Troops who have been referred for alcohol abuse treatment are not getting the care they need because of command deferrals, according to a Defense Department inspector general report published Monday.

There were a few reasons for this, according to an audit. Some commanders thought the requirements for getting a service member into treatment were unclear; some treatment centers were understaffed or didn’t have enough spots; and some commanders put off getting their troops into treatment because of “operational requirements, legal actions, or other reasons.”

“According to the medical records we reviewed and unit leadership we interviewed, leadership encouraged service members to self‑refer instead of submitting a command referral following an alcohol‑related incident or suspected alcohol misuse,” DoD IG spokesman Megan Reed said in a statement.

There was a reason behind it, she added, though in practice it amounted to passing the buck.

“Personnel from a substance abuse center stated that there is stigma associated with the overall substance abuse program and there is a belief that service members will be more motivated to change and receive treatment if they self‑refer before a command or medical referral forces them to seek help,” she said. “However, the substance abuse personnel stated that when left to the Service members to self‑refer, the Service members do not always choose to go to the substance abuse center.”

Of 270 personnel who were sent for alcohol treatment, 104 didn’t get an intake assessment within the required timeline, 98 did not receive their treatment within the required timeline and three did receive treatment at all.

And of those 270 who were recommended for treatment, according to the IG, 103 of them were involved in an alcohol-related incident that triggered the treatment.

The finding was one of many the IG reported in the audit, which reviewed the military services’ alcohol screening and treatment programs writ large.

Every active-duty service member is supposed to complete an alcohol use screening at least once a year to help determine whether they should be referred to treatment. A total of 78% of troops audited, out of 210 from across seven units, didn’t undergo the assessment on time.

Across seven units reviewed, the IG found, screenings were done an average of 66 to 200 days late, with 15 troops who were screened more than 300 days late.

Some of that might have been due to the fact that although the screenings are required every 12 months, the DoD-mandated physical health assessment where they mostly occur can be pushed out to every 15 months.

On top of that, there’s no central tracking mechanism to make sure every service member is receiving the screening on time. That is the IG’s first recommendation following the report.

“Furthermore, we recommend that the [Defense Health Agency] Director, in coordination with the Military Services, review the civilian hiring and retention practices for substance abuse personnel and make applicable improvements to minimize vacant positions; establish a maximum number of days between a substance abuse referral and an intake assessment for a substance use disorder; and establish the maximum number of days to provide substance abuse treatment following a diagnosis of a substance use disorder,” according to the report.

The IG also recommended that the Army and Navy mandate annual substance abuse training for leadership, and that all of the services do a sample audit of their forces each year to verify that their troops are receiving substance abuse training.

The Pentagon and the services have already begun incorporating the recommendations into their regulations, according to the report.

Meghann Myers is the Pentagon bureau chief at Military Times. She covers operations, policy, personnel, leadership and other issues affecting service members.

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