1) Service Regulations 

Since the 1980s each of the US armed forces has adopted a policy of “zero tolerance” for consumption of illicit narcotics, including the unprescribed use of prescription medicines with narcotic effects.  Service members should familiarize themselves with the substance abuse policy of their individual services, listed as follows: 

• Air Force and Space Force: Department of the Air Force Manual 44-197, Military Drug Demand Reduction Program 
• Army: Army Regulation 600-85, The Army Substance Abuse Program 
• Coast Guard: Commandant of the Coast Guard Instruction M1000.10A, Military Drug and Alcohol Policy 
• Marine Corps: Marine Corps Order 5300.17A, Marine Corps Substance Abuse Program 
• Navy: OPNAV Instruction 5350.4E, Navy Alcohol and Drug Misuse Prevention and Control  

Although each program is slightly different, there are themes common throughout all of them.  Urinalysis is the cornerstone of each service's enforcement program, including random individual urinalysis, sub-unit and unit no-notice urinalysis, and policy-driven urinalysis such as after reporting to a new duty station, after return from leave, following deployment, following pre- or post-overseas movement stand-down, upon Guard and Reserve activation, and following unauthorized absence. 

Services have even updated their policies to reflect the COVID-era telework environment, authorizing service members to be called into command HQs or offices to administer urinalysis when otherwise assigned to telework. 

2) What is prohibited?  

Illegal narcotics such as methamphetamines, cocaine and its derivatives, opioids, and hallucinogens such as LSD and MDMA are prohibited for service members.  Marijuana and derivatives like CBD are prohibited even in states where their consumption is legal for civilians.  Synthetic cannabinoids such as “Spice” are prohibited.  Unprescribed consumption of prescription drugs, such as anti-ADHD medication, steroids, and opiates, banned diet drugs (such as Ephedra) and Benzodiazepines (such as Valium or other prescription anti-anxiety or anti-convulsant medicines) is prohibited.  All the above-listed drugs are testable in the service urinalysis programs. 

3) What happens following a positive urinalysis? 

After a urinalysis result that is positive for a banned substance, every service directs unit commanders to refer the member to the administrative separation process.  While the odds of remaining in service are questionable, separation is not mandatory.  Unless they opt for notice of separation, enlisted service members will undergo some form of Administrative Separation Board, at which time they have the opportunity to plead the case for continued service. Officers will similarly face Boards of Inquiry, which will determine not only the opportunity for continued service, but also recommend a grade determination and characterization of discharge. 

A negative discharge characterization is not a foregone conclusion of the Admin Separation process.  Boards are instructed that for an Other-Than-Honorable (OTH) discharge to apply, the balance of a service member's service must be more negative than positive.  A lone positive urinalysis result in an enlistment, otherwise characterized by good behavior and achievement, does not guarantee an OTH discharge.  The longer the time in service, the more likely a favorable outcome. 

4) What happens when service members self-refer for drug use? 

Each service treats self-referral slightly differently, but there are some general themes that unify the approach to self-identified users.  Generally, self-identified users are not viewed as recreational drug users, but rather as having a medical condition requiring treatment.  Self-referral is not something to be undertaken lightly, however. 

The Air Force instruction notes “Members may not be disciplined under the UCMJ when they legitimately self-identify for drug abuse and enter the ADAPT program.” The Army instruction similarly notes that command policies should provide support for soldiers “seeking self-referral for problematic substance use.”  The Navy and Marine Corps manuals are more explicit: “personnel who self-refer and who are determined to meet criteria for a substance abuse disorder must be considered valid self-referrals and are exempt from any disciplinary action.”  In each service, a self-referral will be accompanied by a medical determination on whether the service member has a disorder or is trying to evade discipline. 

Regardless of whether the self-referring service member meets the criteria for treatment, a referral for Administrative Separation follows. 

5) Innocent or Unknowing Ingestion – a very specific set of circumstances 

The Navy's instruction makes specific reference to circumstances in which service members claim not to have known that they ingested a banned substance.  Service members who make this claim must still be referred to an Admin Separation proceeding, where the facts of their claims are tested.  In these cases, the circumstances matter: Did the service member go to medical or a hospital to be checked out?  Or did the service member make this report after a positive urinalysis result?  The former is helpful to service members seeking retention.  The latter is often viewed by boards as a disingenuous attempt to evade discipline.