Afi 90 507
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Which treatment programs include substance use/misuse prevention, education, treatment and urinalysis testing?
The Air Force Alcohol and Drug Abuse Prevention and Treatment (ADAPT) and Drug Demand Reduction programs.
What assistance will individuals with substance use/misuse problems receive?
Counseling and treatment, as needed.
Air Force members are not responsible for unacceptable behavior resulting from substance use/misuse. T/F
False.
What are the four objectives of the Alcohol and Drug Abuse Prevention and Treatment (ADAPT) program?
To 1) promote readiness, health and wellness by preventing and treating substance misuse and abuse; 2) minimize the negative consequences of substance misuse and abuse; 3) provide comprehensive substance misuse or abuse education and treatment; and 4) restore function and return identified substance abusers to unrestricted duty status, or assist them in their transition to civilian life.
What is the DoD policy on drug abuse?
To prevent and eliminate drug and alcohol abuse and dependence from the DoD.
Drug and alcohol abuse and dependence are incompatible with _____, high performance standards and military discipline.
Readiness.
Define drug abuse.
The wrongful, illegal or improper use, possession, sale, transfer or introduction of any drug onto a military installation, as defined in AFI 90-507, Military Drug Demand Reduction Program.
_____ use of substances is use without legal justification or excuse.
Wrongful.
To ensure military readiness, Air Force policy prohibits ingestion of products containing or derived from hemp seed or hemp seed oil. Why?
These products may contain THC, the active ingredient of marijuana.
Products made with hemp seed or hemp seed oil may contain THC, the active ingredient of marijuana, and therefore their ingestion is prohibited. Failure to comply violates Article 92, UCMJ. T/F
True.
Other than the lawful use of alcohol or tobacco, the _____ use of any intoxicating substance that is inhaled, injected, consumed or introduced into the body in any manner to alter mood or function is prohibited.
Knowing. (Failure to comply by military personnel violates Article 92, UCMJ.)
Patients who are diagnosed with a substance use disorder and entered into the Alcohol and Drug Abuse Prevention and Treatment (ADAPT) program will be recommended for limited duty, indicating the patient is not _____ qualified.
Worldwide.
Air Force policy recognizes that _____ negatively affects public behavior, duty performance, and/or physical and mental health.
Alcohol abuse.
AFI _____ provides guidance for the identification, treatment and management of personnel with substance use problems, and describes Air Force policy regarding alcohol and drug abuse.
AFI 44-121.
AFMAN 31-116, Air Force Motor Vehicle Traffic Supervision, establishes guidance on court hearing procedures, convictions, nonjudicial punishment (NJP), civilian administrative action or appropriate punishment for violation of _____ and intoxicated driving policies.
Impaired.
Military members are presumed to be impaired with what blood-alcohol percentage?
At least 0.05 but less than 0.10.
Intoxicated driving is operating a motor vehicle under alcohol intoxication only. T/F
False. (Drugs also qualify.)
Driving or being in physical control of a motor vehicle with a blood alcohol percentage _____ or greater results in a one-year driving privilege suspension.
0.10. (If more stringent, the state limit applies.)
What is the blood alcohol limit for intoxicated driving overseas?
0.10. (The SecDef may set a lower limit.)
Under what circumstances does the Air Force review members' drinking habits?
When they affect public behavior, duty performance or physical and mental health.
What is the supervisor's role in assessing potential drug- and alcohol-related problems?
To identify subordinates with problems early and motivate them to seek and accept help.
Substance use/misuse signs and symptoms always indicate a substance use problem. T/F
False. (Although they are common indicators, do not use them to make a conclusive diagnosis.)
What should you do if you are concerned that an Air Force member has a substance use problem?
Talk with him or her and explain your concern. Also document and discuss specific instances of unusual behavior with the supervisor, first sergeant or unit commander. Do not hesitate to document and refer troubled subordinates to the Alcohol and Drug Abuse Prevention and Treatment (ADAPT) program.
Help must be offered to every individual with substance use problems. T/F
True.
Name at least five of the 15 signs and symptoms of substance use/misuse.
Any five of the following: 1) deteriorating duty performance; 2) unexplained or frequent absences; 3) frequent errors in judgment; 4) financial irresponsibility; 5) arrests or legal problems; 6) increased alcohol use; 7) memory loss; 8) morning drinking and hangovers; 9) health problems related to drinking; 10) violent behavior; 11) suicidal thoughts or behaviors; 12) dramatic mood swings; 13) denial or dishonesty about use; 14) failed attempts to stop or cut down; and 15) concerns expressed by family or friends.
What are the five basic substance use disorder or misuse identification methods?
1) Medical care referrals; 2) commander's identification; 3) drug testing; 4) results of a medical examination; and 5) self-identification.
When must medical personnel notify the unit commander and the Alcohol and Drug Abuse Prevention and Treatment Program Manager (ADAPTPM) about suspected substance use/misuse?
