Headquarters U.S. Air Force
Int egr ity - Ser vice - Exce llence
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)
Integrity - Service - Excellence 2
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
Integrity - Service - Excellence 3
DOD Survey
DOD Survey of Health Related Behaviors Among
Military Personnel
http://www.ha.osd.mil/special_reports/2005_Health_B
ehaviors_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 40
Navy
40
35 35
30 30
25
Percentage
25
Percentage
20 20
15 15
10 10
5 5
0 0
1980
1982 1985 1988 1992 1995 1998 2002 2005 1982 1985 1988
1980 1992 1995 1998 2002 2005
Year of Survey Year of Survey
Marine Corps Air Force
40 40
35 35
30 30
25 25
Percentage
Percentage
20 20
15 15
10 10
5 5
0 0
1982 1985 1988
1980 1992 1995 1998 2002 2005 1982 1985 1988
1980 1992 1995 1998 2002 2005
Year of Survey 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 45
Army Navy
40 40
35 35
30 30
Percentage
Percentage
25 25
20 20
15 15
10 10
5 5
0 0
1982 1985 1988
1980 1992 1995 1998 2002 2005 1982 1985 1988
1980 1992 1995 1998 2002 2005
Year of Survey Year of Survey
45 45
40
Marine Corps 40
Air Force
35 35
30 30
Percentage
Percentage
25 25
20 20
15 15
10 10
5 5
0 0
1982 1985 1988
1980 1992 1995 1998 2002 2005 1982 1985 1988
1980 1992 1995 1998 2002 2005
Year of Survey Year of Survey
Serious Consequences Productivity Loss
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DoD Self-Reported Drug Use
2005 DoD Survey of Health Related Behaviors Among Military Personnel
Marijuana 8.0 Analgesics 7.3
5.0 4.5
4.2 7.0
4.0 6.0
Percentage
Percentage
5.0
3.0
4.0
2.0 3.0
2.0 1.5a
1.0
1.0
0.0
0.0
2002 2005
2002 2005
5.0 Steroids Any Illicit Drug
12.0 10.9
4.0 10.0
Percentage
a
Percentage
8.0 6.9
3.0
6.0
2.0
4.0
1.2
0.9a
1.0 2.0
0.0
0.0 2002 2005
2002 2005
a 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
25
Percentage
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 5481
5226 5306
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
7% Alcohol-related crimes
against property
Note: Airmen under 21 account for
32% only 9% of AF population
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Total AF: Underage
Drinking
2500 2284
2157
1970 2014
2000 1774
1401
1500
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
0.2 FY02
FY03
0.15 FY04
0.1 FY05
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
2% 3%0%
5%
4% DUI
31%
Underage Drinking
7% Drunk & Disorderly
Crimes Against People
Duty-Related Incident
Public Intoxication
15% Accidental Injury
Contrib to Delinquency
Crimes Against Property
Open Container
8% 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% Excellent
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
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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
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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
20
1st Quarter 2005
10
0
Alcohol Driving Underage
Related Under the Drinking
Incidents Influence
68% 64% 93%
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0-0-1-3’s 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
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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 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
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CoRC:
AF Functional Community Players
Public
Legal
Affairs
Mission
Security Senior Leadership Support/
Forces CC/1st Sergeants
Services
Medical
Treatment Chaplains
Facility
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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
Integrity - Service - Excellence 37
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
Integrity - Service - Excellence 38
Questions ?
Integrity - Service - Excellence 39
2. INDIVIDUAL LEVEL
3.BASE 4. LOCAL
COMMUNITY 1. LEADERSHIP COMMUNITY
INTEGRATED
4-PRONGED
COMMUNITY
APPROACH
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