Understanding and Identifying Substance Abuse

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

Substance abuse is defined as the wrongful use of a controlled substance, prescription medication, over-the-counter medication, or intoxicating substance to the extent that it has an adverse effect on performance, conduct, discipline, or mission effectiveness. This also includes the intentional inhalation of fumes or gasses of intoxicating substances, with the intent of achieving an intoxicating effect on the user's mental or physical state, and steroid usage other than that specifically prescribed by a physician.

Alcohol Abuse

Alcoholism is a disease that can have serious effects on a person's physical and emotional health as well as on their personal and professional relationships. If you or someone you know has an alcohol abuse problem, it's vital to get help as soon as possible.

Substance Abuse v. Drug and Alcohol Dependence

Drug and alcohol dependence refer to the psychological or physiological (physical) reliance on alcohol, a chemical substance, or pharmacological agent. Substance abuse is the wrongful use of a substance that could lead to dependence. Both can result in adverse personal, professional, physical, and social effects. Both are clinical diagnoses determined from an assessment by a qualified mental health professional or physician. Individuals experiencing either substance abuse or dependence can benefit from treatment intervention. However, drug dependence requires treatment as well as possible medical monitoring for physical withdrawal.

Risk Factors

Any service member, regardless of rank or specialty, can be at risk. Often, alcohol and other illicit drug use are associated with significant stressors linked to military life, such as combat, deployment, field duty, and frequent moves or separations from family.

Persons who use alcohol or other drugs as a preferred way to socialize, to "relax," or to cope with life stressors are most vulnerable to becoming regular users and potentially dependent on alcohol or drugs. It is also not uncommon for service members to use alcohol or other drugs to alleviate their distress or to try to escape from depression, post-traumatic stress, or anxiety. However, using alcohol or drugs as a means of coping will only make the original problem worse and will likely cause additional complications.

Warning Signs

Dependence on alcohol or other drugs might occur gradually over time (months or years) or with a quick onset over the course of only a few weeks. The following are some of the potential indicators of substance abuse or dependence:

  • Physical - decreased physical capabilities, less energy, decreased appetite, nutritional deficiencies, increased injuries and falls, symptoms of alcohol or drug withdrawal (e.g., tremors [hands shaking], sweating, vomiting, hallucinations). Increased tolerance for alcohol or drugs (needing more of the substance to achieve the desired effect).
  • Psychological - denial of the problem, irritability, agitation, mood swings, anxiety, depression, difficulty concentrating, memory lapses, black outs, or efforts to stop using drugs or drinking.
  • Financial - difficulties with budgeting or with debts, inability to pay bills due to money spent on alcohol or drugs, borrowing money before pay day to buy alcohol or other drugs, or borrowing money to pay late bills.
  • Legal - encounters with law enforcement or the courts for drug-related offenses (e.g., driving under the influence, public intoxication, underage drinking, possession of drugs, assault, sexual assault, domestic violence, child abuse, or child neglect).
  • Work Performance - low motivation, poor morale, loss of interest, increased errors, faulty judgments, tardiness, increased sick days, and avoidance of others.
  • Relationships - strained, conflicted relationships or reports of physical abuse, domestic violence, separation, or divorce can be indicators of a substance abuse problem. Some substance abusers become isolated or withdrawn, whereas others become more social when under the influence of alcohol or other drugs, wanting to be the center of attention.
  • Behavioral Changes - changes in appearance (less attention to grooming or dress), excessive use of eye drops or breath mints, increased difficulties on the job and with relationships, and becoming more aloof or secretive.
  • Social Changes - efforts to seek out activities that involve alcohol or drugs.

Note: These indicators can also be the result of other issues and may not necessarily be substance-abuse related. However, a combination of several of these indicators warrants further inquiry or assessment.

Effects of substance abuse

If untreated, substance abuse can lead to serious medical problems like cirrhosis of the liver, increased cancer risk, heart disease, and damage to the brain. Substance abuse can also lead to serious family conflicts, loss of friendship, problems at work, and mental health problems such as depression, loss of self-esteem, and chronic feelings of guilt.


Strategies to decrease substance abuse issues:

  • Be knowledgeable of the symptoms of substance abuse and dependence.
  • Implement healthy coping strategies in lieu of using alcohol or drugs to cope with stress or to relax.
  • Create and implement a proactive plan to address physical, psychological, social, and work-related stressors.
  • If needed, seek consultation from a supervisor or a mental health professional.
  • Tips for leaders in preventing substance abuse include:
  • Be proactive and don't wait until there is a significant problem within the unit.
  • Keep an open dialogue with junior service members about substance use, abuse, and dependence.
  • Promote healthy alternatives to coping with stress and an open, non-judgmental environment that encourages service members to get help when they need it before problems become unmanageable.

Recognizing a Problem

If you recognize symptoms of substance abuse or dependence in yourself or find that your use of alcohol or other drugs is interfering with work and personal relationships, it is time to seek professional help. This is not to suggest that you have failed in any way. In fact, getting help can be the key to getting better and being able to return more fully and more effectively to leadership and work roles.

Treatment for substance abuse

Most people who abuse alcohol and/or drugs need long-term support and professional help. There are many kinds of help, including self-help programs like Alcoholics Anonymous, detox programs, outpatient or inpatient (residential) programs, and halfway houses. Other programs offer support to the friends and families of substance abusers, such as Al-Anon and Alateen. You can learn more by calling the National Clearinghouse for Alcohol and Drug Information hotline at (800) 729-6686.

The first step in getting treatment is getting a formal assessment of the problem. This should be done in person with a trained substance abuse professional. Ask your doctor for a referral. Your employee assistance program (EAP) may have additional information. Remember that the program that provided this publication also has many resources on substance abuse.


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