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. 2018 Jul;48(10):1624-1633.
doi: 10.1017/S0033291717003105. Epub 2017 Oct 17.

Prospective risk factors for post-deployment heavy drinking and alcohol or substance use disorder among US Army soldiers

Laura Campbell-Sills  1 , Robert J Ursano  2 , Ronald C Kessler  3 , Xiaoying Sun  4 , Steven G Heeringa  5 , Matthew K Nock  6 , Nancy A Sampson  3 , Sonia Jain  4 , Murray B Stein  1
Affiliations

Prospective risk factors for post-deployment heavy drinking and alcohol or substance use disorder among US Army soldiers

Laura Campbell-Sills et al. Psychol Med. 2018 Jul.

Abstract

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.

Keywords: Alcohol-related disorders; binge drinking; life stress; military personnel; risk factors.

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Conflict of interest statement

Conflict of Interest: Dr. Stein has in the past three years been a consultant for Actelion, Dart Neuroscience, Healthcare Management Technologies, Janssen, Oxeia Biopharmaceuticals, Pfizer, Resilience Therapeutics, and Tonix Pharmaceuticals. In the past 3 years, Dr. Kessler received support for his epidemiological studies from Sanofi Aventis; was a consultant for Johnson & Johnson Wellness and Prevention, Shire, Takeda; and served on an advisory board for the Johnson & Johnson Services Inc. Lake Nona Life Project. Kessler is a co-owner of DataStat, Inc., a market research firm that carries out healthcare research. The remaining authors have no financial disclosures.

Figures

Figure 1.
Figure 1.
Weighted prevalence by gender of binge drinking and heavy drinking at pre-deployment (T0), 3 months post-deployment (T2), and 9 months post-deployment (T3). Group n’s total slightly less than 4645 due to rare missing gender data. Prevalence of binge drinking and heavy drinking was lower among women than men at all waves [X2(1)=21.98 to 63.42, ps<.001].
Figure 2.
Figure 2.
Weighted prevalence by age group of heavy drinking at pre-deployment (T0), 3 months post-deployment (T2), and 9 months post-deployment (T3). Group n’s total slightly less than 4645 due to rare missing age data. Prevalence of heavy drinking differed by age group at all waves [X2(3)=85.01 to 92.02, ps<.001].
See this image and copyright information in PMC

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