No DOD-wide alcoholism prevention and rehabilitation p existed for military personnel, nor were there any guidelines spo procedures to be followed in treating them. As a result the tre given to the military alcoholic at many bases was limited. Aled rehabilitation programs, however, have been formally establis some military installations, and DOD has recently established force to study all aspects of alcohol abuse among military per (See pp. 11 to 12.)

RECOMMENDATIONS OR SUGGESTIONS

The Secretary of Defense should establish a comprehensive a ism control program for military personnel which would provide alcoholism be recognized as a disease which is treatable than as misconduct which is punishable and changes to pe regulations and proposals for changes in legislation nee accomplish that purpose be made expeditiously,

educational programs be established to inform militar sonnel of the dangers of the abusive use of alcohol and to co supervisors that many alcoholics can recover and becom productive,

rehabilitative measures be made available to all m personnel having alcoholism problems, and

DOD undertake a study to determine more precise incidence of alcoholism and problem drinking. (See pp. 15 a

AGENCY ACTIONS AND UNRESOLVED ISSUES

DOD concurred with GAO's recommendations concerning est ment of educational programs, availability of rehabilitative me and studies to more precisely determine the incidence of alco and problem drinking. (See app. II.) DOD-wide policies will tablished in the near future to achieve these goals.

With respect to GAO's recommendation that alcoholism b sidered a disease rather than misconduct, DOD would per recognize alcoholism as a condition which is preventable and tre through the application of enlightened attitudes and techniques disease is equated with physical disability which is compensabl GAO recognizes that certain statutes and regulations aff military compensation hold alcoholism to be misconduct. As earlier, however, these statutes and regulations have resulted in the alcoholism problem. GAO believes that if they are not mo there is little assurance that this condition will be corrected.

Title V, section 501, of Public Law 92-129, amending the M Selective Service Act, requires the Secretary of Defense to mak recommendations for additional legislation as are necessary to with the problem of drug and alcohol dependence. GAO believe the Secretary's recommendations properly should include pro to deal with the problems of recognizing alcoholism as a disease. problems include those involving pay, retirement, and relative be (See p. 17.)

CHAPTER 1
INTRODUCTION

Our review of alcoholism among military personnel was made at the request of the Chairman, Subcommittee on Alcoholism and Narcotics, Senate Committee on Labor and Public Welfare. (See app. I.) Previously, at the request of the Chairman, we had made a similar study concerning Federal civilian employees. In that study (summarized in app. III), we estimated that the Federal Government could realize annual savings of $135 million to $280 million from an alcoholism program for civilian employees, assuming a prevalence of alcoholism ranging from 4 to 8 percent.

The following definitions of "alcoholism" and "problem drinker" were used in our review and were taken from the National Industrial Conference Board's report, "Company Controls for Drinking Problems," published in March 1970.

"Alcoholism: a highly complex illness: It is a chronic disease characterized by repeated excessive drinking which interferes with the individuals' health, interpersonal relations or economic functioning. If untreated, alcoholism becomes more severe and may be fatal. It may take several years to reach the chronic phase."

"Problem drinker: To management, a problem drinker is any employee whose drinking affects his work adversely. Regardless of whether a physician would classify the employee as an alcoholic, his drinking is hurting the company.'

During our review we interviewed more than 600 individuals at over 30 military locations in the continental United States and overseas.

(3)

CHAPTER 2

ALCOHOLISM AMONG MILITARY PERSONNEL-HOW PREVALENT IS

The prevalence of alcoholism in the military services cannot determined accurately because there is very little statistically v data. In our interviews we obtained personal estimates of incide ranging from 0 to 40 percent. Such diverse responses indicated these estimates may be affected by the interviewee's rank, relig beliefs, personal observations, and drinking habits and by the exter the interviewee's personal contact with large numbers of person Although the incidence estimates were subjective, the informa developed during our review indicated that there may be a ser alcoholism problem among military personnel. At the same time tl appeared to be an inability or reluctance among some military per: nel to recognize the existence of any problem.

Many senior command and staff officers we talked with believed t the incidence of alcoholism among military personnel was neglig and, in any event, was lower than that among the civilian populat On the other hand many of those we talked with, including mili physicians, psychologists, chaplains, Alcoholics Anonymous memb and others closely involved with alcoholism, made estimates of i dence which were comparable with those for the civilian work fo others made estimates which were higher. Various individuals in Department of Defense, the Veterans Administration, and the Dep ment of Health, Education, and Welfare, who had official respo bilities in this area, also made estimates of the incidence of alcohol and problem drinking among the military, which were compar with estimates of incidence in the civilian work force. An official in Office of the Secretary of Defense (Health and Environment) stated that "it is commonly assumed that the incidence is at least e parable to the estimates of 4 to 8 percent given in civilian indust surveys." A study completed in 1969 by an Air Force officer, in wh he asked over 200 randomly selected squadron commanders to iden known problem drinkers in their commands, disclosed an incidenc about 4 percent.

Many individuals said that alcoholism was most prevalent am senior noncommissioned officers and commissioned officers, prima affecting personnel who had 10 or more years of military service. alcoholism is reportedly less a problem in the military services tha the general population because the servicemen are primarily young alcoholism is considered a problem of the older individual. We told that today young servicemen have turned to drugs rather tha alcohol.

Nonetheless about 38 percent of the problem drinkers identified by squadron commanders in the study referred to above were in the 17 to 24 age group. That study concluded that there were two broad groups of problem drinkers: (1) the younger servicemen whose drinking was repetitive, was undisciplined, and had caused themselves and their commanders problems and (2) older servicemen whose alcoholism problem had taken on more serious physical and psychological aspects. Officials of the National Council on Alcoholism believed that the incidence of alcoholism in the military was no less than in industry. The Council identified three variables which influenced the incidence in a particular population: average age, male-to-female ratio, and the extent of permissiveness toward drinking behavior. The officials believed also that the last two variables operated so strongly in the military that the effect of the low average age was somewhat lessened. They believed further that the heavy-drinking younger servicemen were also abusing alcohol but that their problem was less visible to responsible officials.

CHAPTER 3

DOES MILITARY SERVICE ENCOURAGE ALCOHOLISM?

Many factors were indentified by the individuals we interviewed which could affect the incidence of alcoholism among military personnel. Some of the frequently mentioned factors follow.

Social climate

FACTORS ENCOURAGING ALCOHOLISM

The use of alcoholic beverages in the military services traditionally has been accepted and dates back at least to the time when liquor rations were given to servicemen. Military social life has centered around activities where the extensive use of alcohol generally is expected. A few examples are: hail-and-farewell, promotion, cocktail, and wetting-down parties; "happy hours" at the various clubs; and "beer busts" for the troops. We have been told by an Alcoholics Anonymous member that the continual round of mandatory cocktail parties makes it difficult for military alcoholics to avoid a drinking environment.

Family separations

Military servicemen often are separated from their families. In the opinion of some of those we interviewed, these separations tend to encourage more drinking.

Low cost and ready availability of alcoholic beverages

Generally alcoholic beverages are sold to military servicemen at lower prices, especially overseas, than the prices charged to the general public. During happy hours the already low prices are further discounted. An economical price, coupled with ready availability, tends to increase consumption. Other persons that we interviewed, however, felt that these factors were not significant in encouraging excessive drinking. They said that drinking by alcoholics and problem drinkers would not be affected materially by accessibility and price advantages. Boredom

If recreational facilities are not adequate, particularly in remote overseas locations, the serviceman turns to the military club where activities frequently are centered around the consumption of alcohol.