Audio
Transcript
Source: 1975 Denver International Convention – 1975 Denver Int AA in the Armed Services with Martin L, Capt Jack, A Pursch, Major Wm S King and Raleigh H, Part 1 of 2.mp3 File: 1975-denver-international-convention-1975-denver-int-aa-in-the-armed-services-with-martin-l-capt-jack-a-pursch-major-wm-s-king-and-raleigh-h-part-1-of-2.mp3 Duration: 00:54:23
============================================================
But not in active, desperate trouble with compulsive drinking, I was upset my performance had to be affected because I did not feel at ease or a part of my peer group in the Navy, and I don't see how I could have effectively functioned as well as I might have. I'm going to stop there on myself and give you the first of my speakers because they have a much more important current message for you. My first speaker is Captain Joseph A. Pursh. He's Captain of the Medical Corps of the United States Navy, Chief of the Alcohol Rehabilitation Service, Naval Regional Medical Center at Long Beach, California.
He was raised in Yugoslavia and came to the U.S. after World War II, I think an important attribute to have in an international AA convention. He has been a naval flight surgeon and a psychiatrist and has been involved in the treatment and rehabilitation of alcoholics for about 10 years. He has lectured and conducted panels and seminars worldwide, has made films and television appearances, and has published and presented numerous articles and papers on alcoholism.
It is my pleasure to give you Captain Joseph Pursh. Thank you very much, Mr. Chairman. Good morning, AAs and friends of AAs. I guess the fact that I'm here this morning to speak to you and the fact that I'm a Navy captain, non-alcoholic in the U.S. Navy with a Bulgarian accent, just shows that AA will accept anybody. Recently I was introduced to be the speaker on alcoholism before a ladies' luncheon. The chairman or the chairperson there was primarily concerned with convincing the audience that they were about to hear an expert.
So after enumerating all my attributes like all the duty stations I have and the rank I have and so on, she finally wanted to give us the coup de grace and to really show them I know who I was and what I was talking about. So she finally said, and now it will be my pleasure to present to you Dr. Joe Pursh, who is the senior alcoholic medical officer in the Navy. And with that I immediately wanted to say I can take it or leave it, and I just thought I'd get in too deep and I said nothing.
Since I'm not a member of the fellowship I can't give you my own drunkologue, but I can certainly do the next best thing which is to give you the drunkologue of the United States Navy, because I think we have one. In order to show you what we in the Navy are doing about alcoholism, I thought I would disclose in a general way what the Navy used to be like and what happened. As you all know, heavy drinking among seashoring men is as old as probably the sailing tradition itself.
As a matter of fact, every departing ship used to take aboard far more rum than water, and the saying drunk as a sailor became commonplace. After alcohol was no longer allowed on Navy ships, the saying became drunk in every port. The shore-based Navy wasn't far behind. There were just as many drinking rituals and customs among people on the beach. So that eventually we amounted to a Navy about which one could say the following.
Alcohol, along with protocol, had become one of the twin pillars supporting naval establishment. Without protocol, we couldn't get anything done, and without alcohol, we couldn't have any fun. We had so much fun that a recent survey disclosed that 38% of us in the Navy are problem drinkers. Now, Navy lawyers, chaplains, priests, and all the others had seen this all along. They had seen the drinker's hangovers at Captain's Mask, his deteriorating health in the sick bay, his career at court-martials, his life in the confessional, his broken bones in the orthopedic ward, his bleeding ulcer in the OR, and his shrunken liver at autopsy.
There was no doubt that the sailor was in trouble. But nothing could be done for him, as we heard in the introduction, because alcoholism was a disciplinary problem. And as a result, the old question, what do you do with a drunken sailor, was answered, well, you kick him out or you retire him if he's had enough time in.
[00:05:07]
As a result, the alcohol problems in VA hospitals doubled between about 1965 and 1969. Well, that's what it used to be like. And then something happened. One of these Navy men, Naval officers who was retired, was a Navy commander named Dick Jewell. I have been prevailed on by many friends of mine to mention his full name, and I have his permission to break his anonymity. Dick Jewell loved his Navy, and he learned to drink in the Navy, and he also became an alcoholic in the Navy.
As a matter of fact, he was hospitalized for the eighth time in our Naval hospital in Long Beach, but was not diagnosed alcoholic. After he was discharged from there, he found his sobriety through you people, through AA, and he began to recover his sanity. Slowly, as his brain was clearing of the alcoholic haze, it occurred to him that maybe one ought to hold AA meetings on the Naval base for shipmates who still had the disease.
So, barely sober himself, he approached the senior medical officer on the base, and they talked about this, and the senior medical officer became curious when he heard that there might be a way to help alcoholics by having them meet and talk to each other about their problems. So, on February 20th, 1965, the first meeting of Alcoholics Anonymous, Dr. Dreidacher's group, was held on the base in Long Beach.
