A team of researchers from Columbia University has found that civilian life stresses – divorce, job loss, legal problems – are more likely to lead to alcohol abuse in returning National Guard soldiers than members of the general public, regardless of whether they had experienced traumatic events on the battlefield or not.

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Over a third of the returning National Guardsmen investigated had experienced civilian stressors since returning home, increasing their risk of alcohol use disorders.

While the effect of traumatic experiences on the battlefield has been well documented with regard to alcoholism, less attention has been paid to the link between civilian stressors and alcohol use disorders post-deployment.

Considering that problems such as divorce, job loss, legal problems and serious financial problems are commonplace within military families, civilian stressors may particularly affect National Guard soldiers who return from deployment to return to civilian communities and other employment.

In 2012, 6.8% of the US population either depended upon or abused alcohol, but within the population of reserve-component soldiers, this figure was 14% – nearly double that of the general public. The statistic represents a public health concern that the study, published in the American Journal of Preventive Medicine, aims to investigate.

The researchers, from Colombia University’s Mailman School of Public Health, examined a group of 1,095 soldiers from the Ohio National Guard. These soldiers had primarily served on tours in either Iraq or Afghanistan in 2008 and 2009.

For the study, the researchers followed the soldiers for 3 years after their service, interviewing them three times via telephone to ask about their alcohol use, traumatic events and stressors related to their military deployment, and any stressors related to their civilian life since returning home.

Deployment-related traumatic events and stressors included coming under enemy fire, land mines, military sexual harassment, vehicle crashes and witnessing casualties.

The researchers found that 60% of the responding soldiers had experienced trauma related to combat, 36% had experienced civilian stressors since returning home and 17% had been sexually harassed during their deployment.

In the first interviews, 13% of the participants reported problems consistent with alcohol abuse and dependence. In the second round of interviews, this figure fell to 7%, and for the third round of interviews, it was 5%.

The authors of the study found that the experience of at least one civilian stressor and sexual harassment were associated with higher odds of alcohol abuse and dependence. By contrast, combat-related and post-battle traumatic events were only marginally associated with these alcohol use disorders.

The authors write that the findings of their study must be taken within the context of its limitations: the risk of recall bias, interviews being carried out too soon for mental health problems to manifest following military service, potential misclassification of alcohol use disorders and the fact that the sample of soldiers may not be representative of all National Guard.

Magdalena Cerdá, lead investigator for the study, says that what defines long-term mental health problems such as alcohol use disorders “is having to deal with a lot of daily life difficulties that arise in the aftermath – when soldiers come home.”

The more traumatic events soldiers are exposed to during and after combat, the more problems they are likely to have in their daily life – in their relationships, in their jobs – when they come home. These problems can in turn aggravate mental health issues, such as problems with alcohol that arise during and after deployment.”

The findings illustrate the impact of the stresses of civilian life on returning National Guard soldiers, raising the suggestion that targeted interventions in order to help those affected by stressful life events could be beneficial in reducing alcohol use disorders.

Prof. Karestan Koenen, senior author of the study, says that returning guardsman “need help finding jobs, rebuilding their marriages and families, and reintegrating into their communities. Too many of our warriors fall through the cracks in our system when they return home.”

With more than 1.6 million service personnel deployed to support military actions in Iraq and Afghanistan, the findings of the study suggest that improving the reintegration of soldiers following military service should be a high priority.

Recently, Medical News Today reported on a study that found more than 15% of returning soldiers use opioids for pain relief.

Written by James McIntosh