Problems stemming from the misuse and abuse of alcohol and other drugs are by no means a new phenomenon, although the face of the issues has changed in recent years. National trends indicate substantial increases in the abuse of prescription medications. These increases are particularly prominent within the military, a population that also continues to experience long-standing issues with alcohol abuse. The problem of substance abuse within the military has come under new scrutiny in the context of the two concurrent wars in which the United States has been engaged during the past decade-in Afghanistan (Operation Enduring Freedom) and Iraq (Operation Iraqi Freedom and Operation New Dawn). Increasing rates of alcohol and other drug misuse adversely affect military readiness, family readiness, and safety, thereby posing a significant public health problem for the Department of Defense (DoD). To better understand this problem, DoD requested that the Institute of Medicine (IOM) assess the adequacy of current protocols in place across DoD and the different branches of the military pertaining to the prevention, screening, diagnosis, and treatment of substance use disorders (SUDs). Substance Use Disorders in the U.S. Armed Forces reviews the IOM's task of assessing access to SUD care for service members, members of the National Guard and Reserves, and military dependents, as well as the education and credentialing of SUD care providers, and offers specific recommendations to DoD on where and how improvements in these areas could be made.

Navy Medicine in Vietnam begins and ends with a humanitarian operation-the first, in 1954, after the French were defeated, when refugees fled to South Vietnam to escape from the communist regime in the North; and the second, in 1975, after the fall of Saigon and the final stage of America's exit that entailed a massive helicopter evacuation of American staff and selected Vietnamese and their families from South Vietnam. In both cases the Navy provided medical support to avert the spread of disease and tend to basic medical needs. Between those dates, 1954 and 1975, Navy medical personnel responded to the buildup and intensifying combat operations by taking a multipronged approach in treating casualties. Helicopter medical evacuations, triaging, and a system of moving casualties from short-term to long-term care meant higher rates of survival and targeted care. Poignant recollections of the medical personnel serving in Vietnam, recorded by author Jan Herman, historian of the Navy Medical Department, are a reminder of the great sacrifices these men and women made for their country and their patients.