4039 — Suicidal Ideation among National Guard Soldiers Reporting Hazardous Drinking and Prescription Medication Misuse

Lead/Presenter: Heather Walters, COIN - Ann Arbor
All Authors: Walters HM (COIN-Ann Arbor) Massey LS (University of Michigan) Valenstein M (COIN-Ann Arbor) Bohnert AB (COIN-Ann Arbor) Ilgen MA (COIN-Ann Arbor) Blow FC (COIN-Ann Arbor)

Objectives:
Data from a larger randomized controlled trial were used to examine rates and correlates of suicidal ideation, hazardous drinking, and prescription opioid and sedative misuse among National Guard Soldiers.

Methods:
Soldiers were enrolled during drill weekends, from April 2015 to March 2017 after being screened for hazardous drinking (HD; AUDIT-C score > 4/5) and prescription opioid or sedative misuse (POSM; i.e., using for reasons other than prescribed, borrowing from others, or taking more than prescribed). Suicidal ideation was measured using the PHQ-9 suicide ideation item. Multinomial logistic regression analyses were used to compare substance misuse groups: no misuse, HD, and POSM.

Results:
Among those screened (n = 2502), 64 (3%) endorsed POSM and 681 (27%) endorsed HD. Rates of suicidal ideation were significantly higher among the POSM group (19%) compared to the HD group (9%) and no misuse group (9%) (X2 = 43.6; p < .0001). There were no differences in demographic variables (age, sex, race, marital status, education) or military history (rank, deployment history) among those reporting suicidal ideation and HD or POSM. Regression analysis showed that soldiers with POSM were significantly more likely to report suicidal ideation (AOR = 3.24 CI = 1.48, 7.10), use marijuana (AOR = 11.5 CI = 5.69, 23.4), overdose (AOR = 8.56 CI = 4.6, 15.9) and report poor health (AOR = 5.19, CI 2.79, 9.68) than the non-misusers. The HD group was also significantly more likely to report suicidal ideation (AOR = 2.59 CI = 1.74, 3.86), use marijuana (AOR = 3.67 CI = 2.37, 5.66), and overdose (AOR = 2.84 CI = 2.0, 4.04) than the no-misuse group. When comparing POSM to HD, the POSM group was significantly more likely to use marijuana (AOR = 3.15 CI = 1.62, 6.10), overdose (AOR = 3.01 CI = 1.65, 5.49) and report poor health (AOR = 3.65, CI 1.96, 6.81).

Implications:
Suicidal ideation and overdose are ongoing concerns among military personnel in the National Guard. Hazardous drinking and prescription opioid and sedative misuse were associated with higher rates of both suicidal ideation and overdose. Innovative interventions may be needed to address the inter-related behaviors of hazardous drinking, prescription misuse, and suicidal ideation and acts.

Impacts:
The larger trial will investigate whether web-based brief interventions can reduce substance misuse, and subsequently have an impact in suicidal ideation among National Guard Soldiers.