The burden of alcohol use disorders in US military veterans: results from the National Health and Resilience in Veterans Study

Fuehrlein, Brian; Mota, Natalie; Arias, Albert J.; Trevisan, Louis; Kachadourian, Lorig K.; Krystal, John H.; Southwick, Steven M.; Pietrzak, Robert H.

doi:10.1111/add.13423

Cited by 144 publications

(104 citation statements)

References 54 publications

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“…AUDs were the most prevalent lifetime disorders among Ohio National Guard members (44%)(Fink et al, 2016a) and Canadian Regular Force members (32%)(Pearson et al, 2014). A contemporary survey of U.S. military veterans revealed that 42% had lifetime AUD and 15% had past-year AUD (Fuehrlein et al, 2016). Finally, there is evidence that deployments are associated with increased risk of new-onset AUDs (Jacobson et al, 2008).…”

Section: Discussionmentioning

confidence: 99%

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Alcohol Misuse and Co‐Occurring Mental Disorders Among New Soldiers in the U.S. Army

Stein

Campbell‐Sills

et al. 2016

Alcoholism Clin & Exp Res

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BACKGROUND Problem drinking that predates enlistment into military service may contribute to the overall burden of alcohol misuse in the Armed Forces; however, evidence bearing on this issue is limited. The current study examines prevalence and correlates of alcohol misuse among new US Army soldiers. METHODS Cross-sectional survey data were collected from soldiers reporting for basic combat training. The survey retrospectively assessed lifetime alcohol consumption and substance abuse/dependence, enabling estimation of the prevalence of lifetime binge drinking and heavy drinking in a sample of 30,583 soldiers and of probable alcohol use disorder (AUD) among 26,754 soldiers with no/minimal lifetime use of other drugs. Co-occurrence of mental disorders and other adverse outcomes with binge drinking, heavy drinking, and AUD was examined. Discrete-time survival analysis, with person-year the unit of analysis and a logistic link function, was used to estimate associations of AUD with subsequent onset of mental disorders and vice versa. RESULTS Weighted prevalence of lifetime binge drinking was 27.2% (SE=0.4%) among males and 18.9% (SE=0.7%) among females; respective estimates for heavy drinking were 13.9% (SE=0.3%) and 9.4% (SE=0.4%). Among soldiers with no/minimal drug use, 9.5% (SE=0.2%) of males and 7.2% (SE=0.5%) of females had lifetime AUD. Relative to no alcohol misuse, binge drinking, heavy drinking, and AUD were associated with increased odds of all adverse outcomes under consideration [adjusted odds ratios (AORs)=1.5 to 4.6; ps<.001]. Prior mental disorders and suicidal ideation were associated with onset of AUD (AORs=2.3 to 2.8; ps<.001); and prior AUD was associated with onset of mental disorders and suicidal ideation (AORs=2.0 to 3.2, ps<0.005). CONCLUSIONS Strong bidirectional associations between alcohol misuse and mental disorders were observed in a cohort of soldiers beginning Army service. Conjoint recognition of alcohol misuse and mental disorders upon enlistment may provide opportunities for risk mitigation early in a soldier's career.

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Section: Discussionmentioning

confidence: 99%

“…A study of mental disorders in a representative sample of 671 Ohio Army National Guard members found that AUD was the most common lifetime disorder, with a prevalence of 44% (Fink et al, 2016a). U.S. military veterans also have a high prevalence (42%) of lifetime AUD (Fuehrlein et al, 2016). …”

Section: Introductionmentioning

confidence: 99%

Alcohol Misuse and Co‐Occurring Mental Disorders Among New Soldiers in the U.S. Army

Stein

Campbell‐Sills

et al. 2016

Alcoholism Clin & Exp Res

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“…Among veterans from the recent conflicts, of those seeking treatment at VA, 11% were diagnosed with a substance use disorder and 55 to 75% of those had comorbid PTSD (Seal et al., ). In a sample of veterans in the community, those with a lifetime history of alcohol use disorders had higher rates of both mood and anxiety disorders (Fuehrlein et al., ). Comorbidity is associated with a number of worse outcomes including higher rates of psychological problems, higher rates of relapse, hospitalizations, as well as medical and social complications such as unemployment and homelessness (Blanco et al., ; Drapkin et al., ; Ouimette et al., ).…”

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confidence: 99%

Posttraumatic Stress Disorder and Alcohol Use Disorder: A Critical Review of Pharmacologic Treatments

