Problems stemming from the misuse and abuse of alcohol and other drugs are by no means a new phenomenon, although the face of the issues has changed in recent years. National trends indicate substantial increases in the abuse of prescription medications. These increases are particularly prominent within the military, a population that also continues to experience long-standing issues with alcohol abuse. The problem of substance abuse within the military has come under new scrutiny in the context of the two concurrent wars in which the United States has been engaged during the past decade-in Afghanistan (Operation Enduring Freedom) and Iraq (Operation Iraqi Freedom and Operation New Dawn). Increasing rates of alcohol and other drug misuse adversely affect military readiness, family readiness, and safety, thereby posing a significant public health problem for the Department of Defense (DoD). To better understand this problem, DoD requested that the Institute of Medicine (IOM) assess the adequacy of current protocols in place across DoD and the different branches of the military pertaining to the prevention, screening, diagnosis, and treatment of substance use disorders (SUDs). Substance Use Disorders in the U.S. Armed Forces reviews the IOM's task of assessing access to SUD care for service members, members of the National Guard and Reserves, and military dependents, as well as the education and credentialing of SUD care providers, and offers specific recommendations to DoD on where and how improvements in these areas could be made.

Alcohol abuse is more prevalent than drug abuse among military personnel and impairs the effectiveness and efficiency of military performance more than illegal drug use does. The Department of Defense (DOD) is aware that it has severe alcohol problems but it is not doing enough to correct them. DOD has placed much more emphasis on its drug control program. Yet, despite the larger resources being made available to it, the drug control program has problems. A responsive information system is needed. DOD needs to gauge the size of its alcohol problem, recognize problems affecting the operation of both the alcohol and the drug control programs, and direct the services on actions needed to improve their respective programs.