with prevention and awareness training (U.S. Army, 2009). Prevention and awareness training includes information on “a) ASAP policies and services, b) consequences of alcohol and other drug abuse, and c) incompatibility of alcohol and other drug abuse with physical and mental fitness, combat readiness, Army Values, and the Warrior Ethos” (U.S. Army, 2009, p. 55). Training to sustain and improve prevention counseling and training also is emphasized as a mission-wide effort. Specifically, the policy requires cooperation and partnerships with the installation and local communities and the availability of information about counseling and other substance abuse services at the installation. Deglamorization of alcohol is viewed as essential, and marketing and promotion of practices that glamorize alcohol use are prohibited. Commanders and supervisors are trained to identify early substance abuse problems among their personnel. The Army Training System incorporates alcohol and other drug abuse education and is compatible with the indoctrination of recruits in standards of discipline, performance, and behavior.

Drug testing is part of the prevention program, with detailed requirements for urine sample collection, screening of tests, breath testing, and personnel training. The policy extends substance abuse awareness training to all civilian employees and drug testing to those in designated positions (e.g., Department of Transportation [DOT] personnel). Prevention programs are encouraged for families, retirees, and off-duty contract personnel and their families, as well as for K-12 schools associated with military installations. ASAP is specifically authorized to purchase promotional items to encourage prevention (e.g., T-shirts, mugs, pens), particularly in connection with prevention campaigns (e.g., Red Ribbon Week, Warrior Pride, National Alcohol Awareness month). However, the committee did not identify any published peer-reviewed articles evaluating the effectiveness of these prevention campaigns and activities in military populations. Training in healthy life choices, responsible decision making, Army values, and alternatives to alcohol all reinforce the mission of preventing alcohol and other drug abuse. ASAP establishes goals and milestones in annual prevention plans and evaluates methods and outcomes of prevention activities. (The committee did not receive copies of evaluation reports or data on outcomes of prevention services.) Army policy states that prevention programs must be science based and focuses on deterrence through drug testing and law enforcement (i.e., eliminating supplies of illegal drugs, enforcing laws on driving under the influence and underage drinking).

Screening, Diagnosis, and Treatment

Chapter 7 of AR 600-85 addresses identification, referral, and evaluation of substance use, abuse, and dependence (U.S. Army, 2009). The

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