Alcohol Misuse Among Formerly Deployed U.S. Service Members Seen in Non-VA Facilities: Results From the Veterans\u27 Cohort Study

Background: Since reports suggest that alcohol misuse is a health problem among U.S. military personnel, our objective was to assess the prevalence of alcohol-use disorders among formerly deployed service members seen at non-VA health care facilities. Because research also suggested higher alcohol abuse among Vietnam veterans, our hypothesis was that Vietnam veterans would have a higher prevalence of alcohol misuse than deployed veterans from the other service eras. Methods: We surveyed a random sample of veterans who were patients in a large non-VA multihospital system located in central and northeastern Pennsylvania to assess their mental health and substance use. The study included veterans from four service eras: Vietnam, Gulf War, Global War on Terror, and other veterans. Results: Of 1,289 veterans surveyed (response rate: ~60%), 53.6% were from the Vietnam era, 95.0% were male, 54.5% were 65+ years old, 95.7% were white race, and 26.9% were recent National Guard or Reserve veterans. Based on the AUDIT-C and CAGE instruments, the prevalence of alcohol misuse was 27.3% and 14.1%, respectively, compared to only 8.7% for current posttraumatic stress disorder and 8.8% for current depression. Altogether, 25.8% reported using alcohol to cope postdeployment, and 21.0% reported heavy drinking in the past year. Bivariate analyses indicated that alcohol misuse was more common among those who were older, Vietnam veterans, higher-income veterans, and those who had a history of cigarette smoking (P \u3c 0.05 for all). However, multivariable analyses that adjusted for gender, education, combat exposure, life stressors and social support found no significant differences for alcohol misuse or abuse by the different veteran groups. The best predictors of current alcohol misuse on multivariable analyses were having used alcohol to cope postdeployment (odds ratio: 2.99, P \u3c 0.001) and younger age (odds ratio: 0.97, P \u3c 0.001). Conclusion: Our analyses suggest that while deployed Vietnam service members had a higher prevalence of alcohol misuse, when the data were adjusted for demographic factors and potential confounders, there were no significant differences between the veteran groups. Further research that examines the high prevalence of alcohol misuse among veterans and the adverse impact of using of alcohol to cope postdeployment is planned