Petrakis

Simpson

2017

Alcoholism Clin & Exp Res

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Treatment of alcohol use disorder (AUD) is complicated by the presence of psychiatric comorbidity including posttraumatic stress disorder (PTSD). This is a critical review of the literature to date on pharmacotherapy treatments of AUD and PTSD. A systematic literature search using PubMed MESH terms for alcohol and substance use disorders, PTSD, and treatment was undertaken to identify relevant randomized clinical trials (RCTs). The studies were independently evaluated (IP and TS) and those that evaluated the efficacy of a pharmacotherapy for individuals diagnosed with AUD and PTSD and were randomized controlled trials (RCT) were selected. Studies were grouped in three categories: (1) those that evaluated first line treatments for PTSD, (2) those that evaluated medications to target AUD and (3) those that evaluated medications hypothesized to be effective in targeting alcohol consumption as well as PTSD symptoms. Nine RCTs were identified; three focused on medications to treat PTSD, four focused on AUD, and three to target both. One study included both a medication to treat PTSD and one to treat AUD so was discussed twice. All but one of the studies found that PTSD symptoms and drinking outcomes improved significantly over time. There is not one agent with clear evidence of efficacy in this comorbid group. The results for medications to treat PTSD are inconclusive because of contradictory results. There was weak evidence to support the use of medications to treat AUD among those with comorbidity with PTSD. Findings for medications that were hypothesized to treat both disorders were also contradictory. Most studies provided a combination of interventions to treat both disorders. Despite the contradictory results, this review suggests that individuals with AUD and comorbid PTSD can safely be prescribed medications used in non-comorbid populations and patients improve with treatment.

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“…The NHRVS sample was drawn from a research panel of more than 50,000 households that is developed and maintained by GfK Inc., which maintains KnowledgePanel®, a probability-based, online non-volunteer access survey panel of a nationally representative sample of U.S. adults that covers approximately 98% of U.S. households, including cell-phone only households (see Fuehrlein et al, 2016 for detailed information on sampling procedures). GfK uses probability-based sampling of household addresses from the US Postal Service’s Delivery Sequence File, a method that allows for the inclusion of even those households with no telephone access.…”

Section: Methodsmentioning

confidence: 99%

American Military Veteran Entrepreneurs: A Comprehensive Profile of Demographic, Service History, and Psychosocial Characteristics

Heinz

Freeman

Harpaz‐Rotem

et al. 2017

Military Psychology

Self Cite

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American military veterans are nearly twice as likely to be self-employed compared to non-veterans, and are majority owners in nine percent of all businesses nationwide. Despite their contribution to the broader economy and the potential for training programs to cultivate and foster successful self-employment and veteran-lead entrepreneurial ventures, research on veteran entrepreneurs remains limited. In order to gain a better understanding of the potential strengths and vulnerabilities of veteran entrepreneurs, the current study utilized data from a large, nationally representative sample to profile self-employed veterans (n=230) and compare them to veterans who work as employees (n=1,055) with respect to demographic, military service history, and psychosocial characteristics. Results indicated that self-employed veterans were older and more educated and more likely to utilize VA healthcare. Self-employed veterans were more likely to serve in Vietnam and to serve in the military for fewer years. No differences were noted in perceived military experience, level of combat exposure, or military branch served as a function of self-employment. Although reporting more lifetime traumas, self-employed veterans did not experience higher rates of current or lifetime psychopathology or lower perceived quality of life. Potential protective resilience-promoting factors may be associated with the higher levels of openness, extraversion, optimism, achievement-orientation (purpose in life), and greater need for autonomy and professional development observed among self-employed veterans. Moreover, self-employed veterans demonstrated higher levels of gratitude, community integration, and altruistic service to others. Findings have potential to inform human resources management strategies and vocational training and reintegration initiatives for veterans.

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The burden of alcohol use disorders in US military veterans: results from the National Health and Resilience in Veterans Study

Cited by 144 publications

References 54 publications

Alcohol Misuse and Co‐Occurring Mental Disorders Among New Soldiers in the U.S. Army

Alcohol Misuse and Co‐Occurring Mental Disorders Among New Soldiers in the U.S. Army

Posttraumatic Stress Disorder and Alcohol Use Disorder: A Critical Review of Pharmacologic Treatments

American Military Veteran Entrepreneurs: A Comprehensive Profile of Demographic, Service History, and Psychosocial Characteristics

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