Letter to Secretary Panetta

Letter

By:  Paul Tonko
Date: Sept. 25, 2012
Location: Albany, NY

Congressman Paul Tonko has teamed up with a bipartisan group of colleagues, including fellow Co-Chairs of the Addiction, Treatment and Recovery Caucus to author a letter to Secretary of Defense Panetta calling on the Secretary to implement reforms recently outlined by the Institute of Medicine.

Issued ten days ago, a National Academies report found that the incidence of binge drinking in the military has risen from 35 percent in 1998 to 47 percent in 2008 and the rate of prescription drug abuse among service members also increased from 2 percent in 2002 to 11 percent in 2008. It also notes that TRICARE does not regularly cover intensive outpatient programs, office-based individual counseling, or certain pharmacological therapies for individuals with a substance use disorder. The report offers recommendations that the Department of Defense (DoD) could take to implement a comprehensive, consistent program to identify and treat substance use disorders in the military.

Fifteen Members of Congress signed onto the letter, including both Republicans and Democrats. They are Reps. John Sullivan, Tim Ryan, Mary Bono Mack, Charles Rangel, Raul Grijalva, Betty McCollum, Glenn Thompson, Elijah Cummings, Alcee Hastings, Stephen Lynch, James McGovern, Ron Barber, Bobby Rush and Henry Waxman.

Together, the legislators wrote: "Substance abuse in our nation's military not only impairs our military readiness; it also cripples the lives of the young men and women who are bravely sacrificing much for our country. Left untreated, substance abuse can lead to more severe mental health issues and has been strongly linked to increased incidences of both suicide and homelessness. If we fail to effectively address this public health crisis, we will be turning our backs on a generation of young soldiers in their time of need."

The full text of the letter is below:

September 25, 2012

The Honorable Leon E. Panetta

United States Secretary of Defense

1000 Defense Pentagon

Washington, D.C. 20301-1000

Dear Secretary Panetta,

We are writing to you with grave concern over the findings of the recent report released by the Institute of Medicine (IOM) entitled: "Substance Abuse Disorders in the United States Armed Forces."[1] We urge you to take immediate steps to implement the recommendations of the report and address the serious health and military readiness issues associated with substance use by military personnel.

The scope of the substance use disorders in the United States Armed Forces brought to light by the IOM report is very disturbing. The IOM report found that the incidence of binge drinking in the military has risen from 35 percent in 1998 to 47 percent in 2008 and the rate of prescription drug abuse among service members also increased from 2 percent in 2002 to 11 percent in 2008. These figures are increasing at a significantly higher rate than the levels of substance abuse reported in the civilian population.

Given these stark numbers, we feel it is imperative that this problem be addressed immediately. The recommendations contained in the IOM report included several steps the Department of Defense (DoD) could take to implement a comprehensive, consistent program to identify and treat substance use disorders in the military. For example, the conduct of routine screenings among all personnel for unhealthy alcohol use, coupled with consistent referrals for treatment for individuals found to have a substance abuse problem would ensure we are providing timely assistance to military personnel. Historically, implementation of substance abuse programs was overseen by the individual branches of the service with limited involvement of senior officials at DoD. The findings of this report clearly indicate this approach has not been effective, especially in the circumstances where multiple deployments have required additional sacrifices by the men and women in the services. The report provided information to illustrate specific deficiencies in these programs. For example, only 0.2 percent of 6,669 Army solders received a referral for alcohol abuse treatment after self-reporting levels of drinking consistent with alcohol misuse. These figures are appalling, and we can no longer turn a blind eye and allow business as usual to continue.

Additionally, the IOM report documented critical shortcomings in the TRICARE Substance Use Disorder (SUD) benefit that severely hampers access to care for our nation's service members and their dependents. Most notably, TRICARE does not regularly cover intensive outpatient programs, office-based individual counseling, or certain pharmacological therapies for individuals with a substance use disorder. These are successful, standard methods of care relied upon by private insurance companies, and often cost less than the hospital-based treatment that is heavily utilized by TRICARE. By modernizing TRICARE's SUD benefit, we can ensure that all beneficiaries have access to quality, affordable substance abuse treatment.

Substance abuse in our nation's military not only impairs our military readiness; it also cripples the lives of the young men and women who are bravely sacrificing much for our country. Left untreated, substance abuse can lead to more severe mental health issues and has been strongly linked to increased incidences of both suicide and homelessness. If we fail to effectively address this public health crisis, we will be turning our backs on a generation of young soldiers in their time of need. We can and must do better, and as such, we strongly urge you to immediately implement the recommendations of the IOM report.

Thank you for your time and for your attention to this critically important issue. We look forward to your response and continuing to work with you to address the needs of service members who suffer from substance abuse and addiction.

Sincerely,