abuse among military personnel returning from Iraq and Afghanistan has increased substantially since the start of the wars (Bray et al., 2009). Although there have been reductions in the use of tobacco and illicit drugs, the stress of multiple deployments has been linked with increases not only in heavy drinking but also in posttraumatic stress disorder, depression, and suicidal ideation and attempts (Blume et al., 2010; Bray et al., 2010; Marshall et al., 2012). In addition, new substances, such as “Spice” and “bath salts,” are posing new challenges for public health in both the civilian and military populations (Horgan et al., 2001; Rosenbaum et al., 2012; SAMHSA, 2011; U.S. Air Force Special Operations Command, 2011).

Outdated Policies

Another concern among some members of Congress was the outdated policies on SUD care that DoD and many of the branches continued to implement. Many of these policies had been drafted more than 10 years previously and had not been revised to reflect emerging knowledge on evidence-based practices for the prevention, screening and diagnosis, and treatment of SUDs. Table 1-1 displays the SUD policies in place when Senator McCaskill first introduced S. 459. Since Senator McCaskill and other

TABLE 1-1 Military Policies Addressing Substance Use Disorders as of February 2009

Policy Number Policy Name Date of Enactment

DoD Directive 1010.1

Military Personnel Drug Abuse Testing Program

9 December 1994a

DoD Directive 1010.4

Drug and Alcohol Abuse by DoD Personnel

3 September 1997a

DoD Instruction 1010.6

Rehabilitation and Referral Services for Alcohol and Drug Abusers

13 March 1985

DoD Directive 1010.9

DoD Civilian Employee Drug Abuse Testing Program

23 August 1988b

DoD Instruction 6490.03

Deployment Health

11 August 2006

Army Regulation 600-85

The Army Substance Abuse Program

2 February 2009

AFI44-121

Alcohol and Drug Abuse Prevention and Treatment (ADAPT) Program

26 September 2001

SECNAVINST 5300.28D

Military Substance Abuse Prevention and Control

5 December 2005

OPNAVINST 5350.4C

Drug and Alcohol Abuse Prevention and Control

15 October 2003

MCO P1700.24B

Marine Corps Personal Services Manual

27 December 2001

a Incorporating Change 1, January 11, 1999.

b Incorporating Change 1, January 20, 1992.



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