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

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

doi:10.1111/add.13423

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

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

Research output: Contribution to journal › Article › peer-review

129 Scopus citations

Abstract

AIMS: To analyze data from a large, contemporary, nationally representative sample of US veterans to evaluate: (1) the prevalence of life-time alcohol use disorder (AUD) and past-year AUD; (2) common psychiatric comorbidities associated with life-time AUD; and (3) correlates of life-time and past-year probable AUD.

DESIGN: Data were analyzed from the National Health and Resilience in Veterans Study (NHRVS), a web-based survey of a random probability sample of a contemporary, nationally representative sample of US military veterans.

SETTING: United States.

PARTICIPANTS: Nationally representative sample of 3157 US veterans aged 21 years and older.

MEASUREMENTS: Life-time alcohol abuse and dependence were assessed according to DSM-IV diagnostic criteria using the Mini International Neuropsychiatric Interview, and combined into a single variable: AUD. Past-year probable AUD was assessed using the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C). Correlates of AUD, including psychiatric comorbidities, suicidality and demographic characteristics, were also assessed.

FINDINGS: The prevalence of life-time AUD and past-year probable AUD was 42.2% [95% confidence interval (CI) = 40.5-43.9%)] and 14.8% (95% CI = 13.6-16.0%), respectively. Compared with veterans without AUD, those with life-time AUD had substantially elevated rates of life-time and current mood and anxiety disorders [odds ratios (ORs) = 2.6-4.1], drug use disorder (OR = 10.7), life-time suicide attempt (OR = 4.1) and current suicidal ideation (OR = 2.1). Younger age, male sex, lower education, lower annual household income and greater number of life-time traumatic events were associated independently with life-time AUD. Younger age, male sex, unpartnered marital status and a life-time diagnosis of major depressive disorder were associated independently with past-year probable AUD.

CONCLUSIONS: More than 40% of US military veterans have a life-time history of alcohol use disorder. Veterans with a life-time history of alcohol use disorder have substantial comorbid psychiatric burden, including elevated rates of suicidal ideation and attempts. Certain socio-demographic (e.g. younger age, male sex, lower education) and clinical (e.g. trauma burden, history of depression) characteristics are associated with increased risk of AUD.

Original language	English
Pages (from-to)	1786-1794
Number of pages	9
Journal	Addiction
Volume	111
Issue number	10
DOIs	https://doi.org/10.1111/add.13423
State	Published - 1 Oct 2016
Externally published	Yes

Keywords

Alcohol use disorder
anxiety disorder
comorbidity
dual diagnosis
epidemiology
military
mood disorder
veterans

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10.1111/add.13423

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@article{b22b76c42eac48b68bb4bd0367eca517,

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

abstract = "AIMS: To analyze data from a large, contemporary, nationally representative sample of US veterans to evaluate: (1) the prevalence of life-time alcohol use disorder (AUD) and past-year AUD; (2) common psychiatric comorbidities associated with life-time AUD; and (3) correlates of life-time and past-year probable AUD.DESIGN: Data were analyzed from the National Health and Resilience in Veterans Study (NHRVS), a web-based survey of a random probability sample of a contemporary, nationally representative sample of US military veterans.SETTING: United States.PARTICIPANTS: Nationally representative sample of 3157 US veterans aged 21 years and older.MEASUREMENTS: Life-time alcohol abuse and dependence were assessed according to DSM-IV diagnostic criteria using the Mini International Neuropsychiatric Interview, and combined into a single variable: AUD. Past-year probable AUD was assessed using the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C). Correlates of AUD, including psychiatric comorbidities, suicidality and demographic characteristics, were also assessed.FINDINGS: The prevalence of life-time AUD and past-year probable AUD was 42.2% [95% confidence interval (CI) = 40.5-43.9%)] and 14.8% (95% CI = 13.6-16.0%), respectively. Compared with veterans without AUD, those with life-time AUD had substantially elevated rates of life-time and current mood and anxiety disorders [odds ratios (ORs) = 2.6-4.1], drug use disorder (OR = 10.7), life-time suicide attempt (OR = 4.1) and current suicidal ideation (OR = 2.1). Younger age, male sex, lower education, lower annual household income and greater number of life-time traumatic events were associated independently with life-time AUD. Younger age, male sex, unpartnered marital status and a life-time diagnosis of major depressive disorder were associated independently with past-year probable AUD.CONCLUSIONS: More than 40% of US military veterans have a life-time history of alcohol use disorder. Veterans with a life-time history of alcohol use disorder have substantial comorbid psychiatric burden, including elevated rates of suicidal ideation and attempts. Certain socio-demographic (e.g. younger age, male sex, lower education) and clinical (e.g. trauma burden, history of depression) characteristics are associated with increased risk of AUD.",

keywords = "Alcohol use disorder, anxiety disorder, comorbidity, dual diagnosis, epidemiology, military, mood disorder, veterans",

author = "Fuehrlein, {Brian S.} and Natalie Mota and Arias, {Albert J.} and Trevisan, {Louis A.} and Kachadourian, {Lorig K.} and Krystal, {John H.} and Southwick, {Steven M.} and Pietrzak, {Robert H.}",

note = "Publisher Copyright: {\textcopyright} 2016 Society for the Study of Addiction.",

year = "2016",

month = oct,

day = "1",

doi = "10.1111/add.13423",

language = "English",

volume = "111",

pages = "1786--1794",

journal = "Addiction",

issn = "0965-2140",

publisher = "Wiley-Blackwell Publishing Ltd",

number = "10",

}

TY - JOUR

T1 - The burden of alcohol use disorders in US military veterans

T2 - results from the National Health and Resilience in Veterans Study

AU - Fuehrlein, Brian S.

