Substance Abuse in the Reserve and National Guard

Key Takeaways

• Substance abuse is a significant issue within the Reserve and National Guard, exacerbated by factors like stress and trauma.
• Alcohol, prescription drugs, and illicit substances like fentanyl are commonly misused, posing risks to individual health and military readiness.
• Substance misuse prevalence is notably higher among Reserve and National Guard members compared to the civilian population, with factors including deployment-related stress and a strong influence from military culture.
• Comprehensive prevention and treatment programs are in place, with efforts to tailor strategies to the unique needs of military personnel.
• Barriers to accessing substance abuse treatment include stigma and limited resources.
• Assessing the effectiveness of current strategies is crucial for ongoing improvements in the prevention and treatment of substance misuse in the military.

Substance Abuse Prevalence Among Reserve and National Guard Members

The prevalence of substance misuse within the Reserve and National Guard is a significant concern, with various studies highlighting both the scope and the unique challenges faced by these service members. Research indicates that hazardous drinking is associated with non-deployment emotions (NDE) among male US Army Reserve/National Guard soldiers, reflecting the stress related to not being deployed. Alcohol use disorders are notably prevalent, with more than 10% of military veterans diagnosed with a substance use disorder (SUD), a rate that exceeds the general population. The National Guard also has a higher suicide rate compared to other military branches, which may correlate with substance misuse and mental health issues.

Substance misuse policies and programs within the Reserve and National Guard aim to mitigate these issues with mandatory random drug testing and stringent penalties for illicit substance use. Despite these measures, substance misuse persists, and rates of drug use, particularly marijuana, tend to increase after leaving military service. 

It is essential to address the complex factors contributing to substance misuse among Reserve and National Guard members, including the impact of deployment, military culture, and the transition to civilian life. Effective prevention and treatment strategies are critical to improving the health and readiness of service members while reducing the personal and societal consequences of substance misuse.

Commonly Abused Substances in the Reserve and National Guard

There are several commonly misused substances by members of the Reserve and National Guard. The most prevalent include the following:

• Alcohol
  Alcohol misuse is a widespread concern, often used as a coping mechanism for stress or trauma. The 2018 Health Related Behaviors Survey (HRBS) found that 20.2% of reservists acknowledged the support of drinking culture within the military.
• Prescription drugs
  Prescription drug misuse includes medications like opioid painkillers, benzodiazepines, and stimulants such as Adderall and Ritalin.
• Illicit drugs
  Illicit drug use may involve marijuana, cocaine, heroin, and, increasingly, synthetic opioids like fentanyl, which, according to the Centers for Disease Control and Prevention (CDC), has been a main contributor of overdose deaths.The rise of fentanyl has made even experimental drug use highly dangerous. Another illicit drug concern is synthetic cannabinoids and cathinones, often referred to as “bath salts.”

Understanding the types of misused substances is crucial for developing targeted prevention and treatment strategies within the military. Addressing substance misuse in the Reserve and National Guard not only benefits the individuals affected but also enhances overall military readiness and effectiveness.

Substance Abuse Trends: Reserve and National Guard vs. Civilian Population

Comparing substance misuse rates between members of the Reserve and National Guard and the civilian population reveals distinct patterns. Over 10% of military veterans are diagnosed with a substance use disorder (SUD), a rate that exceeds the general population. Service members, particularly those deployed in combat, also have higher rates of SUD diagnoses than civilians.

The National Guard, specifically, has been noted for its high suicide rates, which may be linked to substance misuse and mental health issues. This has prompted initiatives like the Suicide Prevention and Readiness Initiative for the National Guard to address such challenges.

Overall, while active-duty policies such as mandatory drug testing may deter substance misuse among service members, rates of drug use, particularly marijuana, tend to increase after leaving military service. This suggests that transition periods post-service are critical times for intervention and support to prevent escalations in substance misuse among veterans.

Key Factors Influencing Substance Abuse in Reserve and National Guard Members

A complex interplay of factors influences substance misuse within the Reserve and National Guard. Research indicates that military culture and stress associated with service may lead to unhealthy drinking patterns, which can persist even after leaving the military.The study reported by the RAND Corporation revealed that 20.2% of reservists acknowledged the presence of a drinking culture within the military. Tobacco and nicotine product usage also remains a significant concern, with 45.5% of current smokers in the Reserve attempting to quit within the past year, highlighting the challenges of substance dependence.

Members of the Reserve and National Guard may encounter unique stressors that contribute to substance misuse. Deployment and the stressors associated with it are significant contributors to substance misuse.  Also, a study by Rachel Hoopsick, Ph.D., emphasizes that reservists, who comprise about one-third of the US Armed Forces, often receive less attention in military health research than active service members and veterans, suggesting a potential gap in support and resources.

The rise in overdose deaths, particularly involving fentanyl, has prompted legislative action, mandating the Department of Defense to track drug overdoses and provide access to opioid overdose antidotes. This measure reflects the growing concern over substance misuse as a national security threat. The overall picture is one of a population at risk due to unique service-related stressors, cultural factors, and the broader opioid crisis affecting the US.

Deployment-Related Stress and Substance Abuse in Military Personnel

Deployment and the associated stressors significantly contribute to substance misuse among military personnel. Service members who have been deployed to combat zones, such as Iraq and Afghanistan, often encounter extreme stressors and may witness or participate in traumatic events. These experiences can lead to the development of substance use disorders (SUDs), as individuals may turn to substances as a coping mechanism for the psychological impact of their experiences. Research has highlighted the need for social work practice in addictions to recognize risk and protective factors associated with military service and deployments among diverse military populations and communities.

