CHAPTER 8 AGENCY COMMENTS AND GAO EVALUATION In commenting on the draft of this report, the Principal Deputy Assistant Secretary of Defense (Health and Environment) emphasized the humanitarian benefits to be gained from a comprehensive alcoholism control program and did not take issue with our estimates of the economic savings to be gained. He concurred in our findings and those recommendations concerning establishment of educational programs, availability of rehabilitative measures, and studies to determine the incidence of alcoholism and problem drinking. (See app. II.) The Deputy Assistant Secretary advised that acceptance of our recommendation that alcoholism be recognized as a disease would present difficulties to DOD, since a disease is considered a physical disability and is therefore compensable under existing statutes. He went on to say, in part, that: it would be preferable to recognize chronic alcoholism as a condition which is preventable and treatable through the application of enlightened attitudes and techniques toward this condition, both on the part of supervisory personnel and medical department personnel." We recognize that certain statutes and regulations affecting military compensation currently hold alcoholism to be misconduct. As stated earlier, however (see pp. 9 to 12), the effect of punitive statutes, policies, and regulations has been to hide the problem of alcoholism. If they are not modified, there is little assurance that this condition will be corrected. Public Law 92-129, amending the Military Selective Service Act, was enacted on September 28, 1971, with provisions for identification and treatment of persons dependent on alcohol and drugs in the Armed Forces. Both Houses of the Congress agreed to these provisions with the understanding that they were a prelude to further legislative actions by their respective Armed Services Committees. Title V, section 501, of the act requires the Secretary of Defense to prescribe and implement procedures and provide necessary facilities to identify, treat, and rehabilitate members of the Armed Forces who are dependent on drugs or alcohol. The Secretary is also required to report to the Congress 60 days after enactment of the act (1) the plans and programs which have been initiated and (2) such recommendations for additional legislation as are necessary to effectively combat drug and alcohol dependence in the Armed Forces and to treat and rehabilitate effectively any member found to be dependent on drugs or alcohol. We believe that the Secretary of Defense properly should include in his proposals to the Armed Services Committees, contemplated by Public Law 92-129, recommendations to deal with the problems of recognizing alcoholism as a disease. These problems include those involving pay, retirement, and related benefits. CHAPTER 9 SCOPE OF REVIEW Our review was made during early 1971 at the Office of the Secret of Defense, the headquarters of the military services, and over Army, Navy, Air Force, and Marine Corps installations. At the stallations we interviewed more than 600 personnel including co manders, staff judge advocate officials, provost marshal person medical personnel, base chaplains, and senior noncommissio officers. Specifically we asked questions concerning (1) the incide of alcoholism among military personnel, (2) the factors in the milit environment which might tend to encourage or discourage alcoholi (3) the alcoholism treatment programs available to the bases, (4) the policies and practices followed in handling alcoholic milit members. Most of the military installations that we visited had la troop populations and were located in the continental United Stat Europe, and the Far East. We met with representatives of local and State alcoholism coun as well as the National Council on Alcoholism, local chapters of Al holics Anonymous, the Veterans Administration, and the Departm of Health, Education, and Welfare. We attended open Alcoho Anonymous meetings and visited the rehabilitation clinics at the Lo Beach Naval Station and at Fort Benning. We did not attempt an exhaustive search of all statutes and regu tions affecting the military alcoholic; however, some of the m pertinent are included in this report. A search of the literature alcoholism in the military services was made principally through use of the Classified Abstract Archive of Alcoholism Literature ma tained by the Center of Alcohol Studies, Rutgers University, N Brunswick, New Jersey. DEAR MR. STAATS: You will recall that in May, 1970, I requested that your office conduct a study to determine the cost savings which might be brought about in the civilian and military branches of the Government through the implementation of a strong Federal alcoholism personnel program. The request was based, in part, upon our Subcommittee's findings that treatment which is tied to employment personnel programs, where alcoholism is dealt with at a less advanced stage and with strong motivational tools, has brought about recovery rates much higher than those found in clinic and hospital settings which are unrelated to such an environment. It was also based upon a deep and increasing concern in the Congress about the growing impact of alcoholism in our society. I felt that if it were clear there was a sound economic basis, as well as a humanitarian basis, for establishing such a program, that that information would be of key importance to the Subcommittee and would be of great interest throughout the Executive Branch as well. After visiting with your staff about the fact that a study of this type-a costsaving study was a new type of a study for the General Accounting Office to conduct and that the alcoholism personnel programs area was one in which your personnel had not previously worked, we agreed that the study should be limited to the civilian branch of the Government, in order to first determine, in that more limited area, the extent to which firm results might be obtained in a study of this kind. As you