Transcript Total Force Brief for EBO Conference

Headquarters U.S. Air Force
Integrity - Service - Excellence
History of CoRC
Dr. Milton H. Cambridge
Demand Reduction Prevention and
Outreach Coordinator
Overview

Development of CoRC

2005 DOD Survey of Health-Related Behavior

Alcohol-Related Incidents (ARIs)

Drug Positives

Comprehensive Substance Abuse Prevention
Program (CSAPP)
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Overview

NIAAA 2002: A Call to Action: Chaging the Culture of
Drinking at U.S. Colleges

Institute of Medicine 2003: Reducing Underage
Drinking: A Collective Responsibility

F. E. Warren 0-0-1-3 Program

CORONA Tasker

CoRC: Fundamental Principles
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DOD Survey

DOD Survey of Health Related Behaviors Among
Military Personnel
http://www.ha.osd.mil/special_reports/2005_Health_Be
haviors_Survey_1-07.pdf
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Heavy Alcohol Use Trends by Service
2005 DoD Survey of Health Related Behaviors Among Military Personnel
Army
35
35
30
30
25
25
20
15
20
15
10
10
5
5
0
0
19801982 1985 1988
1992 1995 1998
Navy
40
Percentage
Percentage
40
19801982 1985 1988
2002 2005
Marine Corps
2002 2005
Air Force
40
40
35
35
30
30
25
25
Percentage
Percentage
1992 1995 1998
Year of Survey
Year of Survey
20
15
20
15
10
10
5
5
0
0
19801982 1985 1988
1992 1995 1998
2002 2005
19801982 1985 1988
Year of Survey
1992 1995 1998
2002 2005
Year of Survey
Unadjusted
Adjusted
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Trends in Alcohol-Related Negative Effects
2005 DoD Survey of Health Related Behaviors Among Military Personnel
45
40
Navy
40
35
35
30
30
Percentage
Percentage
45
Army
25
20
15
25
20
15
10
10
5
5
0
0
19801982 1985 1988
1992 1995 1998
2002 2005
19801982 1985 1988
Year of Survey
45
45
Marine Corps
40
35
35
30
30
Percentage
Percentage
40
1992 1995 1998
2002 2005
Year of Survey
25
20
15
25
20
15
10
10
5
5
0
Air Force
0
19801982 1985 1988
1992 1995 1998
2002 2005
Year of Survey
Serious Consequences
19801982 1985 1988
1992 1995 1998
2002 2005
Year of Survey
Productivity Loss
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DoD Self-Reported Drug Use
2005 DoD Survey of Health Related Behaviors Among Military Personnel
5.0
Marijuana
4.5
4.2
Percentage
Percentage
6.0
3.0
2.0
5.0
4.0
3.0
2.0
1.0
1.5a
1.0
0.0
0.0
2002
2002
2005
Steroids
5.0
2005
Any Illicit Drug
12.0
4.0
10.9
10.0
3.0
2.0
0.9a
1.2
Percentage
Percentage
7.3
7.0
4.0
1.0
Analgesics
8.0
8.0
6.9
a
6.0
4.0
2.0
0.0
0.0
2002
2002
2005
a
2005
Significant difference between 2002 and 2005
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DoD Self-Reported Drug Use
2005 DoD Survey of Health Related Behaviors Among Military Personnel
35
30
Percentage
25
20
15
Significant increase from 2002
10
5
0
19801982 1985 1988
1992 1995 1998
2002 2005
Year of Survey
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Air Force
Alcohol Related Incidents (ARI)
7000
6591
6532
6441
5900
6000
5226
5306
5481
5000
4000
Total ARIs
3000
2000
1000
0
CY99
CY00
CY01
CY02
CY03
CY04
CY05
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2005 Air Force Alcohol Related
Incidents (total = 6441)
6%
DUI
33%
22%
Underage Drinking
Alcohol-related accidental
death/injury
Alcohol-related crimes
against people
Alcohol-related crimes
against property
7%
32%
Note: Airmen under 21 account for
only 9% of AF population
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Total AF: Underage
Drinking
2500
2284
2157
2014
1970
2000
1500
1774
1401
Underage Drinking
1000
500
0
CY00 CY01 CY02 CY03 CY04 CY05
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Air Force: Percent Drug Positive
0.6
0.5
0.4
0.3
0.2
0.1
0
FY98
FY99
FY00
FY01
FY02
FY03
FY 04
FY 05
AF AD Drug Positives
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Air Force: Top 4 Drug
Positives By Drug Class
0.35
0.3
0.25
FY02
FY03
FY04
FY05
0.2
0.15
0.1
0.05
0
THC
Cocaine
Amp
Methamp
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AF Illicit Drug Use

AD AF FY04 0.45% Drug Positives (1,572 total)
 Discharge ≃ 1500 Airmen a year b/c of drug positives



$36-79k avg. cost to produce each trained Airman
Demand Reduction (Detection and Deterrence)

Detection is important to the mission
 But once caught, we lose an airman

Deterrence is vital to the mission
 Effective prevention results in saving an airman
Comprehensive approach to further reduce use
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Substance Misuse:
A Clear and Present Danger

Must reduce Alcohol Related Events!

