Substance Use, Financial Stress, Employment Disruptions, and Anxiety among Veterans during the COVID-19 Pandemic

Abstract

The COVID-19 pandemic has resulted in financial, employment, and mental health challenges. In general, American veterans report high rates of substance use, which may be influenced by the COVID-19 pandemic. Those with pre-existing mental health problems, employment disruptions, or financial stress may be particularly vulnerable. We examined the relationships between pre-existing self-report screens for a probable anxiety disorder, COVID-19-related financial stress, employment disruption (e.g., lost job, reduced hours), and alcohol, cannabis, and cigarette use during the pandemic among 1230 veterans ( Mage = 34.5; 89% male). Participants were recruited through various social media sites and completed an online survey 1 month prior to implementation of the nationwide physical distancing guidelines in the United States (February 2020). Six months later (August 2020), they completed a follow-up survey. Compared to veterans who screened negative for anxiety prior to the pandemic, veterans who screened positive reported consuming more drinks per week ( b = 3.05), were more likely to use cannabis ( OR = 6.53), and smoked more cigarettes ( b = 2.06) during the first 6 months of the pandemic. Financial stress was positively associated with alcohol ( b = 1.09) and cannabis use ( OR = 1.90). Alcohol use was heaviest among veterans with a positive pre-existing anxiety screen and high financial stress. Moreover, veterans who experienced employment disruption due to the pandemic consumed less alcohol but were more likely to use cannabis during the pandemic. Veterans with pre-pandemic anxiety and pandemic-related financial stress may be using substances at higher rates and may benefit from intervention to mitigate negative substance use-related outcomes. Findings also enhance our understanding of veteran substance use behaviors following disruptions in employment due to the pandemic.

Psychological consequences among veterans during the COVID-19 pandemic: A scoping review

“…The rate of anxiety among veterans was between 9.4% and 53.5% during the pandemic( Hill et al, 2021 ; Kelly et al, 2022 ; Mahar et al, 2022 ; Na et al, 2022a ; Richardson et al, 2022 ; Tran et al, 2022 ; Umucu et al, 2022 ). Three studies demonstrated that veterans had a higher rate of anxiety during the global outbreak compared to the pre-pandemic( Hill et al, 2021 ; Na et al, 2022a ; Wynn et al, 2021 ), while Katherine et al found no difference in anxiety symptoms during the COVID-19 pandemic( Iverson et al, 2022 ).…”

Public acceptance of COVID-19 control measures and associated factors during Omicron-dominant period in China: a cross-sectional survey

“…After the adjustment of multivariate analysis, the potential factor, occupation, had both statistical and practical significance. Despite the emotional toll [ 30 ] or elevated workload [ 31 , 32 ] from all walks of life during the pandemic, when compared with the financial stress and anxiety resulted from employment disruptions (the jobless or retired), students and those who were still employed had less financial burden and were better trained, so they showed more willingness to cooperate with control measures [ 29 , 33 , 34 ]. Likewise, public acceptance would be low when the household per capita monthly income fell below 5000 yuan.…”

The impact of stress and well‐being during the COVID‐19 pandemic on mental health in U.S. veterans

“…Our findings further suggest that health‐related impacts of the pandemic, including more difficulties engaging in activities that support health or decreased access to healthcare, may have resulted in lower health satisfaction thereby increasing the likelihood of MH concerns. Financial and work‐related dimensions of well‐being are often overlooked; however, previous research suggests that aspects of financial well‐being were associated with more severe MH symptoms in veterans (Elbogen et al., 2012; Tran et al., 2022) and that job loss and job satisfaction were associated with MH outcomes, including probable anxiety and PTSD (Adler et al., 2011; Smith et al., 2005; Umucu et al., 2022; Vogt et al., 2017). Pandemic‐related employment changes (e.g., job loss, change to remote work) and associated financial implications likely had an impact on satisfaction within these domains, which then had implications for MH during this time period as evidenced in previous research by Burdett et al.…”