Military psychologist talks facts, prevention of substance, alcohol misuse among service members

By Dr. Kimberly Buckingham, Defense Centers for Public Health-Aberdeen, Division of Behavioral and Social Health Outcomes PracticeMarch 21, 2023

Military psychologist talks facts, prevention of substance, alcohol misuse among service members
Army data from a recent behavioral health investigation of Soldiers in one unit showed that 22 percent reported hazardous or heavy drinking. Public health studies indicate that alcohol use disorders are the most common form of substance use disorders among Soldiers, who sometimes view drinking as part of their culture. (Defense Centers for Public Health-Aberdeen graphic illustration by Graham Snodgrass) (Photo Credit: Graham Snodgrass) VIEW ORIGINAL

Dr. Buckingham holds a doctorate in clinical psychology.

ABERDEEN PROVING GROUND, Md. – National Drug and Alcohol Facts Week® is an annual week-long observance established by the National Institute on Drug Abuse, or NIDA, which is part of the National Institutes of Health. This year’s observance will be held March 20–26 and provides an opportunity to reflect upon substance use issues in the Army community.

Substance use disorders, referred to as SUDs, include the misuse of alcohol, cannabis, cocaine, hallucinogens, opioids, sedatives or stimulants.

Public health studies indicate that alcohol use disorders are the most common form of SUDs among Army personnel. Alcohol misuse continues to be a problem across the Army, contributing to behavioral health issues, misconduct/crimes, suicidal risk behaviors and other high-risk behaviors that threaten readiness and well-being.

Data on Army substance abuse

Here are some behavioral health findings and recommendations about SUDs in the Army:

  • Army data from a recent behavioral health investigation of Soldiers in one unit showed that 22 percent reported hazardous or heavy drinking. Heavy drinking was defined as more than 4 drinks per day or more than 14 drinks per week for men and more than 3 drinks daily or more than 7 drinks per week for women. These individuals were significantly more likely to report sleep problems and job dissatisfaction.
  • The 2021 Health of the Force report indicates that rates of substance use disorder diagnoses among Soldiers were highest among those less than 25 years old. Engaging with young adult service members to build healthy coping strategies and prevent substance misuse is especially important.
  • Statistics reported by NIDA indicate that service members may be more likely to abuse alcohol than civilians, particularly in levels of binge drinking. Active-duty service members may see drinking as part of their culture. Drinking alcohol may serve as a means to connect or de-stress with fellow service members and may be modeled as a way of handling stress within a military unit. Combat deployments, permanent changes of station, and prolonged work hours are a unique set of military-specific stressors that may contribute to substance misuse as compared to the stressors that may be experienced within the civilian sector.

SUDs have a domino effect on those around the abuser. They can cause conflict, higher rates of tension, and can negatively impact relationship bonds and trust. This can result in possible emotional abuse, physical abuse and neglect that may create a traumatic experience for family members. SUDs can impact a family on every level of functioning: emotional, psychological, financial and social. This impact can extend past the family and into units, eventually rippling outward to the Army enterprise level, where it can impact overall readiness.

In some ways, being in the military can help you overcome or avoid SUDs.

The help provided by unit cohesion and teaching of healthy coping/problem solving skills are examples. The support network and many available resources are especially valuable when strong leadership promotes healthy lifestyles, recognizes problems early and encourages use of behavioral support.

What can be done?

The military environment can encourage certain behaviors and habits that can lead to positive or negative outcomes. Units that are healthy, cohesive, supportive, and reinforce positive coping and problem-solving skills can decrease overall risk.

Recognizing the warning signs of alcohol abuse and then receiving proper treatment can have a significant impact on the recovery process. Warning signs that might indicate a person is abusing alcohol include decreased energy, short-term memory loss, denial of substance abuse, mood swings, irritability, poor work performance, and sleep problems, among others.

Leaders can have an important impact and influence on units’ overall health and wellness.

 “When drinking problems get serious, they need to be a Commander issue,” said Dr. Charles Milliken, clinical director of the Army's Substance Use Disorder Clinical Care office, U.S. Army Office of the Surgeon General. “Safety and mission readiness have to be protected. Under Voluntary Care, the goal is for non-commissioned officers to help a Soldier get care before alcohol becomes a serious problem.”

“Like many problems, drinking problems are much easier to treat while they are small—while still in an early stage,” said Milliken. “Untreated alcohol problems are also at the root of problems that devastate unit morale—up to 50% of suicides, sexual assaults and intimate personal violence incidents are alcohol-related.”

Each of us can help prevent substance misuse among families, friends and communities. Having open communication, education and awareness is one form of prevention.

Here are some key facts to remember about treating substance misuse to help the military family:

Early intervention is key.

Addressing substance misuse in its early stages reduces risk and can result in more positive outcomes. If you see your battle buddy struggling with substance abuse, your support and intervention in helping your buddy get to professional treatment can save your buddy’s life.

Stigma and worries about impact on career can prevent service members from getting the help they need.

Voluntary Care, or self-referral to a treatment program, is career-safe. It does not limit readiness or schooling eligibility and does not potentially impact security clearances.

Engagement in treatment will actually protect and support one’s career and family.

Driving under the influence, absence from duty, and other alcohol-related behaviors can negatively impact personal and unit readiness, a relationship, a career, or even a life. If a service member is unable or unwilling to seek help, Commander-Directed Care is an important intervention tool that helps save lives by directing service members to the help they need.

There is hope in treatment and intervention.

Many SUDs intervention and treatment resources are available to service members and their families, including:

To see more lessons learned from military epidemiological consultation work, visit Division of Behavioral and Social Health Outcomes Practice of the DCPH-A.

The Defense Centers for Public Health-Aberdeen advances Joint Force health protection with agile public health enterprise solutions in support of the National Defense Strategy.

NOTE: The mention of any non-federal entity and/or its products is for informational purposes only, and not to be construed or interpreted, in any manner, as federal endorsement of that non-federal entity or its products.