Supporting Uniformed Personnel by Providing Oversight and Relevant Treatment for Substance Use Disorders Act or SUPPORT for Substance Use Disorders Act - Directs the Secretary of Defense to conduct a comprehensive review of Department of Defense (DOD) programs and activities for the prevention, diagnosis, mitigation, treatment, and management of, and research on, substance use disorders among members of the Armed Forces. Requires the Secretary to submit to the congressional defense and appropriations committees a plan for the improvement and enhancement of such programs and activities for members and their dependent family members, which shall include mechanisms to ensure the availability of appropriate treatment for such disorders and facilitate their prevention and reduction. Requires the plan to include instructions on: (1) the prevention of such disorders; (2) the appropriate training of health care professionals in the treatment of such disorders; (3) services for the dependents of members with such disorders; and (4) the dissemination of disorder prevention materials.
Directs the Secretary to study such disorders in members and establish within DOD a Center of Excellence in the Prevention, Diagnosis, Mitigation, Treatment, and Management of Substance Use Disorders.
[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3420 Introduced in House (IH)]
111th CONGRESS
1st Session
H. R. 3420
To improve and enhance substance use disorder programs for members of
the Armed Forces, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
July 30, 2009
Mr. Kennedy (for himself, Mr. Jones, Mr. Pierluisi, Ms. Schakowsky, Mr.
Loebsack, Mr. Bishop of New York, Mr. Tonko, and Mr. Grijalva)
introduced the following bill; which was referred to the Committee on
Armed Services
_______________________________________________________________________
A BILL
To improve and enhance substance use disorder programs for members of
the Armed Forces, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Supporting Uniformed Personnel by
Providing Oversight and Relevant Treatment for Substance Use Disorders
Act'' or the ``SUPPORT for Substance Use Disorders Act''.
SEC. 2. FINDINGS.
Congress makes the following findings:
(1) The Armed Forces is comprised of more than 1,400,000
members in the regular components and more than 1,080,000
members in the Reserves. More than 1,800,000 members of the
Armed Forces have been deployed in Operation Iraqi Freedom,
Operation Enduring Freedom, and the Global War on Terrorism
since 2001.
(2) Substance use disorders are chronic diseases that can
be prevented, treated, and managed effectively. Failure to
prevent or treat these conditions results in severe and
widespread consequences, including increased risk of suicide,
exacerbation of mental and physical health disorders, increased
risk of domestic violence and family discord, and increased
risk of unemployment and homelessness.
(3) According to the 2005 Department of Defense Survey of
Health Related Behaviors Among Active Duty Personnel, 24
percent of the members of the Armed Forces surveyed reported
symptoms of alcohol dependence and nearly 11 percent of the
members surveyed reported use of an illicit drug. Misuse of
controlled prescription drugs, particularly narcotic
painkillers, is a significant and growing problem among members
of the Armed Forces as well.
(4) Substance abuse disorders often co-occur with other
health problems. According to the 2007 Report of the Department
of Defense Task Force on Mental Health, 17 percent of soldiers
from brigade combat teams are at risk of developing clinically
significant symptoms of post-traumatic stress disorder, major
depression, or anxiety after deployment, and an even higher
percentage of such soldiers, 28 percent, would experience
symptoms based upon broader screening criteria. The prevalence
of post-traumatic stress disorder within a year of combat
deployment was estimated to range from 10 to 25 percent.
(5) According to the 2007 Report of the Department of
Defense Task Force on Mental Health, symptoms of disorders such
as post-traumatic stress disorder often include complex
disinhibitory behaviors such as self-medicating with alcohol,
other medications, or illicit drugs in an attempt to return to
``normalcy''.
(6) According to the 2007 Report of the Department of
Defense Task Force on Mental Health, of the 686,306 veterans
separated from active duty between 2002 and December 2006 who
were eligible for care from the Department of Veterans Affairs,
229,015 (or 33 percent) accessed care at a Department facility.
Of those veterans who accessed such care since 2002, 83,889 (or
37 percent) were diagnosed with or were evaluated for a mental
disorder, including post-traumatic stress disorder (39,243 or
17 percent), nondependent abuse of drugs (33,099 or 14
percent), and depressive disorder (27,023 or 12 percent).
(7) According to the 2007 Report of the Department of
Defense Task Force on Mental Health, 20 percent of married
soldiers planned to separate or divorce.
