policy notes (Chapter 7, section I) that substance abuse and dependence are preventable and treatable and states that military personnel who abuse alcohol should receive education, counseling, and rehabilitation services. Self-identification is the preferred mode of identification, but Command referral is more common. Positive identification of alcohol abuse and dependence requires referral to ASAP in order to return the service member to “full duty status.” Although DoD policies identify alcohol and other drug abuse and dependence as chronic conditions, AR 600-85 permits only “one period of rehabilitation” per alcohol incident. In exceptional cases, commanders may recommend a second period of rehabilitation. Any alcohol-related incidents occurring after two rehabilitation periods require separation. According to the policy, soldiers identified as drug abusers are referred to ASAP, and a diagnosis of drug dependence leads to detoxification and treatment while separation procedures are initiated. AR 600-85 (U.S. Army, 2009, p. 47) asserts that soldiers diagnosed as drug dependent “generally, do not have potential for continued military service and should not be retained.”
AR 600-85 describes six different methods of identification of alcohol and other drug abuse and dependence: (1) voluntary (self-referral), (2) Command referral, (3) drug testing, (4) alcohol testing, (5) medical referral, and (6) investigation and apprehension. As noted, voluntary disclosure is the preferred method of identification, and commanders must be involved in the process of evaluation. Commanders should encourage self-identification and avoid actions that would discourage personnel from seeking help. Civilian employees and family members seeking help should be offered employee assistance program evaluation. Commander identification, drug and alcohol testing identification, and identification through investigation and/or apprehension lead to referral to ASAP. Referrals to ASAP are required within 5 duty days of receipt of test results. If identification occurs during a routine medical screening, the provider should refer the soldier to ASAP and notify the commander. In the case of identification of a problem in a civilian employee or family member, the referral should be to the employee assistance program.
Overall, the methods of identification described in the policy are comprehensive, and the emphasis on encouraging self-referral is constructive. The specification of the number of days within which referral to the ASAP program should be made strengthens the policy. Still, the policy is vague regarding identification methods, especially during routine medical exams. As suggested above, commander involvement and disclosure of self-referral to commanders by health care providers may discourage rather than encourage self-disclosure because it gives commanders access to in-depth confidential information about soldiers’ alcohol and other drug abuse and dependence.