Health Services Research & Development

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2007 HSR&D National Meeting Abstract

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National Meeting 2007

1013 — Prevalence of Hazardous Alcohol Use and Risk Reduction Counseling among OIF/OEF Veterans

Calhoun PS (VISN-6 Mental Illness Research, Education, and Clinical Center; VA Center for Excellence in Primary Care; Durham VAMC, Duke University Medical Center) , Straits-Troster K (VISN-6 Mental Illness Research, Education, and Clinical Center; Durham VAMC, Duke University Medical Center), Kudler H (VISN-6 Mental Illness Research, Education, and Clinical Center; Durham VAMC, Duke University Medical Center)

Objectives:
Military service in Iraq (OIF) and Afghanistan (OEF) has been associated with high rates of mental health problems. Relatively little is known, however, about the prevalence of risky drinking among OIF/OEF veterans using VA healthcare. This study examined the prevalence of hazardous alcohol use among OIF/OEF veterans and the incidence of alcohol risk reduction counseling offered by VA providers.

Methods:
A secondary analysis of data extracted from the FY2005 national VA outpatient Survey of Healthcare Experiences of Patients (SHEP), a stratified random sample of VA clinic users, was conducted. The Alcohol Use Disorders Identification Test (AUDIT-C) was scored to include gender-specific cut points for hazardous drinking and alcohol dependence. Patient report of alcohol counseling by a VA provider in the past year was queried for risky drinkers. The association of demographic variables with hazardous alcohol use, alcohol dependence, and alcohol risk reduction counseling was estimated using logistic regression.

Results:
Of the OIF/OEF sample (n=1104), 16% were women, 31% reported minority race/ethnicity, and 65% served in Reserve/National Guard. Overall, 40% of the sample screened positive for hazardous alcohol use, 23% reported binge drinking (> 5 drinks/episode), and 21% screened positive for alcohol dependence. Older age (OR=0.97, 95% CI 0.96-0.99), being female (OR=0.68, CI 0.48-0.97), being married (OR=0.59, CI 0.45-0.78), and minority race/ethnicity (OR=0.70, CI 0.53-0.92) were associated with decreased odds of hazardous alcohol use. Only 30% of hazardous drinkers reported being counseled to cut back or to not drink alcohol, and only 40% of those who screened positive for alcohol dependence reported counseling. Among patients reporting hazardous drinking, those with only a high school education (OR=2.43, CI 1.51-3.92) and those who met criteria for alcohol dependence (OR=2.8, CI 1.78-4.42) were more likely to receive counseling.

Implications:
Hazardous drinking is prevalent among OIF/OEF veterans; however, the proportion of at-risk veterans who reported receiving alcohol counseling is low. VA providers appear less likely to counsel better educated patients about cutting back on their alcohol use.

Impacts:
Hazardous alcohol use is prevalent among OIF/OEF veterans seeking VA healthcare. There is a clear need for increased vigilance and action to identify and counsel at-risk veterans in this population.