(8) According to the 2007 Report of the Department of
Defense Task Force on Mental Health, relationship problems are
the top risk factor for suicide. Mental disorders, alcohol and
substance use disorders, and significant stress are other
significant risk factors for suicide. The National Violent
Death Reporting System of the Centers for Disease Control and
Prevention determined that, of a group of former or current
military personnel who died by suicide in 2005, 17.2 percent
had an alcohol problem and 7.7 percent had a problem with other
substances. The suicide prevention action network (SPAN)
reports a 20 percent increase in suicide among members of the
Armed Forces on active duty, 89 suicides in 2007 with 32 deaths
under investigation, and a rise of attempted suicides by
soldiers by 6 times higher than it was at the start of
Operation Iraqi Freedom.
(9) While some commands and facilities in the Armed Forces
provide outstanding services for members of the Armed Forces
for substance use disorders, the prevention, diagnosis,
mitigation, treatment, and management of, and research on,
substance use disorders in members of the Armed Forces is
inconsistent in availability, structure, and success among the
various Armed Forces.
SEC. 3. COMPREHENSIVE PLAN ON PREVENTION, DIAGNOSIS, MITIGATION,
TREATMENT, AND MANAGEMENT OF SUBSTANCE USE DISORDERS IN
MEMBERS OF THE ARMED FORCES.
(a) Review and Assessment of Current Capabilities.--
(1) In general.--Not later than 180 days after the date of
the enactment of this Act, the Secretary of Defense shall, in
consultation with the Secretaries of the military departments
and the Secretary of Veterans Affairs, conduct a comprehensive
review of the programs and activities of the Department of
Defense for the prevention, diagnosis, mitigation, treatment,
and management of, and research on, substance use disorders in
members of the Armed Forces.
(2) Elements.--The review conducted under paragraph (1)
shall include, at a minimum, an assessment of each of the
following:
(A) The current state and effectiveness of the
programs of the Department of Defense and the military
departments relating to the prevention, diagnosis,
mitigation, treatment, and management of, and research
on, substance use disorders in members of the Armed
Forces.
(B) The adequacy of the availability of and access
to care for substance use disorders in military medical
treatment facilities and under the TRICARE program.
(C) The adequacy of oversight by the Department of
programs relating to the prevention, diagnosis,
mitigation, treatment, and management of substance use
disorders in members of the Armed Forces.
(D) The adequacy and appropriateness of current
credentials and other requirements for healthcare
professionals treating members of the Armed Forces with
substance use disorders, including an assessment of the
advisability of adopting uniform credentials and
requirements for such treatment for healthcare
professionals who are members of organizations such as
the Association for Addiction Professionals (NAADAC),
the American Society of Addiction Medicine (ASAM), the
American Psychiatric Association (APA), and the
National Board for Certified Counselors (NBCC).
(E) The advisable ratio of physician and non-
physician care providers for substance use disorders to
members of the Armed Forces with such disorders.
(F) The adequacy and appropriateness of protocols
for the diagnosis, treatment, and management of
substance use disorders in members of the Armed Forces.
(G) The adequacy of the availability of and access
to care for substance use disorders for members of the
reserve components of the Armed Forces when compared
with the availability of and access to care for
substance use disorders for members of the regular
components of the Armed Forces, including an
identification of any obstacles that are unique to the
prevention, diagnosis, mitigation, treatment, and
management of substance use disorders in members of the
reserve components of the Armed Forces.
(H) The adequacy of the prevention, diagnosis,
mitigation, treatment, and management of substance use
disorders and related distress in dependent family
members of members of the Armed Forces, whether such
family members suffer from their own substance use
disorder or because of the substance use disorder of a
member of the Armed Forces.
(I) Any gaps in the current capabilities of the
Department of Defense for the prevention, diagnosis,
mitigation, treatment, and management of, and research
on, substance use disorders in members of the Armed
Forces.
(3) Report.--Not later than 180 days after the date of the
enactment of this Act, the Secretary of Defense shall submit to
the congressional defense committees a report setting forth the
findings and recommendations of the Secretary as a result of
the review conducted under paragraph (1). The report shall--
(A) set forth the findings and recommendations of
the Secretary regarding each element of the review set
forth in paragraph (2);
(B) set forth relevant statistics on the frequency
of substance use disorders in members of the regular
components of the Armed Forces, members of the reserve
component of the Armed Forces, and dependents of such
members (including spouses and children); and
(C) include such other findings and recommendations
on improvements to the current capabilities of the
Department of Defense for the prevention, diagnosis,
mitigation, treatment, and management of, and research
on, substance use disorders in members of the Armed
Forces as the Secretary considers appropriate.
