BC-MILITARY-DRUG-ABUSE-2NDLD-WRITETHRU-NYT

Despite a well-documented increase in the abuse of alcohol and prescription medications among military personnel over the past decade, the Defense Department's strategies for screening, treating and preventing those problems remains behind the times, a major new report finds.

''Better care for service members and their families is hampered by inadequate prevention strategies, staffing shortages, lack of coverage for services that are proved to work, and stigma associated with these disorders," said Charles P. O'Brien, chairman of the panel that wrote the report and the director of the Center for Studies of Addiction at the University of Pennsylvania.

The report by the Institute of Medicine, a branch of the National Academy of Sciences, asserts that heavy drinking "is an accepted custom" within the military that needs to be regulated more carefully, recommending routine screening for excessive alcohol use.

The panel also suggested that base commanders consider restricting the availability of alcohol by increasing prices at base stores and by policing underage drinking more strictly.

About 20 percent of active-duty military personnel reported heavy drinking in 2008, the latest year for which data were available, and reports of binge drinking increased to 47 percent in 2008, from 35 percent in 1998, according to the report.

Similarly, the misuse of prescription medications, particularly of opioid painkillers, has risen: 11 percent of active-duty personnel reported misusing prescription drugs in 2008, up from 2 percent in 2002.

While abuse of prescription drugs is a nationwide problem, the report said, it is rising faster in the military, and has perhaps become more common than the use of illegal drugs like cocaine or marijuana.

Yet the military's drug-testing regimen, created in the post-Vietnam era, continues to focus on certain illegal drugs that may not pose as great a risk as they did years ago, the panel concluded.

The 14-member panel, consisting mainly of substance abuse experts from academia, generally commended the Pentagon for taking steps in recent years to curb prescription drug abuse and expand availability of substance abuse programs. But it said the department needs to go further in updating regulations, hiring personnel and reducing the stigma attached to substance abuse care.