After returning from service in Iraq and Afghanistan, younger service members and Reserve and National Guard combat personnel are more likely to begin heavy drinking, binge drinking, or other alcohol related problems. These findings are reported in a study published in the August 13 issue of JAMA.
Previous studies have suggested a strong link between posttraumatic stress disorder (PTSD) and substance abuse. Additionally, several other psychological disorders are known to occur after stressful and traumatic events such as war. As alcohol is commonly used to help those cope with traumatic events, there is a high probability that military deployment is associated with increased rates of alcohol consumption or problem drinking. There have been reports from earlier conflicts that personnel have misused alcohol at high rates after deployment, but there is little information on patterns of alcohol use regarding the most current crop of soldiers returning from Iraq and Afghanistan.
To determine if deployment to wars in Iraq and Afghanistan is linked to new-onset or changes in alcohol consumption, binge drinking behavior, or other alcohol related problems, Isabel G. Jacobson, M.P.H. (Naval Health Research Center, San Diego) and colleagues analyzed data from the Millennium Cohort Study. Baseline data were collected via questionnaires from 77,047 participants from July 2001 to July 2003, and 55,021 participants completed follow-up surveys from June 2004 to February 2006. A series of inclusion and exclusion criteria yielded a sample of 48,481 participants – 26,613 active duty and 21,868 Reserve or National Guard personnel. Of the total sample, 5,510 were deployed with combat exposures, 5,661 were deployed without combat exposures, and 37,310 did not deploy.
Jacobson and colleagues report that among Reserve or National Guard personnel who deployed with combat exposure, 8.8% developed new-onset heavy weekly drinking, 25.6% developed new-onset binge drinking, and 7.1% developed new-onset alcohol-related problems. Active-duty personnel had new-onset rates of 6.0%, 26.6%, and 4.8%, respectively. Members of the Reserve or National Guard who were deployed with combat exposure were more likely to develop all three drinking outcomes compared to their nondeployed counterparts. Specifically, these personnel with combat experience were found to be 63% more likely to experience onset of heavy weekly drinking and 63% more likely to experience alcohol-related problems than nondeployed personnel.
Deployed active-duty personnel were found to be 31% more likely than their nondeployed counterparts to develop new-onset binge drinking at follow-up. Though significantly less likely to report new-onset or changes in binge drinking or alcohol-related problems, women were found to be 1.2 times more likely to report new-onset heavy weekly drinking. In addition, the researchers found that personnel born after 1980 – younger soldiers – were at 6.7 times increased odds of new-onset binge drinking and 4.7 times increased odds of new-onset alcohol-related problems.
The authors conclude: “These results are the first to prospectively quantify changes in alcohol use in relation to recent combat deployments. Interventions should focus on at-risk groups, including Reserve/Guard personnel, younger individuals, and those with previous or existing mental health disorders. Further prospective analyses using … data [from this study group] will evaluate timing, duration, and [co-existing illnesses] of alcohol misuse and other-alcohol related problems, better defining the long-term effect of military combat deployments on these important health outcomes.”
Alcohol Use and Alcohol-Related Problems Before and After Military Combat Deployment
Isabel G. Jacobson, MPH; Margaret A. K. Ryan, MD, MPH; Tomoko I. Hooper, MD, MPH; Tyler C. Smith, PhD, MS; Paul J. Amoroso, MD, MPH; Edward J. Boyko, MD, MPH; Gary D. Gackstetter, DVM, PhD, MPH; Timothy S. Wells, DVM, PhD, MPH; Nicole S. Bell, ScD, MPH
JAMA(2008). 300: pp. 663-675.
Written by: Peter M Crosta