PREVENTIONPrevention programs are an important aspect ofm i l i t a r y l i f e .P R E V E N T 2 0 0 0( P e r s o n a lResponsibility and Values, Education and Training) isa program designed specifically for the younger Sailor.ADAMS (Alcohol and Drug Abuse, Managers andSupervisors) is required for E-5 and above.Most commands have full-time or collateral-dutyDAPAs, Drug and Alcohol Program Advisors, whoprovide the direct liaison between law enforcement,medical, the Family Services Center, and thecommanding officer in all matters dealing withintervention, identification, and treatment. The DAPAcoordinates on-site training, facilitates AlcoholAnonymous meetings, and provides referrals foroutside intervention and inpatient treatment ifindicated. Personnel can be identified to the DAPAthrough aberrant behavioral patterns, suspiciousmedical findings, and by self-referral to either medicalor the chaplain’s office.CONTROLMedical personnel become professionallyinvolved in substance abuse programs when calledupon to withdraw blood or urine from an individualsuspected of drug or alcohol abuse. Few areas cause asmuch concern and confusion to healthcare providers asthe question of when those bodily fluids may belawfully extracted.At the outset, a few basic facts must be discussed.1. The healthcare provider should not undertake afluid extraction procedure when to do so ismedically contraindicated.2. Refusal to perform an extraction in the face oflawful authority could subject the healthcareprovider to charges of obstruction of justice orwillful disobedience of an order.3. The healthcare provider is not an arbiter of thelaw. (In other words, the admissibility ofevidence derived from a blood or urine sample isnot a matter for Medical Department personnelto decide.)4. Common sense and cooperation with commandand law enforcement officials should be theguideposts in every instance where extraction ofbodily fluids is an issue.The following are the circumstances wherewithdrawal of blood or urine from active duty militarymembers is authorized:Consensual withdrawal—If an individualexpressly consents to an extraction of bodilyfluids and there is a legitimate reason for theextraction, the healthcare provider may performthe procedure.Valid medical purpose—Specimens may beobtained from an individual for a valid medicalexamination, provided the individual hasexpressly or implicitly consented to theexamination.Competence for duty examinations—TheCompetence for Duty Examination request form(NAVMED 6120/1) contains a block for thesubmitting authority to request laboratoryanalysis. See figures 15–1 and 15–2. Thefollowing procedures should be used in handlingcompetence for duty requests.—The command initiating the request shouldcomplete items 1 through 12 of the form. Theindividual submitting the request must haveauthority to make the request. Normally, thiswill be a commanding officer, executiveofficer, or command duty officer of theinitiating command.—After proper initiation of the request, themedical officer or other authorized healthcareprovider will complete blocks 13 through 49on the form.—If the command has requested laboratoryanalysis, the patient should first be requestedto give written consent to the procedure. If thepatient will not give consent but will allowextraction, the sample should be taken. If thepatient refuses consent and will physicallyresist extraction, the requesting commandshould be notified and no extractionattempted unless a search authorization isissued.PHYSICAL READINESS PROGRAMLEARNING OBJECTIVE: Recognize thepolicies and procedures pertaining to thePhysical Readiness Program.15-5
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