History of CoRC

1
History of CoRC

• Dr. Milton H. Cambridge
• Demand Reduction Prevention and Outreach
  Coordinator

2
Overview

• Development of CoRC
• 2005 DOD Survey of Health-Related Behavior
• Alcohol-Related Incidents (ARIs)
• Drug Positives
• Comprehensive Substance Abuse Prevention Program
  (CSAPP)

3
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

4
DOD Survey

• DOD Survey of Health Related Behaviors Among
  Military Personnel http//www.ha.osd.mil/special_r
  eports/2005_Health_Behaviors_Survey_1-07.pdf

5
Heavy Alcohol Use Trends by Service2005 DoD
Survey of Health Related Behaviors Among Military
Personnel
Navy
Army
Air Force
Marine Corps
Adjusted
Unadjusted
6
Trends in Alcohol-Related Negative Effects 2005
DoD Survey of Health Related Behaviors Among
Military Personnel
Navy
Army
Air Force
Marine Corps
Serious Consequences
Productivity Loss
7
DoD Self-Reported Drug Use2005 DoD Survey of
Health Related Behaviors Among Military Personnel

Marijuana
Analgesics
Steroids
Any Illicit Drug
a Significant difference between 2002 and 2005
8
DoD Self-Reported Drug Use 2005 DoD Survey of
Health Related Behaviors Among Military Personnel
Significant increase from 2002
9
Air Force Alcohol Related Incidents (ARI)
10
2005 Air Force Alcohol Related Incidents (total
6441)
Note Airmen under 21 account for only 9 of AF
population
11
Total AF Underage Drinking
12
Air Force Percent Drug Positive
13
Air Force Top 4 Drug Positives By Drug Class
14
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

15
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 ARIs
• (17-24 year olds)

16
FY06 Alcohol-Related Misconduct
Airmen under 21 account for only 9 of our total
population
17
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!
18
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

19
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

20
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

21
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

22

• The best models for change

23
Community Approach toPopulation Health Services
Excellent
100
Leadership Supports Health Behavior Change
Installation Policies Enhance Health
Prevention and Education
Helping Agency Support (IDS)
POPULATION
Primary Care
HEALTH
Early Intervention
Specialty Care
Treatment of Disease
0
Poor
24
Research Says.

• Comprehensive community approach ideal
• Leadership Driven, Environmental Change,
  Information, Early Identification and
  Intervention, Policy/Deterrence, Alternative
  Activities
• Key Identify those at of risk
• Population based screening/assessment
• Good 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

25
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

26
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 Commanders 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

27
Prevention 0-0-1-3 Results
? 68
? 64
? 93
28
0-0-1-3s Savings in Resources

• 68 decrease in alcohol related incidents
• 8 increase in available-for-duty rate (or 38
  more airmen)
• ? 230 duty days not lost to Alcohol-Related
  Incidents
• 70 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
29

• The Road from CSAPP and 0-0-1-3 to CoRC..

30
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

31
CSAF Basics for CoRC

• Guiding principles
• Commanders 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!
32
CoRCRoles and Responsibilities

• HQ Personnel (DP) Deliver Concept of Operations
• Functional groups developed area specific
  Toolkits
• MTF role at the base level
• Enhanced screening and early intervention
• Participation in outreach
• Serve as subject matter expert consultants to the
  CC

33
CoRCAF Functional Community Players
Public Affairs
Legal
Security Forces
Mission Support/ Services
Senior Leadership CC/1st Sergeants
Chaplains
Medical Treatment Facility
34
1. LEADERSHIP
INTEGRATED 4-PRONGED COMMUNITY APPROACH
35
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

36
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

37
Summary

• Development of CoRC
• 2005 DOD Survey of Health- Related Behaviors
• ARIs
• Drug Positives
• CSAPP

38
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

39

• Questions ?

40
1. LEADERSHIP
INTEGRATED 4-PRONGED COMMUNITY APPROACH