That chance meeting of an alcoholic Navy officer who had nothing to lose and a non-alcoholic Navy doctor who was curious and wanted to help resulted in what is today known as the Navy Alcohol Prevention Program. Some of you might agree with me that there might be some parallels between that chance meeting and another chance meeting between Bill W. and Dr. Bob and Dr. Silkworth and many others. My own interpretation was that Dick Jewell had made a 12-step call on the Navy when the Navy needed it.
People attending those early meetings were all old salty sea dogs who had been jailed and beat up and abused in every harbor throughout the world many times over. Many of them were on their last leg and were fearful of being kicked out of the Navy because they had an alcohol problem and no way to lick it. They attended these first few meetings and they came in to get their barnacles scraped and to get their sea legs back and to dry out.
And from there came the inspiration to call this the Dry Doc group of AA. Meanwhile, Dick, the founder, had also gotten a lot of support from the AA community in Long Beach. Among some of the early people that helped were people like Lyle S., Lorraine S., Frank H., Boy S.R., Chuck C. and Chuck S., Johnny and Buddy H., many of whom you know, John Mack, Bud S., Tom P., Gene V., Mary Ellen A., and a lot of others whom I can't mention here.
All of them spent generously of their time and energy and money driving sailors to meetings, cross stepping, giving lectures, doing individual counseling, doing many great things. Many of these patients were housed by Dick and some of these other folks in their homes with their own families because there was no way for the drunken sailor to go except to jail or out. And the Long Beach AA community, with many old ties to a Navy tradition, opened its arms supportingly, lovingly, and generously to the drunken sailor.
And thus, Long Beach was changed from one of the Navy's primary watering holes to being the Navy's first drying out spot. Of the first 30 patients, not one got well. Gradually, there are some more seats up in front for those of you who are brave enough. Gradually, a few got well and the ships at sea and the captains became impressed, maybe, that there was some hope for the alcoholic sailor. Officially, though, we still had no such thing as an alcoholic officer.
We couldn't have missed that. Actually, the alcoholic officers were smuggled into the sick bay and treated under a pseudonym. And again, I'm reminded of a parallel here because this is similar to what Sister Ignatia and Dr. Bob and others did at St. Thomas Hospital many, many years before that. The alcoholic officer, of course, was a fact of life. We had him and the best way I can describe him to you is to tell you what happened to one of our sailors who was alcoholic.
He was describing to us after he got sober. Now, he was up before a captain's mast in front of the big box for the umpteenth time for being drunk and disorderly. And the captain was kind of angry that morning and addressed the sailor down by saying, Now, look, Jones, I'm sick and tired of seeing you up here time and again for drinking too much. Now, why don't you learn to drink like an officer?
[00:10:00]
And the sailor said, I'm sorry, sir, captain, but I've tried out and I just can't hold that much alcohol. A lot of the captains in Long Beach liked the Navy alcohol situation with A.A. helping out and doing really the work, but some were angered. And unofficial word got to Washington that in Long Beach they were hiding alcoholics and that it was a, really it was a shame on the Navy image. But the founders continued with the program because they knew that the real shame was the suffering alcoholic who was dying while he was being covered up.
Eventually, the founders came to the conclusion that maybe if they could get the sailors in, ordered into them, and not wait for them to hit bottom, and treat them full time rather than part time, they might get higher results. So the Navy decided to start ordering patients to alcohol rehabilitation. Even though the men were ordered in, the philosophy remained the same. It was an A.A. oriented program.
The patients were taken to meetings in the local community once or twice a day where they found the love and the support and the understanding of A.A. And also where they found the inspiration to use A.A. worldwide as a follow on network after they left Long Beach. And they learned that the best way to stay sober is one day at a time with total abstinence as a goal. Washington finally authorized this bootleg operation in Long Beach.
But interestingly enough, the message came in the form of a secret document. We have it in our archives today. It is stamped secret to be declassified over the next 12 years slowly. You see, Dr. Bob told you guys to keep it simple, and the Navy told us to keep it secret. But the program couldn't be suppressed because too many sailors were getting sober and going back to ships, and they were attracting attention by being so sober.
It is kind of reminiscent of your 11th tradition, you see. It was a program that grew by attraction because heaven knows there was no promotion from the Navy. I phoned the chairman to deduct some of the money. I phoned the chairman to deduct some applause time. Finally, in 1971, after Senator Hughes and others pushed for the Department of Defense to really look at the alcoholic, we began to treat them more officially and established a Navy alcohol prevention program in Washington with Captain Jim Baxter at the helm of a staff of recovered alcoholics.
That was the early beginnings. In 1973, Long Beach Alcoholic Center, which is what it was called now, showed that it had come of age because it survived the retirement of one of its founders, Dick Zuro, correction, Captain Joe Zuska, who was the doctor founder, and it survived it without much of a ruffle to the serenity of the program. It showed that the program was something. It was no longer a personality thing.
Dr. Zuska turned his post over to me, and in my opinion, at least, we have continued right on without any detriment. In 1974, we were moved into the Naval Hospital to add even more recognition to the fact that we think it's a disease. The name of our place was changed to the Alcoholic Rehabilitation Service, not SEMR or unit or anything, and it's called a service so that we are equal with the rest of the world.
