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


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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  1. 1.

    Bachman JG, Freedman-Doan P, O'Malley PM, Johnston LD, Segal DR. Changing patterns of drug use among US military recruits before and after enlistment. Am J Public Health. 1999;89(5):672–7.

    CAS  Article  Google Scholar 

  2. 2.

    Borack JI. An estimate of the impact of drug testing on the deterrence of drug use. Mil Psychol. 1998;10(1):17–25.

    Article  Google Scholar 

  3. 3.

    Bray RM, Marsden ME, Peterson MR. Standardized comparisons of the use of alcohol, drugs, and cigarettes among military personnel and civilians. Am J Public Health. 1991;81(7):865–9.

    CAS  Article  Google Scholar 

  4. 4.

    Bray RM, Marsden ME, Herbold JR, Peterson MR. Progress toward eliminating drug and alcohol abuse among US military personnel. Armed Forces Soc. 1992;18(4):476–96.

    Article  Google Scholar 

  5. 5.

    Bureau USC. American community survey, 2012. Suitland: U.S. Department of Commerce; 2013.

    Google Scholar 

  6. 6.

    Cooper RV. Military manpower and the all-volunteer force: a report prepared for Defense Advanced Research Projects Agency. Santa Monica: Rand; 1977.

    Google Scholar 

  7. 7.

    Degenhardt L, Bharat C, Glantz MD, Sampson NA, Al-Hamzawi A, Alonso J, et al. Association of cohort and individual substance use with risk of transitioning to drug use, drug use disorder, and remission from disorder: findings from the world mental health surveys. JAMA Psychiat. 2019;76(7):708–20.

    Article  Google Scholar 

  8. 8.

    Gamache G, Rosenheck R, Tessler R. The proportion of veterans among homeless men: a decade later. Soc Psychiatry Psychiatr Epidemiol. 2001;36(10):481–5.

    CAS  Article  Google Scholar 

  9. 9.

    Grant B, Chu A, Sigman R, Amsbary M, Kali J, Sugawara Y, et al. National institute on alcohol abuse and alcoholism national epidemiologic survey on alcohol and related conditions-III (NESARC-III) source and accuracy statement. Bethesda: NIAAA; 2015.

    Google Scholar 

  10. 10.

    Ingraham LH, Manning FJ. The boys in the barracks: observations on American military life. Philadelphia: Study of Human Issues; 1984.

    Google Scholar 

  11. 11.

    Kim C, Nestel G, Phillips R, Borous M. National longitudinal survey of youth labor market experience: military studies. Columbus: Center for Human Resources Research, Ohio State University; 1980.

    Google Scholar 

  12. 12.

    Kulka RA. The national Vietnam veterans readjustment study: tables of findings and technical appendices. New York: Brunner/Mazel Publisher; 1990.

    Google Scholar 

  13. 13.

    Laurence JH. Women and the US military. Inclusion in the American Military: a force for diversity. London: Lexington; 2017. p. 111–2.

  14. 14.

    McCabe SE, West BT, Morales M, Cranford JA, Boyd CJ. Does early onset of non-medical use of prescription drugs predict subsequent prescription drug abuse and dependence? Results from a national study. Addiction. 2007;102(12):1920–30.

    Article  Google Scholar 

  15. 15.

    Mehay SL, Pacula RL. The effectiveness of workplace drug prevention policies: does' zero tolerance'work? Cambridge: National Bureau of Economic Research; 1999.

    Google Scholar 

  16. 16.

    Merline AC, O’Malley PM, Schulenberg JE, Bachman JG, Johnston LD. Substance use among adults 35 years of age: prevalence, adulthood predictors, and impact of adolescent substance use. Am J Public Health. 2004;94(1):96–102.

    Article  Google Scholar 

  17. 17.

    National Institute on Alcohol Abuse and Alcoholism. National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III). 2017. Retrieved August 15, 2018, from Accessed 15 Aug 2018.

  18. 18.

    National Institute on Alcohol Abuse and Alcoholism. National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III): Source and accuracy statement. 2018. Retrieved August 15, 2018, from Accessed 15 Aug 2018.

  19. 19.

    Olfson M, Blanco C, Wall M, Liu S-M, Saha TD, Pickering RP, et al. National trends in suicide attempts among adults in the United States. JAMA Psychiatry. 2017;74(11):1095–103.

    Article  PubMed  PubMed Central  Google Scholar 

  20. 20.

    Polich JM. Epidemiology of alcohol abuse in military and civilian populations. Am J Public Health. 1981;71(10):1125–32.

    CAS  Article  Google Scholar 

  21. 21.

    Quester A, Shuford R. Population representation in the military services: fiscal year 2015 summary report. Washington, DC: Center for Naval Analyses; 2017.

    Google Scholar 

  22. 22.

    Robins LN, Davis DH, Nurco DN. How permanent was Vietnam drug addiction? Am J Public Health. 1974;64(12_Suppl):38–43.

    Article  Google Scholar 

  23. 23.

    Rosenheck R, Frisman L, Chung A-M. The proportion of veterans among homeless men. Am J Public Health. 1994;84(3):466–9.

    CAS  Article  Google Scholar 

  24. 24.

    Rostker BD, Yeh K. I want you!: the evolution of the all-volunteer force. Santa Monica: Rand Corporation; 2006.

    Google Scholar 

  25. 25.

    SAS. Statistical analysis software, ver. 9.4. Cary: SAS Institute Inc.; 2014.

    Google Scholar 

  26. 26.

    Segal D. Illicit drug-use in United-States-army. Paper presented at the sociological symposium; 1977.

  27. 27.

    Stanton MD. Drugs, Vietnam, and the Vietnam veteran: an overview. Am J Drug Alcohol Abuse. 1976;3(4):557–70.

    CAS  Article  Google Scholar 

  28. 28.

    Steadman HJ, Osher FC, Robbins PC, Case B, Samuels S. Prevalence of serious mental illness among jail inmates. Psychiatr Serv. 2009;60:761–5.

    Article  Google Scholar 

  29. 29.

    Tanielian TL, Tanielian T, Jaycox L. Invisible wounds of war: psychological and cognitive injuries, their consequences, and services to assist recovery, vol. 1. Santa Monica: Rand Corporation; 2008.

    Google Scholar 

  30. 30.

    Tsai J, Rosenheck RA. Risk factors associated with homelessness among U.S. veterans. Epidemiol Rev. 2015;37:177–95.

  31. 31.

    Ward GC, Burns K. The Vietnam war: an intimate history. New York: Random House; 2018.

    Google Scholar 

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Correspondence to Robert Rosenheck.

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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).

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  • Male veterans
  • Substance use
  • DSM-5