The Army has experienced a dramatic increase in opioid use, misuse, and addiction since 2001, with nearly 14% of soldiers prescribed opioid pain medication as of 2010. These levels adversely impact force readiness, Army death rates, and overall soldier health. The Army response has been uncoordinated, with the medical branch framing widespread opioid use as a medical issue, Army leadership deeming it the result of risk taking soldiers and poor leadership, and the legal branch addressing it as a disciplinary issue. Opioid use is a new threat environment created by changing medical views on pain treatment, unique wartime drivers that render soldiers particularly susceptible to opioid abuse, and military culture. The Army must review this issue anew to develop an effective response. Army policies, using Vietnam era drug enforcement methods, are failing to mitigate the problem. Preventative policies such as medical monitoring of soldiers prescribed opioids, opioid risk training, and removing stigma for those seeking opioid abuse help are needed to reverse the problem. Erroneously framing the threat as primarily a disciplinary issue is perpetuating misuse and harming soldiers, force readiness, and civilian communities.