Not SEMR or unit or anything, and it's called a service so that we are equal with the medicine service, surgery service, orthopedic service, and so on, and to show that we think it's a disease and that people who have it ought to be treated as if they had a disease. The staff now includes a psychiatrist, that's me, a general practitioner, a nurse, a chaplain, three part-time psychologists, and a staff of eight, nine, or ten or so recovered alcoholic counselors from the Navy and the Marine Corps.
The program today in Washington is headed by Captain Stu Brownell and a staff of about 250 recovered alcoholics throughout the Navy world. The program now comprises five alcohol centers for 15 units and about 30 dry docks throughout the world. We treat about 5,000 patients a year, inpatients. We've returned about 10,000 to duty with a 70% success rate. We consider all these guys promoted. If you go from drunken sailor to sober alcoholic, that's a promotion.
Some of these men who found their sobriety through the early dry dock days in Long Beach have gone throughout the world and have established 70 or more independent AA groups that work together. are independent AA groups that work just like any Alcoholics Anonymous group anywhere else in the world,
[00:15:03]
without any association, ties, or commitments to the Navy. These are regular AA groups. Our patients today come to us from all over the world, and they've mostly been ordered in by the Navy. I personally feel there probably are no such things as volunteers among recovered alcoholics. I think it was either the Navy or the judge or the wife or John Barley Korn or somebody. So in our place, they arrive, there are no barred windows, there are no locked doors, there are no restraints other than military regulations.
Each patient is treated with respect and dignity in a helping, learning, problem-solving environment. No preaching, condemning, condoning, theorizing, nothing like this. We feel that the man has a disease, his life has become unmanageable, and even though we're going to help him, only he can be now responsible for what his drinking is going to do to him, and this obviously seduces him right into taking the first step.
During the first two weeks, he's under restriction, and he's under restriction not because we don't trust him, but because we don't trust his disease. We found that many a high-principled alcoholic who has come to our place and who made a sincere resolve not to drink again, went on liberty the first weekend and was brought back intoxicated in a blackout, and two days later, he couldn't understand what happened to him, and he had a setback, and he had to start from scratch.
So now, by putting him under restriction, we relieve his toxic brain of the responsibility for making a decision when he is in no shape to make a decision. After he has been detoxified, we prescribe no more pills of any kind. We prescribe people instead of pills from then on. It's a completely non-chemical environment that we use. He is assigned to a group with a counselor. The counselor is an active-duty, AA-oriented man or woman who is a firm example for identification.
He stands tall and smiles easily and looks confident, and his debts are paid, and his car is paid, and his wife is happy, and so on. So the alcoholic who comes in and sees this has visible proof that this program works, and he begins to consider taking the first step with his counselor, because the counselor to our patient is very much like the AA sponsor is to the pigeon or the baby. In daily group sessions, the patients learn how to get in touch with their feelings and how to learn in a drug-free, socially acceptable way to live with these feelings.
A lot of fourth-step material, such as rationalization, cop-outs, conning, and so on, come up, and honesty with self and others is the first order of priority in our place. Daily, we have speakers who come from the world of medicine, law, industry, show business, almost all of them are recovered alcoholics, and they talk about alcoholism as they see it in their various fields of expertise. AA remains the central focus of our program.
We use AA literature. We use step meetings where patients learn about the 12 steps and traditions and so on. They are bused to AA meetings in Long Beach every night of the week, and on Thursday nights, they attend an AA meeting in our place, which is called the RIDOC meeting, which is AA even though it's in the hospital building. It is conducted just like any AA meeting anywhere else. It is attended by a lot of alumni, a lot of people who have been through there years ago, and every 20th of February, we have the anniversary of this whole establishment, this whole idea of AA and the Duncan Sailor.
Since our patients are all in bad shape physically when they arrive, we use physical fitness and sports. They all jog one or more miles a day, and that's a real eye-opener when they get there. We have a staff meeting every Monday where we discuss the progress of each patient. Anybody who cannot seem to accept his alcoholism gets confronted by the counselor's board, which consists of a doctor, a psychologist, and three or four counselors.
They confront the patient in a closed session in order to break through his denial and explore additional ways how he can become responsive. After six weeks of rehab, our patient is returned to duty almost always, with very, very, very few exceptions, to the same job and the same position from which he came. We have been successful doing that in the Navy. We now have over 55 medical department officers back on duty, from neurosurgeons to nurses and other specialists.
We also have over 50 pilots flying jets and all kinds of airplanes. When they leave our place, they are free of drugs. They have been thoroughly familiarized with AA, in possession of AA contacts from the World Directory and from our own Navy network. In Illinois, we have a network of over 1,500 recovered alcoholics and others in the Navy
[00:20:00]
who have shed their anonymity to the Navy Department and are offering their services all the time as 12-steppers, crisis intervention people, and advisors to the command on what to do with alcoholism. Our patients attach themselves in a way that I can't really tell you in a speech. Perhaps I can describe it to you this way. Sometimes a man will walk into my office, introduce himself, and say that he went through here seven years ago, and would I object if he walked through to look at his room?
