Navy Shutters Premier East Coast Substance Abuse Program Amid Staffing Shortages

The Navy has suspended operation of its residential substance abuse treatment program at Naval Medical Center Portsmouth, Virginia, as a result of staffing shortages that affected the quality of care.

The service closed the program, considered the Navy's top rehab center on the East Coast, in September, officials confirmed this month. All patients were sent to or are being referred to other Defense Department residential programs or the Tricare network, NMCP Public Affairs Officer Christina Johnson said.

"Due to critical staffing shortfalls, [Substance Abuse Rehabilitation Program] Level 3 service is temporarily suspended to ensure quality care via safe staff-to-patient rations and to preserve other SARP services and graduate medical education requirements," Johnson said in an email Nov. 1 to Military.com.

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"Providing safe and effective substance abuse treatment for our active-duty service members remains a priority," she added.

The closure comes two years after Navy officials were forced to transfer residential patients out of the building, which is separate from the main hospital, due to maintenance problems and a rat infestation.

Those issues, which were not publicly disclosed, prompted SARP leaders to reduce the number of spots available for residential treatment and move all patients to a nearby barracks that was less secure than a locked-down rehabilitation facility.

Emails between the then-SARP commander and the hospital's chief of mental health described the SARP facility as not "hazardous," but said the "berthing areas were not to acceptable standards for continued residential use."

"Talks are already underway about both immediate solutions and long-term solutions," wrote the SARP program director to the director and staff on March 15, 2022, according to emails obtained by Military.com.

Those included investing nearly $500,000 in renovations, including replacing carpeting, windows and tiles and "bringing rooms up to living standards."

Navy SARP leadership also explored transferring the program to Langley Air Force Base in nearby Hampton at the time, but abandoned the plans out of concerns that the move could jeopardize program accreditation, compliance with the American Society of Addiction Medicine standards as a residential program, the ability to care for medically complex patients and space concerns, according to the emails.

Level 3 treatment is a 35-day, abstinence-based program for service members with moderate to severe substance abuse whose addiction has affected their professional and personal lives.

Patients live at the facility and have access during the day to addiction treatment, mental health services and medical care.

In fiscal 2024, the program served 163 personnel, according to Johnson.

A source with professional knowledge of addiction and the situation at the facility said the movement of patients to a barracks jeopardized care, because it reduced the number of spots in the program and gave patients struggling with addiction more freedom to access alcohol or drugs since they weren't in a locked-down facility.

The decline in services, which included discussions of staff furloughs, also jeopardized morale, the source said.

"The program was under-resourced," the source said. "The employees banded together and filed complaints about it. Many quit."

The issues at the SARP coincided with the deaths of at least seven sailors, including four suicides, among the crew of the carrier George Washington, which at the time was in the Newport News Shipyard.

At least one of the sailors was found to have been drinking heavily when he died by suicide, according to the Navy's investigation into the deaths.

"It's a state of mismanagement and decay and atrophy, and it's really frustrating, because service members say the military drives them to drink -- it doesn't cause them to drink, you know, it's part of the culture of the military. But then the resource isn't there to help them stop drinking," said the source, a mental health professional who treats service members across the six branches of the armed forces.

While misuse of illegal drugs and prescription medications is lower in the U.S. military than the general public, the Defense Department's Survey of Health-Related Behaviors, last published in 2021, found that alcohol use is higher than the U.S. population. More than a third of active-duty personnel report they engaged in binge drinking, defined as more than four drinks at a time for women and five for men, within the previous 30 days, compared with roughly a quarter of U.S. adults.

And nearly 10% of troops in active components said they drank heavily, compared with 9% of U.S. adults.

The individual service branches operate their own substance use disorder programs, each with varying levels of treatment, including residential rehabilitation. The Army’s programs are known as ASAP, or Army Substance Abuse Program, while the Air Force offers its Alcohol and Drug Abuse Prevention and Treatment, or ADAPT, program for Air Force and Space Force members.

Navy SARP serves sailors and Marines.

Johnson said the Navy program needs 33 full-time staff members to support residential care, including psychologists, psychiatrists, nurse practitioners, social workers, behavioral health technicians, and drug and alcohol counselors.

She was unable to provide a time frame for when the program may restart but said that other outpatient programs such as intensive outpatient care remain operational, as do all training programs for personnel.

Under reforms of the military health system that began in 2017, the Defense Health Agency is charged with managing and staffing military health facilities, while the services are responsible for what is known as "operational medicine," treating active-duty personnel for illness and injuries and supporting training and combat.

Earlier this year, the Defense Health Agency awarded contracts worth up to $43 billion to 11 health-care companies to recruit and staff 591 military hospitals and clinics. Whether that contract will help the Portsmouth SARP program remains to be seen.

"NMCP is working with our DHA Headquarters to restore staffing to support the residential SARP program. Further updates will be provided as information becomes available," Johnson said.

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