BACKGROUND
Problem drinking that predates enlistment into military service may contribute to the overall burden of alcohol misuse in the Armed Forces; however, evidence bearing on this issue is limited. The current study examines prevalence and correlates of alcohol misuse among new US Army soldiers.
METHODS
Cross-sectional survey data were collected from soldiers reporting for basic combat training. The survey retrospectively assessed lifetime alcohol consumption and substance abuse/dependence, enabling estimation of the prevalence of lifetime binge drinking and heavy drinking in a sample of 30,583 soldiers and of probable alcohol use disorder (AUD) among 26,754 soldiers with no/minimal lifetime use of other drugs. Co-occurrence of mental disorders and other adverse outcomes with binge drinking, heavy drinking, and AUD was examined. Discrete-time survival analysis, with person-year the unit of analysis and a logistic link function, was used to estimate associations of AUD with subsequent onset of mental disorders and vice versa.
RESULTS
Weighted prevalence of lifetime binge drinking was 27.2% (SE=0.4%) among males and 18.9% (SE=0.7%) among females; respective estimates for heavy drinking were 13.9% (SE=0.3%) and 9.4% (SE=0.4%). Among soldiers with no/minimal drug use, 9.5% (SE=0.2%) of males and 7.2% (SE=0.5%) of females had lifetime AUD. Relative to no alcohol misuse, binge drinking, heavy drinking, and AUD were associated with increased odds of all adverse outcomes under consideration [adjusted odds ratios (AORs)=1.5 to 4.6; ps<.001]. Prior mental disorders and suicidal ideation were associated with onset of AUD (AORs=2.3 to 2.8; ps<.001); and prior AUD was associated with onset of mental disorders and suicidal ideation (AORs=2.0 to 3.2, ps<0.005).
CONCLUSIONS
Strong bidirectional associations between alcohol misuse and mental disorders were observed in a cohort of soldiers beginning Army service. Conjoint recognition of alcohol misuse and mental disorders upon enlistment may provide opportunities for risk mitigation early in a soldier's career.