Author Affiliations: Department of Physical Medicine and Rehabilitation, Ohio State University, Columbus (Dr Corrigan). Dr Cole is Contributing Editor, JAMA.
Substance use disorders, traumatic brain injury (TBI), and posttraumatic stress disorder (PTSD) are common in military and civilian populations, and often occur together. A substantial proportion of military personnel misuse alcohol. A study of the UK armed forces1 reported that 67% of men and 49% of women had scores of 8 or higher, defined as hazardous drinking, on the Alcohol Use Disorders Identification Test, compared with 38% of men and 16% of women in the general population. In a population-based cohort of US soldiers returning from service in Iraq,2 11.8% reported alcohol misuse on a 2-item alcohol screening test. Recent military service is also associated with TBI, PTSD, and depression. In a 2008 survey,3 19.5% of US armed services personnel returning from service in Afghanistan and Iraq reported experiencing a possible TBI, 18.5% met criteria for PTSD or depression, and 7.3% both reported a possible TBI and met criteria for PTSD or depression. By comparison, the lifetime prevalence of PTSD estimated for the general US population is 7.8%, and of those 51.9% of men and 27.9% of women have a lifetime prevalence of both PTSD and alcohol abuse or dependence.4
Corrigan JD, Cole TB. Substance Use Disorders and Clinical Management of Traumatic Brain Injury and Posttraumatic Stress Disorder. JAMA. 2008;300(6):720–721. doi:10.1001/jama.300.6.720