Substance Abuse in the Air Force

Key Takeaways

• Substance use in the Air Force is influenced by deployment, combat exposure, and military stressors.
• Alcohol misuse is common, with binge and heavy drinking being significant concerns.
• There is a high rate of comorbidity between PTSD and SUDs among military personnel.
• Substance use can lead to serious physical and mental health issues, impacting job performance and personal lives.
• Despite the availability of treatment programs, there is a stigma associated with seeking help for SUDs.
• The Air Force has implemented the ADAPT program to prevent and treat substance use.
• Disciplinary actions for substance use can include court-martial, NJP, administrative actions, and discharge.
• Future strategies may involve enhancing prevention and treatment programs and leveraging technology for support.

Substance Abuse Patterns in the Air Force

The prevalence of substance use within the Air Force is a multifaceted issue, influenced by various factors, including deployment, combat exposure, and the unique stressors associated with military life. Research has indicated that service members, particularly those who have been deployed to combat zones, are at an increased risk for developing substance use disorders (SUDs) compared to civilian populations.

Alcohol Misuse in the Air Force

Alcohol misuse is one of the most common forms of substance use in the military, with binge and heavy drinking being significant concerns. The 2015 Department of Defense Health Related Behaviors Survey (HRBS) highlighted that the patterns of binge and heavy drinking among service members were comparable to those in the general U.S. population. However, the military’s unique environment and the stigma associated with seeking treatment for SUDs can lead to lower rates of referral to treatment services despite the availability of programs tailored for active-duty personnel.

Co-Occurrence of Substance Use and Mental Health Disorders

Furthermore, the co-occurrence of post-traumatic stress disorder (PTSD) and SUDs is prevalent among military populations, with studies showing a higher rate of comorbidity than in the general population. This has prompted a focus on integrated treatment options that address both PTSD and SUD symptoms concurrently. The Air Force, like other branches of the military, has implemented various policies and programs aimed at preventing and treating substance use, including the use of evidence-based practices and trauma-informed care interventions.

Substance Abuse Prevalence in the Air Force

The Air Force, like other military branches, faces challenges with substance use among its personnel. Studies indicate that service members, especially those deployed to combat zones, are at a higher risk of developing substance use disorders (SUDs) compared to civilian populations. In particular, post-deployment periods show a marked increase in substance use, including alcohol and prescription medications, often linked to difficulties in transitioning back to civilian life and the onset of mental health conditions such as post-traumatic stress disorder (PTSD).

Statistical data highlights that individuals recently deployed to Iraq and Afghanistan 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. Furthermore, Reserve and National Guard personnel exhibit similar post-deployment increases in substance use problems. Despite these higher rates of substance use, there is a notable gap in referrals to SUD treatment services, largely attributed to stigma within the military community.

Commonly Abused Substances in the Air Force

The prevalence of substance use within the Air Force encompasses a range of substances, with alcohol and prescription medications cited as the most common. 

Alcohol misuse is a significant concern, as it is linked to various adverse outcomes, including mental health issues and increased risk of suicide. Binge drinking, in particular, is a behavior that stands out, with some reports indicating that one in three service members may engage in this practice. This compares to one in four individuals within the civilian population. This consumption pattern can lead to many problems, including legal issues and health ramifications. However, not all individuals who binge drink are considered to have an alcohol use disorder.

Prescription medication misuse is another area of concern, often involving medications that are either overprescribed or misused. The Air Force has established policies to prohibit the use of controlled substances and certain ingredients in dietary supplements, reflecting a commitment to curtail substance use among its ranks. Illicit drug use is reported to be relatively low, which is attributed to frequent drug testing and stringent penalties associated with drug offenses. Despite these measures, the issue of substance use persists, highlighting the need for continued efforts in prevention, education, and treatment within the military community.

Consequences of Substance Abuse Among Air Force Personnel

Substance use within the Air Force has significant implications for personnel, affecting their physical health, mental well-being, careers, and personal lives. Alcohol use disorder (AUD) is a particular concern, with evidence suggesting many service members do not receive adequate treatment. A report from the Department of Defense’s Inspector General highlighted that some members diagnosed with AUD received no care, and military culture often does not discourage alcohol use, with 68% of active-duty troops perceiving it as supportive of drinking. This environment can exacerbate issues related to anxiety, depression, and even suicidal ideation.

