Substance Use Disorders in the Military: The Perspective of the National Institute On Drug Abuse

Over 2 million service members have been deployed in support of the war efforts in Afghanistan (Operation Enduring Freedom) and Iraq (Operation Iraqi Freedom; OEF/OIF) and U.S. military personnel, veterans and their families have endured many challenges since September 11, 2001.  They include the separation of families for long periods of time, military personnel experiencing long and often multiple deployments, and for some there have been injuries and fatalities.  Epidemiological reports indicate that military personnel returning from OEF/OIF experience increased difficulties, including traumatic brain injury, post traumatic stress disorder, depression, anxiety, alcohol abuse, and non-medical use of prescription drugs.  Those who served in the reserve and National Guard and their families have been identified at increased risk, for they have less access to military support systems, health care, and fewer connections to other military families.   The National Institute on Drug Abuse (NIDA) has been involved since 2008 in an initiative focused on substance use and comorbid disorders in military personnel, veterans and their families.  This included leading multi-agency funding opportunities in which $6 million in grants were funded that focused on substance abuse and comorbid mental health problems in military personnel, veterans and their families.  The 2012 Institute of Medicine report on “Substance Use Disorders in the Armed Forces” recommended that the Department of Defense (DoD) and the individual branches of Service should implement a comprehensive set of evidence-based prevention programs and policies that include universal, selective, and indicated intervention.  The need for research in this area is great and provides an opportunity for prevention scientists to become involved by adapting and testing known efficacious and effective prevention interventions and implementing them with military personnel, veterans and their families.