However, given that the Afghanistan and Iraq wars make up the longest period of conflict in US history, Chiarelli warns, “There are second- and third-order effects that have grown out of this that our nation has never experienced before.”

The Army’s study, released Thursday and entitled “Generating Health and Discipline in the Force,” found: “Many soldiers who are suffering from behavioral health issues or ‘invisible wounds’ remain undetected throughout the force, suffering in silence in Army formations at camps, posts, and stations and – within the Reserve component – across communities nationwide.”

This sort of suffering can manifest itself in some troubling ways, according to senior US military officials. Incidences of domestic violence among soldiers increased by one-third between 2006 and 2011, the study found. At the same time, alcohol abuse that was associated with domestic violence increased by 54 percent.

Indeed, the study noted, “soldier demographics in relationship to binge drinking are at the forefront of issues confronting the Army.” As much as 43 percent of active-duty soldiers reported binge drinking “within the past month,” according to a recent study.

Prescription-drug abuse among troops continues to be a source of concern for Pentagon officials as well. A report appended to the Defense Department’s 2012 budget noted, “25-35 percent of wounded soldiers are addicted to prescription or illegal drugs while they await medical discharge.”

Roughly half of soldiers returning from Iraq and Afghanstan “report pain-related problems and symptoms,” according to the Defense Department study, which says that roughly 14 percent of soldiers have been prescribed an opioid painkiller. Oxycodone accounts for 95 percent of those prescriptions.

Soldiers are also increasingly using synthetic marijuana like spice, which can be purchased in shops around the country. The use of synthetic marijuana is now banned by the Uniform Code of Military Justice.

During the height of the wars, drug and alcohol infractions were pursued less. Some of the military police who had been responsible for the random drug testing of troops were put to work on other jobs, Chiarelli says.

But a lack of enforcement is beginning to change, he says.

Today, there are a few bright spots amid the struggles, Chiarelli says. The number of soldiers being referred to treatment programs is increasing. And while waivers for drug and alcohol violations peaked at 1,307 in 2007 so soldiers could continue serving in a time of war, by 2009 those waivers had been reduced to 337. By 2011, they were at zero.

As force reductions increase in the face of budget cuts, it could add to the stress of troops who have fought in wars and now must leave the military, Chiarelli warns. “It’s absolutely essential that when soldiers leave the Army, we do everything possible to get them situated,” he says. This includes treatment programs, he adds.

“We have a saying in the Army: There are lessons noted and there are lessons learned,” Chiarelli says. “Too often we say that these are lessons learned, but they’re actually lessons noted.” As soldiers grapple with the wounds of war, he adds, that must change.

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