And I say, for heaven's sake, no, I'll get a cup of coffee, and we both walk there. And it's like if he walked into a chapel. It's hushed, and he gets a catch of the throat, and he says, that's why I got sober, Captain. And he thanks me, and I had nothing to do with it. I'm a non-alcoholic Navy officer. But he comes back to where he first saw the light, and that's significant. Next to rehabilitating alcoholics, we in the Navy consider the training of medical staff as our most important job, because we found over years of experience that physicians in general don't know much about alcoholism.
They know almost nothing about alcoholism, with some exceptions. They think of it as a hopeless condition. They're frequently uncomfortable or hostile around the alcoholic. They treat only his physical complications, because that's all they've learned to treat. And they unwittingly help the alcoholic to get hooked on pills or lengthy psychotherapy. I'm a psychiatrist, and I have for years now preached.
I hope that's not the right word. I have lectured against psychiatrists like me taking on any one alcoholic in a one-to-one psychotherapeutic relationship. As long as the alcoholic continues to drink alcohol or take any other kind of chemical, it doesn't work. A good psychiatrist might take on an alcoholic and treat him for three years, three times a week, and if the alcoholic was an obsessive-compulsive personality to begin with, something will happen in the course of three years.
He'll continue to drink and be an alcoholic, but a lot of money will change hands. And at the end of three years, he'll no longer be an obsessive-compulsive personality. Now he'll be obnoxious-repulsive. We'll have to feel insecure about alcoholics until we begin to learn something about them. And this professional insecurity is seen by the alcohol counselor as defensive arrogance on the part of the doctor.
And the doctor retaliates by seeing the counselor as a zealot. And maybe there is a kernel of truth in each of these delusions, but it's probably true. We have problems with doctors. One of our counselors probably said it best when he one day told me, when I asked him about doctors in general, he said, Well, it's really easy, Doc. You can always tell a doctor, but not much. In order to bring together these people who can help the alcoholic, namely the doctor and the alcohol counselor, in order to bring them together, we've trained all of our counselors to function as consultants.
And we keep one on duty in the hospital 24 hours a day, and he helps the doctor. So when a doctor sees an alcoholic now in the emergency room or in some other ward where he's been hidden under a different diagnosis, the alcohol counselor helps him. As a matter of fact, he quite often is the one who does the interview of the patient and the family because the doctor is too scared or too clumsy to talk about alcoholism.
And the doctor then, we see a newfound mutual respect between these two people. The counselor ends up as a counselor to the patient and as a trainer to the doctor and to the nurse. And this improves our situation quite a bit. So now at Long Beach, when an alcoholic shows up in the emergency room, he's very likely going to be admitted for detox because the counselor is there, rather than be sent out with a pocket full of pills because you don't have the DTs yet or some other enlightening statement like that.
As a result, we also get transfers now from inpatients in the hospital. For example, one case is a 20-year-old Marine who had shot himself to the chest in a suicide attempt. While he was convalescing and while going on liberty and awaiting an administrative discharge board, he kept getting drunk, which was a good thing because that tipped us off. We were asked to see him in consultation. He was diagnosed alcoholic and transferred to our service.
After eight weeks, he had recovered, changed his mind, and he's back in the Marines, not kicked out. Other examples are the sailor with the broken jaw, and we have a number of those, stumbling around the oral surgery service with his jaws wired together. In the old days, the first night on liberty, you'd see him across the street in the Bon Juan bar sipping scotch or soda through a straw because he couldn't open his mouth anymore.
He talks like that. Quite often, they'd bring him back from the same bar with a broken arm because he punched somebody. Well, this no longer happens. We have trained over 200 doctors so far in the Navy in our two-week training program.
[00:25:05]
Doctors check in with us and stay for two weeks. We assign them to a group of patients, and they're treated exactly like an alcoholic patient, which is quite an eye-opener. They get very angry, they get very nervous, and in about two weeks, they turn out beautiful with very, very few exceptions. There are about 10 percent, and that's a very interesting thing, about 10 percent turn themselves in as alcoholic and stay there.
They undergo rehabilitation, and they come face-to-face with what they had suspected about themselves or with what they had been accused of previously. They then leave and return as recovered alcoholics back to their previous duty stations. Our society, as I see it, is health-oriented, and the availability of health care services is ever more increasing. Since alcoholics repeatedly get into medical difficulties, which bring them face-to-face with the health care deliverer, which is the doctor, the nurse, the administrator, and so on, education of these health care deliverers about alcoholism would enable them to make the diagnosis earlier and get these patients into treatment.
