Substance Abuse in the Reserve and National Guard

Key Takeaways

• Substance misuse prevalence is higher among deployed service members, with alcohol and tobacco being the most commonly misused substances.
• Cultural factors and the co-occurrence of PTSD and SUDs necessitate integrated treatment approaches.
• Substance misuse undermines unit cohesion and operational effectiveness, highlighting the need for effective prevention and treatment strategies.
• Prevention strategies include educational programs and resilience training, while treatment encompasses outpatient and inpatient care.
• The National Guard Bureau’s Substance Abuse Program provides policy guidance and training resources for prevention.
• Comprehensive care programs address co-occurring disorders such as PTSD and combat trauma.
• Government initiatives like the Overdose Prevention Strategy aim to expand treatment capacity and prevent overdoses.
• Continuity of care and family involvement are crucial for recovery and relapse prevention in substance misuse treatment.

What Is Substance Abuse in the Reserve and National Guard?

Challenges of Substance Abuse

Service members in the Reserve and National Guard face unique challenges that contribute to the prevalence of substance misuse. Research indicates that deployed individuals, especially to recent conflicts, are at higher risk for developing substance use disorders (SUDs) compared to civilians.

• In 2013, 44% of returning service members struggled with transition issues, often involving problematic substance use behaviors.
• A systematic review shows that recently deployed individuals were 1.36 times more likely to develop alcohol use disorder and 1.14 times more likely to develop drug use disorder compared to non-deployed service members.
• Despite similar post-deployment increases in substance use problems, there is a low rate of referral to SUD treatment due to stigma.
• Cultural factors within military life and the co-occurrence of SUDs with PTSD necessitate an integrated treatment approach.

Substance Abuse Trends in the US Reserve Forces

The 2018 Health Related Behaviors Survey (HRBS) provides insights into substance misuse rates among US Reserve forces:

• Approximately 20.2% of reservists reported attitudes supporting drinking, highlighting the prevalence of alcohol use.
• 45.5% of current smokers in the Reserve attempted to quit within the past year, indicating a significant desire for cessation support.

Examining Substance Abuse Rates in the National Guard

Substance misuse within the National Guard mirrors challenges faced by active-duty service members and veterans:

• The National Guard has the highest suicide rate among military branches, often linked to SUDs and mental health issues. Research highlights the importance of initiatives like the Suicide Prevention and Readiness Initiative to combat these challenges.
• More than 10% of military veterans, including National Guard members, have been diagnosed with an SUD, with alcohol use disorders being particularly prevalent.
• Deployment and combat exposure increase the risk of SUDs, with a notable co-occurrence of PTSD and SUDs requiring integrated treatment.

The data underscores the need for targeted prevention and intervention strategies within the Reserve and National Guard, addressing unique stressors and promoting healthy behaviors. Comprehensive support systems are crucial for reducing substance misuse rates and improving overall well-being among service members.

For more detailed information, refer to the full HRBS report accessible through RAND Corporation’s research brief on substance use in the Reserve Component.

Contributing Factors to Substance Abuse: The Reserve and National Guard Members

Substance misuse within the Reserve and National Guard is influenced by various factors, highlighting the complex interplay between individual experiences and military culture:

• Research from the University at Buffalo has identified unit support and support from family and friends during deployment as crucial protective factors against drug use among service members.
• Military culture, particularly around alcohol use, can contribute to substance misuse patterns that persist after service.
• Transitioning back to civilian life can exacerbate stress and trauma-related disorders, often leading to substance use as a coping mechanism.
• High suicide rates within the National Guard reflect underlying mental health and substance use issues.
• Strict military policies curb illicit drug use, but alcohol remains the most prevalent substance misused.
• Rates of marijuana and other drug use tend to increase after leaving military service, influenced by policies and fear of repercussions during service.

Stress, Trauma, and Substance Abuse in Military Reservists

Stress and trauma significantly contribute to substance misuse among Reserve and National Guard members:

• Childhood trauma and combat trauma are closely associated with substance use disorders (SUDs) in military personnel.
• Studies have found that early trauma can sensitize neural pathways, increasing impulsivity and the risk of substance use initiation.
• Reservists face unique stressors such as prolonged absences from family, financial challenges, and limited support services during transitions.
• The National Guard reports a higher suicide rate, with substance misuse as a contributing factor.
• RAND research suggests policy solutions are necessary to ensure reservists have access to quality mental health care and preventive measures post-service.

