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

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 4,645 U.S. 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 U.S. (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 (consuming 5+ alcoholic drinks at least 1-2x/week) and Alcohol or Substance Use Disorder (AUD/SUD). Results: Prevalence of past-month heavy drinking at T0, T2, and T3 was 23.3% (SE=0.7%), 26.1% (SE=0.8%), and 22.3% (SE=0.7%); corresponding estimates for any binge drinking were 52.5% (SE=1.0%), 52.5% (SE=1.0%), and 41.3% (SE=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 heavy drinking at T2 [per standard score increase: AOR=1.20, 95% CI 1.06-1.35, p=.003]; incidence of AUD/SUD at T2 (AOR=1.54, 95% CI 1.25-1.89, p<.0005); and persistence of AUD/SUD at T2 and T3 (AOR=1.30, 95% CI 1.08-1.56, p=.005). Any binge drinking pre-deployment was associated with post-deployment onset of HD (AOR=3.21, 95% CI 2.57-4.02, p<.0005) and AUD/SUD (AOR=1.85, 95% CI 1.27-2.70, p=.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.