -- such as the Oscar-winning Oliver Stone drama Platoon -- popularly feature soldiers abusing cannabis, alcohol, and other drugs in ways that would be unimaginable in a cinematic depiction of World Wars One or Two, or the Korean conflict. (They are also omitted from most depictions of the U.S. Civil War, despite the widespread use of cannabis and opium as medications during that conflict, in an era before governmental regulation of these substances.) But the visibility of drug abuse by military personnel in the period following the 1960s to the present day is presumably what prompted the legislation that created the Army Substance Abuse Program, whereas the overall trend in that time period has been away from a criminal deviance paradigm regarding substance abuse, and more toward a paradigm of understanding substance abuse as a disease, and approaching it accordingly through education, prevention, and treatment.

Agency and Clientele

For a little over four decades, the Army Substance Abuse Program has been implemented for the purposes of treating the abuse of these chemical substances as a disease meriting rehabilitation before regarding them, accurately but harshly, as criminal actions requiring disciplinary sanction. All military and civilian employees of the Department of Defense are potential beneficiaries of the services provided by the Army Substance Abuse Program if they are determined to require rehabilitation for abuse of or dependency upon drugs.

However, the policies for the Army Substance Abuse Program underwent significant overhaul in 2012, probably as a result of the shocking findings that more than one in five active duty Army personnel and more than one in four National Guard personnel tested positive for illicit drug use in the time period between 2009 and 2012 (Platteborze et al. 2014, 653). Again, this may be indicative of a comorbidity with post-traumatic stress disorder, diagnosed at much higher rates in the wake of the Afghanistan and Iraq conflicts than in previous military history, Vietnam included. The difficulty, however, is that the relation between the two -- while a matter of accepted folklore regarding "self-medication" -- has not been properly documented by medicine to establish the precise connection between post-traumatic stress and abuse of alcohol or drugs (Larson Wooton et al. 2012, 7).

Worker's Job and Responsibilities

Commanders within the Army Substance Abuse Program exist at the level of Installation or Garrison, making them responsible for the implementation of the Army Substance Abuse Program within that individual jurisdiction. The main enumerated duties of an Installation or Garrison Commander are to establish a full unit with staff in order to make certain that the complete panoply of offerings guaranteed to personnel by Army Substance Abuse Program are accessible and operational. Because the Army Substance Abuse Program mandates both military staff as well as trained counselors, the Installation or Garrison Commander maintains charge of both of these elements of the personnel within a single location to maximize the efficient co-workings of personnel despite a difference of background or even military status. The necessary staff that is under the direct jurisdiction of the Installation or Garrison Commander includes one Alcohol and Drug Control Officer to liaise with the administration of the garrison or installation, one Prevention Coordinator in charge of prevention and education, one Employee Assistance Program Coordinator to work with the civilian personnel, one Drug Testing Coordinator to be in charge of drug and alcohol testing, one Installation Breath Alcohol Technician who operates the "breathalyzer" equipment for alcohol intoxication tests, and one Risk Reduction Program Coordinator in charge of the mandated risk reduction actions.

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Beyond the appointment and supervision of this core staff, an Installation of Garrison Commander will set up an additional team or council that focuses on substance abuse and risk reduction, and serves as the chair of this body, which must include representatives from all different sectors related to military life including the chaplaincy, the medical teams, the safety office, social workers, the provost marshal, and suicide prevention workers, among others. The Installation or Garrison Commander is then responsible for the implementation of all further policies related to drug and alcohol abuse, including the reporting of illegal activity (such as the trade in illicit drugs, or underage drinking) to the Criminal Investigation Division, and otherwise implement policies and represent the military's official policies regarding the reduction of abuse of alcohol and other drugs.

The revisions to the Army Substance Abuse Program mandated in 2012 add one final duty for the Installation or Garrison Commander, which is to pass on the information regarding soldiers who test positive for drugs or alcohol to the first General Officer in the chain of command with the assured legal assistance of a judge advocate or similar legal advisor, who then will make the retention decision regarding such soldiers. This is in accordance with the rather sweeping revisions made in 2012 to military policy for separation actions, which changed the approach and guidelines regarding rehabilitation rather than disciplinary action as the preferred tool for handling the issue. The upshot of this for the Installation or Garrison Commander should be obvious, however: whoever holds this position is entrusted with gathering and submitting information and evidence which might potentially end a soldier's career entirely and result in criminal charges and penalties. Considering the real and very high levels of drug and alcohol abuse within the military, this job must therefore not be taken lightly.

Worker's Credentials

From the standpoint of requirements for the position of Installation or Garrison Commander, there is a slightly counterintuitive element in play. Most jobs in this field do require a level of licensing or certification -- as, for example, with the relatively low-level position of the Installation Breath Alcohol Technician, who requires official certification as one trained to use the relevant "breathalyzer" equipment with such facility as would prove satisfactory in the event of such test results required for evidentiary purposes in a legal action, along with the sworn evidentiary testimony of this credentialed technician -- but the Installation or Garrison Commander does not require any specific license or certification as credentials for eligibility.

Instead it must be noted that Installation or Garrison Commander is a military position of command, and thus the qualifications for holding it are exclusively military: no specific educational background or training is mandated for the job, although in practice it is likely that specific training in drug and alcohol counseling and an employment background within the Army Substance Abuse Program are desirable qualifications. It is unlikely that an Artillery Captain with extensive combat experience but no prior experience of subjects like psychological counseling or medical treatment of disease would be promoted to this post -- but as it is a military command position, the only stated qualification is the correct military rank to be considered for a position of command. We may perhaps therefore understand this as a matter where common sense takes over at the point where enumerated regulations leave off.

Worker's Theory-of-Use

The theoretical background behind all jobs in the Army Substance Abuse Program is that which has been endorsed by all reputable medical personnel, in which abuse of alcohol and other drugs is understood foremost as a disease rather than a criminal act. Now obviously there are criminal laws in place regarding drugs and alcohol, but obviously to insist on their enforcement by prosecuting all who abuse drugs and alcohol would have resulted in the expulsion and possible incarceration of over one in four National Guardsmen and over one in five active-duty soldiers in the period between 2009 and 2012. The….....

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