Impact of Substance Abuse on Reserve and National Guard Members

Substance misuse within the Reserve and National Guard presents multifaceted challenges with severe consequences for individuals and military readiness. The prevalence of substance misuse, particularly alcohol use disorders, is significant, with studies indicating that military culture and stressors contribute to unhealthy drinking patterns that may persist post-service. The issue is amplified by the unique stressors faced by Reserve and National Guard members, such as transitioning back to civilian life, which can exacerbate mental health issues like PTSD, depression, and anxiety, often leading to substance use as a coping mechanism.

Recent legislative actions reflect growing concern over substance misuse in the military. The FY24 Defense Appropriations Act passed by the House Appropriations Committee allocates increased funding, which includes a provision for a 5.2% military pay raise. Moreover, a new law mandates the Pentagon to compile data on overdoses and provide opioid overdose antidotes to troops, highlighting the urgency of addressing the fentanyl crisis within the ranks.

Resources for recovery, including inpatient and outpatient services, are available through the VA and community providers. However, the high rate of suicides in the National Guard underscores the gravity of the issue. Behavioral health programs specifically tailored for military members, including those addressing PTSD and combat trauma, are vital in providing comprehensive care and reducing relapse rates.

The consequences of substance misuse extend beyond personal health, affecting military readiness and effectiveness. It is critical to understand these impacts and continue developing targeted interventions to support the well-being of Reserve and National Guard members.

Impact of Substance Abuse on Military Readiness

Substance misuse poses significant risks to the readiness and effectiveness of the Reserve and National Guard. According to a study by the Army Substance Abuse Program (ASAP), alcohol is the most misused substance in the US Army, with 27% of soldiers meeting the criteria for treatment referral after returning from service. This prevalent issue can lead to various detrimental outcomes, affecting soldiers’ ability to fulfill their duties and obligations.

• Substance misuse can result in failure to fulfill major obligations, compromising operational effectiveness.
• It can lead to use in physically hazardous situations, endangering the individual’s and others’ safety.
• Substance misuse can cause withdrawal symptoms and tolerance, affecting a soldier’s physical and mental health.
• It may lead to a decrease in social, occupational, and recreational activities, further impacting unit cohesion and morale.

The Department of Defense mandates substance misuse education for all service members and operates prevention programs targeted at education and training. Despite these efforts, after leaving military service, rates of drug use, particularly marijuana, tend to increase among veterans. The National Guard has also initiated a special program focusing on suicide prevention, recognizing the link between substance use and mental health issues.

Ultimately, addressing substance misuse is critical to maintaining the operational readiness of the Reserve and National Guard, ensuring that service members are physically and mentally prepared to meet the demands of their military roles.

Substance Abuse Prevention and Treatment in the Reserve and National Guard

The Reserve and National Guard face unique challenges when it comes to substance misuse, and a variety of prevention and treatment strategies have been developed to address these issues. The Department of Defense operates comprehensive programs focusing on the prevention, treatment, and research of substance misuse, including alcohol, illicit drugs, and the non-medical use of prescription drugs. Substance Abuse Prevention, Treatment, and Research Efforts in the Military report details these longstanding efforts.

One key initiative is the partnership between the Substance Abuse and Mental Health Services Administration (SAMHSA) and various states to strengthen behavioral health systems serving service members, veterans, and their families. This partnership provides technical assistance through the SMVF TA Center, as outlined in the Addressing Substance Use Among Our National Guard and Reserve report.

In addition to federal programs, the National Guard has initiated the Suicide Prevention and Readiness Initiative to help identify risk factors and provide information about effective intervention techniques. Moreover, the National Guard is testing a substance abuse prevention program in 12 pilot states to enhance its efforts, as reported by the National Guard amplifying substance misuse prevention efforts.

For treatment, the Veterans Affairs (VA) offers numerous programs to assist veterans, including those from the National Guard and Reserve. 

Overall, these strategies and programs aim to reduce substance misuse rates, provide support, and ensure military readiness among the Reserve and National Guard members.

Barriers to Substance Abuse Treatment in Military Personnel

Despite the availability of evidence-based practices across the Department of Defense (DoD) and Veterans Affairs (VA) continuum of care, barriers to accessing treatment persist. These include 

• perceived stigma or career harm from seeking help, 
• inadequate behavioral health service capacity for military members and their families, and 
• infrequent use or availability of evidence-based protocols in military programs. 

Notably, self-reported use of counseling services is substantially lower among Reserve component members, with only 1% seeking counseling for substance use, indicating additional barriers to behavioral health care in this group.

Assessing the Effectiveness of Current Substance Abuse Prevention and Treatment Strategies

The effectiveness of current strategies to prevent and treat substance misuse within the Reserve and National Guard is multifaceted, involving various programs and initiatives. The Biden-Harris Administration’s Overdose Prevention Strategy, launched by HHS in 2021, has seen substantial progress, with a significant increase in patients seeking buprenorphine treatment, a key medication-assisted treatment for opioid use disorder. The average of 37,000 new patients per month indicates a growing accessibility and acceptance of this treatment modality. More information can be found on the HHS website.

The NIH HEAL Initiative is another cornerstone in the fight against substance misuse, with its research contributing to the development of novel treatments for pain and opioid use disorder. The initiative has made strides towards reducing the stigma associated with opioid use disorder and its treatment, a significant barrier to seeking help. Details on the progress can be found in the NIH HEAL Initiative 2024 Annual Report.

While these strategies show promise, areas for improvement remain. Integrating such treatments into the military healthcare system is critical, where stigma and logistical barriers may be more pronounced. Additionally, the development of support networks for service members seeking treatment, including peer support and counseling, can enhance the effectiveness of these strategies. Tailoring prevention and treatment programs to address the unique challenges faced by the Reserve and National Guard, such as deployment-related stress, is also essential for improving outcomes.

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