Physical Health Risks of Substance Abuse in Air Force Personnel

Substance use poses significant risks to the physical health of Air Force personnel, mirroring the dangers seen in the general population. The use of illicit drugs, prescription medications, alcohol, and tobacco can result in a wide range of health complications that not only impair an individual’s ability to perform their duties but also have long-term consequences. 

• Research indicates that substances like alcohol and tobacco are linked to cardiovascular problems and heart disease, which are particularly concerning in a profession that demands high physical fitness levels.
• Injection drug use can lead to serious infectious diseases such as HIV and hepatitis C due to shared needles or unsafe practices. 
• Inhalants may cause irreversible nerve cell damage, impacting both the brain and the peripheral nervous system.
• Substance use can lead to respiratory illnesses, particularly with substances like marijuana, which is known to impair lung function. 
• Stimulants, such as methamphetamine, can immediately affect blood pressure, increasing the risk of heart attack and stroke. 

It is crucial for Air Force personnel to be aware of these risks, as the physical demands of their role require optimal health. The Air Force implements rigorous policies and support systems to mitigate these risks and provide assistance to those in need of help with substance use issues.

Mental Health Implications of Substance Abuse Among Air Force Personnel

Substance use within the Air Force has significant mental health implications for service members, particularly those with combat exposure. Research indicates that personnel returning from deployments exhibit markedly higher rates of substance use disorders (SUDs) than their civilian counterparts, with a 2013 study revealing that 44% of returning service members faced challenges transitioning back to civilian life, including the development of problematic substance use behaviors. 

Comorbidity of PTSD and SUDs

The prevalence of co-occurring post-traumatic stress disorder (PTSD) and SUDs is particularly high in military populations, with recent data indicating that 58% of individuals seeking treatment for alcohol use disorder also meet the criteria for PTSD. This comorbidity can severely impact mental health, leading to an increased risk of suicide, depression, and anxiety. The military has recognized the need for integrated treatment approaches that address both PTSD and SUD symptoms concurrently, advocating for evidence-based practices and trauma-informed care interventions across all service branches.

Impact of Substance Abuse on Air Force Careers

Substance use within the Air Force can significantly affect an individual’s military career. Despite efforts to normalize treatment-seeking behaviors, stigma and systemic issues persist. A report from the Department of Defense’s Inspector General highlighted that service members diagnosed with alcohol use disorder often did not receive adequate treatment, and some received no care at all. This lack of support can lead to further health complications, such as anxiety, depression, and suicidal thoughts, which can impair job performance and readiness.

Career Barriers to Treatment in the Air Force

Commanders are mandated to refer airmen to the Alcohol and Drug Abuse Prevention and Treatment (ADAPT) program when substance use is suspected to be a factor in misconduct. However, participation in ADAPT can lead to temporary deployment restrictions and duty limitations, which can impact career progression. High-ranking officers have begun sharing their own experiences with treatment to reduce stigma and demonstrate that careers do not have to be negatively impacted by seeking help. Still, the fear of career repercussions remains a barrier for many service members.

The Air Force’s policies on substance use are strict, with the intent to maintain high standards of performance and discipline. As such, substance use can lead to disciplinary actions, including discharge, which can abruptly end a service member’s career and complicate their transition to civilian life.

The Effects of Substance Abuse on Air Force Personnel’s Personal Lives

Substance use among Air Force personnel can profoundly impact their personal lives, affecting relationships, financial stability, and overall quality of life. The use of substances, particularly alcohol and prescription medications, may initially serve as a coping mechanism for stress or trauma but often escalates to addiction, leading to a pattern of behavior that disrupts daily functioning. Substance use can also increase the risk of mental health disorders such as PTSD, depression, and anxiety, which have been linked to higher rates of divorce, domestic violence, and social isolation among veterans. Additionally, the financial burden of substance use, including the costs associated with healthcare, legal issues, and potential loss of employment, can be significant. 

Air Force Substance Abuse Policies and Programs

The Air Force is committed to maintaining the health and readiness of its personnel through comprehensive substance use policies. 

Air Force Substance Abuse Prevention Programs

The Air Force has implemented a comprehensive approach to combat substance use through its Alcohol and Drug Abuse Prevention and Treatment (ADAPT) program. ADAPT’s primary goal is to promote readiness, health, and wellness by preventing and treating substance misuse among Air Force personnel. The program offers a multifaceted strategy that includes education, treatment, and preventive measures to minimize the negative consequences of substance misuse on individuals, families, and the organization as a whole.

