of the committee’s key findings regarding the programs and policies that address prevention, screening, diagnosis, treatment, and management of SUDs within the armed forces. Other findings on access to and utilization of programs and the TRICARE benefit used to provide SUD coverage for military dependents and on the adequacy of the workforce are presented in Chapters 7 and 8, respectively. The review of programs and policies in this chapter and Appendix D, along with the findings presented in Chapters 7 and 8, serves as a foundation for the conclusions and recommendations presented in Chapter 9.

DEPARTMENT OF DEFENSE

This section reviews the policies outlined in DoD’s Comprehensive Plan, and others the committee identified, pertaining to SUD prevention, screening, diagnosis, and treatment at the DoD-wide level.

Prevention

The committee made use of the best-practice elements for SUD prevention discussed in Chapter 5 to assess the adequacy and appropriateness of DoD and branch SUD policies and programs. In summary, evidence-based SUD prevention (1) addresses the appropriate risk and protective factors for the population in question, (2) employs approaches with demonstrated effectiveness, (3) takes place at the appropriate time chronologically and developmentally, (4) makes use of proper settings and domains for delivery, and (5) manages programs effectively (Office of National Drug Control Policy, 2001).

Two DoD policies—DODD 1010.1 and DODD 1010.4 (DoD, 1994, 1997)—articulate DoD’s interest in preventing and eliminating alcohol and other drug abuse and dependence in service members and employees because the disorders are incompatible with readiness. As a result, DoD seeks to “deter and identify drug and alcohol abuse and dependence,” and will not take into service military personnel or hire civilians who present with these disorders (DoD, 1997). The policies call for the provision of education to ensure that personnel understand the implications of not adhering to DoD alcohol and other drug use policies.

DODD 1010.1 guides the Military and Civilian Drug Testing Program and requires urinalysis screening to detect illicit drug use among active duty service members. Urinalysis screening deters drug use because of the consequences of positive results. However, use of random urinalysis to deter drug use has limitations, as use of substances not included in the testing panel or not included on a routine basis may not be detected. In addition, if the screening is not performed randomly or is anticipated, individuals



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