Prevalence of Drug Use among Applicants
for Military Service -- United States, June-December 1988
Since June 1988, the U.S. Department of Defense has screened all
applicants for military service (including the U.S. Coast Guard)
for
evidence of marijuana and/or cocaine use as mandated by the
National
Defense Authorization Act of 1988. Applicants confirmed as
cocaine-positive are not eligible for military service for 1 year
from
the date of screening; those confirmed as marijuana-positive are
not
eligible for military service for 6 months from the date of
screening.
Persons who tested positive twice for either drug are not eligible
for
military service for 2 years from the date of the second test (1).
A pilot study was conducted during March and April 1988 to
determine
the prevalence of marijuana and/or cocaine use among applicants
before
the initiation of the program in June. For the pilot study,
applicants
were not informed about the drug test. However, because personal
identifiers were not recorded, results could not be linked to
individual applicants. Urine specimens collected as part of the
induction physical examination were sent to three of nine military
laboratories and screened by radioimmunoassay (Roche Diagnostic
Systems
Abuscreen Test Kits*) for marijuana and cocaine. Six thousand (42%)
urine specimens were selected at random from approximately 14,200
obtained from 12 of 70 Military Entrance Processing Stations. Four
hundred thirty-seven (7.3%) and 108 (1.8%) screened positive for
marijuana or cocaine, respectively, or their metabolites, and 42
(0.7%)
were positive for both marijuana and cocaine (Office of the Army
Surgeon General, unpublished data). Although positive specimens
were
not confirmed, data from military drug-screening laboratories
indicate
that at least 85% of cocaine and 90% of marijuana users would have
been
confirmed positive (Office of the Assistant Secretary of Defense
for
Health Affairs, unpublished data).
From June through December 1988, 322,256 applicants were informed
that
a urine specimen would be collected for drug screening at the
induction
physical examination. Positive specimens were confirmed by gas
chromatography/mass spectrom etry.** The Headquarters for the U.S.
Military Entrance Processing Command (2) provided demographic data
(Table 1).
Of all applicants tested, 3.5% were positive for marijuana and/or
cocaine (Table 1). Men were 2.6 times more likely than women (3.9%,
compared with 1.5%, respectively) to be positive for marijuana
and/or
cocaine. Blacks were 1.9 times and Hispanics 1.4 times more likely
than
whites to test positive (5.6% for blacks and 4.0% for Hispanics,
compared with 2.9% for whites). The percentage positive for either
drug
increased with age (1.3% in 17- and 18-year-olds, compared with
5.3% in
greater than or equal to 26-year-olds). Geographic variation for
cocaine and/or marijuana ranged from 2.5% in the West North Central
to
5.3% in the Mid-Atlantic states. The percentage screened positive
for
marijuana and/or cocaine varied inversely with education level: the
highest prevalence was in applicants who had not graduated from
high
school (7.5%) and the lowest in those educated beyond a 4-year
college
degree (0.7%).
Reported by: WF Vogl, CDR, USN (MSC), MR Peterson, LT COL, USAF,
BSC,
Office of the Assistant Secretary of Defense (Health Affairs),
Washington, DC. JS Jewell, LTC, USA, Office of the Army Surgeon
General, Washington, DC. Div of Environmental Hazards and Health
Effects, Center for Environmental Health and Injury Control, CDC.
Editorial Note
Editorial Note: This report summarizes the findings of the largest
nonrandom drug testing program in the United States and
characterizes
evidence of drug use by age, race, and sex in a defined population.
Applicants for U.S. military service are a geographically diverse
sample of young persons. Extrapolation of marijuana and/or cocaine
use
in this group to the U.S. population may not be reliable because of
social and demographic differences of military applicants in the
same
age groups. Men and racial and ethnic minorities are
overrepresented
among applicants.
The decrease in percentage of positives among applicants from the
pilot study to the systematic screening program indicates that
notifying applicants of the drug-testing program may deter
continued
use, prompt users to withdraw from the application process, or
discourage application for military service.
References
Secretary of Defense. Memorandum: policy on pre-accession drug,
chemical, and alcohol use and dependency testing. January 15, 1988.
US Department of Defense. Headquarters, US Military Entrance
Processing Command memorandum: Department of Defense Pre-accession
Drug
and Alcohol Testing Program. January 13, 1989.
*Use of trade names is for identification only and does not imply
endorsement by the Public Health Service or the U.S. Department of
Health and Human Services.
**In the initial screening, the following levels indicated
positivity:
greater than or equal to 100 ng/mL for marijuana and greater than
or
equal to 300 ng/mL for cocaine. Positivity was confirmed at greater
than or equal to 15 ng/mL for marijuana and greater than or equal
to
150 ng/mL for cocaine.
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