Alcoholism

[George Wallace]

Just curious as I have zero knowledge on the subject of alcohol misuse from my career - if a member voluntarily comes forward and says "I have a bad drinking problem, can I get help?" Is that individual going to be on the receiving end of disciplinary action? Let's suppose his drinking has never interfered with his work performance, he just finds he spends his evenings after work whetting his whistle and wants to get treatment to stop the drinking BEFORE it turns into an issue at work. Or would this be a supervisory call? (ie - His immediate C o C likes or dislikes him, and this becomes an easy way to nail him to the wall)

I would tend to agree with Eye In The Sky.

It only becomes a disciplinary issue if the individual is charged for inappropriate actions they took under the influence of alcohol, or any other substance abuse. 

 

[reccecrewman]

Thanks Eye in the Sky & George.  I'm out now, but that's good info to know as I still have plenty of still serving friends. However, Eye in the Sky brought another question to mind that got me thinking.  If alcoholism is considered a medical issue, it makes me wonder if a diagnosed alcoholic would be able to apply to VAC for a pension for alcoholism.  Before you blow me off or laugh at me, consider this; 

Many people join the Military as 18 or 19 year old kids.  They do a full physical upon entry and SHOULD have a clean bill of health.  Now, perhaps my argument here isn't as relevant for today's still serving members as the Army has changed greatly over the years, BUT, lets use the older soldiers and Veterans as my examples.  Right up until the early 2000's, drinking alcohol in the Army was, for the most part, expected of soldiers.  Especially as one climbed the ranks.  The Snr NCO's & Officers Mess regularly has Mess functions and such that soldiers are/were expected to attend (and, drink); Beer calls after work, the Officer's are required to show up to the Mess Friday after work; Smokers after/during FTX.... these are just a few examples of how the Army (I'm using the Army here as that is were my familiarity is) took alcohol and it was etched into the Army culture.

Now, turn around and couple the Army drinking culture with the horrors soldiers endure on operations; I've seen the booze flow freely overseas despite the two beer per soldier rule, the underground railroad inevitably gets on track shortly after each rotation changes hands and the troops find ways to get their booze.  Soldiers come home and many turn to alcohol to blot out the images seared into their minds.  As years progress, some drink more and more and next thing you know, you have a full blown alcoholic on your hands.

Now, don't get me wrong, no one is holding a gun to soldiers heads saying "drink!".  We all choose to drink or not drink, but there was considerable pressure on soldiers TO drink in the years past and get into the old boys club.  Chats about subordinates, courses, postings and such have all echoed off the walls of the Snr. NCO's and Officer's Messes as the liquor flowed freely.

I'm just throwing this out there as food for thought.  By no way would I expect a soldier/Veteran to receive a 5/5th pension from VAC for alcoholism, but 2/5 or 3/5, by my opinion, shouldn't be out of the question. (I'm no VAC adjudicator, I just used those percentages as hypothetical) An approved pension needs 1) A confirmed diagnosis - which alcoholism is by medical definition, and 2) A link to Military service, which, I think anyway, that I have illustrated that a Veteran COULD argue a valid case against VRAB if he had a diagnosis of alcoholism.  I especially think this would be important if a Veteran had no other pensions from VAC, or, if he did, he was only an A client and therefore, only entitled to VAC coverage for his pensioned condition.  If he had even a 2/5 pension, he would still have ENTITLEMENT on his file for the pensioned condition of alcoholism, and thus, guaranteed coverage after he left the service if he happened to fall off the wagon and wanted to seek rehabilitation services.

I apologize now, as I didn't mean to hijack PPCLI WO's original post.  Eye in the Sky just got my mind going.

 

[Eye In The Sky]

Alcohol can be addictive, addictions = medical issue.

I remember the days when "supporting The Mess" happened regularly and in cases, not 'optional' like it is today.  That has been both good, and bad, in different ways.

I have no valuable input WRT to you post from a medical or policy application side, however as a guy who has been in awhile and seen things change over a few decades, I can see where you are coming from and think there is some merit in what you said.  Sure, everyone makes the choice to tip the bottle or not...in reality, that is not the ONLY factor though.  Peer pressure, self medicating, etc come to mind.  Cultural expectations/norms. 

 

[dapaterson]

Well, VRAB has a case where gonhorrea was pensionable, so who knows?

 

[StaffGuy]

Hope this is not considered as hijacking this thread, but here's my situation vis-à-vis alcohol....

1. July 2015 - got very drunk at a work-related social function, at the mess, where I went into blackout drive conducted myself very poorly. First such offence (or any offence, for that matter) in my 12 years in the CAF. Investigation launched, which took a ridiculous length of time (see below).

2. May 2016 - placed on RW for conduct ,backdated to Jan 2016, as it was recognized that I had been on a very short leash for 10 months already. Medical referral issued, go see the doc who in turn refers me to addictions counsellor for assessment for alcoholism.

3. Also May 2016 - finally charged with drunkenness, summary trial, admit to all particulars, guilty.

4. July 2016 - RW successfully completed on 18 Jul. On same day, I finally get in to see the addictions person. Her conclusion is that I had a binge drinking (behavioural) problem, not an alcohol dependency. I say "had", because it's been a year that I don't drink to blackout point anymore - ever. I learned a hard lesson, but a very good one. She agrees, and says not treatment required, but would like to follow up in 3 months. No problem. HOWEVER, the doc disagrees, wants to put me on a 6-month TCAT, whereby I'm must completely abstain from alcohol, with regular follow up (every 2 weeks) and regular piss tests. Addictions counsellor thinks this is draconian and not required, but her hands are tied. I am not upset about not drinking for 6 months (although it kinda sucks), but it's now like I'm being 'punished' a third time for this (yes, I get the diff between disc, admin, and medical, but you get my point...), for something that happened over a year ago and has not re-occurred. Not to mention the fact that I'm in Ottawa, so every trip to Montfort eats up half a work-day that I have to somehow make up.

