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The Army is shifting operation of its drug and alcohol substance abuse program from garrison to medical command following a newspaper investigation.(Photo: John Bazemore, AP)
The Army is placing medical officials in charge of substance abuse treatment for soldiers<span style="color: Red;">*</span>in the wake of a<span style="color: Red;">*</span>USA TODAY investigation that uncovered<span style="color: Red;">*</span>poor treatment and a<span style="color: Red;">*</span>spike in suicides among those suffering addiction.
Army Secretary John McHugh decided to shift oversight of the program back to the Army Medical Command to improve the counseling soldiers receive,<span style="color: Red;">*</span>an Army deputy assistant secretary, Anthony Stamilio, said in an interview. About 20,000 soldiers are screened each year for drug and<span style="color: Red;">*</span>alcohol abuse.
Problems<span style="color: Red;">*</span>began surfacing after the Army decided in 2010 to place the program<span style="color: Red;">*</span>under the Army's<span style="color: Red;">*</span>Installation Management Command, which operates<span style="color: Red;">*</span>garrisons and lacks medical expertise.
That<span style="color: Red;">*</span>move led to a sharp decline in the quality of care.<span style="color: Red;">*</span>Half of the Army's treatment clinics fell<span style="color: Red;">*</span>below professional standards, veteran personnel left en masse and clinics hired<span style="color: Red;">*</span>unqualified directors and counselors, according to senior Army clinical staff members and records obtained by USA TODAY.
Stamilio<span style="color: Red;">*</span>defended the program,<span style="color: Red;">*</span>saying that under Installation Command management the "program is running well," current counselors are fully credentialed, and rates of soldiers successfully completing treatment and staying<span style="color: Red;">*</span>sober are high.
The USA TODAY report<span style="color: Red;">*</span>in March said that since 2010, about<span style="color: Red;">*</span>90 soldiers had committed suicide within three months of receiving substance-abuse treatment and at least 31 suicides followed documented cases of substandard care, according to tabulations by clinical staff, though they<span style="color: Red;">*</span>did not specifically blame<span style="color: Red;">*</span>the deaths on poor treatment.
Current and former clinic staff members told USA TODAY that about half of the 7,000 soldiers screened for alcohol or drug problems last year and turned away with a clean bill of health<span style="color: Red;">*</span>should<span style="color: Red;">*</span>have been enrolled and counseled for substance abuse.
USA TODAY
Investigation: Army substance-abuse program in disarray
The USA TODAY reports prompted McHugh and then-Army chief of staff<span style="color: Red;">*</span>Gen. Ray Odierno<span style="color: Red;">*</span>to order<span style="color: Red;">*</span>an inspector general investigation of the program. The Army has not released those results, but McHugh later ordered the program back<span style="color: Red;">*</span>to<span style="color: Red;">*</span>medical supervision<span style="color: Red;">*</span>over a phased-in period to be completed by next<span style="color: Red;">*</span>October.
"They're finally going to bring some reasonable and responsible action to help soldiers," said Dr. Patrick Lillard, a psychiatrist and former clinical director of the Army's largest in-patient substance abuse program at Fort Gordon, Ga.
"It means that the direction of the substance abuse treatment program will be back in the province of medical people rather than command, so that decisions will be made by medical people" said Lillard, a vocal critic of the earlier change in management.<span style="color: Red;">*</span>"The people in command do not understand the nature of the (substance abuse) disease and the complications that occur."
The latest move was<span style="color: Red;">*</span>well-received by medical experts.<span style="color: Red;">*</span>David Rosenbloom, professor of public health at Boston University said "if they're putting it under medical control they're probably going in the right direction."
Wanda Kuehr, a psychologist and former director of clinical services for the Army substance-abuse program who also had<span style="color: Red;">*</span>been critical of its management, cautioned that<span style="color: Red;">*</span>"safeguards must ensure that (treatment) clinicians continue to be licensed, trained and certified in substance abuse rehabilitation. If not, soldiers' treatment is not likely to be optimal. In fact, it may well put the soldiers at risk."
The Army plans call for placing substance-abuse counselors within mental health clinics now<span style="color: Red;">*</span>"embedded" with combat brigades to make care more accessible<span style="color: Red;">*</span>and reduce the stigma associated with seeking help. Currently, drug and alcohol counselors work in<span style="color: Red;">*</span>separate clinics on each Army base.
"What we have found is that our soldiers are more willing to go into an embedded behavioral health facility to be seen," said Maj. Gen. Jimmie Keenan, deputy commander for operation under the Medical Command.
"Their mental health care and their substance-abuse treatment can be delivered in the same location and the people providing that care can make sure it's coordinated and risk is managed even better than it is now," said Army Lt. Col. Chris Ivany, Army director of behavioral health.
Lillard said that non-medical<span style="color: Red;">*</span>leaders often fail to recognize alcoholism or drug abuse as<span style="color: Red;">*</span>an illness that may be related to<span style="color: Red;">*</span>post-traumatic stress disorder (PTSD) or mild traumatic brain injury (TBI) stemming from combat.<span style="color: Red;">*</span>The result:<span style="color: Red;">*</span>soldiers are sometimes denied necessary treatment or expelled<span style="color: Red;">*</span>from the Army<span style="color: Red;">*</span>for behavior linked to PTSD or TBI.
In one case documented by USA TODAY<span style="color: Red;">*</span>in August, Spc.<span style="color: Red;">*</span>Stephen Akins, a veteran of several tours to Iraq and Afghanistan who returned home with<span style="color: Red;">*</span>PTSD and TBI<span style="color: Red;">*</span>was kicked out of the Army with a general discharge for abusing drugs and alcohol<span style="color: Red;">*</span>despite pleas by his then-Army psychiatrist, Lillard, that Akin needed a medical discharge.
USA TODAY
Military doctor blames Army addiction program for 2 deaths
A two-star general determined that Akins' substance abuse had nothing to do with his brain injury or emotional problems.<span style="color: Red;">*</span>Akins committed suicide in July in the<span style="color: Red;">*</span>basement of his mother's home outside Atlanta.
Another USA TODAY report revealed that in 2011, an alcoholic soldier was denied hospitalization by Army commanders who<span style="color: Red;">*</span>overruled a medical opinion.<span style="color: Red;">*</span>The soldier later<span style="color: Red;">*</span>murdered a sheriff's deputy while in a drunken state and then<span style="color: Red;">*</span>killed<span style="color: Red;">*</span>himself<span style="color: Red;">*</span>outside Fort Gordon, Ga., in an event that rocked the local community of Augusta, Ga.
USA TODAY
Another soldier spurned by Army dies of apparent suicide
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