A new study in the American Journal of Medicine shows alcohol abuse among veterans climbed in the second and third year of the coronavirus pandemic after dipping at the onset of the lockdowns in 2020. (KatarzynaBialasiewicz, Getty Images, U.S. Army Acquisition Support Center)
WASHINGTON — A new study in the American Journal of Medicine shows alcohol abuse among veterans climbed in the second and third year of the coronavirus pandemic after dipping at the onset of the lockdowns in 2020.
Veterans are more susceptible than the general population to mental-health and substance-abuse problems, and researchers sought to determine the prevalence of alcohol abuse among veterans during the pandemic.
The study’s conclusions stem from studies by Rand Corp., the Veterans Affairs Department and other organizations showing veterans who have been deployed are more likely to suffer from mental health conditions or traumatic brain injuries.
One in five veterans of the wars in Iraq and Afghanistan have experienced post-traumatic stress disorder or depression, according to Rand, which is higher than the general population.
An estimated one in 11 Americans will be diagnosed with PTSD in their lifetime, according to the American Psychiatric Association.
While there have been small studies on alcohol consumption in the general population during the coronavirus pandemic showing an increase in use, there has been little research on veterans and drinking during and after the pandemic, according to the study.
“Multiple small studies suggest that during the pandemic, about 25% of people drank more than usual, often to cope with stress. Sales of hard liquor, or spirits, accounted for most of the increase,” George F. Koob, director of the National Institute on Alcohol Abuse and Alcoholism, said about the pandemic’s impact on Americans’ alcohol use.
Coronavirus was declared a public emergency in March 2020, leading to sweeping lockdowns and guidance to shelter-in-place. The declaration was lifted in January 2023.
“Few studies have examined longer-term trends in alcohol use beyond the first year of the pandemic, and to the best of our knowledge, no studies to date have examined nationwide trends in alcohol use among veterans three years after the onset of the pandemic,” according to the study, which was published in December.
The new research looked at alcohol use self-reported by roughly 2.5 million veterans from March 2018 to February 2023 at Department of Veterans Affairs outpatient facilities, which ask patients to complete questionnaires on alcohol consumption.
The statistics represented veterans who completed alcohol consumption scorecards during the study period, researchers said. The scorecards are called AUDIT-C — alcohol use disorders identification test-concise.
The annual screening for veterans has been in place at VA health care facilities since 2004. The scorecards categorize consumption levels as zero risk, low risk or high risk.
Findings showed about 15% of veterans studied — or 375,000 veterans — abused alcohol in 2021 and 2022, with the trend continuing into early 2023.
The figure rose one point from the onset of the pandemic, representing about 25,000 more veterans abusing alcohol.
By comparison, the rate of alcohol abuse among the general population in 2021 and 2022 was 6.3%, based on figures from the National Institute on Alcohol Abuse and Alcoholism.
The institute defines high-risk alcohol use for men — also referred to as heavy drinking — as having five or more alcoholic drinks on any given day or 15 or more per week. Among women, the amount is four or more glasses of alcohol or any day or eight or more drinks per week.
Researchers for the medical journal looking at alcohol use during and after the pandemic focused exclusively on veterans, looking at gender, age and ethnic groups. They did not seek to study the general population.
Findings showed high-risk alcohol use dipped among veterans in the first year of the pandemic but ticked upward in years two and three of the pandemic. The study looked at veterans by gender, age and ethnic groups who fell into the high-risk category.
Rates of alcohol abuse overall were highest among veterans between ages 18 and 39, at more than 20%, for the period studied.
The study also found the percentage of female veterans who reported engaging in high-risk alcohol use inched passed male veterans.
The researchers said they did not seek to determine the reasons for changes in consumption levels but to identify trends.
“We don’t know what future trends will look like, [but] this highlights the need for greater attention, particularly in women, to assess and provide resources to address high-risk alcohol use and alcohol addiction,” said Dr. Robert J. Wong, a Stanford University researcher and lead author of the study.
The higher rate among female veterans versus men extended across ethnic groups, the study noted.
Sixteen percent of white female veterans, for example, self-reported high-risk alcohol use from March 2022 to February 2023, the period studied after the pandemic, a one-point increase over alcohol consumption before the pandemic.
For white male veterans, the numbers were reversed, dropping from 16% to 15% — though still more than double the general population.
“While the differences seem small, the overall trends are concerning, such that high risk alcohol use among female veterans is rising more rapidly than men to the point that it has surpassed men,” Wong said.
Ella Mae Gray, an Air Force veteran and psychotherapist with a practice in Gaithersburg, Md., said the findings do not surprise her.
“There are a lot of people struggling out there,” said Gray, a former senior airman who served in the Air Force from 1994-1998 with consecutive tours in Turkey and the United Kingdom. She said she has many clients who are veterans.
“Year one of [the pandemic], veterans were all in, doing what was needed to address a national emergency. We were on it,” she said. “By year two of sheltering in place, many folks started turning to unhealthy coping strategies.
“Alcohol was so accessible during the pandemic. Liquor stores remained open. Isolation intensified stressors people already were feeling,” she said.
Gray said veterans might already have heightened feelings of isolation from PTSD and depression related to their military service that increased due to shelter-in-place policies during the pandemic.
Female veterans struggling with alcohol addiction seemed at particular risk due to economic uncertainties and family turmoil worsened by the pandemic that has yet to fully stabilize, Gray said.
Women in general bear greater caretaking responsibilities — whether it is for young children or aging parents — in addition to holding down jobs or pursuing higher education, she said.
Gray believes there is a pressing need for more transitional services for veterans that start before they leave the military and help them navigate life as civilians.
“The military serves as such a foundation for service members,” she said. “When they get out, all that goes away. There needs to be a more holistic — and realistic — approach for helping our veterans.”
Terry Motley, 60, suffers from PTSD and depression related to military service. Motley of Dallas said he sought services through the Greenhouse Treatment Center, an alcohol and drug treatment program.
Motley said the coronavirus lockdown triggered addiction problems that extended to narcotics. But he said he found it difficult to ask for help over the phone after doctors’ offices closed during the pandemic.
“It has been a slow climb back to recovery. I had a lot of vivid images and flashbacks from my time in the service,” said Motley, who served as an Army first sergeant with deployments to Kuwait, Iraq and Germany. He retired from the military in 2002 after 20 years of service.
Maria Esther Ontiveros, a therapist who works with veterans and first responders at Greenhouse Treatment Center, said alcohol was highly accessible to the public during the pandemic, while many programs that assist veterans closed.
She said using alcohol became a convenient way for some veterans to ease negative thoughts and despair brought on by PTSD.
Ontiveros noted substance abuse often is a contributing factor in veteran suicides. Suicide rates among veterans are 1.57 to 1.66 times greater than for nonveterans, according to the Department of Veterans Affairs.
