Substance use and psychological distress before and after the military to civilian transition

Karen Derefinko, Troy A. Hallsell, Matthew B. Isaacs, Francisco I. Salgado Garcia, Lauren W. Colvin, Zoran Bursac, Meghan E. McDevitt-Murphy, James G. Murphy, Melissa A. Little, Gerald W. Talcott, Robert C. Klesges

Research output: Contribution to journalArticle

Abstract

Background Those currently serving in the military constitute a vulnerable population given their high-risk status for substance use, and population data suggest that veterans continue to engage in significant substance use long after their military service ends. Recent research suggests that the separation transition from active duty to civilian life may be critical in terms of the future functioning of the veteran. Methods We sought to explore substance use prevalence, as well as potential emotional distress among veterans by retrospectively assessing substance use during active duty and following separation to examine possible changes in use over this period. This study assessed substance use and emotional distress in veterans (N = 80; 90% male) across the military to civilian transition. Findings Repeated measures tests indicated that endorsement of alcohol use, cigarette use, and prescription drug misuse was similar during active duty and post-separation, and marijuana and hard drug use endorsement increased significantly in the 6-mo period post-separation. Further, comorbid use of different substances was common. Active duty levels of anxiety/depression and aggressive feelings were maintained from active duty to post-separation, and feeling alone and military-based trauma symptoms increased significantly. Finally, participants indicated that only a minority of the veterans they knew were doing emotionally well or did not have alcohol/substance use issues. Discussion These findings indicate a clear need for substance use and psychological intervention availability before and after transition to enable veterans to transition to civilian life effectively. Based on the many issues at work during the transition process, programs may do well to focus more specifically on identification of problems and raising awareness, rather than awaiting more severe issues in the future. Validation of the difficulties of the separation transition, veterans' feelings of isolation, and the importance of veteran community support may help newly transitioning veterans find advocates who may help them navigate existing assistance programs.

Original languageEnglish (US)
Pages (from-to)e258-e265
JournalMilitary medicine
Volume183
Issue number5-6
DOIs
StatePublished - May 1 2018

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Veterans
Psychology
Emotions
Prescription Drug Misuse
Alcohols
Vulnerable Populations
Cannabis
Tobacco Products
Anxiety
Depression
Wounds and Injuries
Research

All Science Journal Classification (ASJC) codes

  • Public Health, Environmental and Occupational Health

Cite this

Derefinko, K., Hallsell, T. A., Isaacs, M. B., Salgado Garcia, F. I., Colvin, L. W., Bursac, Z., ... Klesges, R. C. (2018). Substance use and psychological distress before and after the military to civilian transition. Military medicine, 183(5-6), e258-e265. https://doi.org/10.1093/milmed/usx082

Substance use and psychological distress before and after the military to civilian transition. / Derefinko, Karen; Hallsell, Troy A.; Isaacs, Matthew B.; Salgado Garcia, Francisco I.; Colvin, Lauren W.; Bursac, Zoran; McDevitt-Murphy, Meghan E.; Murphy, James G.; Little, Melissa A.; Talcott, Gerald W.; Klesges, Robert C.

In: Military medicine, Vol. 183, No. 5-6, 01.05.2018, p. e258-e265.

Research output: Contribution to journalArticle

Derefinko, K, Hallsell, TA, Isaacs, MB, Salgado Garcia, FI, Colvin, LW, Bursac, Z, McDevitt-Murphy, ME, Murphy, JG, Little, MA, Talcott, GW & Klesges, RC 2018, 'Substance use and psychological distress before and after the military to civilian transition', Military medicine, vol. 183, no. 5-6, pp. e258-e265. https://doi.org/10.1093/milmed/usx082
Derefinko, Karen ; Hallsell, Troy A. ; Isaacs, Matthew B. ; Salgado Garcia, Francisco I. ; Colvin, Lauren W. ; Bursac, Zoran ; McDevitt-Murphy, Meghan E. ; Murphy, James G. ; Little, Melissa A. ; Talcott, Gerald W. ; Klesges, Robert C. / Substance use and psychological distress before and after the military to civilian transition. In: Military medicine. 2018 ; Vol. 183, No. 5-6. pp. e258-e265.
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AU - Hallsell, Troy A.

AU - Isaacs, Matthew B.

AU - Salgado Garcia, Francisco I.

AU - Colvin, Lauren W.

AU - Bursac, Zoran

AU - McDevitt-Murphy, Meghan E.

AU - Murphy, James G.

AU - Little, Melissa A.

AU - Talcott, Gerald W.

AU - Klesges, Robert C.

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N2 - Background Those currently serving in the military constitute a vulnerable population given their high-risk status for substance use, and population data suggest that veterans continue to engage in significant substance use long after their military service ends. Recent research suggests that the separation transition from active duty to civilian life may be critical in terms of the future functioning of the veteran. Methods We sought to explore substance use prevalence, as well as potential emotional distress among veterans by retrospectively assessing substance use during active duty and following separation to examine possible changes in use over this period. This study assessed substance use and emotional distress in veterans (N = 80; 90% male) across the military to civilian transition. Findings Repeated measures tests indicated that endorsement of alcohol use, cigarette use, and prescription drug misuse was similar during active duty and post-separation, and marijuana and hard drug use endorsement increased significantly in the 6-mo period post-separation. Further, comorbid use of different substances was common. Active duty levels of anxiety/depression and aggressive feelings were maintained from active duty to post-separation, and feeling alone and military-based trauma symptoms increased significantly. Finally, participants indicated that only a minority of the veterans they knew were doing emotionally well or did not have alcohol/substance use issues. Discussion These findings indicate a clear need for substance use and psychological intervention availability before and after transition to enable veterans to transition to civilian life effectively. Based on the many issues at work during the transition process, programs may do well to focus more specifically on identification of problems and raising awareness, rather than awaiting more severe issues in the future. Validation of the difficulties of the separation transition, veterans' feelings of isolation, and the importance of veteran community support may help newly transitioning veterans find advocates who may help them navigate existing assistance programs.

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