Trajectories of alcohol consumption in U.S. military veterans: Results from the National Health and Resilience in Veterans Study

Fuehrlein, Brian; Kachadourian, Lorig K.; DeVylder, Elizabeth K.; Trevisan, Louis; Potenza, Marc N.; Krystal, John H.; Southwick, Steven M.; Pietrzak, Robert H.

doi:10.1111/ajad.12731

Cited by 26 publications

(22 citation statements)

References 43 publications

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“…Nearly 1 in 5 soldiers reports problems with social support (Griffith, 2017), and poor postdeployment social support has been associated with a greater odds of PTSD (Bloeser et al, 2014), depression (Bloeser et al, 2014), anger (Vest et al, 2017), violence (Van Voorhees et al, 2018, and excessive drinking (Fuehrlein et al, 2018). Previous research by Romero et al demonstrated that family social support buffered the effects of avoidant coping strategies on post-deployment mental health (Romero et al, 2015).…”

Section: Discussionmentioning

confidence: 99%

Resiliency factors that protect against post-deployment drug use among male US Army Reserve and National Guard soldiers

Hoopsick

Benson

Homish

et al. 2019

Drug and Alcohol Dependence

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Background: Service members who have been deployed are at risk for substance use, especially Reserve/Guard troops. However, it is unclear what modifiable factors protect against substance use in this at-risk population. Our objective was to examine the effects of pre-, peri-, and postdeployment resiliency factors on post-deployment drug use. Methods: Data were drawn from Operation: SAFETY (Soldiers and Families Excelling Through the Years), an ongoing study examining the health of US Army Reserve/National Guard (USAR/NG) soldiers. This sample consisted of male USAR/NG soldiers with at least one combat deployment (N = 228). At baseline, we assessed the following as potential protective factors: deployment preparation, unit support and support from family/friends during soldiers' most recent deployment, and marital satisfaction. We examined the relations between each of these resiliency factors with drug use at the first follow-up assessment using the NIDA modified ASSIST 2.0. Results: Greater unit support (AOR = 0.56, 95% CI: 0.34, 0.92; p < 0.05) and support from family/friends during deployment (AOR = 0.64, 95% CI: 0.43, 0.96; p < 0.05) were associated with lower odds of drug use, controlling for age, rank, years of military service, combat exposure, traumatic brain injury, time since last deployment, and baseline drug use. Deployment preparation and marital satisfaction were not associated with drug use (ps > 0.05). Conclusions: Social support provided to soldiers during deployment, either by his unit or his family/friends, showed evidence of protection against post-deployment drug use. In addition to existing post-deployment efforts, we recommend interventions that facilitate stronger interpersonal relationships during deployment.

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Section: Discussionmentioning

confidence: 99%

Resiliency factors that protect against post-deployment drug use among male US Army Reserve and National Guard soldiers

Hoopsick

Benson

Homish

et al. 2019

Drug and Alcohol Dependence

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“…Although reasonable, this is admittedly an unusual finding. Some researchers have found links between depressive disorder and more excessive drinking trajectories as opposed to recovering drinkers [ 3 ], while others have found no systematic link between episodes of emotional dysregulation and episodes of alcohol problem use, as to whether the emotional regulation issues preceded, co-occurred, or followed the alcohol use [ 66 ] and no link between having (or not having) depression and anxiety disorders and remission from alcohol dependence [ 15 ]. The inconsistencies here deserve further study and investigation with respect to potential moderators or interaction effects in the internalizing—alcohol use relationship.…”

Section: Discussionmentioning

confidence: 99%

Transitions in alcohol use over time: a survival analysis

Koenig

Haber²,

Jacob³

2020

BMC Psychol

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Background The current study examined the predictors of the onset of alcohol use as well as predictors of remission and relapse, both from heavy drinking and from alcohol dependence. Similarities and differences in both clinical and psychosocial predictors across the transitions were examined. Methods A sample of men from the Vietnam Era Twin Registry (N = 1769) completed an assessment of lifetime drinking history, which allowed age markers for starting and stopping different drinking patterns. The men also completed various assessments regarding personality, alcohol motives, and psychiatric diagnoses. Survival analyses were used to examine the predictors of the three transitions of onset, remission, and relapse for the phenotypes of heavy drinking and of alcohol dependence, censoring the individuals who had not yet experienced an event. Results As expected, predictors of onset for drinking, heavy drinking, and alcohol dependence were largely consistent and included externalizing symptomology, nicotine dependence, and cotwin history of drinking as risk factors. Predictors of remission from heavy drinking, somewhat similarly to remission from alcohol dependence, included the risk factor of externalizing disorders but also, as predicted, included more risk and protective factors in the psychosocial realm that were not predictors of onset. Contrary to our prediction, relapse to heavy drinking and alcohol dependence were predicted largely by unique psychosocial risk and protective factors including social and coping motives. Conclusion Current findings extend the findings of past research to remission and relapse in the later decades of life and have implications for treatment of alcohol use problems.

