A medical study requested by the U.S. Defense Department says abuse of alcohol and drugs in the U.S. military has become a public health crisis, and says Pentagon efforts to deal with the upturn are out of date.

A study by the congressional-chartered non-profit Institute of Medicine says about one in four military personnel who served in Iraq or Afghanistan last year admitted to having a drinking problem.

It also says the misuse of prescription drugs by military personnel and their families jumped from two percent to 11 percent between 2002 and 2008.

IOM recommendations released this week include overhauling the military's health insurance program to cover standard therapies for substance abuse. The report also calls for measures to limit access to alcohol on military bases.

Additionally, the panel recommends routine Defense Department screenings of military personnel to detect alcohol abuse, and urges the department to create options for confidential treatment services. Currently, most treatment referrals from military medical personnel are routinely reported to an individual's commanding officer.