(b) Plan for Improvement and Enhancement of Programs.--
(1) Plan required.--Not later than 180 days after the date
of the enactment of this Act, the Secretary of Defense shall,
in consultation with the Secretaries of the military
departments and the Secretary of Veterans Affairs, submit to
the congressional defense committees a comprehensive plan for
the improvement and enhancement of the programs and activities
of the Department of Defense for the prevention, diagnosis,
mitigation, treatment, and management of, and research on,
substance use disorders in members of the Armed Forces and
their dependent family members.
(2) Basis.--The comprehensive plan required by paragraph
(1) shall take into account the following:
(A) The results of the review and assessment
conducted under subsection (a).
(B) Any preliminary results of the study required
by section 4.
(C) Similar initiatives of the Secretary of
Veterans Affairs to expand and improve care for
substance use disorders among veterans, including the
programs and activities conducted under title I of the
Veterans' Mental Health and Other Care Improvements Act
of 2008 (Public Law 110-387; 112 Stat. 4112).
(3) Comprehensive statement of policy.--The comprehensive
plan required by paragraph (1) shall include a comprehensive
statement of the policy of the Department of Defense regarding
the prevention, diagnosis, mitigation, treatment, and
management of, and research on, substance use disorders in
members of the Armed Forces and their dependent family members.
(4) Availability of services and treatment.--The
comprehensive plan required by paragraph (1) shall include
mechanisms to ensure the availability to members of the Armed
Forces and their dependent family members of services and
treatment for substance use disorders, including, but not
limited to, services and treatment as follows:
(A) Screening for substance use disorder in all
settings, including primary care settings.
(B) Short-term motivational counseling services.
(C) Marital and family counseling.
(D) Inpatient, intensive outpatient, or other
residential care services.
(E) Private medical, psychiatric, and professional
counseling services.
(F) Relapse prevention services.
(G) Ongoing aftercare and outpatient counseling
services.
(H) Pharmacological treatments aimed at treating
substance use disorders, including treating cravings
for drugs and alcohol.
(I) Detoxification and stabilization services.
(J) Coordination with groups providing peer-to-peer
counseling.
(K) Such other services as the Secretary considers
appropriate.
(5) Prevention and reduction of disorders.--The
comprehensive plan required by paragraph (1) shall include
mechanisms to facilitate the prevention and reduction of
substance use disorders in members of the Armed Forces through
science-based initiatives, including education programs, for
members of the Armed Forces and their families.
(6) Specific instructions.--The comprehensive plan required
by paragraph (1) shall include each of the following:
(A) Substances of abuse.--Instructions on the
prevention, diagnosis, mitigation, treatment, and
management of substance use disorders in members of the
Armed Forces, including the abuse of alcohol, illicit
drugs, and nonmedical use and abuse of prescription
drugs (including addiction to prescription drugs that
is an unintended consequence of otherwise required and
medically appropriate pain treatment).
(B) Healthcare professionals.--Instructions on--
(i) appropriate training of healthcare
professionals in the prevention, screening,
diagnosis, mitigation, treatment, and
management of substance use disorders in
members of the Armed Forces;
(ii) appropriate staffing levels for
healthcare professionals at military medical
treatment facilities for the prevention,
screening, diagnosis, mitigation, treatment,
and management of substance use disorders in
members of the Armed Forces; and
(iii) such uniform training and
credentialing requirements for physician and
non-physician healthcare professionals in the
prevention, screening, diagnosis, mitigation,
treatment, and management of substance use
disorders in members of the Armed Forces as the
Secretary considers appropriate.
(C) Services for dependents.--Instructions on the
availability of services for substance use disorders to
military dependents (including services for dependents
suffering from their own substance use disorder and
dependents suffering because of the substance use
disorder of a member of the Armed Forces), including
instructions on making such services available to such
dependents to the maximum extent practicable.
(D) Prevention materials.--Instructions on the
dissemination of materials regarding substance abuse
prevention, including, at a minimum, materials on the
following:
(i) The dangers of alcohol abuse.
(ii) The risks of self-medication, and the
potential co-occurrence of drug use or abuse
with illnesses such as post-traumatic stress
disorder.
(iii) The risks associated with abuse of
prescription medications and the signs of
inadvertent addiction to prescription
medications that may occur as a consequence of
otherwise prescribed treatment plans, as well
as the need to properly secure and dispose of
such substances to safeguard such substances
from third parties such as children.
(iv) The risks of substance abuse faced by
military dependents due to the stresses of
having a spouse or parent deployed, as well as
other factors relating to substance abuse that
are unique to military families.
(v) Strategies for prevention of drug and
alcohol abuse among children of military
families, and suggestions for military parents
on how to intervene and find help for a child
with a substance use disorder.