80+% ADAPT referrals not Abusing/Dependent on Alcohol
 “Alcoholism” cannot/should not be our sole focus!

Alcohol misuse is involved in:
 33% of suicides
 57% sexual assaults
 28.5% domestic violence cases
 44% PMV accidents

33% of our members commit 81% of our ARI’s
(17-24 year olds)
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FY06 Alcohol-Related
Misconduct
5%
2% 3%0%
4%
31%
7%
15%
8%
DUI
Underage Drinking
Drunk & Disorderly
Crimes Against People
Duty-Related Incident
Public Intoxication
Accidental Injury
Contrib to Delinquency
Crimes Against Property
Open Container
25%
Airmen under 21 account for only 9% of our total population
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Alcohol-Related Misconduct:
CoRC FY 06

~ 5961 counts of Alcohol Related Misconduct (ARM) in FY06

31% Driving While Intoxicated (DWI) or Driving Under the Influence (DUI)
25% Underage Drinking
15% Domestic Violence or Other Crimes Against People or Pets/Family Maltreatment
8% Drunk and Disorderly
7% Duty Related Incident
5 % Accidental Injury
4% Public Intoxication
3% Crimes Against Property
2% Contributing to the Delinquency
.02% Open Container









Greatest mission impact from alcohol misuse not alcoholism!
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The Problem

Impact of drug use and alcohol misuse
 Clear and present danger to the mission
 Reduces readiness
 Wastes critical resources
 Erodes our Core Values/the Culture of Airmen
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CSAPP Historical
Overview

DOD Drug Demand Proposal
 Comprehensive Approach to Substance Abuse
 Smart Testing – 1 Oct 2004
 Original CSAPP Model

Team Awareness
 SHARP Program
 Edwards Program
 Vandenberg's ALCON

Piloted at 4 AFBs
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Air Force Instructions

AFI 44-107 Civilian Drug Testing Program
 AFI 44-120 Drug Abuse Testing Program
 AFI 44-121 Alcohol and Drug Abuse Prevention and
Treatment (ADAPT) Program
 AFI 44-159 Demand Reduction Program
 AFI 90-501 Community Action Information Board and
Integrated Delivery System
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Additional Research
Sources

2002 NIAAA: “A Call to Action: Changing the Culture
of Drinking at US Colleges”

2003 Institute of Medicine (IOM) “ Reducing
Underage Drinking: A Collective Responsibility”

2003 “Preventing Workplace Substance Abuse:
Beyond Drug Testing to Wellness”
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The best models for change…
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Community Approach to
Population Health
Services
100%
Leadership Supports Health Behavior Change
Excellent
Installation Policies Enhance Health
Prevention and Education
Helping Agency Support (IDS)
POPULATION
Primary Care
HEALTH
Early Intervention
Specialty Care
Treatment of
Disease
0%
Poor
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Research Says….
 Comprehensive

Leadership Driven, Environmental Change, Information,
Early Identification and Intervention, Policy/Deterrence, &
Alternative Activities
 Key:

Identify those at of risk
Population based screening/assessment
 Good

community approach ideal:
evidence for brief interventions
Tailored feedback (in-person and mailed), Brief
Interventions, Primary Care, Web-based programs, etc…
Based on SAMHSA and NIAAA recommendations for prevention and early intervention in youth &
young adults
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Changing the Culture

Culture change requires emphasis on prevention:
Leadership sets the tone -Commanders’ program!
 Wide range of prevention efforts
 Broad community involvement
 Medics offer enhanced screening and early intervention
 Create prevention opportunities outside of MTF


Should be responsibility (not morality) based

Standardize elements & evaluation

Implementation must be locally tailored/flexible
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0-0-1-3: Basics

Science-based community program from F.E. Warren
 0-0-1-3 is a slogan that is part of a larger program
0
underage drinking, 0 DUIs, 1 drink/hour, 3 drinks per
sitting max

