A pilot Army program allows soldiers at high risk for developing alcohol problems to enroll in a confidential treatment program that will not adversely impact their careers. The program, which started at three Army installations, is now at six posts.

The Confidential Alcohol Treatment and Education Project (CATEP) is aimed at helping soldiers who abuse alcohol, before more serious substance abuse problems develop that could harmfully impact their finances, health, relationships and military career.

Soldiers are overwhelmingly young males, who have higher rates of drinking than the general population, according to Colonel Charles S. Milliken, MD, of the Walter Reed Army Institute of Research. In addition to drawing from this demographic, soldiers have specific reasons for abusing alcohol, including “self-medicating” sleep problems and irritability. These reasons are common in not just those with post-traumatic stress disorder, but in many soldiers first returning from war.

One study found that an estimated 27 percent of soldiers reported alcohol misuse three months after redeploying from Iraq, Col. Milliken says. “Soldiers who drink too much are at high risk of behaviors that put themselves and others at risk, including drinking and driving or riding with a drunk driver.”

Traditionally, when a soldier enrolls in the Army’s substance abuse treatment program, known as ASAP, his or her Commanding Officer is automatically notified. Soldiers who fail to comply with or respond successfully to treatment are processed for administrative separation from military service.

Recent studies have found that non-commissioned officers (NCOs) and officers alike believe that alcohol abuse treatment is a career killer, and lower-enlisted soldiers feel they are easily replaced if their fitness is questioned, according to Col. Milliken.

The CATEP program aims to reduce the stigma of substance abuse treatment. Soldiers who have no record of drug use or alcohol-related legal problems, such as drunk driving, can confidentially enroll without their commander’s knowledge. The program protects the soldier from any negative consequences from being in the program with regard to promotions, reenlistment or enrollment in school.

If a soldier is charged for driving under the influence, has another alcohol incident, a positive drug test, develops a prescription drug abuse problem, or is deemed a safety or security risk while in the program, the Commanding Officer is notified. “Soldiers are treated with confidentiality to the degree it makes sense—if they are suicidal or a risk to others, then the clinician will alert their Commanding Officer,” Col. Milliken notes.

The project initially started in 2009 at three sites: Schofield Barracks Army Health Clinic in Hawaii, Fort Lewis in Washington and Fort Richardson in Alaska. In April 2010, the program was expanded to include Fort Riley in Kansas, Fort Carson in Colorado and Fort Leonard Wood in Missouri. Col. Milliken estimates that the program now covers about 25 percent of those on active duty in the Army.

CATEP is designed to help all soldiers, not just junior-enlisted officers who have already gotten into trouble. “Career officers and NCOs have known that going in for alcohol treatment would potentially affect their career and the means by which they support their family, so most have said, ‘No thanks,’” he says.

The program’s evening hours are meant to encourage career-minded soldiers to obtain care, Col. Milliken explains. “Senior NCOs really like the evening hours for several reasons. They tend to have more job responsibilities, and intensive daytime treatment for alcohol dependence can interfere with that. They also don’t want to go into the clinic when some of the soldiers reporting to them might see them. Going in the evening means they can wear civilian clothing, which increases their anonymity.”

A study of the pilot project found greater numbers of senior and career-minded soldiers are accessing treatment. The research found soldiers in the program showed a greater willingness to involve family members in their treatment and almost two-thirds of soldiers chose to informally tell their chain of command about their treatment.

Col. Milliken explains, “The program seems to be changing attitudes in soldiers that will promote an earlier and more open dialogue about the potentially harmful effects of alcohol.”