(E) Differentiation of disciplinary action and
treatment.--Instructions on the separation of
disciplinary actions from prevention and treatment of
substance use disorders in members of the Armed Forces.
(F) Confidentiality.--Instructions on
confidentiality for members of the Armed Forces in
seeking or receiving services or treatment for
substance use disorders.
(G) Participation of chain of command.--
Instructions on appropriate consultation, reference to,
and involvement of the chain of command of members of
the Armed Forces in matters relating to the diagnosis,
treatment, and management of substance use disorders in
such members.
(H) Consideration of gender.--Instructions on
gender specific requirements in the prevention,
diagnosis, mitigation, treatment, and management of
substance use disorders in members of the Armed Forces,
including gender specific care and treatment
requirements.
(I) Coordination with other healthcare
initiatives.--Instructions on the integration of
efforts on the prevention, diagnosis, mitigation,
treatment, and management of substance use disorders in
members of the Armed Forces with efforts to address co-
occurring health care disorders (including post-
traumatic stress disorder and depression) and suicide
prevention.
(7) Other elements.--In addition to the matters specified
in paragraph (3), the comprehensive plan required by paragraph
(1) shall include the following:
(A) Lead agent.--The designation by the Assistant
Secretary of Defense for Health Affairs of a lead agent
to coordinate implementation of the plan.
(B) Milestones and schedules.--Milestones and
schedules for the achievement of the goals of the plan,
including goals relating to the following:
(i) Enhanced education of members of the
Armed Forces regarding substance use disorders.
(ii) Enhanced and improved identification
and diagnosis of substance use disorders in
members of the Armed Forces.
(iii) Enhanced and improved access of
members of the Armed Forces to services and
treatment for and management of substance use
disorders.
(iv) Appropriate staffing of military
medical treatment facilities and other
facilities for the treatment of substance use
disorders in members of the Armed Forces.
(C) Best practices.--The incorporation of evidence-
based best practices utilized in current military and
civilian approaches to the prevention, diagnosis,
mitigation, treatment, and management of substance use
disorders.
(D) Available research.--The incorporation of
applicable results of available studies, research, and
academic reviews on the prevention, diagnosis,
mitigation, treatment, and management of substance use
disorders.
(8) Update in light of independent study.--Upon the
completion of the study required by section 4, the Secretary of
Defense shall--
(A) in consultation with the Secretaries of the
military departments and the Secretary of the
Department of Veterans Affairs, make such modifications
and improvements to the comprehensive plan required by
paragraph (1) as the Secretary of Defense considers
appropriate in light of the findings and
recommendations of the study; and
(B) submit to the congressional defense committees
a report setting forth the comprehensive plan as
modified and improved under subparagraph (A).
SEC. 4. INDEPENDENT REPORT ON SUBSTANCE USE DISORDERS IN MEMBERS OF THE
ARMED FORCES.
(a) Study Required.--The Secretary of Defense shall provide for a
study on substance use disorders in members of the Armed Forces to be
conducted by the Institute of Medicine of the National Academies of
Sciences or such other independent entity as the Secretary shall select
for purposes of the study.
(b) Elements.--The study required by subsection (a) shall include a
review and assessment of the following:
(1) The current state and effectiveness of the programs of
the Department of Defense and the military departments relating
to the prevention, diagnosis, mitigation, treatment, and
management of, and research on, substance use disorders in
members of the Armed Forces.
(2) The adequacy of the availability of and access to care
for substance use disorders in military medical treatment
facilities and under the TRICARE program.
(3) The adequacy of the oversight by the Department of
Defense of programs related to the prevention, diagnosis,
mitigation, treatment, and management of substance use
disorders in members of the Armed Forces.
(4) The adequacy and appropriateness of current credentials
and other requirements for physician and non-physician
healthcare professionals treating members of the Armed Forces
with substance use disorders.
(5) The advisable ratio of physician and non-physician care
providers for substance use disorders to members of the Armed
Forces with such disorders.
(6) The adequacy and appropriateness of protocols for the
diagnosis, treatment, and management of substance use disorders
in members of the Armed Forces.
(7) The adequacy of the availability of and access to care
for substance use disorders for members of the reserve
components of the Armed Forces when compared with the
availability of and access to care for substance use disorders
for members of the regular components of the Armed Forces.
(8) The adequacy of the prevention, diagnosis, mitigation,
treatment, and management of substance use disorders in
dependent family members of members of the Armed Forces,
whether such family members suffer from their own substance use
disorder or because of the substance use disorder of a member
of the Armed Forces.
(9) The need for and appropriate provision of
confidentiality for members of the Armed Forces who seek
services or treatment for a substance use disorder.
