Exploring the Protective Properties of Perceived Military and Non-Military Social Support in Relation to Perceived Substance Abuse Among Veterans With Chronic Pain

Abstract

Introduction: Perceived social support serves as a protective factor in the course of chronic pain and substance use disorders in civilian populations, but the role of support from civilians versus other military personnel for combat veterans experiencing chronic pain has not yet been explored. The current study examined differences in the protective properties of perceived social support from (1) military personnel and (2) civilians, regarding substance use and perceived substance abuse for combat veterans experiencing chronic pain. We hypothesized that higher endorsement of both types of perceived social support would be associated with lower odds of self-reported, perceived substance abuse, and support from military personnel would be associated with lower odds of perceived substance abuse after controlling for the role of non-military social support.

Materials and methods: The current study evaluated military personnel who were deployed to a combat zone for more than 1 month. Participants completed an online, anonymous survey including questions regarding experiences with chronic pain, cannabis, and illegal substance use, their beliefs regarding alcohol or prescription pill abuse, and their perceived military and non-military social support. We conducted a series of binary logistic regressions to evaluate whether perceived military and non-military social support predicted the odds of endorsing substance use, with several sociodemographic variables and chronic pain entered as covariates for each model. The Auburn University Institutional Review Board approved all study procedures.

Results: Contrary to our hypotheses, participants reporting higher levels of non-military social support were more likely to endorse using cannabis or other illegal substances and report perceived alcohol or prescription medication abuse, even when controlling for sociodemographic and chronic pain covariates. Our hypothesis that greater support from military personnel would predict lower odds of perceived substance abuse after controlling for the role of non-military social support was not supported.

Conclusions: Our results add to the mixed literature regarding the association between substance use with increased social support among combat veterans, while providing more detail on the role of specific social support sources in relation to drug use as well as alcohol use. Our findings may be because of combat veterans engaging in social drinking with members of their support system or utilizing substances for pain management purposes, but more research is needed on this topic. Results suggest researchers and clinicians should be mindful to inquire of one's social support sources, the quality of these relationships, and what adaptive or maladaptive behaviors may occur within the individual's social support network.