Predictors of Change in Substance Abuse Status in Soldiers

Abstract

Background:Military service is a stressful task that influences the life style of army personnel. Several factors can make soldiers less capable of coping with stressful events; so they may try to start drug abuse or increase in the amount or diversity of substance abuse. Understanding factors responsible for this misbehavior among soldiers is crucial for their commanders to modify these factors.Objectives:This study aimed to determine the predictors of change in substance abuse status in soldiers.Patients and Methods:This cross-sectional research was conducted to evaluate the substance abuse status among Iranian soldiers in 2010. The target population was the soldiers who had spent at least 3 months of their military service. Cluster sampling was done from army service garrisons in 12 provinces in Iran. A total of 3960 soldiers were selected with different levels of education and age. Data gathering was done with demographic questionnaires, Texas Christian university (TCU) drug screen II and ASI questionnaire (fifth edition). Four types of dependent variables were defined: “improvement”, “without change”, “deterioration”, and “severe deterioration”. Backward ordinal regression analysis was done and P values, OR, and SE were calculated by SPSS19 software.Results:Totally, 6.7% of soldiers improved, 82% remained without change, 6.1% deteriorated, and 5.2% severely deteriorated with regard to their substance abuse. Modifiable predictors were distance from home lower than 200 km (OR =1.54), bad relationship with commanders (OR = 1.88), service place dissatisfaction (OR = 1.39), and always feeling lonely (OR = 1.83). Non-modifiable factors were alcohol use within family and friends (P = 0.000); psychiatric drug use history (OR = 1.72); suicidal attempt history (OR = 1.31); divorce, separation, and extramarital contact (P = 0.001); unemployment (P = 0.019); leisure time dissatisfaction (P = 0.004); living alone (OR = 2.43); and substance abuse onset before age 15 (OR = 1.71).Conclusions:Considering non-modifiable risk factors, leaders and commanders may recognize more vulnerable soldiers and try to resolve modifiable factors and decrease the risk of getting worse (with respect to substance abuse) about 7.3 times.

Management of Substance use Disorder in Military Services: A Comprehensive Approach

“…Risk factors in community include individual, social, and environmental factors such as childhood maltreatment/abuse, genetic predisposition, poor decision-making skills, low self-efficacy, low self-confidence, intimate partner violence, peer pressure, permissive attitudes, low psychological resilience, negative peer influences, divorce, unemployment, and availability of low-cost accessible substances. [ 27 28 29 ] Although developmental and early social risk factors are the same as the civilian community, there are also several risk factors associated with military service which are known to increase the risk of substance use disorders, there are cognitive, behavioral, societal, and exposure factors including service-related injuries, experiencing traumatic events in military unit, demands in active duty such as carrying heavy equipment, workplace culture, bad relationship with commanders, service place dissatisfaction, being separated from family members, experiencing boredom, and stress for working in isolated sites. [ 30 31 32 33 ]…”