Wing Commander’s Program
 ADAPT is a team player--not the lead
 All installation IDS/CAIB members had a role
 Public Affairs, Security Forces, Services, Command
Master Chief/First Sergeants, and Chaplains have
particularly involved roles

4 core levels of change:
 Strong Leadership, Individual, Base, & Community
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Prevention: 0-0-1-3
Results
60
50
40
30
1st Quarter 2004
1st Quarter 2005
20
10
0
Alcohol
Related
Incidents
 68%
Driving
Under the
Influence
 64%
Underage
Drinking
 93%
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0-0-1-3’s Savings in
Resources
 *68%


8% increase in available-for-duty rate (or 38 more airmen)
≃ 230 duty days not lost to Alcohol-Related Incidents
 *70%

decrease in alcohol related incidents
decrease in Article 15s
CCs / Shirts with more time for mission / morale / welfare
 Contrary

to popular myths, Services showed a profit!
MWRF NIA increased $173K / Club profit of $13K
*Comparison of First Quarter 2004 to First Quarter 2005
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The Road from CSAPP and 0-0-1-3
to CoRC…..
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Corona Tasker

Develop a plan to incorporate 0-0-1-3 with other “Culture of
Airman” initiatives
 OPR: AF/DP
 OCR: SAF/MR,AF/SG,AF/SE,SAF/IE,AETC, AFSPC
 Suspense: Brief at Corona Top 05

AF/DP co-lead with SG (HQ ADAPT/DR)
 Established IPT of stakeholders

DP, SG, JA, SFS, ILV, CCC, PA, HC, AETC, others
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CSAF: Basics for CoRC

Guiding principles






Commander’s program
Responsible drinking vs. abstinence only
Incident deterrence
Attention to prevention: alcohol misuse and abuse
Emphasize Common Airman Culture
Program goals over first year (baseline year FY04)


Decrease alcohol-related incidents (ARIs) by 25%
- Underage drinking, DUIs, crimes, etc.
- Reevaluate goal after year 1
Decrease confirmed drug positives by 25%
 Reevaluate goal after year 1
WORK HARD – PLAY SMART!
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CoRC:
Roles and Responsibilities
 HQ
Personnel (DP): Deliver Concept of Operations
 Functional
 MTF
groups developed area specific Toolkits
role at the base level:
Enhanced screening and early intervention
 Participation in outreach
 Serve as subject matter expert consultants to the CC

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CoRC:
AF Functional Community Players
Public
Affairs
Security
Forces
Legal
Senior Leadership
CC/1st Sergeants
Medical
Treatment
Facility
Mission
Support/
Services
Chaplains
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2. INDIVIDUAL LEVEL
3.BASE
4. LOCAL
COMMUNITY 1. LEADERSHIP COMMUNITY
INTEGRATED
4-PRONGED
COMMUNITY
APPROACH
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CoRC Basics
1. Leadership Driven Program: Message and support from top down
2. Individual Level Opportunities for Change
 Assessment/Screening of risk in all personnel
 Education/awareness
 Brief Interventions and treatment when needed
 Responsibility and commitment
3. Base Community Opportunities for Change
 Develop range of alternate activities
 Consistent and equitable detection/enforcement
 Media campaign promoting responsibility
 Monitor AF metrics/consider base specific metrics
4. Local Community Opportunities for Change
 Assess threat and availability of drugs and alcohol
 Develop coalition with community agencies
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Culture of Responsible
Choices (CORC)

All 72 SG toolkit documents found at: www.afcrossroads.com

Bucket 1: Resources for universal/primary prevention through
population-level outreach and screening

Bucket 2: Resources for selected/secondary prevention through
targeted, individualized, non-anonymous alcohol and drug screening
at Primary Care/Flight Medicine during PHA and routine care

Bucket 3: Resources for Behavioral Health targeted prevention
through assessment for alcohol related problems (misuse, abuse, and
dependence) and drug use at all Life Skill's intakes

Bucket 4: Resources for ADAPT/DDR staff to use in their role as the
Commanders' substance use subject matter experts
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Summary

Development of CoRC

2005 DOD Survey of Health- Related Behaviors

ARIs

Drug Positives

CSAPP
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Summary

NIAAA – “A Call to Action: Changing the Culture of
Drinking at College Campuses”

IOM – “Reducing Underage Drinking: A Collective
Responsibility”

F. E. Warren 0-0-1-3 program

CORONA Tasker
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Questions
?
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2. INDIVIDUAL LEVEL
3.BASE
4. LOCAL
COMMUNITY 1. LEADERSHIP COMMUNITY
INTEGRATED
4-PRONGED
COMMUNITY
APPROACH
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