Publication year
2011
Citation Title
Prevalence and correlates of alcohol misuse among returning Afghanistan and Iraq veterans.
Journal Name
Addictive Behaviors
Journal Volume
36
Issue Number
8
Page Numbers
801-806
DOI
10.1016/j.addbeh.2010.12.032
Summary
The prevalence and correlation between reported alcohol misuse, the associations with mental health symptoms (depression, posttraumatic stress disorder (PTSD), anxiety, suicidal ideation) and factors related to treatment utilization of recently returned OEF/OIF National Guard (NG) Service members was assessed. Researchers used an anonymous survey in an effort to minimize concerns about stigma and military consequences. Results indicate that National Guard Service members who were younger, male, and displayed symptoms of PTSD/depression were more likely to misuse alcohol.
Key Findings
From the 585 NG Service members who completed the survey, 36% met the criteria for alcohol misuse; of these, 31% had previously received treatment for mental health issues but only 2.5% had received treatment specifically for substance abuse.
No association was found between alcohol misuse and combat exposure.
Concerns affecting the decision to seek mental health treatment for those Service members misusing alcohol included: not wanting the information to appear in their records (30%); concern that the unit leadership may treat them differently (22%); and concerns about embarrassment (22%).
Implications for Program Leaders
Educate Service members' family on how to recognize substance use issues and encourage intervention as a way to support Service member's readiness to engage in needed treatment
Provide education and outreach to Service members about the benefits of seeking treatment and dispelling any myths of repercussion if treatment is sought
Offer workshops during reintegration to help families and Service members adjust to the Service member’s return, especially when the deployment has included combat exposure
Implications for Policy Makers
Continue to support programs that collaborate with community agencies to develop comprehensive outreach, intervention and support, specifically for National Guard families to effectively address alcohol misuse and mental health concerns
Encourage research that examines which subgroups of Service members (e.g., male, National Guard, etc.) are at greater risk for alcohol misuse and related mental health concerns
Continue to support programs that address the unique challenges faced by deployed Service members
Methods
National Guard Service members were recruited from reintegration weekends 45-60 days post-deployment.
Data was collected with self-report instruments: alcohol misuse (Alcohol Use Disorders Identification Test; AUDIT); depressive symptoms (Patient Health Questionnaire; PHQ-9); PTSD symptoms (Post-Traumatic Disorder checklist-Military Version; PCL-M); and anxiety (Penn State Worry Questionnaire; PSWQ).
Statistical analyses were used to examine associations between alcohol misuse and each independent variable (demographics, mental health symptoms, exposure to combat, number of deployments, etc.) as well as to calculate the odds of reporting alcohol misuse in relation to each of the independent variables.
Participants
Participants included 585 National Guard members (87% male).
Seventy-five percent of the sample was White, 58% between the ages of 18 and 30 years old, 38% reported two or more deployments and 41% reported recent combat exposure.
Over half of the participants had more than a high school education (60%) and were in the military five years or more (55%). About one third (38%) reported two or more deployments, and almost half (41%) reported recent combat exposure.
Limitations
Selected participants may differ from non-participants in a way that is not measured but affected the outcome variables, for example, only 60% of returning National Guard Service members who attended a mandatory Reintegration Reunion Workshops chose to participate.
This study was cross-sectional and therefore no conclusions can be made as to causation among the variables.
Surveys assessing combat experience only asked about frequency of events, but did not ask about intensity or other descriptions of the event, which makes it difficult to compare combat exposure across participants.
Avenues for Future Research
Investigate groups of OEF/OIF Service members that might be particularly vulnerable to alcohol misuse
Conduct longitudinal research that includes baseline measures of alcohol use and mental helath symptoms prior to deployment
Collect data from racially and ethnically diverse samples of Service members to examine if similar rates of misuse are present among those samples
Focus
Coast Guard
Target Population
Population Focus
Military Branch
Military Component
Abstract
Objective: Several studies have reported high rates of alcohol misuse and low rates of substance use treatment among OEF/OIF military service members. This study assessed the prevalence and correlates of alcohol misuse and the factors associated with treatment utilization among recently returned National Guard service members. Methods: The sample included 585 members of the National Guard who volunteered to complete an anonymous survey assessing mental health and substance use problems, functional status, and past treatment experiences. Bivariate and multivariate logistic regression analyses were performed examining the significance of associations between alcohol misuse and mental health service use as outcomes and demographic variables, mental health symptoms, and military service characteristics as predictors. Barriers to treatment and factors facilitating treatment were also examined. Results: Thirty-six percent of the service members met criteria for alcohol misuse. Of those misusing alcohol, 31% reported receiving any mental health treatment and 2.5% reported receiving specific substance use treatment in the past year. The barrier to treatment most commonly endorsed by those misusing alcohol was concern that the information about treatment would appear in their records. Among those misusing alcohol who had received services, spouses were most commonly endorsed as facilitating the pursuit of care. Conclusions: Rates of alcohol misuse are high and rates of substance use treatment are low among National Guard service members. Additional research is needed to identify means of overcoming barriers to care and establish more effective approaches to facilitate linkage to care and receipt of appropriate interventions.
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