In 2012, a young serviceman received a “good” rating from an unlicensed counselor at Fort Sill’s alcohol and substance abuse program in Oklahoma. Two hours later, the solider hanged himself. This man’s death isn’t an isolated episode: At least 24 other suicides in the Army have been linked to substandard substance abuse treatment in recent years, USA Today reports.
As these tragic events suggest, when it comes to providing treatment for our servicemen and women who suffer from alcohol and substance use problems, the stakes are extraordinarily high. With skillful care, soldiers can recover sobriety, gain critical life skills, and continue active service. Without it, they may spiral downward, putting their relationships, careers, and lives at risk.
Unfortunately, an in-depth investigation by USA Today revealed last week that the Army’s Substance Abuse and Treatment Programs are in disarray. Tensions began escalating in 2010, when the Army shifted command of the program from medical to nonmedical leadership. Since then, sources in the article allege, program goals have shifted from an emphasis on the treatment of each individual to filling “slots” and getting reports in on time. The result has been an exodus of experienced clinicians, increasing vacancies, eroding care, subsequently, poorer outcomes for many of the 20,000 troop members referred to the programs each year. What’s more, as many as 3,500 soldiers whose screenings show they need help have been turned away from treatment.
Adding insult to injury, those who can’t recover under these conditions risk a less than honorable discharge. This loss of status can mean the loss of benefits and can leave personnel ineligible for many civil service jobs, including those in law enforcement. It’s no wonder that many service members fail to seek help when they need it.
Americans are well aware that countless veterans have struggled with addiction and excessive alcohol use. Less well known is the fact that the problems often begin during active duty. The stress of repeated deployments, long absences from loved ones, combat exposure, and, for too many women, sexual assault, all take their toll. Additionally, soldiers dealing with chronic pain are routinely prescribed painkillers, sometimes as part of a cocktail of antidepressants, sleeping pills, and anti-anxiety medications. Not surprisingly, abuse of prescription pills in the military has grown from 2 percent in 2002 to 11 percent in 2008, according to a 2012 Institute of Medicine report. Soldiers wind up discharged, often in chronic pain and with an opioid addiction. Some turn to the street drugs or the bottle.
As the director of mental health and military services for Phoenix House, I understand how complex treatment can be for both active duty personnel and veterans. Many also suffer not only from addiction, but also post-traumatic stress, depression, and traumatic brain injury. They need high quality evidence-based treatment, along with care for co-occurring disorders, not a mindset that minimizes their needs or prioritizes case management. Just as we routinely provide state-of-the-art care to our physically injured service members, so should we care for their equally impaired brethren.
Despite USA Today’s revelations, I know that military commanders care deeply about this issue. Leaders in the Army War College and others have reached out to Phoenix House for our insights on helping their service members, and they are committed to addressing this problem. They need to start with fixing the Army’s treatment program and returning to appropriate standards of care, ideally under the command of medical leadership. Additionally, more needs to be done to reduce the stigma of receiving help. Soldiers should not have to fear losing their benefits and possibly being denied the option of a civil service job because they seek treatment for substance abuse. Similarly they should not be penalized for finding themselves in the catch-22 of becoming addicted to opioids that military doctors prescribe.
They also need more intensive screening and access to more services while they’re in the military. To do this, the Armed Forces must do more to engage outside organizations such as Wounded Warrior Project and Boots on the Ground New York, and nonprofit treatment providers who want to get involved. Military families and others can also advocate for improved treatment and services. For instance, Phoenix House has partnered with many Veterans Administration Hospitals and other treatment providers to ensure there are lists of services for veterans and family members. Active duty personnel need the same resources.
Our military men and women put their lives on the line. They have served our country and deserve to be able to function in society and jobs in a healthy and substance-free way. Americans need to pull together and make sure that the substance abuse treatment in the Armed Forces is an avenue of hope, before one more member loses his life in despair.
Vice President and Director of Mental Health and Military Services