2020. Prevalence of Hazardous and Harmful Alcohol Use among Veterans: Findings from a National Survey
S Chen, VA Health Economics Resource Center, TH Wagner, VA Health Economics Resource Center, JW Finney, VA Center for Health Care Evaluation

Objectives: Most research on the use of alcohol by veterans in the community has focused on the diagnostic categories of abuse and dependence, whereas the prevalence of hazardous or harmful alcohol use and its correlates has received substantially less attention.  The present study analyzed data from a national probability survey to determine the prevalence of hazardous/harmful alcohol use and to identify veterans most at risk for excessive alcohol consumption

Methods: Between December 1, 2001 and January 21, 2002, we conducted a national, internet-based survey on a probability sample of adults aged 21 and older, oversampling veterans.  The survey was sent to 12,878 persons and 8,935 (69%) provided informed consent and subsequently completed the survey.  Alcohol use and problems were measured by using the Alcohol Use Disorders Identification Test (AUDIT).  Hazardous alcohol use was identified by a score of 4 or higher based on responses to three AUDIT items; harmful alcohol use was indexed by a score or 4 or more based on a different set of four items. 

Results:  Among male veterans, 32% and 7% were identified by the AUDIT as hazardous or harmful drinkers, respectively.  These percentages were less than those for male non-veterans (37% and 11%, p<. 05); however, significant differences disappeared once age was controlled.  Of the hazardous/harmful drinkers, 86% reported that they had not received any VA healthcare services in the past two years.  Although 55% of hazardous/harmful drinkers were eligible to VA health care benefits, 28% of them did not know whether or not they were eligible to VA health benefits.  Logistic regression showed that being young and single, and having less formal education was associated with higher odds of being a hazardous/harmful drinker.

Conclusions: Although almost a fourth of veterans met criteria for hazardous/harmful alcohol use, over half of them reported not having received any care in VHA during the past two years.

Impact: Approximately one-fifth of veterans in the community are engaged in hazardous or harmful alcohol use, and are not receiving care in VHA, where many would be screened and provided brief interventions that have substantial research supporting their effectiveness.