(10) Such other matters as the Secretary considers
appropriate for purposes of the study.
(c) Report.--Not later than one year after the date of the
enactment of this Act, the entity conducting the study required by
subsection (a) shall submit to the Secretary of Defense and the
congressional defense committees a report on the results of the study.
The report shall set forth the findings and recommendations of the
entity as a result of the study.
SEC. 5. CENTER OF EXCELLENCE IN THE PREVENTION, DIAGNOSIS, MITIGATION,
TREATMENT, AND MANAGEMENT OF SUBSTANCE USE DISORDERS.
(a) In General.--The Secretary of Defense shall establish within
the Department of Defense a Center of Excellence in the Prevention,
Diagnosis, Mitigation, Treatment, and Management of Substance Use
Disorders.
(b) Partnerships.--The Secretary of Defense shall ensure that the
Center collaborates to the maximum extent practicable with the
Department of Veterans Affairs, institutions of higher education, and
other appropriate public and private entities (including international
entities) to carry out the responsibilities specified in subsection
(c).
(c) Responsibilities.--The Center shall have responsibilities as
follows:
(1) To implement the comprehensive plan of the Department
of Defense for the prevention, diagnosis, mitigation,
treatment, and management of substance use disorders under
section 3, including the performance of research on gender and
ethnic group-specific health needs related to substance use
disorders.
(2) To provide for the development, testing, and
dissemination within the Department of evidence-based best
practices for the prevention, diagnosis, mitigation, treatment,
and management of substance use disorders.
(3) To provide guidance for healthcare professionals and
support service staff of the health system of the Department in
providing quality health care for members of the Armed Forces
with substance use disorders, and their dependents, when
possible, who are suffering from the effects of substance use
disorders.
(4) To provide guidance for healthcare professionals and
support service staff to make members of the Armed Forces
receiving prescription pain medications aware of the potential
for abuse of or addiction to such substances, and to provide
such members education on ways of properly securing such
substances and disposing of such substances when no longer
needed.
(5) To recommend uniform credentials and other requirements
for healthcare professionals and support service staff who
provide care and support for members of the Armed Forces and
their dependents who suffer from substance use disorders.
(6) To establish, implement, and oversee a uniform and
comprehensive program to train physician and non-physician
healthcare professionals and support staff in the Department in
the screening, intervention, treatment, and management of
substance use disorders.
(7) To coordinate research, data collection, and data
dissemination on the prevention, diagnosis, mitigation,
treatment, and management of substance use disorders, and to
maintain a database of information for that purpose.
(8) To facilitate advancements in the study of the short-
term and long-term physical and psychological effects of
substance use disorders.
(9) To disseminate evidence-based best practices within the
military medical treatment facilities for training healthcare
professionals and support staff with respect to substance use
disorders.
(10) To conduct basic science and translational research on
substance use disorders in members of the Armed Forces for the
purposes of understanding the etiology of substance use
disorders and developing preventive interventions and new
treatments.
(11) To develop programs and outreach strategies for
families of members of the Armed Forces with substance use
disorders to address and to mitigate the impact of substance
use disorders on such family members and to support the
recovery of such members from substance use disorders.
(12) To conduct research on the health needs of families of
members of the Armed Forces with substance use disorders and
develop protocols to address any needs identified through such
research.
(13) To disseminate information to families of members of
the Armed Forces regarding ways to help prevent alcohol and
drug abuse among their children, as well as educational
materials to address how situations unique to military
families, such as having a parent deployed, can increase stress
levels and put a child at increased risk of abusing drugs or
alcohol.
(14) To develop and oversee a long-term plan to increase
the number of healthcare professionals and support personnel
within the Department in order to facilitate the meeting by the
Department of the needs of members of the Armed Forces with
substance use disorders while they remain on active duty and
until their transition to care and treatment from the
Department of Veterans Affairs.
(15) To develop and deploy an education and awareness
training initiative designed to reduce the negative stigma
associated with substance use disorders and treatment.
(16) Such other responsibilities as the Secretary shall
specify.
SEC. 6. CONGRESSIONAL DEFENSE COMMITTEES DEFINED.
In this Act, the term ``congressional defense committees'' means--
(1) the Committee on Armed Services and the Committee on
Appropriations of the Senate; and
(2) the Committee on Armed Services and the Committee on
Appropriations of the House of Representatives.
<all>
Introduced in House
Introduced in House
Referred to the House Committee on Armed Services.
Referred to the Subcommittee on Military Personnel.
Llama 3.2 · runs locally in your browser
Ask anything about this bill. The AI reads the full text to answer.
Enter to send · Shift+Enter for new line