Substance Abuse in the Air Force

Key Takeaways

• Alcohol misuse is a significant issue in the Air Force, with binge drinking being notably prevalent among service members.
• The suicide rate among Airmen has increased, with a 33% rise in 2019, and substance use disorders are more common among those exposed to combat or trauma.
• Commonly misused substances in the Air Force include alcohol, prescription medications, tobacco, and illicit drugs, with strict policies and frequent drug testing in place.
• Alcohol misuse trends show that Airmen under 21 report an average of 18.4 drinks per week, exceeding recommended guidelines and indicating risky drinking behaviors.
• Illicit drug use in the Air Force is lower than in civilian populations, but the rise in synthetic opioid misuse, such as fentanyl, is concerning.
• Substance misuse has significant impacts on Air Force personnel, including increased risk for mental health issues, health complications, and career consequences.
• The Air Force’s substance use policies focus on prevention, disciplinary action, and support, with programs like ADAPT and the Air Force Wounded Warrior Program.
• ADAPT program offers education, treatment, and rehabilitation for substance misuse, encouraging self-referral and commander referrals.
• Disciplinary actions for substance use can range from administrative measures to discharge, depending on the severity of the offense.
• Support and rehabilitation programs are available for Air Force personnel, including the VA’s substance use programs and the Comprehensive Assistance for Family Caregivers program.

Substance Abuse Prevalence in the Air Force

Substance abuse remains a significant concern within the Air Force, despite stringent policies and regular drug testing aimed at reducing illicit drug use. Alcohol misuse is particularly prevalent, often used by Airmen as a coping mechanism for stress and trauma, supported by military culture’s acceptance of drinking. Binge drinking, defined as consuming enough alcohol to reach blood alcohol levels of 0.08% or higher, affects approximately one in three service members, surpassing rates in the civilian population.

Key Points:

• Alcohol Misuse: Airmen frequently turn to alcohol to cope with stress and trauma, contributing to high rates of binge drinking.
• Suicide Rates: The Air Force has seen a 33% increase in suicide completions in recent years, reflecting significant mental health challenges.
• Mental Health Impact: PTSD, depression, and anxiety are prevalent among veterans, particularly those exposed to combat, correlating with higher rates of substance use disorders.
• Prevention and Treatment: Initiatives like the Air Force Wounded Warrior Program and VA’s Comprehensive Assistance for Family Caregivers focus on supporting Airmen and veterans with substance use disorders and co-occurring mental health issues.
• Destigmatization Efforts: Efforts to reduce stigma around seeking help include sharing personal recovery stories to promote treatment uptake and maintain military readiness.

This structured approach highlights the Air Force’s efforts to address substance abuse and mental health challenges, emphasizing prevention, treatment, and support for personnel and veterans.

Commonly Abused Substances in the Air Force

Substance misuse presents significant challenges within the Air Force, paralleling issues seen across other military branches. Key substances commonly misused include alcohol, prescription medications, tobacco, and illicit drugs. Alcohol misuse is notably prevalent, with studies indicating that military personnel spend more days using alcohol than any other profession, and binge drinking is a critical concern.

• Alcohol Misuse: Airmen often use alcohol as a coping mechanism, leading to high rates of binge drinking which exceed recommended guidelines.
• Prescription Drug Misuse: Opioids like Vicodin and stimulants such as Ritalin and Adderall are commonly misused, and due to their increased use, careful prescription and monitoring are needed.
• Tobacco Use: Despite efforts to reduce tobacco use, it remains widespread among veterans and active-duty personnel.
• Illicit Drug Use: Strict policies and drug testing contribute to lower rates of illicit drug use compared to civilians, but challenges persist.

Alcohol Abuse Trends and Prevention in the Air Force

Alcohol misuse is a critical concern within the Air Force, impacting both health and operational readiness. Airmen, especially those under 21, frequently exceed recommended alcohol consumption limits, highlighting pervasive risky drinking behaviors. Brief Alcohol Interventions (BAIs) are employed to address this issue, targeting incidents such as underage drinking and impaired driving, though challenges remain in altering entrenched cultural norms.

Illicit Drug Use Trends in the Air Force

Illicit drug use remains a significant concern despite stringent policies and frequent testing. The rise in fentanyl-related deaths underscores a broader national crisis, prompting intensified efforts to combat opioid misuse.  According to the Defense Department, the number of military deaths involving fentanyl doubled between 2017 and 2021, reflecting a broader national trend. The Air Force continues to refine its strategies to mitigate drug-related risks and uphold the safety and readiness of its personnel. These measures contribute to a lower rate of illicit drug use compared to the civilian population, as outlined in a 2015 Department of Defense Health Related Behaviors Survey. 

