An Institute of Medicine report on substance use in the armed forces has found serious problems with alcohol abuse -- and a drastic increase in the use of prescription pain medication.

After news reports about substance abuse in the military raised congressional concern, the Institute of Medicine of the National Academy of Sciences formed a committee to review the issue and make recommendations.

Committee chairman Charles O'Brien, professor of psychiatry at the University of Pennsylvania School of Medicine, says their suggestions begin at the beginning ... with prevention.

"The first thing that they could do that would really help the situation is more prevention," he said Monday. "They control the environment. They could reduce access to alcohol for example, which is the major drug of abuse."

The report, which was released Monday, notes that prescriptions for pain medication in the military more than quadrupled from 2001 to 2009.

O'Brien says that's another area where prevention could reduce abuse.

"Pain is a major problem for people in the military service. And the people out in the field with them give them opioids -- like morphine, OxyContin, things like that," he said. "And they aren't as controlled as I think they should be. The corpsmen and medics who give out these medicines should have more training."

In detailing the extent of the problems, the report labels the situation a public health crisis -- one that's detrimental to the readiness of the armed forces.