MY QUESTION - does a doc have the authority to order me to piss in a cup on a regular basis as part of 'medical treatment/observation' as condition for lifting a TCAT for (presumably) alcohol dependency (which in itself contradicts the expert opinion)? May not be an answer out there, but I know there are a lot of smart/experienced people here.

 

[ModlrMike]

MY QUESTION - does a doc have the authority to order me to piss in a cup on a regular basis as part of 'medical treatment/observation' as condition for lifting a TCAT for (presumably) alcohol dependency (which in itself contradicts the expert opinion)? May not be an answer out there, but I know there are a lot of smart/experienced people here.

Yes. The Medical Officer has absolute discretion to award a T-Cat after taking ALL of the recommendations into account. I suggest that you read DAOD 5019-7. Part 8 answers your question. The remaining parts bear keeping in mind.

 

[StaffGuy]

ModlrMike,

Thanks for the reply. I had already read the DAOD. Not 100% sure what you mean by "Part 8", as it's not numbered (at least on the version I'm looking at on the DWAN), but I assume you mean the section entitled "Treatment and Rehabilitation".

Ack that the doc has final auth on TCAT, treatment, etc. I was really just questioning his auth to piss test someone, which would be categorized as "control testing" (compliance) which is normally associated with Administrative Action (IAW DAOD 5019-3), whereas abstention from alcohol and regular counselling sessions is prescribed medical treatment.

 

[ModlrMike]

Two points:

a. the command to submit to testing is not manifestly unlawful; and
b. confirming that the member is compliant with treatment falls well within the very broad scope of the MO's responsibility and authority. Mechanisms to ensure same also do.

 

[Eye In The Sky]

I'm more concerned with the amount of time it took for your CofC to direct the medical referral and the RMs in the form of your RW, which they seemed to link together.

 

[StaffGuy]

Eye in the Sky - yeah, the whole process was long and ridiculous, but that's behind me and I'm not fighting something that's already in the past. What irks me is that the alcohol-related conduct (binge drinking at a work social event with adverse behaviour) was over a year ago, was the first such incident, and has not recurred. More importantly, an addictions expert has assessed that I don't have an alcohol dependency. What more 'proof' do they need that I have this behavioural problem under control?

ModlrMike - you're right, it's not manifestly unlawful, but in the case of drug testing it is DAOD 5019-3 that outlines when and how you can do it (cause, control, blind, safety, etc), based on QR&Os, and that is what provides the specific authority to do it, and if you don't do it IAW those guidelines you have no leg to stand on. I just can't find a similar regulation, order or directive that authorizes a doc or anyone to test for alcohol consumption (note that alcohol is specifically excluded from DAOD 5019-3).

 

[ModlrMike]

Eye in the Sky - yeah, the whole process was long and ridiculous, but that's behind me and I'm not fighting something that's already in the past. What irks me is that the alcohol-related conduct (binge drinking at a work social event with adverse behaviour) was over a year ago, was the first such incident, and has not recurred. More importantly, an addictions expert has assessed that I don't have an alcohol dependency. What more 'proof' do they need that I have this behavioural problem under control?

ModlrMike - you're right, it's not manifestly unlawful, but in the case of drug testing it is DAOD 5019-3 that outlines when and how you can do it (cause, control, blind, safety, etc), based on QR&Os, and that is what provides the specific authority to do it, and if you don't do it IAW those guidelines you have no leg to stand on. I just can't find a similar regulation, order or directive that authorizes a doc or anyone to test for alcohol consumption (note that alcohol is specifically excluded from DAOD 5019-3).

Stop tying yourself up in knots. Take the high road - "I'm not sure how I feel about this testing, but I'll do it to show that I'm holding up my end of the bargain." To do otherwise might make people think you have something to hide.

I know that it would energize my spidy senses if you were my patient and challenged a request for testing.

 

[StaffGuy]

Tying myself up in knots? I'm simply trying to understand a process with which I am largely unfamiliar, instead of being a pinball bouncing around in the blind. Isn't the point of this forum to have intelligent and facts-based discussion?

Of course I'll take the high road and comply with whatever I'm told to do (as I always do), even if I think his decision is unjustified based on all the other facts.

As for bargains, I was ordered (both verbally by my CoC, and via remedial measure) to refrain from drinking excessively and conducting myself poorly - I have kept that bargain for over a year, and will continue to do so. I don't understand why this guy thinks a new 'bargain' is required, but I do understand that it's his prerogative to make that conclusion - doesn't mean I have to like it.

 

[StaffGuy]

Just thought I'd close the loop on my part of this discussion. The MO ended up re-considering and is happy with me following up on my own with the addictions counsellor every few months. My mission remains to never put myself in a similar situation again. All's well that ends well.

 

[PuckChaser]

My mission remains to never put myself in a similar situation again. All's well that ends well.

Glad it all worked out for you in the end. We all %$@ up sometimes, but it takes a real professional to admit you did it, and take those visible and hard steps to fix it, especially with the stigma of alcoholism (albeit yours was an isolated incident).