When a member 1) is observed, identified or suspected to be under the influence of alcohol or drugs while seeking medical care; 2) receives treatment for an injury or illness that may be the result of substance use/misuse; 3) is suspected of abusing substances; or 4) is admitted as a patient for alcohol or drug detoxification.
List some examples of misconduct that require unit commanders to refer servicemembers for assessment because substance use or misuse is suspected to be a contributing factor.
1) DUI; 2) public intoxication; 3) drunk and disorderly; 4) spouse or child abuse and maltreatment; 5) underage drinking; 6) positive drug test; and 7) when notified by medical personnel.
Why must commanders and supervisors refer members with suspected or identified substance use problems for treatment?
Failure to refer increases the risk for developing more severe substance use problems and may jeopardize others' safety and, ultimately, mission accomplishment.
What AFI governs Air Force drug testing of personnel?
AFI 90-507, Military Drug Demand Reduction Program.
Military personnel are subject to drug testing depending on their grade, status and position. T/F
False. (All personnel are subject to testing.)
_____ testing is the most common deterrent against drug abuse presently available.
Inspection.
Military members may be ordered or voluntarily consent to provide urine samples at any time. What happens to members who fail to comply?
They are subject to punitive action under the UCMJ.
Commander-directed drug testing should only be used as a last resort. Why?
The results cannot be used in actions under the UCMJ or to characterize a member's service as either general or under other than honorable conditions if they are separated.
What two adjectives best describe drug inspection testing under Military Rule of Evidence (MRE) 313?
Random and unpredictable.
How are individuals selected for inspection testing for drug use?
At random, using a non-biased selection process. Commanders may also select work sections, units or segments of the military population to provide urine samples.
After inspection under Military Rule of Evidence (MRE) 313, how may commanders use a positive result of a urine drug test?
1) To refer a member for substance use evaluation; 2) as evidence to support disciplinary action under the UCMJ or administrative discharge action; and 3) as a consideration for characterization of discharge in administrative discharges.
When does probable cause exist in regards to drug testing?
When there is reasonable belief that drugs will be found in the member's system.
Consult with the _____ regarding appropriate procedures to establish probable cause for substance abuse.
Staff Judge Advocate (SJA).
May the results of any examination conducted for a valid medical purpose (including emergency medical treatment, periodic physical examinations and other examinations for diagnostic or treatment purposes) be used to identify drug abusers?
Yes.
Results of any examination conducted for valid medical purposes that identifies a drug abuser may be used as evidence to support disciplinary action under the UCMJ or administrative discharge action. T/F
True.
Air Force members with substance use problems are encouraged to seek assistance from the unit commander, first sergeant, substance use counselor or a military medical professional. T/F
True. (Following the assessment, the Alcohol and Drug Abuse Prevention and Treatment Program Manager (ADAPTPM) will consult with the Treatment Team (TT) and determine an appropriate clinical course of action.)
Self-identification for substance use is reserved for whom?
Members not currently under investigation or pending action as a result of an alcohol-related incident.
Commanders will grant unlimited protection for Air Force members who voluntarily disclose evidence of personal drug use or possession with the intention of entering treatment. T/F
False. (Limited protection will be granted; however, commanders may not use voluntary disclosure against a member in an action under the UCMJ or when weighing characterization of service in a separation.)
When is disclosure of evidence of personal drug use or possession not considered voluntary?
If the Air Force member has previously been 1) apprehended for drug involvement; 2) placed under investigation for drug abuse; 3) ordered to give a urine sample as part of the drug testing program whose results are still pending or have been returned as positive; 4) advised of a recommendation for administrative separation for drug abuse; or 5) entered into treatment for drug abuse.
When is a member considered under investigation for drug abuse?
When 1) an entry is made in the security forces blotter; 2) the security forces investigator's log shows an initial case entry; 3) the Air Force OSI opens a case file; 4) he or she has been questioned about drug use by investigative authorities or his or her commander; or 5) an allegation of drug use has been made against the member.
Commanders must provide sufficient incentive to encourage members to seek help for problems with alcohol without fear of negative consequences. T/F
True.
Self-identified members enter the Alcohol and Drug Abuse Prevention and Treatment (ADAPT) assessment process and are held to what standards?
The same standards as others entering substance use education, counseling and treatment programs.
The supervisor's role in the drug use/misuse treatment process is limited to identifying and referring members. T/F
False. (Although the supervisor does not provide treatment, his or her daily interaction with personnel and the Treatment Team (TT) can significantly impact the success of treatment efforts.)
What is one of the most critical components of a member's substance use treatment program?
The Treatment Team Meeting (TTM).
When must the commander and/or first sergeant and the supervisor be involved in the Treatment Team Meeting (TTM)?
At program entry, termination and any time there are significant treatment difficulties with the patient.
What is the primary objective of the Treatment Team (TT) in drug use treatment?
To guide the clinical course of the patient's treatment after examining all the facts.
The substance use Treatment Team (TT) consists of whom?
The commander, supervisor, member's counselor, medical consultants, other appropriate helping agencies and the member.
