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Problematic Alcohol Use Trajectories in U.S. Military Veterans during a Public Health Crisis: Results from a 3-year, Nationally Representative, Longitudinal Study

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Abstract

A growing number of studies have examined alcohol use during the COVID-19 pandemic. However, few longitudinal studies evaluated the prevalence and correlates of different trajectories of problematic alcohol use in vulnerable segments of the population, such as US veterans, over the 3-year course of the COVID-19 pandemic. Data were analyzed from the National Health and Resilience in Veterans Study, a nationally representative, longitudinal study of 2,441 US veterans. Latent growth mixture modeling was used to identify the trajectories and correlates of problematic alcohol use. Four trajectories were identified: consistent (N = 170, weighted 7.2%), decreasing (N = 38, weighted 2.2%), increasing (N = 22, weighted 1.2%), and low (N = 2,211, weighted 89.4%) problematic alcohol use. Greater household income, pre-pandemic drug use disorder (DUD), lower social support, and COVID-19 infection to self or non-household members were associated with an increasing relative to decreasing problematic alcohol use trajectory. Greater household income, adverse childhood experiences (ACEs), pre-pandemic DUD, lower social support, and greater COVID-related social restriction stress were associated with an increasing relative to a low problematic alcohol use trajectory. Younger age, male sex, ACEs, pre-pandemic DUD, lower pre-pandemic and greater decline in protective psychosocial characteristics, COVID-19 infection to non-household member, and lower COVID-related financial stress were associated with a consistent relative to a low problematic alcohol use trajectory. Overall, pre-pandemic greater income, DUD, and lower social support were associated with an increase in problematic alcohol use among US veterans during the COVID-19 pandemic. Results may help inform prevention efforts to mitigate problematic alcohol use during prolonged crises in this population.

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Funding

Preparation of this report was supported in part by the U.S. Department of Veterans Affairs 1IK1CX002532-01 (PJN).

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Authors and Affiliations

  1. VA Connecticut Healthcare System, West Haven, CT, USA

    Peter J. Na & Ismene L. Petrakis

  2. Department of Psychiatry, Yale School of Medicine, 300 George Street, Suite 901, New Haven, CT, 06511, USA

    Peter J. Na, Ian C. Fischer, Ismene L. Petrakis & Robert H. Pietrzak

  3. National Center for PTSD, VA Connecticut Healthcare System, West Haven, CT, USA

    Ian C. Fischer, Ismene L. Petrakis & Robert H. Pietrzak

  4. Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA

    Robert H. Pietrzak

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  1. Peter J. Na
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Correspondence to Peter J. Na.

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Conflicts of Interest

In the past 3 years, Dr. Na has received royalties from Wolters Kluwer. Drs. Fischer and Pietrzak report no competing interests. Dr. Petrakis receives in-kind support (medications) for investigator initiated from Alkermes and BioXcel Therapeutics and a grant funded by BioXcel Therapeutics.

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The funding agency had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript, and decision to submit the manuscript for publication.

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Na, P.J., Fischer, I.C., Petrakis, I.L. et al. Problematic Alcohol Use Trajectories in U.S. Military Veterans during a Public Health Crisis: Results from a 3-year, Nationally Representative, Longitudinal Study. Psychiatr Q 95, 157–171 (2024). https://doi.org/10.1007/s11126-024-10067-w

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