12/11/2012

Military cracks down on alcohol abuse amid age-old binging habit

By Bill Briggs, NBC News contributor

Officials within the U.S. military are actively targeting over-boozing troops at home and abroad, but addiction specialists and service members say binge drinking remains as rampant as ever inside the armed services.

Among the new initiatives to stem the problem: The Marines, starting next year, will give random breathalyzer tests to Corps members; the Air Force and Army curbed some overnight liquor sales for U.S. military personnel in Germany; and American service members in Japan were barred from leaving their residences after consuming more than one adult beverage.

The restrictions seem to have been independently created by brass within each branch — for example, the new rules for service members in Japan follow the October sexual assault of an Okinawa woman allegedly carried out by two U.S. sailors. Still, the fresh regulations arise three months after a study commissioned by the Department of Defense found that binge drinking by active-duty troops now constitutes "a public health crisis," noting as well that drunken soldiers were cited as a problem as far back as the Revolutionary War.

"But we can do better," said Dr. Charles P. O'Brien, chairman of the panel that authored the report and director of the Center for Studies of Addiction at the University of Pennsylvania. "We have a lot of research, a lot of medication, and a lot of techniques that have been developed over the years. We don't have to be stuck in the old ways of handling things.


"We found, though, that in the whole Army, there's only one doctor who's trained in addiction medicine. This is a specialty where we need more people and they're not there. So, most people are not getting treated with evidence-based medicine," O'Brien told NBC News. The study was issued by the Washington, D.C.-based Institute for Medicine.

Worse, O'Brien said he has learned — from emails he received in recent days from active-duty personnel — that one of the study's most simple suggestions has not been implemented: that the military's health system, TRICARE, alter its rules and allow substance-abusing service members to be treated with anti-addiction medications like Suboxone.  

"We met a general who is on Suboxone but they (military doctors) are not letting other people have it," O'Brien said. "It's ridiculous ... When we briefed (military leaders in September), they expressed interest in following our recommendations. But, so far, I don't have any concrete evidence that anything has happened." 

NBC News asked the Department of Defense to list which, if any, of the panel's recommendations have been installed to date. 

"The Department of Defense appreciates the hard work of the Institute of Medicine in assessing substance abuse programs and policies in the Military Health System," Cynthia O. Smith, a DoD spokeswoman, responded in an email. "We are in the process of analyzing their findings and recommendations, but most importantly, we want to do the right thing for the Service member. If there are areas in need of improvement, then we will work to improve those areas. The health and well-being of our Service members is paramount."

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The agency has a stated policy to "prevent and eliminate drug and alcohol abuse and dependence from the Department of Defense." The U.S. military, therefore, screens for problem drinking, provides treatment for those identified with alcohol or drug problems, and is working to "change attitudes toward binge drinking," Smith said, adding that "such abuse and dependence are incompatible with readiness, the maintenance of high standards of performance, and military discipline."

Indeed, in its analysis of boozing on military bases, the Institute of Medicine found that 47 percent of active-duty personnel engaged in binge drinking during 2008 (the most recent year for which data was available), and the authors concluded the use of alcohol and other drugs are "currently at unacceptably high levels," making it "detrimental to readiness and total force fitness." 

Military members like Marine Sgt. Thomas Brennan, who joined in 2004 and who later served in Iraq and Afghanistan, describe drinking as a staple of life in uniform. He knows of several recent drunken-driving arrests involving his Marine buddies or his former unit members, he said.  

"With the amount of recreational drinking that goes on, it's like peer pressure times 10," said Brennan, 27. "Everybody's drinking. The Marine Corps is a brotherhood. You want to be part of that brotherhood, and your brothers are doing it. Nobody forces you to do it but the inclination to do it is pretty strong."

In a New York Times blog published in October, Brennan wrote that the "golden rule" among Marine officers and non-commissioned officers seems to be: "If you're going to partake, do so behind closed doors and keep your mouth shut about it. I have heard many leaders tell under-age Marines that if they were going to drink that they should keep their doors locked and be smart about it. Only when they were caught were they told not to do it."

"I couldn't tell you how many times I've heard that over the years," Brennan told NBC News on Monday. "I wasn't perfect either. I let it go on."

The September study on alcohol abuse within the military also chastised the armed services for allowing "ready access to relatively inexpensive alcohol on military bases." 

At Camp Lejeune, where Brennan was stationed, convenience stores contain large refrigerators stocked with domestic and imported beers, sold tax free. A six-pack of Stroh's, for example, costs about $4, he said.

On base, Marines also can purchase "Military Special" liquors, a cut-rate brand of liquor, including vodka and whiskey, that goes for about $6.50 per liter. At AR15.com, a firearms website popular with military members, one commenter described Military Special booze as: "No good for sipping, but for shots it works;" another said: "I am not sure I would clean battery terminals with that crap." 

One combat-related factor exacerbating the overindulgence of alcohol is Post-Traumatic Stress Disorder. In September, the Institute of Medicine reported that Iraq and Afghanistan veterans diagnosed with PTSD have alcohol-abuse rates that are twice as high as those found among civilian young adult males.

Brennan was diagnosed with PTSD and said that self-medicating with alcohol caused him to suffer a "short-lived drinking problem" after he returned from Iraq.  

"You're already depressed because of the PTSD. Alcohol's a depressant. A lot of guys with PTSD just got angry (when they drank) and did dumb stuff, like fighting," Brennan said in a phone interview. "We had one guy throw his refrigerator off the third deck one night when he was drinking. But I don't know if that was PTSD, or just him being a crazy drunk."

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