Transition of Army substance abuse program will improve health readiness

By Mr. Ronald W Wolf (Army Medicine)September 21, 2016

Transition of Army Substance Abuse Program Will Improve Health Readiness
The clinical assets of the Army Substance Abuse Program (ASAP) will transition from the Installation Management Command (IMCOM) to the Army Medical Command (MEDCOM). The transition should be complete by no later than 31 May 2017. Integrating substan... (Photo Credit: U.S. Army) VIEW ORIGINAL

DEFENSE HEALTH HEADQUATERS, FALLS CHURCH, Va. -- The clinical assets of the U.S. Army Substance Abuse Program (ASAP) will transition from the Installation Management Command (IMCOM) to the Army Medical Command (MEDCOM). The transition should be complete by no later than May 31, 2017.

Integrating Substance Use Disorder Clinical Care (SUDCC) treatment into MEDCOM's Behavioral Health System of Care (BHSOC) will enhance the delivery of care for Soldiers to improve the Readiness for the Force. It will also improve outcomes for Soldiers and family members with substance use disorders through earlier detection and intervention.

IMCOM will retain responsibility of ASAP drug testing and deterrence, alcohol and drug abuse prevention training, and the ASAP training curriculum.

Currently, Army SUDCC pilot programs are underway at Fort Riley, Kansas, Fort Stewart, Georgia, Joint-base Lewis McChord, Washington, and Schofield Barracks, Hawaii. The pilot sites are integrating the care for substance use disorders and other behavioral health conditions to improve access to care and coordination between clinical teams.

Substance abuse and substance use disorders have increased dramatically for the Army since 2001, which is largely attributed to the cumulative and continued stressors of a nation at war. Currently, 30 percent of Soldiers with a behavioral health condition screen positive for substance use disorder and 50 percent with suicidal ideations screen positive for excessive alcohol use.

In response to these facts, ASAP has undergone a reassessment of its design, resources, and efficacy to better support the health readiness needs of the Force.

The transition from the IMCOM to the MEDCOM has been in the works for some time. In March 2015, then Secretary of the Army John McHugh directed the Assistant Secretary of the Army (Manpower and Reserve Affairs) to conduct a comprehensive review of the ASAP. McHugh also directed the workgroup to address the 2010 realignment of the ASAP clinical program under IMCOM and its impact on program results.

Following the comprehensive and multidisciplinary review, in October 2015, McHugh approved the recommendations to realign clinical care under MEDCOM by October 1 2016, and integrate it with the BHSOC. The multi-disciplinary approach for treatment used by the BHSOC will help the Army address all aspects of care for Soldiers, family members, and Army civilians who require services for illicit drug use, prescription medication and alcohol abuse.

Integrating ASAP with behavioral health will improve ability to address co-occurring mental and physical illnesses and substance use disorders to allow for effective and evidence-based early intervention.

Army primary care and behavioral health providers, in coordination with addiction providers, will be better able to treat and manage substance abuse disorders as a multi-disciplinary team.

The transition will embed behavioral health providers in the unit footprint and should immediately reduce missed duty time, help to eliminate redundant appointments for Soldiers, and increase positive treatment outcomes.

Healthcare management should see improved integration of outpatient, intensive outpatient, and inpatient care for substance use disorder treatment. In addition, referrals will not be required outside of the treatment team.

Clinical outcomes will be maintained for every patient through the Army's Behavioral Health Data Portal. The Army deployed the data portal to provide real-time clinical outcome data, and established a leadership infrastructure to oversee clinical operations and outcomes.

The standardized clinical program of the BHSOC will reduce variance in the delivery of care; provide a leadership structure that oversees comprehensive behavioral health clinical operations and outcomes; and adhere to a synchronized set of ASAP functions, regulations, and policies.

Overall Army readiness is the number 1 priority for all soldiers, families, and civilians, and substance abuse is incompatible with personnel and unit readiness, performance standards, and military discipline.

The realignment of the ASAP SUDCC program will provide Soldiers and the Army family holistic, integrated care in accordance with Defense policies, national standards and best practices, and enhance command awareness and engagements through unit-aligned behavioral health care.

Integrating clinical services with behavioral health to address co-occurring mental and physical illnesses and substance use disorders will allow for more effective and evidence-based early intervention.