My optimistic prediction and my hope, certainly, is that emergency room treatment and medical detox will someday be looked upon not as treatment, but as a means of referral for treatment, and the treatment should mean rehabilitation and emotional growth. To that end, we are educating our hospital staff in the Navy. How much time? Okay. It's a long way, really, a long road from Dry Rock One Quonset Hut where we started, or where they started, to the Regional Medical Center in the Alcoholic Rehab Service of the Navy Hospital now.
It's a road that goes from 65 to 75, with one founder retired two years ago and Commander Dick Drew, the AA founder, being retired three days ago. He's in the audience today here. The story began, really, with a sick retired alcoholic who was suffering and who was misdiagnosed for the eighth time in our hospital. And the story ends with a 20-year-old seemingly healthy alcoholic with a broken jaw transferred from the oral surgery service to us for treatment.
The story contains many of the elements of the growing alcohol rehab movement as I see it, and that is recognizing not only the 60-year-old heavily damaged alcoholic, but also the 20-year-old seemingly healthy alcoholic and channeling them from emergency medical care into rehabilitation, kindly but firmly and without delay. So far, our work has taught us the following lessons. That alcoholism is a disease which happens to both old and young.
That alcoholics often end up in hospitals where a properly educated staff can really save lives by diagnosing alcoholism early. That medical staff need education in alcoholism and that the recovered alcoholic can play the vital role in that process. That the resistive alcoholic can get well in spite of denial and resentment when he is ordered and coerced into treatment. That recovery as a process is best initiated not in a one-to-one relationship to anybody, including a head shrinker, but in a group setting and in an institution where he is with other alcoholics or in a center or a unit or whatever you call it, a unit which pays attention to body and mind and spirit while it has AA as its central focus and as a worldwide follow-on system.
In terms of alcoholic rehabilitation in the Navy, we feel that everything we have we owe to the fellowship of AA to people like you. We're extremely grateful to Alcoholics Anonymous all over the world. Thank you very much. We've got, all the speakers have agreed to stay for a few minutes afterwards and I think what I'd like to do is to thank each and all of them. Captain Persh, Major King, Roy Baker, Bart, and with all of you who care to…
Independence Day, as I used to say as a youngster the 4th of July. And 199 years ago today, the founding fathers placed to the cause of liberty their lives, their fortune, and their sacred honor. It's significant too because 40 years ago, Bill W. founded Alcoholics Anonymous and showed the path that has proven the most threatened route to recovery for victims of that insidious affliction that we all know as alcoholism.
We all know it's alcoholism, but perhaps we should have said that this is a triply significant day, because I think that what we do here today will give it added significance.
[00:30:06]
I hope that our exchange of ideas during this 40th anniversary convention will ultimately bring freedom from the problem of alcohol to even more who need our help. Accordingly, I'm very pleased to serve on this panel on AA and Armed Forces as a representative of the United States Air Force. It's an honor to participate in this convention of the oldest and most widely recognized organization in the ongoing battle against alcohol abuse.
My presentation is subtitled, Helping Others Help Themselves, because that's what we in the Air Force are doing. In telling you how we're doing that, I also want to tell you how AA is helping us to help others help themselves, because AA is certainly doing that. I learned about AA's help to us about three years ago during my first assignment to this work. My commander had told his subordinate commanders that alcoholism was an intolerable drain on the productivity of his people.
Put the alcoholics among us in touch with AA, he said. Well, they passed that word to me. After some frank phone calls to both the local and the world AA officers, I got stood to the right people. They told me how to put our problem drinkers in touch with AA and also provided me with a wealth of helpful literature. I was pleasantly surprised to find that AA had a list of military installations where AA groups were meeting.
They did even outline some of the pros and cons of meeting on base as opposed to meeting off base. What surprised me most, and even chagrined me a little, was discovering that AA had been providing compassionate and systematic help directly to Air Force alcoholics long before we came up with the Comprehensive Alcohol Abuse Control Program ourselves. Just imagine it. There I was, newly assigned to this program, getting in on the ground floor, so to speak, of a sound and humanitarian program to help us remain mission capable, only to discover suddenly that AA was already there.
Well, it was good it happened that way. Kind of restores your objectivity in the job to be done. But it reminded me for just a moment of the way some of my military predecessors must have felt on occasion way back during World War II. They might be way out in the boonies in some far off land, you know, saying that no fellow American had ever been there before. And they would round the next bend in the road, and there on a high fence to be defined bigger than life, Kilroy was here.
Well, the AA people who had been caring for my brothers and sisters in blue are a bit like the legendary Kilroy in two ways, I learned. They usually get their head of you, and they always remain anonymous. It was about four years ago that we formally established the Air Force Alcohol Abuse Control Program. I'll tell you first I had set up at our Air Force bases because those are where the troops are.
Then I'll briefly fill you in on the upper level structure of it. At each major Air Force base we have a group called the Social Actions Office. And the chief of this office, usually a major with 12 to 15 years service, reports directly to the local commander. Under that chief there are three branches, one of which is concerned with drug and alcohol abuse control. The other two are equal opportunity and treatment and human relations education.
