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May 2019

Combat Exposure, Drinking, and Mental Health: How are They Related?

As you may know, alcohol is one of the most common, if not the most common substance used. There is great variability in the type of users that exist, for example: the casual social drinker who orders a drink on Friday after work; the alcoholic whose alcohol use impairs their daily life; or the weekender who binge drinks all weekend, but then maintains a relatively normal day-to-day life during the workweek. Due to the variation in usage, there are classifications that characterize various types of alcohol users. There are multiple methods of classification and numerous scales used to identify normal to problematic alcohol use. These classifications allow researchers to discuss more specifically the benefits, consequences, and themes that go along with different levels of alcohol use. Here is one way alcohol use is classified:

  • Non-drinker = no alcohol use in the past year
  • Occasional drinker = drinking monthly or less, and no drinking days of 5 or more drinks
  • Moderate drinker = up to 7 drinks a week for women and up to 14 for men, and no days of drinking more than 5 drinks
  • Hazardous drinker = 8 or more drinks a week for women, and 15 or more drinks a week for men, or any day drinking 5 or more drinks (often referred to as binge drinking)

Substance use has been associated with greater physical and mental health problems among veterans and service members. However, recent research has found that both occasional and moderate alcohol users seem to fare well and even reported fewer mental and physical health problems compared to other user classifications. Alcohol, in and of itself, is not always harmful or predictive of negative outcomes, including health problems. In fact, service members who drink alcohol regularly and in moderation seem to do alright! The opposite is also true. Not drinking alcohol is not inherently a sign of health or the absence of health problems.

Research has consistently shown that combat exposure influences mental health. Combat exposure is defined as deployment related stressors from warzone experiences. Results from a recent study found that the more combat exposure experienced by a service member, the more the service member reported limitations to daily activities due to health problems. Additionally, a recent study found that heavy drinking at least once a week was found to enhance the negative association between combat exposure and mental health. This means that greater combat exposure was related to having poorer mental health. This negative relationship was exacerbated if the service member engaged in heavy drinking. Additionally, veterans who fell in the category of hazardous drinker also reported having experienced more combat exposure. It is important to note that although combat exposure is related to hazardous drinking, an individuals’ exposure to combat does not guarantee the development of drinking problems.

Interestingly, both non-drinkers and hazardous drinkers were more likely to experience mental health problems. While not all non-drinkers are at risk for mental health problems, it is important to remember that just because a service member, veteran, family member, or friend does not have a drinking problem, does not mean that they are exempt from mental health problems altogether. Specifically for service members and veterans who have experienced combat exposure, physical and mental health issues can be displayed in various ways.

So what can you do?

What is it: Monitoring involves the parents’ supervision and knowledge about their child’s activities.

1. Know that substance use is a common reaction to combat exposure, so keep the conversation going, and openly discuss substance use with those close to you

2. Utilize available resources. Click the links below to locate helpful services!

Receive routine screening for physical/mental health/pain and substance use, which may allow helping professionals to better connect service members to appropriate resources.

4. Target problematic substance use through interventions, which may improve quality of life for service members, considering how alcohol use can exacerbate the negative effects of combat exposure.

5. Military leadership can help both pre and post deployment by…

  • ensuring service members and veterans are educated about healthy drinking patterns.
  • providing service members with education about common responses to combat exposure.
  • discussing healthy post-combat coping strategies.


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