The Impact of COVID-19 on Self-Reported Substance Use, Well-Being, and Functioning Among United States Veterans: A Cross-Sectional Study

Abstract

As the COVID-19 pandemic sweeps the globe, many veterans with substance use issues have faced the closure of treatment facilities, mandates to shelter in place, and social distancing measures. To better understand their pandemic experiences, substance use changes, and functioning, a survey was nationally administered to a sample of United States veterans reporting substance use issues during the pandemic. The purpose of this cross-sectional online survey for veterans (N = 409) was to report on COVID-19 experiences, safety behaviors, and infection experiences while also investigating the relationship among addictive behaviors, mental and physical health, and COVID-19 impact. Measures also assessed specific substance use concerns, pandemic-related loneliness, and functioning. Though few veterans reported personally receiving a confirmed COVID-19 medical diagnosis (10.5%), the impact of pandemic stressors was evident, with a majority reporting anxiety related to contracting COVID-19 (61.4%) or fear of a family member or close friend contracting COVID-19 (58.7%). Participants reported increased use of alcohol (45.3%), sedatives (36.6%), inhalants (35.7%), tobacco (35.0%), and cannabis (34.9%), attributed specifically to the pandemic. Regression analyses revealed that even when controlling for the contribution of problematic substance use issues, negative pandemic impacts and self-reported COVID-19 related loneliness were related to more impaired physical and mental health functioning during the pandemic. Findings from this sample of veterans with addiction issues add to the growing literature suggesting unique and adverse effects of COVID-19 stressors on functioning while also revealing specific pandemic impacts for this group.

An Avatar-Led Web-Based and SMS Text Message Smoking Cessation Program for Socioeconomically Disadvantaged Veterans: Pilot Randomized Controlled Trial

“…This study was also conducted during the COVID-19 pandemic, which represents a unique context in which to study the effects of tobacco treatment. Changes in smoking attributable to pandemic-related shifts in social and occupational activities as well as changes in physical and mental health [ 50 ] may have influenced both the willingness and ability to engage with a digital cessation program as well as the likelihood of smoking cessation. The study design was also affected by the pandemic, transforming a primarily in-person design into a fully remote one.…”

“…The study design was also affected by the pandemic, transforming a primarily in-person design into a fully remote one. However, this study also had several strengths, including (1) biochemical verification of abstinence, albeit with the limitation that cotinine tests could not be completed for participants who reported quitting smoking but still using other forms of nicotine (n=2; in total, 1 participant in each arm reported abstinence that could not be verified biochemically owing to other nicotine use); (2) a good retention rate compared with other tobacco treatment trials conducted within the VHA [ 51 , 52 ], particularly during the COVID-19 pandemic, which was associated with an increase in tobacco use among veterans during the pandemic period [ 50 ]; (3) blinding of the control condition to reduce expectancy effects on study findings; and (4) the use of an active treatment comparison arm instead of waitlist control, as in previous work [ 32 ].…”

A quantitative and qualitative examination of the impacts of the COVID-19 pandemic on U.S. veterans with self-reported anxiety and alcohol use disorder

“…This study was a planned analysis of data from a nationally representative sample of U.S. veterans managing substance use concerns during the COVID-19 pandemic. The primary study with a full description of the methods is described in Reilly et al ( 26 ). Briefly, the primary study examined the relationship between addiction rates, COVID-19 experiences, and mental and physical functioning among 409 veterans who completed a cross-sectional survey.…”

“…Therefore, all participants had experienced some recent addiction issues with possible impact of additional substances. However, the current paper focused solely on alcohol which was in line with the theoretical framework presented as well as that being the most commonly reported substance used in the primary study (26). Generalizability may also be limited with a sample of 91% White/Caucasian veterans, which is higher than the national estimate of non-Hispanic White veterans [80%; (51)].…”

Cannabis use, abuse and dependence during the COVID-19 pandemic: a scoping review

“…Loneliness and boredom, stress, reactive anxiety and depression as well as social distancing were identified as driving factors for cannabis use, as well as for intake of alcohol, tobacco and other drugs in adolescents and adult populations during the pandemic (e.g., Fitzke et al 2021;Somé et al 2022;Reilly et al 2022;Gutkind et al 2022). In adolescents, cannabis use was related to larger functional impairment in daily activities and this relation was mediated by the sequential effects of difficulty with emotion regulation and pandemic-related distress.…”