Rates of PTSD and Depression Highly Prevalent among OEF/OIF Veterans with Alcohol and/or Drug Use Disorders
The prevalence of mental health disorders in Veterans of OEF/OIF, particularly PTSD, continues to rise. In contrast, far less is known about the prevalence and predictors of alcohol use disorders (AUD), and there is only one published report about non-alcohol drug use disorders (DUD) among this population. Moreover, comorbid substance use disorders are particularly important to consider among OEF/OIF Veterans because of the high rate of co-occurring mental health diagnoses in this group. This retrospective study sought to determine the prevalence and independent correlates of AUD and DUD among 456,502 OEF/OIF Veterans who were first-time users of VA healthcare between 10/01 and 9/09, and were followed through 1/10. Using VA data, investigators also examined demographics and military service characteristics (e.g., branch, number of deployments), as well as four mental health diagnoses associated with combat exposure: PTSD, depressive disorders, anxiety disorders, and adjustment disorders.
- Overall, 11% of the OEF/OIF Veterans in this study received diagnoses of AUD, DUD, or both; 10% received AUD diagnoses and 5% received DUD diagnoses.
- Post-deployment AUD and DUD diagnoses were more prevalent in particular sub-groups of OEF/OIF Veterans and were highly comorbid with PTSD and depression.
- Among Veterans diagnosed with AUD, DUD, or both, 55% to 75% also received a diagnosis of PTSD or depression. AUD, DUD, or both diagnoses were 3 to 4.5 times more likely among Veterans with PTSD and depression.
- AUD and DUD diagnoses were more prevalent among Veterans younger than age 25, men, and those Veterans who were more likely to have had greater exposure to combat, e.g., Veterans who were enlisted versus officers, and those who served in the Army and Marines.
- These results were based on treatment-seeking Veterans only.
- Diagnoses were based on administrative data, which could under- or over-estimate rates.
- Various factors may reduce the rate of documented diagnoses of illicit substance misuse in the electronic medical record: lack of screening for illicit substance misuse, clinician sensitivity to stigma associated with drug and alcohol diagnoses, and lack of time or training.
Dr. Maguen was supported by an HSR&D Career Development award. Drs. Seal and Maguen are part of HSR&D’s Program to Improve Care for Veterans with Complex Comorbid Conditions, San Francisco.
Seal K, Cohen G, Waldrop A, Cohen B, Maguen S, and Ren L. Substance Use Disorders in Iraq and Afghanistan Veterans in VA Healthcare, 2001-2010: Implications for Screening, Diagnosis, and Treatment. Drug & Alcohol Dependence January 28, 2011;e-pub ahead of print.