in order to refine future programming. Based on these findings, the committee makes the following recommendation with regard to access to care for reserve component members:

Recommendation 9: DoD should establish a joint planning process with the VHA, with highly visible leadership (perhaps recently retired military personnel), to address the SUD needs and issues of access to care of reserve component personnel before and after mobilization.

Given that DoD and the individual service branches have the added challenge of providing SUD care to service members and their dependents in remote locations and deployment settings, innovative service delivery methods should be explored. Increasing the use of technology in care for SUDs has the potential to substantially reduce counselor workloads and permit more effective and efficient treatment. DoD has an admirable track record in the implementation and adoption of new technology, and should explore the use of technology for prevention, assessment, treatment, and continuing care for SUDs. With the use of Internet technology, for example, patients can participate remotely in prevention courses, treatment groups, counseling sessions, or continuing care, even when deployed. The committee makes the following recommendation with regard to increasing the use of technology:

Recommendation 10: DoD and the individual service branches should evaluate the use of technology in the prevention, screening, diagnosis, treatment, and management of SUDs to improve quality, efficiency, and access.

Changing SUD Workforce Requirements

Since the 1970s, the SUD patient population has become considerably more complex: poly-substance use has become common, the rates and severity of psychiatric and medical comorbidities have increased, and SUD services have increasingly become integrated with behavioral health and primary care services. The committee found high levels of comorbid mental health disorders among active duty service members, reserve component members, and their dependents who seek care for alcohol and other drug use disorders. Accepted standards of care for the treatment of SUDs and other mental health disorders in the civilian sector rely on multidisciplinary teams led by licensed independent practitioners. Licensed independent practitioners complete multidimensional assessments (which include assessments of mental and physical disorders), develop comprehensive treatment plans, and provide integrated SUD and mental health treatment

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