San Francisco VA Health Care System, 4150 Clement St, San Francisco, CA 94121, USA; University of California - San Francisco, 401 Parnassus Ave, San Francisco, CA 94143, USA; Sierra Pacific Mental Illness Research Education, and Clinical Center, 4150 Clement St, San Francisco, CA 94121, USA.
Health Outcomes of Military Exposures, Epidemiology Program, Office of Patient Care Services, Veterans Health Administration, 810 Vermont Ave NW, Washington, DC 20420, USA.
J Subst Use Addict Treat. 2023 Mar;146:208964. doi: 10.1016/j.josat.2023.208964. Epub 2023 Jan 24.
Research comparing prevalence of alcohol use problems and alcohol treatment utilization between veterans and nonveterans is lacking. Whether predictors of alcohol use problems and alcohol treatment utilization differ in veterans vs. nonveterans is also unclear.
Using survey data from national samples of post-9/11 veterans and nonveterans (N = 17,298; 13,451 veterans, 3847 nonveterans), we investigated associations between veteran status and 1) alcohol consumption, 2) need for intensive alcohol treatment, and 3) past-year and lifetime alcohol treatment utilization. We also investigated associations between predictors and these three outcomes in separate models for veterans and nonveterans. Predictors included age, gender, racial/ethnic identity, sexual orientation, marital status, education, health coverage, financial difficulty, social support, adverse childhood experiences (ACEs), and adult sexual trauma.
Population weighted regression models demonstrated that veterans reported modestly higher alcohol consumption than nonveterans, but were not significantly more likely to need intensive alcohol treatment. Veterans and nonveterans did not differ in past-year alcohol treatment utilization, but veterans were 2.8 times more likely to utilize lifetime treatment than nonveterans. We found several differences between veterans and nonveterans in associations between predictors and outcomes. For veterans, being male, having higher financial difficulty, and lower social support were associated with need for intensive treatment, but for nonveterans, only ACEs were associated with need for intensive treatment.
Veterans may benefit from interventions with social and financial support to reduce alcohol problems. These findings can help to identify veterans and nonveterans who are more likely to need treatment.
缺乏比较退伍军人和非退伍军人之间酒精使用问题和酒精治疗利用情况的研究。退伍军人和非退伍军人之间是否存在酒精使用问题和酒精治疗利用的预测因素也不清楚。
使用来自后 9/11 退伍军人和非退伍军人（N=17298；13451 名退伍军人，3847 名非退伍军人）全国样本的调查数据，我们调查了退伍军人身份与以下三个方面之间的关联：1）酒精消费，2）需要强化酒精治疗，3）过去一年和终生的酒精治疗利用。我们还在退伍军人和非退伍军人的单独模型中调查了预测因素与这三个结果之间的关联。预测因素包括年龄、性别、种族/族裔身份、性取向、婚姻状况、教育程度、健康保险、经济困难、社会支持、不良童年经历（ACEs）和成人性创伤。
人口加权回归模型表明，退伍军人报告的酒精消费略高于非退伍军人，但并不显著更有可能需要强化酒精治疗。退伍军人和非退伍军人在过去一年的酒精治疗利用率方面没有差异，但退伍军人终生接受治疗的可能性是非退伍军人的 2.8 倍。我们发现，在预测因素与结果之间的关联方面，退伍军人和非退伍军人之间存在一些差异。对于退伍军人，男性、经济困难程度较高和社会支持较低与需要强化治疗有关，但对于非退伍军人，只有 ACEs 与需要强化治疗有关。
退伍军人可能受益于具有社会和经济支持的干预措施，以减少酒精问题。这些发现可以帮助识别更有可能需要治疗的退伍军人和非退伍军人。