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“…Specifically, the DoD's prospective Millennium Cohort Study of service members and Veterans ( Ryan et al, 2007 ) previously documented that combat deployment and being Reserve/National Guard were risk factors for both initiation and relapse of unhealthy alcohol use, and that separation from military service was a risk factor for relapse ( Jacobson et al, 2008 ; Williams et al, 2015 ). Other studies have shown a high proportion of unhealthy alcohol use among Reserve/Guard personnel ( Milliken et al, 2007 ; Allison-Aipa et al, 2010 ) and Veterans ( Calhoun et al, 2015 ; Fuehrlein et al, 2018 ). Further, population-based surveys administered to Active Duty military personnel showed increased rates of heavy and binge drinking over a 10-year period, with higher rates among combat-exposed personnel compared with noncombat-exposed personnel ( Bray et al, 2013 ), indicating that active duty combat deployers may be at risk for chronic drinking.…”

mentioning

confidence: 93%

“…Heavy episodic drinking—a particularly risky pattern of unhealthy alcohol use that elevates risk for alcohol use disorder ( Saha et al, 2007 )—is especially common among younger service members ( Jacobson et al, 2008 ; Bray et al, 2013 ). Further, alcohol use disorder with concurrent mental disorders is prevalent among US Veterans ( Fuehrlein et al, 2018 ). Although factors associated with unhealthy alcohol use among service members and Veterans have been well-described in cross-sectional analyses ( Burnett-Zeigler et al, 2011 ), few studies have investigated the factors associated with continued, or chronic, unhealthy alcohol use over time.…”

mentioning

confidence: 99%

Longitudinal Investigation of Military-specific Factors Associated With Continued Unhealthy Alcohol Use Among a Large US Military Cohort

Jacobson

Williams

Seelig

et al. 2019

Journal of Addiction Medicine

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Objective: To examine whether military separation (Veteran), service component (active duty, Reserve/National Guard), and combat deployment are prospectively associated with continuing unhealthy alcohol use among US military service members. Methods: Millennium Cohort Study participants were evaluated for continued or chronic unhealthy alcohol use, defined by screening positive at baseline and the next consecutive follow-up survey for heavy episodic, heavy weekly, or problem drinking. Participants meeting criteria for chronic unhealthy alcohol use were followed for up to 12 years to determine continued unhealthy use. Multivariable regression models—adjusted for demographics, military service factors, and behavioral and mental health characteristics—assessed whether separation status, service component, or combat deployment were associated with continuation of 3 unhealthy drinking outcomes: heavy weekly (sample n = 2653), heavy episodic (sample n = 22,933), and problem drinking (sample n = 2671). Results: In adjusted models, Veterans (compared with actively serving personnel) and Reserve/Guard (compared with active duty members) had a significantly higher likelihood of continued chronic use for heavy weekly, heavy episodic, and problem drinking (Veteran odds ratio [OR] range 1.17–1.47; Reserve/Guard OR range 1.25–1.29). Deployers without combat experience were less likely than nondeployers to continue heavy weekly drinking (OR 0.75, 95% confidence interval 0.61–0.91). Conclusions: The elevated likelihood of continued unhealthy alcohol use among Veterans and Reserve/Guard members suggests that strategies to reduce unhealthy drinking targeted to these populations may be warranted.

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Trajectories of alcohol consumption in U.S. military veterans: Results from the National Health and Resilience in Veterans Study

Cited by 26 publications

References 43 publications

Resiliency factors that protect against post-deployment drug use among male US Army Reserve and National Guard soldiers

Resiliency factors that protect against post-deployment drug use among male US Army Reserve and National Guard soldiers

Transitions in alcohol use over time: a survival analysis

Longitudinal Investigation of Military-specific Factors Associated With Continued Unhealthy Alcohol Use Among a Large US Military Cohort

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