Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2026 Apr;42(2):e70155.
doi: 10.1002/smi.70155.

Substance and Behavioural Addictions Among Evacuees: Findings From Israeli Swords of Iron War

Gabriella Rubin  1 , Uri Lifshin  1 , Vera Skvirsky  1 , Yoav Ankri  1 , Dvora Shmulewitz  1 , Maor Levitin  1   2 , Merav Vider  1 , Shaul Lev-Ran  3   4 , Ariel Kor  5 , Mario Mikulincer  1
Affiliations

Substance and Behavioural Addictions Among Evacuees: Findings From Israeli Swords of Iron War

Gabriella Rubin et al. Stress Health. 2026 Apr.

Abstract

War-related evacuation is a stressful event that may cause mental health problems, which, in turn, might lead to increases in substance and behavioural addictions. We used data collected online during the Swords of Iron to examine associations between being evacuated during the war, mental health, problematic substance use, and behavioural addictions. Study 1 surveyed young adults (ages 18-26) from various areas of Israel. Measures included self-reported anxiety, depression, problematic consumption of alcohol, cannabis, and prescription drugs, and problematic gambling, gaming, and pornography. Evacuees (n = 111) reported higher levels of anxiety, depression, problematic alcohol consumption, and problem gambling than non-evacuees (n = 973), with increased depression, problematic alcohol consumption and problem gambling among men. In Study 2, we used data from a quasi-representative sample of Jewish Israelis (ages 18-70), that included the same measures, in addition to problematic social media and internet usage. Findings replicated and extended those of Study 1: evacuees (n = 158) had higher rates of problematic use of all the assessed outcomes, compared to those not evacuated (n = 2485), with increased problematic use of alcohol, prescription drug, and gambling among men. In both Studies, the results held when controlling for exposure to war stressors and feelings of danger during the war, indicating that evacuation had a unique effect beyond the primary trauma of war. We discuss the limitations of the current research and consider its implications to addiction theory and gender differences in addictions and offer directions for future research and clinical considerations.

Keywords: addiction; alcohol; depression; evacuees; gambling; war.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Problematic alcohol consumption score by evacuation and gender (study 1, N = 1081).
FIGURE 2
FIGURE 2
Problem gambling severity index score, by evacuation and gender (study 1, N = 1081).
FIGURE 3
FIGURE 3
Depression (PHQ‐9) score, by evacuation and gender (study 1, N = 1081).
FIGURE 4
FIGURE 4
Problematic alcohol consumption score, by evacuation and gender (study 2, N = 2643).
FIGURE 5
FIGURE 5
Problem gambling severity index score, by evacuation and gender (study 2, N = 2643).
FIGURE 6
FIGURE 6
Problematic prescription drugs use ASSIST scores (sedative, stimulants, opioids), by evacuation and gender (study 2, N = 2643).
See this image and copyright information in PMC

References

    1. Alimoradi, Z. , Lotfi A., Lin C. Y., Griffiths M. D., and Pakpour A. H.. 2022. “Estimation of Behavioral Addiction Prevalence During COVID‐19 Pandemic: A Systematic Review and Meta‐Analysis.” Current Addiction Reports 9, no. 4: 486–517. 10.1007/s40429-022-00435-6. - DOI - PMC - PubMed
    1. Andreassen, C. S. , Billieux J., Griffiths M. D., et al. 2016. “The Relationship Between Addictive Use of Social Media and Video Games and Symptoms of Psychiatric Disorders: A Large‐Scale Cross‐Sectional Study.” Psychology of Addictive Behaviors 30, no. 2: 252–262. 10.1037/adb0000160. - DOI - PubMed
    1. Augsburger, M. , and Elbert T.. 2017. “When Do Traumatic Experiences Alter Risk‐Taking Behavior? A Machine Learning Analysis of Reports From Refugees.” PLoS One 12, no. 5: e0177617. 10.1371/journal.pone.0177617. - DOI - PMC - PubMed
    1. Bar‐Or, R. L. , Kor A., Jaljuli I., and Lev‐Ran S.. 2021. “The Epidemiology of Substance Use Disorders Among the Adult Jewish Population in Israel.” European Addiction Research 27, no. 5: 362–370. 10.1159/000513776. - DOI - PubMed
    1. Bobzean, S. A. M. , DeNobrega A. K., and Perrotti L. I.. 2014. “Sex Differences in the Neurobiology of Drug Addiction.” Experimental Neurology 259: 64–74. 10.1016/j.expneurol.2014.01.022. - DOI - PubMed