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Substance Abuse Policy and Treatment


*Military OneSource does not provide medical counseling services for issues such as substance abuse, suicide prevention, or posttraumatic stress disorder. The article below is provided for informational purposes only. Military OneSource can provide referrals to your local military treatment facility (MTF), TRICARE, or another appropriate resource.

Drug Testing Policy:

Department of Defense (DoD) policy requires all Service branches to conduct random urinalysis testing to detect and deter drug use among all military personnel. If a service member has a positive drug test, the commander should refer him or her for further assessment. Anyone who is directed by the commander to take a urinalysis test must comply, including those DoD civilians that serve in Department of Health and Human Services approved Testing Designated Positions. If a service member refuses to submit a urinalysis sample, it is considered a failure to obey a lawful order and he or she can be referred for disciplinary action.

There are a number of options for urinalysis testing of service members:

  • Random urinalysis testing involves drug testing of service members with random selection by a DoD-certified computer program.
  • Voluntary consent testing is used prior to a probable cause or command-directed urinalysis test. Commanders should coordinate this test with the Staff Judge Advocate (SJA) office.
  • Probable cause testing occurs when a commander has probable cause to believe that the service member has used illegal drugs. Commanders should coordinate this test with the SJA office.
  • Commander-directed testing is used when the commander suspects drug use but does not have a sufficient basis for probable cause. Commanders should coordinate this test with the SJA office. This test is appropriate if the service member has exhibited drug-related unlawful or atypical behaviors of concern to the commander.
  • Self-identification testing is appropriate when a service member comes to his or her commander and self-identifies as being a drug user prior to being selected to participate in urinalysis testing.
  • Rehabilitation testing is directed by the commander on an unannounced basis for persons who are in rehabilitation (including aftercare) to ensure adherence to sobriety. Unit commanders may discontinue this testing if a court-martial or separation action is initiated on a member in rehabilitation.
  • Other testing options include urinalysis testing as part of unit inspection (all or part of a unit), during the aftermath of a safety mishap, as part of a command-directed assessment for fitness for duty or the need for treatment, or as part of a medical intervention.
  • New members of the military may also be required to submit to testing.

Intervention Services

Service members who abuse alcohol or other drugs may be identified and provided with intervention services in several different ways:

  • Assessment and treatment services are available for service members who seek help with alcohol or drug abuse or dependency. Service members may still be subject to potential disciplinary action, when appropriate, and the limits of confidentiality remain in effect (e.g., the commander's "need-to-know" in terms of the service member's treatment progress with regard to fitness for duty and mission readiness).
  • A health care provider must refer a service member for an assessment if substance abuse or dependence is suspected.
  • Commanding officers who suspect problem drinking or illicit drug use must refer service members for further assessment.
  • A service member could be identified as having substance abuse or dependency issues after an alcohol- or drug-related incident, such as driving while intoxicated, underage drinking, or disorderly conduct, if law enforcement or another disciplinary authority is involved. In such instances, commanders are notified and are responsible for making a substance abuse assessment referral.

Assessments

An assessment is often the initial step toward gaining a better understanding of the extent and nature of the service member's substance use, abuse, or dependence. Professionals who have experience diagnosing substance abuse disorders conduct assessments. An assessment involves a comprehensive bio-psychosocial and substance use history. Upon completion of the assessment, a diagnosis and recommendations are given which may include: no further action, outpatient counseling, intensive substance abuse/dependence treatment, or inpatient medical treatment for substance dependence and possible physical withdrawal.

Confidentiality

If a service member voluntarily seeks treatment, confidentiality is a part of the treatment process. Confidentiality refers to the protection of the personal and private information shared during a counseling session by the service member with a mental health or substance abuse counselor. However, there are exceptions to confidentiality in counseling, which include the service member's involvement with suspected child abuse, threats of potential harm to self or others (suicidal or homicidal), subpoena under court order, and the commander's need to know. In addition, many treatment programs require spouse involvement in the treatment and support of the service member.

If a service member is ordered for treatment, the command has a right and need to know the progress and outcome of the treatment. Commanders can request information about the service member due to their need to know about the service member's fitness for duty; to assure the safety of the service member, of the command, and the unit; and to protect the integrity of the mission. This includes service members who voluntarily receive treatment at a military facility. Therefore, treatment in a military facility is not likely to remain confidential.

Service members and dependents can seek treatment from a civilian facility at their own expense or through a support group without directly notifying command. It is possible that a military treatment facility (MTF) might learn of the treatment through the filing of insurance claims and requests for retroactive referrals. If MTF staff learned that a member was seeking treatment through a civilian program, they would notify command if the member was receiving inpatient care or if the member was addicted to drugs or alcohol.
It is important to note, however, that command involvement in treatment and aftercare can be supportive and beneficial. In fact, successful transition from treatment often depends on the support of others. Therefore, if command is aware of the service member's treatment needs, the commander may be able to help support the service member's efforts to maintain sobriety.

Counseling Services and Resources

Counseling services available through the installation are free to service members and DoD civilian personnel designated as Civilian Expeditionary Workforce and their family members. More information on substance abuse treatment and prevention programs within each Service is available online on their respective websites:


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