Substance Abuse in the US Navy

Key Takeaways

• Substance misuse in the US Navy has evolved due to policy changes, combat deployments, and cultural shifts, with a focus on prevention, intervention, and treatment strategies.
• During the Vietnam War, substance misuse among Navy personnel was significant, with prevalent use of marijuana, heroin, and amphetamines.
• Post-Vietnam, the Navy saw shifts in substance use patterns, with policy changes in the 1980s and ongoing challenges for veterans post-service.
• Alcohol and prescription drugs are the most commonly misused substances in the Navy, with recent policy changes reflecting societal shifts and a focus on reducing attrition rates.
• Substance misuse in the Navy leads to serious physical, psychological, and professional consequences, including health issues, mental health disorders, and career setbacks.
• The Navy has implemented various prevention and treatment programs, such as the Substance Abuse and Rehabilitation Program (SARP) and the Navy Alcohol and Drug Abuse Prevention (NADAP) program.
• Challenges in substance misuse prevention and treatment include cultural factors, deployment-related stress, and stigma, with future directions focusing on enhanced prevention and integrated treatment strategies.

History of Substance Abuse in the US Navy

Early Trends and Historical Context

The issue of substance misuse within the US Navy has evolved significantly over the years, shaped by policy changes, combat deployments, and cultural shifts. Historically, alcohol and tobacco use were prevalent among Navy personnel, prompting the implementation of various policies aimed at curbing their misuse and supporting affected service members. The Department of Defense’s strong stance against alcohol misuse and illicit drug use underscores its commitment to maintaining high standards of performance and discipline.

Combat Deployments and Substance Use Disorders

• Impact of Combat Stress: Service members deployed to conflict zones such as Iraq and Afghanistan have exhibited higher rates of Substance Use Disorders (SUDs) compared to civilians. The stressors of deployment and challenges in reintegration into civilian life contribute significantly to the development of SUDs.
• Co-occurring Conditions: The prevalence of post-traumatic stress disorder (PTSD) alongside SUDs is notably high in military populations. This overlap necessitates integrated treatment approaches for these comorbid conditions.

Response to Prescription Drug Misuse

• Opioid Crisis: In response to the growing concern over prescription drug misuse, particularly opioids prescribed for pain management, the Navy has implemented training for healthcare providers and adjusted prescription practices to curb misuse.

Substance Abuse During the Vietnam War

• Combat-Related Misuse: The Vietnam War era saw a significant prevalence of substance misuse among Navy personnel. Research highlights that drugs such as marijuana, heroin, and amphetamines were commonly used by service members during this period. Factors contributing to high substance misuse rates included:
  • The need for coping mechanisms in a war-torn environment.
  • The relaxation of societal taboos against drug use in the United States.
  • Easy access to inexpensive illicit drugs, often facilitated by profiteering South Vietnamese officials.
• Polydrug Use: Veterans often engaged in polydrug use, combining substances like marijuana, alcohol, and amphetamines with heroin. Research led by sociologist Lee N. Robins highlighted that many soldiers had pre-existing social issues and engaged in extensive polydrug use. Heroin misuse was particularly prevalent, with many veterans continuing their use post-war.
• Research and Support: Extensive research efforts, including those by Lee N. Robins, aimed to understand and support veterans dealing with substance misuse. The research conducted in September 1971 sought to document and address the substance misuse issues faced by returning soldiers.

Post-Vietnam Shifts in Substance Abuse Patterns

• Transition to an All-Volunteer Force (AVF): The post-Vietnam era brought about significant changes, transitioning to an All-Volunteer Force, altering service member demographics and substance use behaviors. During the 1980s, the military enhanced benefits and instituted a zero-tolerance policy for illicit drugs, marking a shift towards stricter substance misuse prevention and control. Research indicates that these policy changes were critical in shaping the landscape of substance use within the military.
• Challenges for Veterans: Despite preventive measures, veterans continued to face substance misuse challenges post-separation. Research indicates that many veterans engage in significant substance use post-service, often alongside physical and mental health issues such as pain, traumatic brain injuries, PTSD, and depression.
• Readjustment Difficulties: Data from the Pew Research Center highlights that many modern-era veterans struggle with readjustment to civilian life, with symptoms of anger and depression potentially exacerbating substance use.

Ongoing Efforts and Prevention Initiatives

• Department of Defense Initiatives: Efforts to address substance misuse include prevention programs and smoking cessation initiatives, aiming for tobacco-free installations. These initiatives reflect the ongoing commitment to mitigating substance misuse among military personnel.
• Veterans Health Administration (VHA): The prevalence of SUDs and co-occurring mental health disorders remains a concern within the VHA system. Studies show that veterans with SUDs often have co-occurring mental health disorders, emphasizing the need for integrated care approaches.