Now, some have questioned the affinity of these with the alcohol abuse control. And some have also questioned our having the drug and alcohol abuse control efforts co-located together. Our answer is simply that this was a marriage of convenience. Actually, each branch had its own separate people and programs. I must also point out, however, that the Department of Defense directs the military departments to integrate their alcohol and drug abuse control programs to the extent practicable.
Now, some of you may have different feelings about this, and I think we can all agree that no well-defined consensus exists on what the relationship between these two efforts should be. Within the Social Actions Office, the drug and alcohol abuse control branch is usually headed by a captain, an Air Force type, not Navy type, or a lieutenant. Somewhere between four and ten years' service. That tells you right there he's not a Navy captain.
He's likely to be assisted by a civilian employee in civil service grades GS-9 or 11. Now, I think that some of you have experience tending to show that higher education isn't necessarily a plus for success in alcohol abuse control.
[00:35:00]
Nevertheless, the officers in our program all do have college degrees, simply because that's required of every officer. For our programs, therefore, we try to get those degrees in the behavioral sciences, psychology, sociology, anthropology. To prepare our people for their jobs in alcohol abuse control, we send them to a school for nine weeks of special training for their work. Now, at Headquarters USAF, the alcohol abuse control program is managed by the Directive Personnel Plan, who comes under the Deputy Chief of Staff's personnel.
Our office in the Pentagon provides direction and policy guidance to our worldwide major commands. Now, perhaps you're not familiar with the term major command. It means our principal organizational entities, such as Strategic Air Command, United States Air Forces Europe, Air Training Command, Military Airlift Command, and so forth. Now, from the major commands, the Deputy Chief of Staff personnel provides direction to the social action officers in the field.
But the people assigned to our base social actions officers are the real business end of our alcohol abuse control program. They're the ones who make contacts with the alcoholics and problem drinkers in the force, and they're the ones who arrange help for these people. The alcohol abuse control personnel, incidentally, are not themselves recovering alcoholics. Let me clarify that. A few of them may be recovering alcoholics, but we have no requirement that they must be to qualify for this work.
In fact, we're not even convinced that to be a recovering alcoholic is necessarily a desirable qualification for the work. Now, I think that some of you will disagree with us on that, and I believe I understood that the ground rules here would permit some honest disagreement, and I certainly hope that's true. Now, speaking of honest disagreement, one way to be sure that any disagreement is only that is to make sure you're communicating effectively.
That means you have to define your terms. So let me get specific and pin down the terms alcoholic and alcohol abuse as we define them. For our purposes, we prefer the latter term, and by alcohol abuse, we mean any use that leads to misconduct, unacceptable social behavior, or to impairment of duty performance, physical or mental health, financial responsibility, or personal relationships. Now, you see, we are including in our program people who may not in fact be alcoholic, and we define alcoholic as one who is diagnosed as being psychologically or physically dependent on alcohol.
Now, as you noted, our definition of alcohol abuse is a rather encompassing one. Any use of alcohol that leads to misconduct, unacceptable social behavior, or to impairment of duty performance, physical or mental health, financial responsibility, or personal relationships is alcohol abuse. Why so broad a judgment? To explain, I ask you to focus your thoughts on the Air Force itself and its reason for being.
Together with the other branches of the armed services, the Air Force shares the vital responsibility of protecting the national interests of the United States. That is our solemn and exacting mission, and in everything we do, the mission comes first. It's our whole reason for being. For an organization so engaged, every one of us must give his work the best effort he is capable of. As we continuously seek maximum reliability in our fighters, bombers, and missiles, we also seek maximum reliability in the personnel who man these.
One concept to help achieve this is what we call human reliability screening. Before a man may be assigned to a combat crew, and also at regular intervals throughout his assignment as a combat crewman, he undergoes intensive physical and mental examination. His personal habits, attitudes, and manner of performance are carefully scrutinized. Human reliability screening does not guarantee that no combat crewman will ever drink abusively, but it does greatly minimize the possibility of abuse, and it does greatly enhance the likelihood of early discovery of alcohol abuse.
As another illustration, all missile combat crewmen always undergo a formal and thorough inspection prior to entering an operational alert duty. There must be an excellent physical and mental health, and even the slightest suggestion to the controller may be grounds for rejection. But human reliability is a costly and time-consuming effort, so the application of it is limited to operational personnel.
That leaves us in round figures with roughly half a million other men and women who are not so screened. And it is primarily those people that our alcohol abuse control program is directed. Because of our broad definition of alcohol abuse, many of the people in our program are, in fact, not alcoholics. The great majority have simply had two bouts with problem drinking. They might later become alcohol-dependent, but at this stage, they're not.
We call this early intervention, and we think it pays dividends, both to the individual and to the Air Force. I think you would all agree that the earlier a person recognizes and accepts that he has a budding problem,
[00:40:01]
the more likely that he will get it under control with minimum damage to his health and self-esteem. But if it were easy to help the problem drinker to recognize and accept the reality of his problem, well, probably we wouldn't even be meeting here today. As I see it, admission of the problem, recognition of what it may do if left unchecked, these are the gist of the challenge. Identification of alcohol abusers is one area in which we are now driving ourselves very hard.
