25.1 Substance Use or Abuse (AFH-1 Section 22D)
Key Takeaways
- Section 22D is ADTC B for both Staff Sergeant and Technical Sergeant (B B B C C from SSgt through CMSgt).
- The USAF goal is a tobacco-free force; designated tobacco areas must be at least 50 feet from building entrances and air intake ducts and at least 100 feet from playgrounds.
- Ingestion of hemp seed, hemp seed oil, delta-8-THC, and CBD products is prohibited and is a violation of Article 92, UCMJ.
- ADAPT program managers review records within seven calendar days; only ADAPT personnel diagnose a substance use disorder.
- Commanders may not use voluntary self-identification against a member in a UCMJ action or when characterizing service in an administrative discharge, and administrative restrictions must rest on behavior (UIF or control roster), not solely on ADAPT enrollment.
ADTC and Why 22D Is Tested
AFH 1, Airman (15 February 2025), Section 22D—Substance Use or Abuse, is ADTC B for Staff Sergeant and Technical Sergeant (the table reads B B B C C from SSgt through CMSgt). Tobacco, alcohol, and other substances are readiness and discipline problems. ADAPT and drug demand reduction programs include prevention, education, treatment, and urinalysis testing. Members are held to the highest standards of discipline on- and off-duty. Counseling and treatment are available; unacceptable behavior is still punished.
Tobacco-Free Force (22.18–22.21)
"The USAF goal is to have a tobacco-free force." Tobacco use includes all products configured to deliver nicotine: cigars, cigarettes, electronic cigarettes/vape pens, stem pipes, water pipes, hookahs, vaporizers, smokeless products, and any other nicotine delivery system defined as a tobacco product. Use is non-conducive to mission readiness and productivity.
AFI 48-104, Tobacco Free Living, governs installations. Commanders and leaders shall minimize designated tobacco use areas to as close to zero as possible.
| Restriction | AFH 1 requirement |
|---|---|
| Building entrances and air intake ducts | At least 50 feet |
| Playgrounds | At least 100 feet |
| Students in technical training, in-residence PME, accession, and graduate medical education | No tobacco products while in uniform |
| Basic military training | No tobacco use at all times |
Do not mix those last two rows: listed student programs are banned in uniform; BMT is banned at all times.
"Tobacco use is the single most preventable cause of disease and death in the United States." Tobacco smoke is a Class "A" carcinogen estimated to cause 480,000 deaths per year, including about 41,000 from secondhand smoke. Smokeless tobacco contains 28 carcinogens. Oral cancers affect 30,000 people annually; one person dies every hour; only 50 percent are alive at five years. Operationally, tobacco decreases endurance, night vision, and fine motor coordination (needed to hold a weapon steady) and increases injury risk.
Nicotine is addictive. Seven of 10 U.S. smokers want to quit; nearly half tried in the past year; some studies cite up to 30 tries. Commanders are expected to support Airmen trying to quit.
Alcohol, Drugs, Hemp, and Limited Duty
All patients diagnosed with a substance use disorder and entered into ADAPT will be recommended for limited duty—not worldwide qualified.
Ingestion of products containing or derived from hemp seed or hemp seed oil, including delta-8-THC and CBD, is prohibited because they may contain THC detectable through USAF drug testing. Non-compliance is Article 92, UCMJ. State legality is not an exception.
ADAPT Policy
ADAPT is designed to promote readiness, health, and wellness through prevention and treatment of substance misuse and abuse. The assessment's central purpose is to determine need for treatment and level of care. ADAPT program managers review medical records and all documentation within seven calendar days of notification.
If signs exist, talk with the individual, then document unusual behavior with the supervisor, first sergeant, or commander. Diagnosis of a substance use disorder lies with ADAPT personnel—supervisors refer; they do not diagnose. The treatment team is the commander, supervisor, member's counselor, medical consultants, other helping agencies, and the member. Supervisors watch duty performance, attendance, and standards. The commander or first sergeant and the supervisor must be involved at entry, termination, and significant treatment difficulties. All Regular Air Force members involved in alcohol-related misconduct will be referred for a substance use assessment.
| Policy item | What AFH 1 requires |
|---|---|
| Commander's identification | Refer all members for assessment when substance use or misuse is suspected as a contributing factor in any misconduct—DUI, public intoxication, drunk and disorderly, spouse or child abuse and maltreatment, underage drinking, a positive drug test, or medical notification |
| Self-identification | Members not under investigation or pending action are encouraged to seek help from the commander, first sergeant, substance use counselor, or a military medical professional. The ADAPT program manager consults the treatment team after assessment. Commanders may not use voluntary self-identification against a member in a UCMJ action or when characterizing service in an administrative discharge |
| Medical care referrals | Medical personnel must notify the commander and the ADAPT program manager when a member is under the influence while seeking care; is treated for injury or illness that may result from substance use; is suspected of abusing substances; or is admitted for alcohol or drug detoxification |
| Nonclinical services | No substance-use-disorder diagnosis: targeted prevention and education by risk, with follow-up |
| Clinical services | Meets diagnostic criteria: level and intensity set by the ADAPT program manager. Detox outpatient to the greatest extent possible. Family involvement strongly encouraged. Patients refrain from alcohol in the initial treatment phase and are strongly encouraged to abstain in aftercare |
| Successful completion | Not complete until treatment and continuing care (aftercare) are both finished |
| Failing the program | A pattern of unacceptable behavior, inability or unwillingness to comply with the treatment plan, or alcohol or drug incidents after initial treatment. Failed ADAPT → commander considers administrative separation |
| Personnel actions | Commander owns assignment availability, promotion eligibility, reenlistment eligibility, PRP, and security clearance. Restrictions rest on a UIF or control roster from unacceptable behavior, not solely on ADAPT involvement |
Substance-use misconduct can trigger a line of duty determination—a finding after investigation into illness, injury, disease, or death that protects both the member and the U.S. Government (DAFI 36-2910). Detox and medical care are provided before separation; separation is not postponed because the member is in ADAPT.
What installation distances does AFH 1 set for designated tobacco use areas, and how does the basic military training tobacco rule differ from the rule for students in technical training, in-residence professional military education, accession, and graduate medical education?
An Airman buys a cannabidiol supplement that is legal under the law of the state where they are stationed. What does AFH 1 say about ingestion?
Who is responsible for diagnosing a substance use disorder, and how quickly must ADAPT program managers review medical records after notification?
A member not under investigation voluntarily self-identifies an alcohol problem and enters ADAPT. Which statement matches AFH 1?