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Combat Veterans From Recent Wars Are At Increased Risk Of Alcohol-Related Problems

After returning from service in Iraq and Afghanistan, youngerservice members and Reserve and National Guard combat personnel aremore likely to begin heavy drinking, binge drinking, or other alcoholrelated problems. These findings are reported in a study published inthe August 13 issue of JAMA.

Previous studies have suggested a strong link between posttraumaticstress disorder (PTSD) and substance abuse. Additionally, several otherpsychological disorders are known to occur after stressful andtraumaticevents such as war. As alcohol is commonly used to help those cope withtraumatic events, there is a high probability that military deploymentis associated with increased rates of alcohol consumption orproblem drinking.There have been reports from earlier conflicts that personnel havemisused alcohol at high rates after deployment, but there is littleinformation on patterns of alcohol use regarding the most current cropof soldiers returning from Iraq and Afghanistan.

To determine if deployment to wars in Iraq and Afghanistan is linked tonew-onset or changes in alcohol consumption, binge drinking behavior,or other alcohol related problems, Isabel G. Jacobson, M.P.H. (NavalHealth Research Center, San Diego) and colleagues analyzed data fromthe Millennium Cohort Study. Baseline data were collected viaquestionnaires from 77,047 participants from July 2001 to July 2003,and 55,021 participants completed follow-up surveys from June 2004 toFebruary 2007. A series of inclusion and exclusion criteriayielded a sample of 48,481participants - 26,613 active duty and 21,868 Reserve orNational Guard personnel. Of the total sample, 5,510 weredeployed with combat exposures, 5,661 were deployedwithout combat exposures, and 37,310 did not deploy.

Jacobson and colleagues report that among Reserve or National Guardpersonnel whodeployed with combat exposure, 8.8% developed new-onset heavyweeklydrinking, 25.6% developed new-onset binge drinking, and 7.1% developednew-onset alcohol-related problems. Active-duty personnel had new-onsetrates of 6.0%, 26.6%, and 4.8%, respectively. Members of the Reserve orNational Guard who were deployed with combat exposure were more likelyto develop all three drinking outcomes compared to their nondeployedcounterparts. Specifically, these personnel with combat experience werefound to be 63% more likely to experience onset of heavy weeklydrinking and 63% more likely to experience alcohol-relatedproblems than nondeployed personnel.

Deployed active-duty personnel were found to be 31% more likely thantheir nondeployed counterparts to develop new-onset binge drinking atfollow-up.Though significantly less likely to report new-onset or changes inbinge drinking or alcohol-related problems, women were found to be 1.2times more likely to report new-onset heavy weeklydrinking. In addition, the researchers found that personnel born after1980 - younger soldiers - were at 6.7 times increased odds of new-onsetbinge drinking and 4.7 times increased odds of new-onsetalcohol-related problems.

The authors conclude: “These results are the first to prospectivelyquantify changes in alcohol use in relation to recent combatdeployments. Interventions should focus on at-risk groups, includingReserve/Guard personnel, younger individuals, and those with previousor existing mental health disorders. Further prospective analyses using… data [from this study group] will evaluate timing, duration, and[co-existing illnesses] of alcohol misuse and other-alcohol relatedproblems, better defining the long-term effect of military combatdeployments on these important health outcomes.”

Alcohol Use and Alcohol-Related Problems Before and AfterMilitary Combat Deployment
IsabelG. Jacobson, MPH; Margaret A. K. Ryan, MD, MPH; Tomoko I. Hooper, MD,MPH; Tyler C. Smith, PhD, MS; Paul J. Amoroso, MD, MPH; Edward J.Boyko, MD, MPH; Gary D. Gackstetter, DVM, PhD, MPH; Timothy S. Wells,DVM, PhD, MPH; Nicole S. Bell, ScD, MPH
JAMA(2008).300[6]: pp. 663-675.
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Written by: Peter M Crosta
Copyright: Medical News Today

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