Vander Weg MW (Iowa City VAMC (CRIISP)), Sadler AG
(CRIISP and Iowa City VAMC), Mengeling MA
(College of Education, University of Iowa), Booth BM
(Little Rock COE, Center for Mental Health Care Outcomes and Research: Central Arkansas Veterans Health Care System), Torner JC
(University of Iowa College of Public Health and Carver College of Medicine), Rosenthal GE
(Iowa City VAMC (CRIISP))
Posttraumatic stress disorder (PTSD) and substance use disorders (SUD) are among the most common and debilitating mental health concerns faced by veterans. While each can have a highly negative impact on health and well-being, when they occur together, the impact can be even more devastating. We examined associations between PTSD and substance use in female veterans.
800 female veterans < = 50 years of age who had used the Iowa City VA or outlying clinics in the past 5 years were surveyed by phone regarding their mental health history, licit and illicit substance use, and exposure to pre-military and military-related traumatic events. Current PTSD status and symptom severity were assessed using the Posttraumatic Symptom Scale (PSS). Multivariate logistic regression analyses were used to investigate associations between PTSD and substance use adjusting for age, race, education, family income, number of tours of duty, and whether participants had served in a combat theater setting.
30.4% of participants met DSM-IV criteria for current PTSD based on responses to the PSS. PTSD was associated with lifetime (OR = 1.46, 95% CI = 1.07-1.99) and past year (OR = 2.76, 95% CI = 1.53-4.97) use of illicit drugs, lifetime use of marijuana (OR = 1.40, 95% CI = 1.03-1.91), lifetime cigarette use (OR = 2.03, 95% CI = 1.46-2.83), and current cigarette smoking (OR = 1.87, 95% CI = 1.35-2.59). Current symptoms associated with re-experiencing, avoidance, and arousal were positively associated with lifetime and past year use of illicit drugs, as well as lifetime use of marijuana and cigarettes (ps < .05). Greater avoidance and arousal symptoms were also associated with an increased likelihood of being a current smoker (ps < .05).
Female veterans with PTSD were more likely to use cigarettes and several forms of illicit substances. More severe symptoms were also associated with a greater likelihood of substance use.
Female veterans with PTSD should be evaluated for comorbid SUD. Future studies should further examine the relationships between PTSD and substance use in an effort to develop more effective treatment programs for veterans experiencing both conditions.