Prospective risk factors for post-deployment heavy drinking and alcohol or substance use disorder among US Army soldiers
Open accessAbstract
Background: Investigations of drinking behavior across military deployment cycles are scarce, and few prospective studies have examined risk factors for post-deployment alcohol misuse. Methods: Prevalence of alcohol misuse was estimated among 4645 US Army soldiers who participated in a longitudinal survey. Assessment occurred 1–2 months before soldiers deployed to Afghanistan in 2012 (T0), upon their return to the USA (T1), 3 months later (T2), and 9 months later (T3). Weights-adjusted logistic regression was used to evaluate associations of hypothesized risk factors with post-deployment incidence and persistence of heavy drinking (HD) (consuming 5 + alcoholic drinks at least 1–2×/week) and alcohol or substance use disorder (AUD/SUD). Results: Prevalence of past-month HD at T0, T2, and T3 was 23.3% (s.e. = 0.7%), 26.1% (s.e. = 0.8%), and 22.3% (s.e. = 0.7%); corresponding estimates for any binge drinking (BD) were 52.5% (s.e. = 1.0%), 52.5% (s.e. = 1.0%), and 41.3% (s.e. = 0.9%). Greater personal life stress during deployment (e.g., relationship, family, or financial problems) – but not combat stress – was associated with new onset of HD at T2 [per standard score increase: adjusted odds ratio (AOR) = 1.20, 95% CI 1.06–1.35, p = 0.003]; incidence of AUD/SUD at T2 (AOR = 1.54, 95% CI 1.25–1.89, p < 0.0005); and persistence of AUD/SUD at T2 and T3 (AOR = 1.30, 95% CI 1.08–1.56, p = 0.005). Any BD pre-deployment was associated with post-deployment onset of HD (AOR = 3.21, 95% CI 2.57–4.02, p < 0.0005) and AUD/SUD (AOR = 1.85, 95% CI 1.27–2.70, p = 0.001). Conclusions: Alcohol misuse is common during the months preceding and following deployment. Timely intervention aimed at alleviating/managing personal stressors or curbing risky drinking might reduce risk of alcohol-related problems post-deployment.
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Epidemiological studies have repeatedly shown that environments with high levels of stressors, poor social support, easy access to drugs, and lack of opportunities and alternative reinforcers increase drug use and addiction risk.
“Epidemiological studies have repeatedly shown that environ ments with high levels of stressors, poor social support, easy access to drugs, and lack of opportunities and alternative rein forcers increase drug use and addiction risk 85,86 .”
From Substance use disorders: a comprehensive update of classification, epidemiology, neurobiology, clinical aspects, treatment and prevention (2023) · cites this paper as [85]
The Results (page not available in our copy) associate greater personal life stress during deployment with increased incidence of post-deployment AUD/SUD among U.S. Army soldiers. The paper does not establish the claim's other factors—poor social support, easy access to drugs, or lack of opportunities and alternative reinforcers—and notes in Methods that most AUD/SUD cases appeared to involve alcohol rather than other drugs. (LLM, conf=0.88)
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Volkow, N. D., Michaelides, M., & Baler, R. (2019) · Physiological Reviews · doi:10.1152/physrev.00014.2018 · Cited by 863 · see citing works
Volkow, N. D., & Blanco, C. (2023) · World psychiatry · doi:10.1002/wps.21073 · Cited by 503 · see citing works
- Authors
- Campbell-Sills, L., Ursano, R. J., Kessler, R. C., Sun, X., Heeringa, S. G., Nock, M. K., Sampson, N. A., Jain, S., & Stein, M. B.
- Affiliations
- Uniformed Services University of the Health Sciences (US)
- Harvard University (US)
- University of California San Diego (US)
- University of Michigan (US)
- Corresponding author
- Ursano, Robert J.
- Kessler, Ronald C.
- Sun, Xiaoying
- Heeringa, Steven G.
- Nock, Matthew K.
- Sampson, Nancy A.
- Jain, Sonia
- Stein, Murray B.
- ORCID
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2017-10-17
- Volume
- 48
- Issue
- 10
- Pages
- 1624-1633
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- PMC
- PMC6620021
- OpenAlex
- W2766164964
- Cited by
- 29
- References
- 4
- Citations by year
- 2026: 5 · 2025: 2 · 2024: 3 · 2023: 4 · 2022: 6 · 2021: 1 · 2020: 1 · 2019: 5 · 2018: 1 · 2017: 1
- FWCI
- 1.71
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Psychological Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
- Funders
- National Institute of Mental Health (U01MH087981)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Health Sciences › Health Professions › Occupational Therapy › Occupational Health and Performance
- Keywords
- heavy drinking, alcoholism, substance use disorders, military deployment, U.S. Army soldiers, binge drinking, combat stress, risk factors, Afghanistan deployment, alcohol abuse
- MeSH terms
- Adult, Alcohol Drinking, Alcoholism, Female, Humans, Longitudinal Studies, Male, Military Personnel, Risk Factors, Stress, Psychological, United States, Substance-Related Disorders, Binge Drinking
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