Hazardous Alcohol Use and Receipt of Risk-Reduction Counseling Among U.S. Veterans of the Wars in Iraq and Afghanistan

Objective: Military service in Afghanistan (Operation Enduring Freedom [OEF]) and Iraq (Operation Iraqi Freedom [OIF]) has been associated with high rates of mental health problems. Relatively little is known, however, about the prevalence of risky drinking among OEF/OIF veterans using U.S. Department of Veterans Affairs (VA) health care. This study examined the prevalence of hazardous alcohol use among OEF/OIF veterans and the incidence of alcohol risk-reduction counseling offered by VA providers.

Method: A secondary analysis of data extracted from the VA outpatient Survey of Healthcare Experiences of Patients, a stratified random sample of VA clinic users from the fiscal year 2005 (October 1, 2004, to September 30, 2005), was conducted. The Alcohol Use Disorders Identification Test (AUDIT-C) was scored to assess hazardous drinking and possible alcohol use disorder (AUD). Patient report of alcohol counseling by a VA provider in the past year was queried for those with risky drinking behavior. The association of demographic variables with potentially hazardous alcohol use, alcohol use disorder, and receipt of alcohol risk-reduction counseling was estimated using logistic regression.

Results: Overall, 40% of the sample screened positive for potentially hazardous alcohol use, and 22% screened positive for possible AUD. Only 31% of those with hazardous drinking behavior, however, reported being counseled to cut back or to not drink alcohol. Higher AUDIT-C scores were associated with increased likelihood of risk-reduction counseling. Among patients reporting hazardous drinking, there was a trend for those with less education and lower income to be more likely to report receiving advice about their drinking.

Conclusions: Hazardous alcohol use is prevalent among OEF/OIF veterans seeking VA health care. There is a need for increased vigilance and action to identify and counsel at-risk veterans in this population.