Key Dates

Related Announcements

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Issued by

National Institute on Alcohol Abuse and Alcoholism (NIAAA)

U.S. Army Medical Research and Development Command, Military Operational Medicine Research Program (MOMRP)

Purpose

The Military Operational Medicine Research Program (MOMRP), as part of the U.S. Army Medical Research and Development Command (USAMRDC), and the NIAAA are requesting information from the broad community of alcohol researchers, clinicians, individual Service Members, and advocates to help identify the most important research questions that may help prioritize future alcohol research investments. The MOMRP and the NIAAA missions and strategic plans provide the current research focus areas for the respective organizations.

Background

Alcohol misuse is a significant health concern across all branches of the military in that it is associated with a myriad of adverse outcomes for Service Members, including first term attrition, as well as negative impacts on health, well-being, occupational performance, and individual and force readiness. Results from the 2015 Health Related Behaviors Survey (HRBS) fielded among active-duty U.S. military Service Members indicate binge drinking, heavy drinking, and hazardous or disordered drinking are prevalent among all Services (Meadows et al., 2018), underscoring the importance of investigating alcohol use within the military and the need for preventing and intervening upon risky drinking behaviors before they become a threat to Service Members’ health, readiness, and resilience.

Military culture seems to play a significant role in alcohol consumption patterns of Active Duty Service Members, including widespread perception that military culture is supportive of drinking (Meadows et al., 2018) and the existence of barriers to help-seeking that are unique to military environments. Service Members experience unique stressors compared to civilian life, such as frequent geographic relocations due to changing duty stations, undergoing deployments, and managing multiple jobs/tasks within their military service specialty, and balancing work-life demands (e.g., supporting their families). These stressors can contribute both acutely and chronically to alcohol use and compromised psychological health, and can ultimately facilitate unhealthy alcohol use behaviors (Mohr, McCabe, Haverly, Hammer, & Carlson, 2018; Ramchand et al., 2011). Understanding the reasons or variables of military culture and environments that contribute to alcohol misuse is a critical step in developing effective mitigation and prevention efforts for Service Members for reducing negative consequences associated with unhealthy alcohol use.

The Veterans Affairs (VA)/DOD Clinical Practice Guideline (CPG) for the Management of Substance Use Disorders (2015) recommends an integrative public health approach process involving screening, brief intervention, and referral to treatment (SBIRT) that include both behavioral interventions and recommended pharmacotherapy treatments. Although this process is initially self-referral, treatment or care becomes mandatory for Service Members who receive an alcohol use disorder (AUD) diagnosis. Of importance is that those who fail to participate adequately in substance misuse programs or to respond successfully to rehabilitation may be faced with administrative separation from the military (DHA-PI 6025.15, 2019). The VA/DOD CPG recommends several evidence-based pharmacotherapy treatments used in civilian populations. However, these medications often make Service Members non-deployable, because of potential side effects of these therapeutics, as well as the act of getting medical treatment in the military. Similarly to receiving treatment for physical injuries, getting medical treatment for AUD can result in limitations being placed on participation in military duties or can result in requiring a waiver to deploy, even after treatment is complete. Furthermore, it is unclear what the implementation process for treatment is within the Military Health System (MHS).

Information Requested

The MOMRP and the NIAAA are soliciting input to advance the understanding of aspects of military culture that impact the range of alcohol consumption patterns, including AUD, in the military; effective preventive interventions for unhealthy alcohol use either currently being used in the military or that could be adapted for implementation across all Services; factors that improve or inhibit effective implementation and service delivery of evidence-based approaches for alcohol misuse prevention and treatment within the military; and integrative prevention and/or treatment implementation strategies for AUD and co-occurring acute stress or adjustment disorder in Service Members. Individuals with relevant expertise are invited to submit comments.

Input sought through this RFI includes, but is not limited to:

• Effects of military culture, leadership attitudes, command environment, group/unit characteristics, and group/unit identification factors on alcohol use in Service Members.
• Effective preventive interventions that address specific elements of military culture that are driving increases in alcohol use.
• Evaluations of effectiveness of alcohol misuse prevention programs that are currently being used in the military (e.g., Prime for Life, Alcohol Brief Counseling, etc.).
• Effective and evidence-based preventive interventions for unhealthy alcohol use behaviors that can be adapted for implementation within the MHS.
• Integrative prevention and/or treatment approaches for AUD plus co-occurring psychiatric conditions, especially acute stress and/or adjustment disorder, and including approaches that address sex differences and minority/health disparities.
• Factors that improve or inhibit effective implementation and service delivery of evidence-based approaches for alcohol misuse intervention and treatment, especially barriers to treatment associated with military culture or context.
• Impact of relevant DOD and Service-specific policies and procedures on alcohol use in Service Members and Service Member readiness [e.g., confidentiality, privacy, type of treatment services available (e.g., in-person vs telehealth), disciplinary consequences for infringement, the cost and availability of alcohol on military installations, etc.].
• Stigma associated with appropriate reporting of an alcohol-related problem (e.g., reporting of self, or peers, or commander/supervisor)

How to Submit a Response

Please submit a response to the email address below in the Inquiries section.

To ensure full consideration, responses must be received by December 1, 2021.

Responses to this RFI are voluntary. Do not include any proprietary, classified, confidential, trade secret, or sensitive information in your response. The responses will be reviewed by NIAAA staff, and individual feedback will not be provided to any responder. The U.S. Government will use the information submitted in response to this RFI at its discretion.

This RFI is for information purposes only and shall not be construed as a solicitation, grant, or cooperative agreement, or as an obligation on the part of the Federal Government, the NIH, or NIAAA to provide support for any ideas identified in response to it. The Government will not pay for the preparation of any information submitted or for the U.S. Government’s use of such information. No basis for claims against the U.S. Government shall arise as a result of a response to this request for information or from the Government’s use of such information.

References

Meadows, S. O., Engel, C. C., Collins, R. L., Beckman, R. L., Cefalu, M., Hawes-Dawson, J., . . . Williams, K. M. (2018). 2015 Department of Defense Health Related Behaviors Survey (HRBS). Rand Health Q, 8(2), 5. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/30323988

Mohr, C. D., McCabe, C. T., Haverly, S. N., Hammer, L. B., & Carlson, K. F. (2018). Drinking Motives and Alcohol Use: The SERVe Study of U.S. Current and Former Service Members. J Stud Alcohol Drugs, 79(1), 79-87. doi:10.15288/jsad.2018.79.79

Ramchand, R., Miles, J., Schell, T., Jaycox, L., Marshall, G. N., & Tanielian, T. (2011). Prevalence and Correlates of Drinking Behaviors of Previously Deployed Military Personnel and Matched Civilian Population. Mil Psychol, 23(1), 6-21. doi:10.1080/08995605.2011.534407

*The views in this RFI are the authors' and do not necessarily reflect the views of the Department of Defense.

Inquiries

Please direct all inquiries to:

Jenica Patterson, Ph.D.
National Institute On Alcohol Abuse And Alcoholism (NIAAA)
Phone: 301-827-6166
E-mail: jenica.patterson@nih.gov

Sarah Maggio, Ph.D.
Deputy Portfolio Manager, Psychological Health and Resilience
U.S. Army Medical Research and Development Command, Military Operational Medicine Research Program (MOMRP)
Email: sarah.e.maggio.ctr@mail.mil