And with good reason. We estimate that about 5% of the people in the total force do have a drinking problem and that we are only now identifying one of every ten of those who do. To speak of identification is to bring up a fundamental difference between the Air Force program and the AA program. In the Air Force, we hold that a real problem drinker cannot remain anonymous. If the problem is real, the commander has to know about it. The mission comes first and the commander's most important resource for accomplishing his mission is people, the men and women who get the job done.
But if any Air Force member merely thinks that he may have a drinking problem and senses the need for help, he may now avail himself of the services of the Alcohol Abuse Control Program on a voluntary self-referral basis. And initially we help him confidentially. We call this the Concerned Drinker Program and it works like this. Let's say the individual's pattern of alcohol use has not caused his duty performance to be unsatisfactory nor caused him legal or other official problems.
Yet he is having other difficulties, such as breakdown in family relationships or financial problems or other burdens for which drinking is a causative factor. He feels deep concern. We keep the welcome mat out for him so he can approach us unofficially and privately to simply inquire about the effects of alcohol abuse, what determines alcoholism and what kind of help is available. We let him tell us about his problem and counsel him on the steps he might take. This may include referrals to other agencies for specialized help with either alcohol problems or not directly related to alcohol.
We also refer him to the Alcohol Awareness Seminar. In the seminar he learns about the sociological and physiological and psychological factors that influence alcohol abuse and about the dangers to physical and mental health in alcohol abuse. We also cite the inconsistency of alcohol abuse with military standards of performance and we discuss positive alternatives available in the local base and community environment.
If the concerned drinker does not come back for a second interview after the seminar, his relationship with the Social Actions Office is considered ended. If he does return it is for the sole purpose of deciding on one of three options. If he either decides that he does not have a drinking problem or that he does but does not choose to enter the rehabilitation program, our relationship is terminated. If he admits to a problem, however, we do refer alternative sources of help such as chaplain and the AA.
Up to this point the entire relationship has been confidential and his anonymity has been preserved. It will continue to be preserved unless he himself subsequently draws attention to his problem. Any files that we have made were for confidential internal use only and are destroyed 30 days after the last interview. The third option the individual may choose at the second interview is that he is a problem drinker and does wish to participate in the rehabilitation program.
Now the concerned drinker program is still so new that we do not yet have any meaningful data on how well it is working. We feel that the basic responsibility for identification of alcohol abusers rests with the individual commanders and on-the-job supervisors. I said earlier that I believe we are identifying only 10 percent of our problem drinkers and one of the reasons for this is that supervisor perception is generally not sufficiently sophisticated to detect the affliction until it eventually results in rather gross impairment of performance.
That means, of course, that we in the personnel management have a problem. We have to better educate our supervisors on early detection of fault in job performance and we are working on that. As part of the effort all supervisors are required to attend the alcohol awareness seminar and then attend it again after each permanent reassignment. Our alcohol awareness seminars, by the way, are specially tailored to the particular group of participants. As you might suppose a seminar for commanders and supervisors is necessary to channel along different lines than a seminar for problem drinkers.
As to treatment and rehabilitation of identified problem drinkers we have had for many years an unofficial expression that says simply the Air Force takes care of its own. I know of no other organization of comparable size. We have several large and modern hospitals, Air Force-wide assignment of highly trained medical personnel,
[00:45:01]
and nine alcohol treatment centers. Through these resources, we can and are providing professional treatment and rehabilitation of alcoholic abusers. And we are doing this quietly as part of our total service commitment to our people and to their dependents. The problem drinker who chooses rehabilitation, after referring himself to us voluntarily, is necessarily identified to his commander. First, he's going to be briefly taken off the job for rehabilitation.
And second, his commander becomes a member of the committee that will later determine whether rehabilitation was in fact accomplished. In addition to our revealing the identity of a known alcohol abuser, there are other fundamental differences between our handling of alcohol abuse and that of Alcoholics Anonymous. Some of you might say that the Air Force approach is a hard-line approach, at least in contrast to that of AA.
But let me remind you again that AA and the Air Force have very different reasons for existence. Our foremost concern is to preserve the physical and mental ability of our people to perform effectively. If those abilities suffer from alcohol abuse, then job performance will also suffer, and ultimately our mission capability might be degraded if we did nothing about the problem. So we do something about it.
You might say that the Air Force is in the alcohol abuse control business principally because preservation of mission capability requires us to be. Note what I said principally. We do have a heart. We're loyal to our people. Anyone may stumble along the rocky path of life. Our help is humane, but not unlimited. The Air Force simply cannot carry indefinitely anyone who did not respond to efforts to help themselves.
Let me state here, however, that any whom we must ultimately discharge are not discharged for alcohol abuse per se. Because of misunderstanding about this, we have taken a fair share of unjust criticism. Those whom we separate from the service involuntarily, we separate for inability to perform satisfactorily and reliably, for insubordination, for damage to government property, for being a hazard to themselves or others, for absenteeism, or for other misconduct.