What is the central purpose of the substance use assessment?
To determine the patient's need for treatment and the level of care required.
Alcohol and Drug Abuse Prevention and Treatment (ADAPT) staff members conduct the substance use assessment within how many calendar days of notification?
Seven.
Alcohol and Drug Abuse Prevention and Treatment Program Managers (ADAPTPM) conduct required reviews of what materials on a priority basis?
The patient's medical records and all documentation provided by the ADAPT staff.
What two services is substance use treatment divided into?
Nonclinical and clinical.
All active duty members involved in alcohol-related misconduct will be referred for substance use assessment. T/F
True.
How are the length and number of targeted prevention and education visits determined for members referred for substance use, who do not meet the diagnostic criteria for a substance use disorder?
Based on a thorough assessment, determination of risk and tailored to the individual.
Members not meeting diagnostic criteria for a substance use disorder receive counseling and education, and at least two 30-minute follow-ups. What do the follow-ups involve?
Reassessing risk, assessing progress and, as appropriate, reviewing the educational components.
What does the alcohol education module include?
Information on 1) Air Force policy; 2) the relationship between consumption, metabolism and intoxication; and 3) the physiological effects of alcohol on the brain and body.
What determines the length of involvement in nonclinical substance use treatment?
The patient's presenting problems and agreed-upon treatment or behavioral contract.
Individuals being processed for separation will be provided appropriate medical care (detoxification) prior to separation. Will separation be postponed due to participation in the Alcohol and Drug Abuse Prevention and Treatment (ADAPT) program?
No.
Which substance use patients are entered into clinical substance use services with a level and intensity of care determined by the Alcohol and Drug Abuse Prevention and Treatment Program Manager (ADAPTPM)?
Those meeting the Diagnostic Statistical Manual-5 (DSM-5) diagnostic criteria for a substance use disorder.
What is the Air Force's philosophy regarding placing personnel with substance use problems in treatment programs?
They are placed in the least intensive or restrictive treatment environment that is appropriate to their therapeutic needs.
Substance use treatment plans are individually tailored to each patient's needs; _____ involvement is strongly encouraged.
Family. (Depending on the needs of the patient, variable lengths of stay or duration of treatment are provided within an array of treatment settings.)
Are individuals diagnosed with a substance use disorder required to refrain from drinking during the initial phase of substance use treatment?
Yes. (They are strongly encouraged to continue to abstain during aftercare.)
A relapse into unacceptable drinking behavior implies failure of the substance use treatment process. T/F
False. (Because of the nature of alcoholism, a relapse should be anticipated.)
Involvement in self-help recovery groups is encouraged as an adjunct to substance use treatment. How is the frequency of attendance determined?
It is determined by the Treatment Team (TT) with the patient.
Substance use detoxification should be managed on an outpatient basis prior to inpatient treatment. Where are patients requiring medically managed detoxification placed?
An appropriate medical facility.
When are patients considered to have successfully completed the Alcohol and Drug Abuse Prevention and Treatment (ADAPT) program?
When they meet the Diagnostic Statistical Manual-5 (DSM-5) criteria for early full remission.
When are patients considered to have failed the Alcohol and Drug Abuse Prevention and Treatment (ADAPT) program?
When the Treatment Team (TT) observes patterns of unacceptable behavior, inability or unwillingness to comply with their treatment plan or involvement in alcohol or drug-related incidents after initial treatment.
Individuals who have failed the Alcohol and Drug Abuse Prevention and Treatment (ADAPT) program will be considered for administrative _____ by their commander.
Separation.
Decisions regarding substance use aftercare services will be based on treatment history. T/F
False. (They will be based on an assessment of current status.)
What does the substance use aftercare treatment plan identify?
Specific goals, interventions and means to assess them.
The commander is responsible for all personnel and administrative actions pertaining to patients involved in the Alcohol and Drug Abuse Prevention and Treatment (ADAPT) program. What does this include?
1) Assignment availability; 2) promotion eligibility; 3) reenlistment eligibility; 4) Personnel Reliability Program; and 5) security clearances.
What should administrative restrictions for substance use be based on?
The establishment of an Unfavorable Information File (UIF) or control roster resulting from the member's unacceptable behavior, not solely on their involvement in the Alcohol and Drug Abuse Prevention and Treatment (ADAPT) program.
What is a Line of Duty (LOD) determination?
A finding made after an investigation into the circumstances of a member's illness, injury, disease or death to determine whether it 1) Existed Prior to Service (EPTS) (and if EPTS, whether it was aggravated by military service); 2) occurred while the member was absent from duty; and 3) was due to the member's own misconduct.
Can a member's substance use misconduct lead to a Line of Duty (LOD) determination?
Yes.
What entitlements may a Line of Duty (LOD) determination impact?
1) Disability retirement and severance pay; 2) forfeiture of pay; 3) period of enlistment; and 4) veteran benefits. (Additional guidance may be found in AFI 36-2910, Line of Duty (Misconduct) Determination.)
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