Alcohol Abuse Among Returning U.S. Veterans

Aug 6, 2014, 1:08 PM

The focus on military concerns in the last few weeks has understandably been on events in the Middle East, Ukraine and Afghanistan. But a new study from the Mailman School of Public Health at Columbia University is shining a light on the continuing problems faced by returning U.S. military personnel—in particular their increased risk of abusing alcohol.

The study found that regardless of whether they experienced traumatic events during deployment, returning National Guard soldiers were more likely to develop a drinking problem when faced with civilian life setbacks, including job loss, legal problems, divorce, and serious financial or legal problems. The study authors say these are all very common for military families. The study was published in the American Journal of Preventive Medicine.

Previous studies have shown that alcohol abuse is a major concern for reservists returning home. While almost 7 percent of Americans abuse or are dependent on alcohol, the rate of alcohol abuse among reserve soldiers returning from deployment is 14 percent, or almost double that of the civilian population, according to the Mailman researchers.

The study looked at 1,095 Ohio National Guard soldiers who had primarily served in either Iraq or Afghanistan in 2008 and 2009. The soldiers were interviewed three times over three years via telephone about their alcohol use, exposure to deployment-related traumatic events and stressors such as land mines, vehicle crashes, taking enemy fire and witnessing casualties. They were also questioned about any stress related to everyday life since returning from duty.

More than half (60 percent) of the soldiers who responded experienced combat-related trauma, 36 percent of soldiers experienced civilian stressors and 17 percent reported being sexually harassed during their most recent deployment. The researchers found that having at least one civilian stressor or a reported incident of sexual harassment during deployment raised the odds of alcohol use disorders; combat-related traumatic events were only marginally associated with alcohol problems.

“Exposure to the traumatic event itself has an important effect on mental health in the short-term, but what defines long-term mental health problems is having to deal with a lot of daily life difficulties that arise in the aftermath—when soldiers come home,” said the lead investigator, Magdalena Cerdá, DrPH, MPH, an assistant professor of epidemiology at the Mailman School of Public Health. “The more traumatic events soldiers are exposed to during and after combat, the more problems they are likely to have in their daily life—in their relationships, in their jobs—when they come home. These problems can in turn aggravate mental health issues, such as problems with alcohol that arise during and after deployment.”

The researchers said that with high rates of alcohol abuse among soldiers, there is a critical need for targeted interventions to help soldiers handle stressful life events without alcohol.

“Guardsmen who return home need help finding jobs, rebuilding their marriages and families, and reintegrating into their communities,” said Karestan Koenen, PhD, professor of epidemiology at the Mailman School and senior author of the study. “Too many of our warriors fall through the cracks in our system when they return home...we need to support our soldiers on the home front just as we do in the war zone.”

Similar findings have recently been published. Last year the Institute of Medicine published a report on the serious mental health issues faced by military personnel returning from Iraq and Afghanistan. The report indicated a critical need for the U.S. Department of Defense (DOD) to develop an evidence base on the effectiveness of prevention and treatment programs targeting  service members and their families.

The Mailman study was funded by the DOD, the National Institute on Drug Abuse and the National Institute of Mental Health.

The U.S. Department of Veterans Affairs (VA) has created online tools that veterans and their family members can use to assess their drinking levels and access help, including screening tests on MyHealtheVet:

  • A four-question alcohol screening tool can give users feedback on alcohol abuse tendencies in less than a minute.
  • A slightly longer questionnaire screens for abuse of alcohol and other substances, such as prescription and illegal drugs. All responses remain confidential. The test taker is the only person who can access the information. It cannot be seen by anyone at VA or anyone else.
  • All VA care locations offer first-time alcohol screening and intervention for veterans, who can choose to include family members in their treatment. Treatment can range from a single visit to a course of treatment, such as behavioral couples therapy.
  • The VA’s Make the Connection website shares stories from other veterans who have dealt with substance abuse problems. It also offers resources for veterans and their family members.

This commentary originally appeared on the RWJF New Public Health blog.