Overview: Substance Abuse in the US Navy

Challenges and Efforts 

The US Navy, like any large organization, grapples with challenges related to substance misuse among its personnel. While specific data from the provided research is limited, the US Navy Health of the Force Report and the Navy Drug and Alcohol Deterrence programs indicate ongoing efforts to maintain a healthy and resilient force. The Navy’s approach to substance misuse encompasses prevention, treatment, and maintaining operational readiness.

Policy Changes and Adaptations

Recent policy changes, as reported by Military.com, reflect a nuanced approach towards substance misuse issues, including a more lenient stance on recruits’ prior marijuana use to reduce attrition rates during boot camp. However, strict policies against drug use during service underscore the serious consequences of substance misuse on physical health, psychological well-being, and career progression.

Prevalence of Alcohol Misuse in the Navy

• Significant Concern: Alcohol misuse is prevalent within the US Navy, with studies indicating a heightened risk of Alcohol Use Disorders (AUDs) among deployed personnel, especially following recent conflicts.
• Normative Behavior: Within military culture, alcohol consumption is normalized, contributing to increased misuse rates. A substantial portion of veterans seeking treatment report alcohol as the most commonly misused substance, highlighting its pervasive impact within the Navy community.
• Co-occurrence with PTSD: The co-occurrence of PTSD and AUDs is well-documented, complicating treatment outcomes and necessitating integrated approaches to care.
• Department of Defense Initiatives: Efforts include smoking cessation programs and initiatives towards tobacco-free installations, aimed at mitigating alcohol-related issues and promoting overall health among sailors.

• Higher Risk Compared to Civilians: Navy personnel face an elevated risk of developing Substance Use Disorders (SUDs) compared to the general population, influenced by factors such as deployment and combat exposure.
• Focus on Prescription Drugs: Notably, prescription drug misuse, particularly opioids, poses a significant challenge. Efforts to integrate treatment for co-occurring PTSD and SUDs are crucial in addressing this issue.
• Prevalent Substance Misuse: Despite efforts, substance misuse, including alcohol and prescription drugs, remains a concern. The Navy implements prevention and treatment programs to support personnel and maintain readiness.

The US Navy’s multifaceted approach to substance misuse includes robust prevention strategies, treatment initiatives, and policy adaptations to address evolving challenges. By prioritizing the health and well-being of its personnel, the Navy aims to mitigate substance misuse’s impact and ensure a resilient force capable of meeting operational demands.

Health and Career Consequences: Substance Abuse Among Navy Personnel

The systematic narrative review by Osborne et al. identifies four key themes: military characteristics and alcohol use, consequences of deployment on alcohol use, implications of mental health on alcohol use, and the role of cultural and social factors on alcohol use.

Physical Health Risks

Substance misuse within the US Navy poses significant physical health risks, compromising both readiness and overall well-being. Alcohol and drug misuse are associated with various health problems including liver diseases, cardiovascular issues, respiratory complications, and heightened injury risk. Illicit drug use further poses acute medical emergencies and long-term health complications. The Navy, committed to combat effectiveness, implements stringent policies under OPNAV Instruction 5350.4E to prevent and manage substance misuse, aiming to maintain sailors’ health and deployability. The Navy’s Health of the Force Report highlights the need for continuous efforts to address substance misuse and its associated health risks. 

Alcohol Misuse Concerns

Alcohol misuse remains prevalent within the Navy, linked closely with distress and exacerbating other health-related problems that can impair mission effectiveness. The Navy’s Health of the Force Report underscores the ongoing need for efforts to address substance misuse and mitigate associated health risks, emphasizing holistic approaches that monitor health behaviors, promote mental well-being, and provide treatment options.

Psychological Consequences

Substance misuse in the Navy profoundly impacts mental health, exacerbating conditions like PTSD and depression. The psychological impact is particularly pronounced among those who have been deployed to combat zones, with research indicating that deployed personnel are 1.36 times more likely to develop an alcohol use disorder and 1.14 times more likely to develop a drug use disorder than their non-deployed counterparts.

Deployed personnel are significantly more likely to develop alcohol and drug use disorders compared to non-deployed counterparts, with approximately 58% seeking treatment for alcohol use disorder also meeting PTSD criteria. The importance of trauma-informed care interventions has been highlighted in recent studies, suggesting the need for a concerted effort to provide comprehensive and empathetic support to those affected. Stigma around mental health care in military culture complicates access to evidence-based treatments, necessitating efforts to destigmatize care and enhance access for integrated treatment addressing both SUDs and PTSD.

Career Implications

Substance misuse carries severe career implications in the Navy, including disciplinary actions like demotion, loss of security clearance, or dishonorable discharge. SUDs decrease productivity, impair judgment, and elevate accident risks, hindering career advancement. Despite deterrent and treatment programs, stigma surrounding SUD treatment persists, dissuading personnel from seeking necessary support. Co-occurring PTSD further complicates mental health challenges, impacting duty performance and career progression.