ADAPT’s Key Components

Key components of the ADAPT program include:

• Policy development and operational guidance to Major Commands.
• Collaboration with the Department of Defense, Air Force, and civilian agencies.
• Comprehensive education on substance misuse.
• Treatment services to restore function and return individuals to unrestricted duty.
• Self-referral options for Airmen seeking help without facing disciplinary actions.
• Integrated Primary Prevention Workforce (IPPW) to support leadership in policy crafting and program implementation.

Additionally, the ADAPT program mandates participation for any Air Force member suspected of or tested positive for substance use, with refusal to participate leading to potential administrative actions and separation from the Air Force. Civilian employees are also eligible for the program, emphasizing the inclusive nature of ADAPT’s support network. For more information or help with substance use, Air Force personnel can reach out to their base’s mental health clinic or chaplain corps.

Disciplinary Actions for Substance Abuse in the Air Force

The United States Air Force maintains a stringent policy regarding substance use among its personnel, reflecting the serious nature of such violations. While specific penalties can vary depending on the circumstances of the offense, they typically involve a combination of disciplinary actions and could lead to discharge from service. The Uniform Code of Military Justice (UCMJ) outlines the legal framework for handling substance use violations, which can include court-martial, non-judicial punishment, or administrative actions:

• Court-Martial: A service member may face a court-martial for serious offenses, which can result in imprisonment, fines, and dishonorable discharge.
• Non-Judicial Punishment (NJP): For less severe infractions, NJP under Article 15 of the UCMJ allows commanders to impose disciplinary measures without a court-martial. Penalties may include reduction in rank, restriction to base, extra duties, and forfeiture of pay.
• Administrative Actions: These can include mandatory substance use treatment programs, administrative discharge, or other corrective measures.
• Discharge: Depending on the severity and circumstances, a service member may be administratively separated with a characterization of service that could impact future veterans’ benefits and employment opportunities.

It is important to note that the Air Force promotes treatment and rehabilitation programs for those struggling with substance use, emphasizing support and recovery as part of its overall approach to maintaining a fit and ready force.

Strategies for Combating Substance Abuse in the Air Force

The Air Force, like other branches of the military, faces unique challenges in addressing substance use among its personne and is compelled to evolve its strategies to combat these issues effectively. Future directions may include enhancing existing prevention and treatment programs, incorporating evidence-based practices, and leveraging technology for better outreach and support:

• Targeting high-risk populations: Prevention programs could be strengthened by targeting high-risk populations, such as young recruits, through tailored interventions like Brief Alcohol Interventions (BAIs). These have shown efficacy in reducing alcohol use among young adults and could be adapted for the military context. 
• Increasing drug testing: Increasing the frequency and comprehensiveness of drug testing could act as a deterrent against illicit substance use.
• Using evidence-based therapies: Treatment programs may benefit from integrating a broader range of evidence-based therapies, such as Cognitive Behavioral Therapy (CBT), and ensuring continuity of care through coordination with primary healthcare providers. 
• Expanding services: The Air Force’s Alcohol and Drug Abuse Prevention and Treatment (ADAPT) program can serve as a platform for expanding services and support systems for airmen in need.
• Facilitating access to resources and education: Technology can play a pivotal role in future efforts by facilitating access to mental health resources and substance use education. Digital platforms can offer anonymous support, reduce stigma, and provide a safe space for airmen to seek help. 
• Developing a tracking system: The implementation of a comprehensive tracking system for alcohol and drug-related events could also enable better monitoring and early intervention.

Most of all, fostering a culture that encourages help-seeking behavior without fear of stigma or career repercussions is critical. This requires policy changes that protect the careers of those seeking help and promote a supportive environment for recovery and rehabilitation.

Addiction and Mental Health Treatment at The Recovery Village at Baptist Health

The Recovery Village at Baptist Health is an industry-leading treatment provider for addiction and co-occurring mental health disorders. Our clinicians are specially trained in trauma-informed care, military culture and treating veteran-specific addiction and mental health needs. We’re also proud members of the VA Community Care Network, so we can accept VA health benefits as payment at no cost to the veteran.

If you’re a veteran struggling with alcohol or drug addiction, our physician-led, private rehab program could be your path to recovery. Call us today and request a specialized Veteran Advocate to assist you.