Consequences of Substance Abuse Among Air Force Personnel

Substance abuse within the Air Force profoundly affects personnel across physical health, mental well-being, and career trajectories. Service members, especially those deployed to combat zones, face heightened risks of developing substance use disorders (SUDs), particularly alcohol use disorders, which are nearly double compared to the general population. Co-occurring PTSD exacerbates these challenges, with a majority of those seeking help for alcohol use disorder also meeting PTSD criteria.

• Increased Risk: Deployed personnel are more likely than civilians to receive diagnoses of SUDs, reflecting higher rates of alcohol use disorders.
• Dual Diagnosis Impact: PTSD and SUDs often co-occur, amplifying risks for depression, anxiety, and other mental health issues.
• Physical Health Complications: Substance use contributes to a spectrum of health complications, potentially impairing operational readiness.
• Career Consequences: Substance abuse can lead to disciplinary actions, loss of security clearances, and discharge from service, impacting long-term career prospects.
• Treatment Barriers: Stigma and perceived career repercussions deter personnel from seeking SUD treatment, underscoring the need for enhanced support and access to evidence-based interventions.

This overview highlights the complex impacts of substance abuse on Air Force personnel and underscores the importance of effective prevention and treatment strategies to safeguard both individual well-being and operational effectiveness.

Policies and Support Systems: Air Force Substance Abuse

The United States Air Force maintains rigorous policies and robust support systems to address substance use among its personnel, focusing on prevention, education, and treatment to safeguard readiness and well-being.

Substance Abuse Prevention Programs in the Air Force

• ADAPT Program: Mandated by Air Force Instruction 44-121, ADAPT (Alcohol and Drug Abuse Prevention and Treatment) is pivotal in promoting awareness and providing education on substance misuse. It offers comprehensive treatment services aimed at restoring function and enabling a return to unrestricted duty.
• Education and Awareness: ADAPT emphasizes early identification and rehabilitation of service members dealing with substance use issues, encouraging self-referral and commander referrals without career repercussions.
• Collaborative Approach: The program collaborates with DoD, Air Force, and civilian agencies to ensure a holistic approach to prevention and treatment, reducing stigma associated with seeking help.

Disciplinary Actions for Substance Abuse in the Air Force

• Enforcement of Policies: Air Force policies, outlined in AFI 36-2907, employ measures such as UIF, control rosters, LORs, LOAs, and LOCs to document and address misconduct related to substance use.
• Commander’s Role: Commanders have authority to refer personnel to ADAPT when substance misuse is suspected, ensuring disciplinary actions align with maintaining discipline and readiness.
• Discharge Considerations: Misconduct related to substance use may lead to discharge, assessed based on an individual’s military record and the severity of the offense.

Support and Rehabilitation Programs for Air Force Personnel

• ADAPT Program Support: ADAPT offers treatment and rehabilitation efforts without adverse career consequences for self-referrals, promoting proactive help-seeking behaviors among service members.
• Air Force Wounded Warrior Program: Provides specialized support for mental health disorders and substance use issues, addressing the unique needs of wounded, ill, or injured personnel.
• Veteran Support: Veterans benefit from tailored programs such as Salute to Recovery and VA substance use programs, ensuring comprehensive care including mental health support.
• Family Caregiver Support: The Comprehensive Assistance for Family Caregivers program offers holistic support, including stipends, healthcare, and training, enhancing the caregiving environment for veterans.

Types of Misconduct explains the discharge process in more detail. Through these initiatives, the Air Force upholds its commitment to maintaining the health, readiness, and resilience of its personnel by addressing substance use with proactive policies and comprehensive support systems. 

Case Studies on Substance Abuse in the Air Force

The prevalence of substance use within the Air Force can be better understood through case studies that shed light on the personal and systemic challenges faced by service members. These real-world scenarios reveal the intricacies of substance misuse and its impact on individuals and military readiness:

• Higher Risk Among Combat Personnel: Research indicates military personnel, especially those with combat deployments, are at a heightened risk of developing substance use disorders (SUDs) compared to civilians. Many face challenges during the transition back to civilian life, often compounded by co-occurring PTSD.
• Military Culture and Alcohol Use: Case studies highlight that a significant percentage of active-duty troops find the military culture inadvertently supportive of alcohol use, posing challenges despite the Air Force’s comprehensive Alcohol and Drug Abuse Prevention and Treatment (ADAPT) program.
• Successes in Smoking Cessation Programs: Studies from the National Institute on Drug Abuse (NIDA) show decreased smoking rates among military personnel due to targeted prevention strategies and cessation programs, demonstrating effective interventions amidst military-specific stressors.

These case studies underscore the need for ongoing adaptation and improvement in substance abuse prevention and treatment strategies within the Air Force to better support the well-being of service members.

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