Strategies and Programs: Combating Substance Abuse in the US Navy

Prevention Programs

The US Navy has implemented robust substance misuse prevention programs to uphold the health and readiness of its personnel. Central to these efforts is the Navy Alcohol and Drug Abuse Prevention (NADAP) program, operational across Navy installations worldwide. NADAP focuses on promoting readiness, health, and wellness through preventive measures and treatment of substance misuse.

Drug Education for Youth (DEFY)

Established under SECNAVINST 5355.3A, DEFY collaborates with the US Department of Health and Human Services, integrating best practices from the Center for Substance Abuse Prevention (CSAP). It continually updates its curriculum to remain effective in educating youth about substance abuse prevention.

Navy Drug and Alcohol Counselor School (NDACS)

NDACS offers intensive training for enlisted personnel (E-4 through E-9) interested in becoming drug and alcohol counselors. This initiative ensures qualified counselors are available to support Navy members in need, enhancing the effectiveness of substance abuse prevention and treatment efforts.

Substance Abuse Rehabilitation Program (SARP)

Located at the Naval Medical Center Portsmouth, SARP provides comprehensive services ranging from screening and preventive measures to intensive outpatient and residential treatment. It includes specialized programs like Prime for Life, Dual Diagnosis Residential treatment, and Continuing Care, tailored to meet the diverse needs of individuals struggling with substance misuse.

Treatment and Rehabilitation

Recognizing the critical need to address substance misuse, the Navy offers various levels of treatment through SARP at Naval Medical Center Portsmouth. These include Prime for Life, Intensive Outpatient, Dual Diagnosis Residential treatment, and Continuing Care, emphasizing effective intervention and promoting overall readiness, health, and wellness among personnel.

Supportive Technologies

The Navy has embraced technological advancements to enhance support for substance misuse treatment. Partnering with Hazelden, the Navy provides online recovery support services, catering particularly to younger sailors and active-duty personnel who prefer digital platforms for assistance.

Comprehensive Approach

The Navy’s approach encompasses education, detection, deterrence, and treatment to combat substance misuse effectively. Guided by policies like OPNAV Instruction 5350.4E, these efforts aim to maintain a healthy, resilient community and ensure the readiness of service members.

Challenges and Future Directions: Navy Substance Abuse Prevention and Treatment

The US Navy confronts significant challenges in addressing substance misuse among its personnel, influenced by cultural factors, deployment-related stress, and the stigma associated with seeking treatment. Military service members, particularly those deployed to combat zones, are at heightened risk for developing substance use disorders (SUDs). Studies underscore higher rates of SUD diagnoses among veterans returning from deployment, with a notable comorbidity with post-traumatic stress disorder (PTSD).

Challenges

1. Stigma and Referral Rates: There is a pervasive stigma surrounding seeking help for SUDs, compounded by concerns over career implications, leading to low referral rates for treatment services.
2. Need for Enhanced Protocols: Despite initiatives like the Alcohol and Drug Abuse Prevention and Treatment (ADAPT) program, there remains a requirement for more robust screening, referral protocols, and the widespread adoption of evidence-based practices across military programs.

Future Directions

1. Enhanced Prevention Strategies: Focus on bolstering prevention efforts tailored for new active duty personnel, aiming to mitigate the onset of substance misuse from the outset of military service.
2. Integration of SUDs and PTSD Treatment: Implement integrated treatment approaches that address both substance use disorders and co-occurring PTSD, recognizing the intertwined nature of these conditions.
3. Interdisciplinary Pain Management: Emphasize interdisciplinary pain management strategies to reduce reliance on long-term opioid therapy, aligning with current medical best practices.
4. Adaptability and Resilience: Foster a culture of adaptability, innovation, and resilience within the Navy to maintain combat effectiveness and support the well-being of sailors and their families effectively.

Addiction Treatment for Veterans 

There are quite a few different options for people who are seeking treatment for drug & alcohol addiction. Your individualized treatment plan at The Recovery Village Palmer Lake may include:

• Medical detox: Patients detox from substances in a clinical environment where doctors monitor health and provide medications to ease withdrawal symptoms.
• Inpatient treatment: Patients in inpatient treatment live at our facility and attend a full schedule of individual and group therapy, counseling and peer support sessions.
• Partial hospitalization program (PHP): PHPs provide patients with additional flexibility and independence than inpatient programs.
• Intensive outpatient program (IOP): IOPs help patients transition to life outside of rehab, with fewer hours of care and more time building skills and habits for recovery.
• Outpatient treatment: Outpatient care provides ongoing treatment after an inpatient stay and supports patients as they transition back into their daily lives.
• Aftercare: Aftercare programs help support long-term recovery through clinical and medical recommendations for follow-up care, relapse prevention plans and more.

If you or someone you love is struggling with drug or alcohol addiction, help is available. The Recovery Village Palmer Lake is here to support you throughout the entire recovery process. It’s time to get your life back. Call our Recovery Advocates today.