Now, while it is usually correct in these cases that alcohol abuse was the precipitating cause of their wrongdoing, it is the wrongdoing itself that brings the separation. You know, a remark we often hear in the Air Force after someone has just made a close discretionary judgment is, that's a distinction without a difference. Well, the judgment I just gave about unsatisfactory performance being the cause of separation and not the problem of drinking is not that kind of distinction.
Air Force policy holds that alcohol abuse is no excuse for poor performance or other wrongdoing. In AA, you have a well-known expression, I am responsible. To me, the words have a ring of truth about them. We are responsible. We are responsible for what we say and for what we do, for what we do not say and do not do. God's law holds us responsible. Man's law holds us responsible. The Air Force expects every member to know and believe the mission comes first, and I am responsible.
That's the kind of organization that we are because that's the kind of people, that's the kind the people want us to be. And through their representative government is the kind of organization they have legally chartered us to be. We have, for our total Air Force population, only one set of standards for performance, appearance, and behavior. These standards apply across the board. They serve as fairly as a test for alcohol abusers to meet, as they do for all Air Force people.
But what about the recovered alcoholic, the one who is successfully rehabilitated? Again, the standards are the same for him as for everybody. He has exactly the same chance for reenlistment and promotion as anybody else. And that's because he makes, that's the chance that he makes for himself by the extent to which he measures up. We are, to be sure, a results-oriented organization. But being that kind of organization, nevertheless, there are a few who have private but very pleased looks of deep satisfaction.
And one of our recovered alcoholics makes it and keeps on making it. And those are worn by those of us whose work it is to help them do just that. In that, we do share a common bond with you and all the good and kind advocates of AA the world around. We in the Air Force regard AA as one of the primary and most valuable resources available to us. So our approach is different, and we hope that you will understand and respect that it must necessarily be so.
We also have the most profound respect for your approach. Moreover, we hold the efficacy of your approach to be inarguable, and as a consequence of that conviction, we strongly publicize AA throughout the Air Force as the very helpful and understanding source of good works that it is. As part of my preparation for participating in this panel,
[00:50:01]
I ask our social action officers around the globe to tell me of their local relationships with AA. I'd like to give you a few quotes from their replies. A base in the Pacific said, the positive aspects of association with AA are so self-obvious as to decry elaboration. It is basically a viable extension of the rehabilitation effort. In another paragraph of its wire, that base also said about the spouse and children of problem drinkers, this area holds the greatest degree of promise for increased interaction as most agencies on base are poorly equipped to deal on a realistic or effective level with the family of the alcoholic.
From a base in California, the relationship between AA and the Air Force at this base is good. AA utilizes the room in the social actions office for the weekly meeting on base, and they assist our people in the alcohol treatment center with transportation to the meeting on base as well as to the introductory meetings in the local area. We have not experienced any notable problems, and our programs supplement and complement one another.
From a base in the Midwest, the role of official Air Force rehabilitation programs is essentially limited to providing support in the form of arranging meeting places, usually in chapels, community centers, and social actions facilities. Clients are encouraged to explore AA, and notices of meeting times and places are published in base media. In a base in the northern tier of states reported, social actions provides the facilities for AA to meet on base three nights weekly.
This includes one open meeting, two closed, and one hour non-group. Conveniency of having groups meet on base encourages people to attend who might otherwise use the distance involved as an excuse for non-attendance. Well, that's a sampling of comments from the field that show how highly AA is regarded by our people. Now, of course, we have other people who also regard AA with high esteem. They are the recovered alcoholics who, with the help of their AA contacts, are making it day by day, making important contributions to the national security.
They, like their AA brethren, will remain anonymous. In closing, may I make a personal observation about the priceless value of the human attribute that we call optimism, that persistent resilience to see things hopefully. Man everywhere needs it, and always has. At times I think we need the truly optimistic outlook more than ever. We must at least have sufficient of it to ensure that we counter the gloomy naysayers among us.
Not too long ago, one cynic grumbled, What good are all the churches doing in this world? Look how rotten things are. What help is religion in a time like this? Well, I was at first inclined to reply that in times like this it is helpful to remember that there have always been times like this. I stifled that crap. I said instead, as softly but as firmly as I could, think of all the people who do go to church.
Think of the strengths of their belief. Think of the weekly reminders they get from the pulpit about morality and kindness. Think of the strength they get from this. Think how it helps them and others around them. And then I added, think how much worse a world this would be if it were not for the great good being done by all our churches and all the people who attend them, and who then try harder to set a good example and to do right by each other and by all of us.
Thank God, I said, we don't live in a world where there is no faith. To that true life anecdote, I would just like to add this final thought. When I think of the great force for good that AA is, and that this abiding faith and optimism is giving daily hope and strength to millions, I'm left with only this conclusion. Thank God we don't live in a world where there is no AA. Thank you.