Substance Access and Its Role

Access to substances plays a significant role in substance misuse within the Reserve and National Guard:

• Availability of alcohol, prescription drugs, and illicit substances contributes to increased rates of SUDs.
• Environmental factors, such as where service members serve, influence substance use behaviors.
• Factors like exposure to substances, neighborhood disadvantage, and barriers to treatment impact SUD rates.
• Military policies, including drug testing and consequences for substance use, influence behavior during service.
• Rates of drug use, particularly marijuana, increase post-service despite strict policies.

Addressing substance misuse among Reserve and National Guard members requires comprehensive strategies that integrate mental health care, support during transitions, and policies that consider environmental factors and access to substances. Prevention efforts, as advocated by organizations like the American Academy of Family Physicians and SAMHSA, should focus on enhancing support networks, improving healthcare integration, and adapting policies to support service members throughout their military careers and beyond.

Consequences of Substance Abuse: The Reserve and National Guard

Substance Misuse

Substance misuse in the Reserve and National Guard has profound consequences affecting individuals, units, and military readiness:

• The National Guard reports the highest suicide rates among military branches, often linked to substance misuse and mental health issues.
• Initiatives like the Suicide Prevention and Readiness Initiative aim to identify risk factors and provide effective interventions.
• Substance use disorders affect over 10% of military veterans, emphasizing the need for targeted support and treatment options.
• Programs focus on comprehensive care, including PTSD and combat trauma treatment, aiming to reduce relapse and engage families in recovery.
• Alcohol remains more prevalent than illicit drugs due to strict military policies, though drug use rates increase post-service, with marijuana being common.
• The 2018 Health Related Behaviors Survey highlights a supportive drinking culture among reservists and ongoing concerns about tobacco use.

Effects of Substance Abuse 

Substance misuse has far-reaching effects on Reserve and National Guard members:

• Military identity is associated with certain substance use and mental health outcomes.
• Research links a strong veteran identity with non-medical use of prescription drugs and increased symptoms of anger, anxiety, depression, and PTSD.
• Despite support efforts, gaps in care persist, with National Guard members facing the highest suicide rates among military branches.
• Substance misuse correlates with increased rates of traumatic brain injury (TBI) and complicates PTSD treatment and recovery.
• Interventions must address the complex interplay between military identity, mental health, and substance use for effective care.

Unit Cohesion and Operational Effectiveness

Substance misuse undermines unit cohesion and operational effectiveness in the Reserve and National Guard:

• Unit cohesion, crucial for morale and operational success, is eroded by substance misuse, which undermines trust and reliability. Studies, such as those reported by the National Institutes of Health, have highlighted the importance of unit cohesion in fostering resilience against mental health challenges post-deployment. 
• Soldiers with SUDs may struggle to perform duties reliably, increasing mission risks and reducing overall unit readiness.
• Higher rates of mental health issues and treatment needs, including PTSD, depression, and substance misuse, are noted among Reserve/National Guard soldiers compared to active-duty counterparts.
• Disciplinary issues and legal consequences further impact unit integrity and professional efficacy.
• The Substance Abuse and Mental Health Services Administration (SAMHSA) has noted the need for targeted support and intervention strategies within military communities to address these challenges. 

Prevention and Treatment Approaches: Substance Abuse in Military Reserves

Substance misuse in the Reserve and National Guard demands comprehensive strategies:

Prevention:

• Educational programs like Comprehensive Soldier Fitness raise awareness about substance misuse’s impact.
• The National Guard Bureau’s Substance Abuse Program provides policy guidance and training resources.
• State-specific Army National Guard Substance Abuse Programs adapt prevention efforts based on local data.
• Federal initiatives, such as the Overdose Prevention Strategy, expand addiction treatment capabilities.
• Special initiatives like the Suicide Prevention and Readiness Initiative address mental health issues linked to substance misuse.

Treatment:

• Options range from outpatient to intensive inpatient programs like the Substance Abuse Residential Treatment Program.
• Comprehensive care programs address co-occurring disorders like PTSD tailored for military personnel.
• Long-term recovery integrates family and environmental support into intervention strategies.
• Mandatory drug testing and consequences for substance use complement community-based support programs.
• Innovations like Youth Opioid Recovery Support and medication-assisted treatment enhance recovery outcomes.
• VA resources offer both inpatient and outpatient services, supported by online screenings and the Veterans Crisis Line.

Prevention and treatment efforts in the Reserve and National Guard collaborate across levels to support service members, combat substance misuse, and promote mental health, crucial for maintaining military readiness.

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