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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or their metabolites, and 42 (0.7%) were positive for both marijuana and cocaine (Office of the Army Surgeon General, unpublished data).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of marijuana users would have been confirmed positive (Office of the Assistant Secretary of Defense for Health Affairs, unpublished data).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

  1. Secretary of Defense. Memorandum: policy on pre-accession drug, chemical, and alcohol use and dependency testing. January 15, 1988.

  2. 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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