Association of the Military Transition to an All-Volunteer Force and Subsequent Zero-Tolerance Drug Policy with Characteristics of Male Veterans in the Vietnam, Post-Vietnam and Subsequent Post-Post Vietnam Cohorts

Psychiatric Quarterly (2021)Cite this article

Abstract

In the 1970s, following the Vietnam Conflict, the U.S. military transitioned to an All-Volunteer Force (AVF). In the 1980’s military benefits increased and a zero-tolerance policy for illicit drugs was instituted. Changes in characteristics of veterans deserve study. National survey data from 2012 to 2013 compare vetderan-non-veteran differences in three age cohorts: the Vietnam cohort; the AVF (Post-Vietnam) cohort; and volunteers under the no tolerance policy (Post-Post-Vietnam). Comparisons addressed socio-demographic, behavioral, and substance use and psychiatric diagnoses. Multivariate interaction analyses between veteran status and age cohorts were used to identify significant veteran-non-veteran differences between the first and second, and second and third cohorts. Significant interactions showed that veteran-non-veteran comparisons for the Post-Vietnam cohort as compared to Vietnam cohort reveal later veterans to be relatively more likely to be black, disabled, with lower incomes, less health insurance, more homelessness, incarceration, and suicide attempts with greater substance use diagnosis. In contrast interactions show veteran-non-veteran comparisons for the Post-Post-Vietnam cohort as compared to Post-Vietnam cohort were less likely to be black, more likely to be married, retired, with incomes over $40,000, more education and private health insurance. They were less likely to have been homeless, incarcerated or to have made suicide attempts. The veteran cohort serving in the first years of the AVF showed significant socio-economic and behavioral disadvantage (e.g homelessness) compared to their predecessors while their successors, under no tolerance drug policy, showed reversal of these trends. Military recruitment and disciplinary policies significantly affect veteran economic and health status.

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Affiliations

  1. VA New England Mental Illness Research, Education and Clinical Center/151D, VA Connecticut Healthcare System, 950 Campbell Ave., Building 35, West Haven, CT, 06516, USA

    Robert Rosenheck, Elina Stefanovics & Taeho Greg Rhee

  2. Department of Psychiatry, School of Medicine, Yale University, New Haven, CT, USA

    Robert Rosenheck, Elina Stefanovics & Taeho Greg Rhee

  3. Department of Public Health Sciences, School of Medicine, University of Connecticut, Farmington, CT, USA

    Taeho Greg Rhee

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  1. Robert Rosenheck
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  2. Elina Stefanovics
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  3. Taeho Greg Rhee
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Correspondence to Robert Rosenheck.

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Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

The study was approved by the IRB of the VA Connecticut healthcare System which granted a waiver of informed consent.

This article does not contain any studies with animals performed by any of the authors.

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Robert Rosenheck declares that he has no conflict of interest. Elina Stefanovics declares that she has no conflict of interest. Taheo Greg Rhee declares that he has no conflict of interest.

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Rosenheck, R., Stefanovics, E. & Rhee, T.G. Association of the Military Transition to an All-Volunteer Force and Subsequent Zero-Tolerance Drug Policy with Characteristics of Male Veterans in the Vietnam, Post-Vietnam and Subsequent Post-Post Vietnam Cohorts. Psychiatr Q (2021). https://doi.org/10.1007/s11126-021-09882-2

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Keywords

  • Male veterans
  • Substance use
  • NESARC-III
  • DSM-5