AU - Mota, Natalie

AU - Arias, Albert J.

AU - Trevisan, Louis A.

AU - Kachadourian, Lorig K.

AU - Krystal, John H.

AU - Southwick, Steven M.

AU - Pietrzak, Robert H.

PY - 2016/10/1

Y1 - 2016/10/1

N2 - AIMS: To analyze data from a large, contemporary, nationally representative sample of US veterans to evaluate: (1) the prevalence of life-time alcohol use disorder (AUD) and past-year AUD; (2) common psychiatric comorbidities associated with life-time AUD; and (3) correlates of life-time and past-year probable AUD.DESIGN: Data were analyzed from the National Health and Resilience in Veterans Study (NHRVS), a web-based survey of a random probability sample of a contemporary, nationally representative sample of US military veterans.SETTING: United States.PARTICIPANTS: Nationally representative sample of 3157 US veterans aged 21 years and older.MEASUREMENTS: Life-time alcohol abuse and dependence were assessed according to DSM-IV diagnostic criteria using the Mini International Neuropsychiatric Interview, and combined into a single variable: AUD. Past-year probable AUD was assessed using the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C). Correlates of AUD, including psychiatric comorbidities, suicidality and demographic characteristics, were also assessed.FINDINGS: The prevalence of life-time AUD and past-year probable AUD was 42.2% [95% confidence interval (CI) = 40.5-43.9%)] and 14.8% (95% CI = 13.6-16.0%), respectively. Compared with veterans without AUD, those with life-time AUD had substantially elevated rates of life-time and current mood and anxiety disorders [odds ratios (ORs) = 2.6-4.1], drug use disorder (OR = 10.7), life-time suicide attempt (OR = 4.1) and current suicidal ideation (OR = 2.1). Younger age, male sex, lower education, lower annual household income and greater number of life-time traumatic events were associated independently with life-time AUD. Younger age, male sex, unpartnered marital status and a life-time diagnosis of major depressive disorder were associated independently with past-year probable AUD.CONCLUSIONS: More than 40% of US military veterans have a life-time history of alcohol use disorder. Veterans with a life-time history of alcohol use disorder have substantial comorbid psychiatric burden, including elevated rates of suicidal ideation and attempts. Certain socio-demographic (e.g. younger age, male sex, lower education) and clinical (e.g. trauma burden, history of depression) characteristics are associated with increased risk of AUD.

AB - AIMS: To analyze data from a large, contemporary, nationally representative sample of US veterans to evaluate: (1) the prevalence of life-time alcohol use disorder (AUD) and past-year AUD; (2) common psychiatric comorbidities associated with life-time AUD; and (3) correlates of life-time and past-year probable AUD.DESIGN: Data were analyzed from the National Health and Resilience in Veterans Study (NHRVS), a web-based survey of a random probability sample of a contemporary, nationally representative sample of US military veterans.SETTING: United States.PARTICIPANTS: Nationally representative sample of 3157 US veterans aged 21 years and older.MEASUREMENTS: Life-time alcohol abuse and dependence were assessed according to DSM-IV diagnostic criteria using the Mini International Neuropsychiatric Interview, and combined into a single variable: AUD. Past-year probable AUD was assessed using the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C). Correlates of AUD, including psychiatric comorbidities, suicidality and demographic characteristics, were also assessed.FINDINGS: The prevalence of life-time AUD and past-year probable AUD was 42.2% [95% confidence interval (CI) = 40.5-43.9%)] and 14.8% (95% CI = 13.6-16.0%), respectively. Compared with veterans without AUD, those with life-time AUD had substantially elevated rates of life-time and current mood and anxiety disorders [odds ratios (ORs) = 2.6-4.1], drug use disorder (OR = 10.7), life-time suicide attempt (OR = 4.1) and current suicidal ideation (OR = 2.1). Younger age, male sex, lower education, lower annual household income and greater number of life-time traumatic events were associated independently with life-time AUD. Younger age, male sex, unpartnered marital status and a life-time diagnosis of major depressive disorder were associated independently with past-year probable AUD.CONCLUSIONS: More than 40% of US military veterans have a life-time history of alcohol use disorder. Veterans with a life-time history of alcohol use disorder have substantial comorbid psychiatric burden, including elevated rates of suicidal ideation and attempts. Certain socio-demographic (e.g. younger age, male sex, lower education) and clinical (e.g. trauma burden, history of depression) characteristics are associated with increased risk of AUD.

KW - Alcohol use disorder

KW - anxiety disorder

KW - comorbidity

KW - dual diagnosis

KW - epidemiology

KW - military

KW - mood disorder

KW - veterans

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U2 - 10.1111/add.13423

DO - 10.1111/add.13423

M3 - Article

C2 - 27061707

AN - SCOPUS:85041095486

SN - 0965-2140

VL - 111

SP - 1786

EP - 1794

JO - Addiction

JF - Addiction

IS - 10

ER -

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

Abstract

Keywords

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