know, the study was highly successful, both in terms of obtaining professionally reliable data and in terms of providing an extremely useful document to the Congress, the other branches of the Federal Government, and to State governments, about the significant cost savings which can be obtained by establishing such programs. The report has received extremely favorable comment by health professionals both within and outside the Government; it has been received favorably by businessmen and by the business media as well (the Wall Street Journal placed its story on the report on the front page). The Committee on Labor and Public Welfare is making a committee print of the report, so that it may be distributed to the members of Congress and to State and local groups and organizations who are interested in it. Public demand for the document from the Committee has been high. Because of the success of the study, I would now like to request that a similar study be made in the military branch of the Government. Certainly the reasons for carrying out such a study in the civilian branch of the Federal Government apply to the military branch as well. In fact, there are indications that the need for such a study in the military area is even more pressing. The majority of our young men are required to serve in the military service and are encouraged to go on to careers there as well. As a result, we have a special obligation to them. Our Subcommittee has found many indications that men, often with many years' training, are being forced to retire or are being removed with no benefits and less than honorable discharges because they are the victims of alcoholism. It would be extremely helpful for Congress, as well as the Executive Branch, to know the economic impact of a program which would encourage a somewhat different approach to this problem. There are indications that cost savings would affect the veterans area as well. According to the Veterans Administration, one in every six beds in our Veterans Hospitals is now occupied by a patient who is an alco holic or who has alcohol-related problems. Though a report on the m branch would pose problems which the report on the civilian branch did not hopeful that the expertise which the men who worked on the earlier report now obtained could now be used to advantage in the military area. It would be helpful if your office could designate a representative of the G Accounting Office to contact Mr. Wade Clarke, Counsel to the Subcomm for additional information concerning the areas which such a study might and the supportive information or assistance the Subcommittee might be position to provide. Thank you for your consideration. HAROLD E. HUGHES, Chairman, Special Subcommittee on Alcoholism and Narco APPENDIX II Mr. FORREST R. BROWNE, ASSISTANT SECRETARY OF DEFENSE, DEAR MR. BROWNE: The GAO draft report on "Alcoholism Among Military Personnel” (OSD Case No. 3299) has been reviewed and evaluated. The findings and recommendations in the GAO study are concurred in subject to the following discussion. The recognition of alcoholism "as a disease which is treatable rather than as misconduct which is punishable" presents difficulties, from our standpoint, due to the equating of "disease" with "physical disability," which is compensable. We believe that it would be preferable to recognize chronic alcholism as a condition which is preventable and treatable through the application of enlightened attitudes and techniques toward this condition, both on the part of supervisory personnel and medical department personnel. Alcoholic intoxication, and offenses which are related to this state, for which the individual should be held responsible Should be clearly differentiated from the chronic underlying alcoholic dependency state. While we have no basis on which to differ with the estimated economic savings to be gained from a comprehensive alcoholic rehabilitation program, we believe that the benefits should be measured primarily in terms of the human values involved, with the savings considered as balancing off the cost of the program. We are in general agreement with the recommendations concerning establishment of educational programs, availability of rehabilitative measures, and studies to more precisely determine the incidence of alcoholism and problem drinking. We anticipate that in the near future Department of Defense-wide policies will be established to achieve these goals. Sincerely, GEORGE J. HAYES, Brigadier General, Medical Corps, U.S. Army, Principal Deputy. APPENDIX III SUBSTANTIAL COST SAVINGS FROM ESTABLISHMENT OF ALCOHOLISM PROGRAM FOR FEDERAL CIVILIAN EMPLOYEES B-164031 (2) DIGEST WHY THE REVIEW WAS MADE The Chairman, Special Subcommittee on Alcoholism and Narcotics, Senate Committee on Labor and Public Welfare, asked the General Accounting Office (GAO) to make a study to determine the cost savings to the Government that might be brought about through a program aimed at identification, prevention, and treatment of alcoholism among Federal civilian employees. The study was requested because of the Subcommittee's concern about the growing impact of alcoholism upon our society, strong congressional and public interest in this important health area, the Subcommittee's finding that treatment tied to employment personnel programs-under which alcoholism is dealt with in its early stages-had brought about recoveries at rates much higher than those in clinics and hospitals unrelated to such an environment, the cost savings achieved by private industry, as a result of alcoholism programs, and the existing potential for the Federal Government to implement, within its own administrative structure, a strong alcoholism program for its employees. On August 10, 1970, the Senate passed a bill (S. 3835) that provides for a comprehensive Federal program for the prevention and treatment of alcohol abuse and alcoholism, including the development and maintenance of appropriate policies and services for Federal civilian employees. |