In order to better understand current substance use problems within the U.S. military, the Department of Defense (DoD) asked the Institute of Medicine (IOM) to analyze policies and programs that pertain to prevention, screening, diagnosis, and treatment of substance use disorders (SUDs) for active duty service members in all branches, members of the National Guard and Reserve, and military families.
Service members’ rising rate of prescription drug addiction and their difficulty in accessing adequate treatment for alcohol and drug-related disorders were among the concerns that prompted members of Congress to request this review.
The IOM committee presented its findings and recommendations in a report Substance Use Disorders in the U.S. Armed Forces.
While rates of both illicit and prescription drug abuse are low, the rate of medication misuse is rising. Just 2 percent of active duty personnel reported misusing prescription drugs in 2002 compared with 11 percent in 2008. The armed forces’ programs and policies have not evolved to effectively address medication misuse and abuse, the committee noted.
TRICARE, which provides health insurance to service members and their dependents, does not cover several evidence-based therapies that are now standard practice, the committee found. It also does not permit long-term use of certain medications for the treatment of addiction and covers treatment delivered only in specialized rehabilitation facilities.
The report recommended that TRICARE’s benefits should be revised to cover maintenance medications and treatment in office-based outpatient settings delivered by a range of providers, which would enable ongoing care for patients struggling to avoid relapses.
Data from fiscal year 2010 shows that only 6 active duty service members received methadone treatment for opioid addiction averaging a 42-day supply. A total of 405 active duty service members received buprenorphine treatment averaging an 89 day supply.
Medications for Addiction Treatment Given to Active Duty Service Member and Active Duty Family Member Adult Dependent Beneficiaries (Aged 18 and Over),
All Systems of Care (FY 2010)
|Active Duty Service Members||Active Duty Family Members|
|Medication||Sum of Days Supply||# Users||Sum of Days Supply||# Users|
Source: Personal communication, Greg Woskow, TRICARE Management Activity, May 7, 2012.
The press release can be accessed at: http://www.iom.edu/Reports/2012/Substance-Use-Disorders-in-the-US-Armed-Forces/Press-Release.aspx
The report brief can be accessed at: http://www.iom.edu/Reports/2012/Substance-Use-Disorders-in-the-US-Armed-Forces/Report-Brief.aspx
The full report can be accessed at: http://www.nap.edu/catalog.php?record_id=13441
Sources: Institute of Medicine and National Academy Press – September 17, 2012