Substance Abuse Program Overview for HQMC Behavioral Health Conference

1. Marine and Family Programs Substance Abuse Program Overview for HQMC Behavioral Health Conference

2. Mission Statement Staffing and Function Overview HQMC Oversight Current Initiatives Challenges Integration Substance Abuse Program

3. Enhancing the readiness of the Marine Corps by providing evidence-based prevention tools and training; and wellness oriented treatment and aftercare. MFC-4 Mission

4. Substance Abuse 1-Section Head (vacant) 1-Prevention Program Manager (vacant) 1-Clinical Program Manager (vacant) 1-Prevention Specialist 1-Program Analyst Drug Demand Reduction 1-Program Manager (vacant) 1-Program Analyst 2-DDR Specialists Staffing Overview (HQMC)

5. 15 Substance Abuse Counseling Centers Staff: 58 Substance Abuse Counselors 7 vacant 6 Alcohol Prevention Specialists 19 Drug Demand Reduction Coordinators Staffing Overview (Installation)

6. Focus on prevention, education, treatment and rehabilitation Objective is to inform: Policy Available services Consequences Indicators Administrative Substance Abuse Program

7. Drug Demand Reduction Coordinators (DDRC) Evaluating Demand Reduction Education Standardize SACO Training Standardize Drug Demand Reduction Duties Substance Abuse Counseling Center IGMC Inspections Substance Abuse Control Officers (SACO) Reviewing unit level aftercare program Monitoring periodic inspection of the SACOs by DDRCs HQMC Oversight

8. Current Initiatives • Program Review and Analysis • IG Assessment • Drafting changes to Substance Abuse Order (MCO 5300.17) • NHRC Program Evaluation on Prevention Efforts • Prevention Outreach • Campaign Plan • Prevention Plan • Prime for Life • NHRC Evaluation of Prescription Drugs and Correlation with Sexual Assault

9. Personnel Lack of Prevention Specialists Treatment Program Reviewing current effectiveness Implementation of evidence-based practices Ineffective unit level Aftercare Program Challenges

10. Alcohol Prevention Funding to support alcohol prevention efforts Underage drinking Driving While Under the Influence Tracking of off-base DUI/DWIs Screening and treatment compliance Drug Prevention Synthetic drugs Data reporting Challenges

11. Integration

12. Alcohol “Hub of the Wheel” • 18% had evidence of alcohol use at the time of death • 24% had evidence of past alcohol abuse or dependence diagnosis • 80% of individuals with TBI met criteria for alcohol abuse and dependence Suicide COSC Alcohol Misuse Over 50% of victims and offenders of sexual assaultwere associated with alcohol 30% of spouse abuse involved alcohol Sexual Assault Family Advocacy Substance Abuse Data from internal Marine Corps Behavioral Health Program statistics: TBI data from RAND (2008)

13. What does BH integration mean? Set the tone Strategic Partnerships Educating Outside the “BOX” Improve credibility, reduce stigma Target the right audience Change the environment Eliminating Program Overlaps Early identification and referral Screening and treatment compliance Integration

14. Backup Slides

15. Findings • 1. Not all ARIs are reported or result in screening. • No one entity is tracking ARIs and follow-on substance abuse • screenings. • No single database exists for tracking ARIs and Command • action, including screenings and treatment. • Pulling ARI screening/treatment data from existing databases • is cumbersome and results in incomplete and unreliable data • because existing CLEOC and ADMITS databases are not linked. • CLEOC is a law enforcement database that only includes certain ARIs reported to NCIS. • On-base incidents. • Some local civilian jurisdictions.

16. Findings • ADMITS is a legacy system that is not meeting the needs of the Marine Corps Substance Abuse Program in part due to inconsistent data input policies. • ADMITS doesn’t distinguish between types of ARIs. • Members are lost in the system due to deployments or PCS and don’t • always receive screenings. • Blotter reports don’t include most civilian ARIs. • Not all SACC Directors receive blotter reports. • Not all SACC Directors who receive blotter reports act on reported information.

17. Findings • MCO 5300.17, Marine Corps Substance Abuse Program, doesn’t provide a uniformed approach to substance abuse screening and treatment. • 13. All 16 SACCs continue to operate independently. • Staff credentials and methods vary. • Wait times for screenings vary. • Screening protocols and treatment methods vary. 14. No uniform staffing T/O exists for SACCs. • 68% of SACCs report they are understaffed (11 of 16 Directors)

18. Findings • 15. Lack of transparency on SACC policies/procedures leads to unnecessary command frustration. • SACCs triage cases causing extended wait times for some Marines sent for screenings. • 16. Most SACOs are multi-tasked. • 17. Some Commanders overload their SACOs with collateral duties. • 18. SACOs are responsible for monitoring aftercare treatment programs, but aren’t adequately trained for the task. • 19. From a command training perspective the substance abuse program is not adequately linked to other conditions (depression, PTSD, TBI) or suicide, spouse abuse, and sexual assault.

19. Findings • 20. Junior leaders are not adequately trained on prevention and early intervention techniques. • 21. Treatment for alcohol abuse is viewed as a punitive measure. • 22. Due to the existing stigma, Marines are reluctant to self-report alcohol problems and seek treatment.

20. . Questions