Arielle Cruz
Alcohol misuse and military service have a complex relationship. Research has linked the stress experienced by military personnel to alcohol use and post-traumatic stress disorder (PTSD). Traumatic events, such as combat exposure, military sexual trauma, and training accidents, can lead to PTSD and other psychiatric disorders, with individuals using alcohol as a means of self-medication. This correlation is evident in the US military, which recorded 1.19 million fatalities between 1775 and 1991, including non-combat deaths related to accidents, illnesses, and self-inflicted wounds, with alcohol sometimes being a contributing factor. From 1980 to 2022, 60,770 deaths occurred, with accidental deaths decreasing by 83% during this period. However, self-inflicted injuries, including suicides, have become the leading cause of death in the military, with alcohol and substance abuse playing a role. Excessive drinking among troops has led to concerns about health, productivity, and medical treatment costs, with the Defense Department facing significant financial impacts.
| Characteristics | Values |
|---|---|
| Total US military deaths between 1775 and 1991 | 1,190,085 |
| Total recorded US military deaths from 1980 to 2022 | 60,770 |
| Percentage of US military deaths from 1980 to 2022 that were due to accidents, illnesses, and self-inflicted wounds | 83.6% |
| US military deaths from accidents between 1980 and 2022 | 28,995 |
| US military deaths from accidents that include vehicle crashes and alcohol or substance abuse between 1980 and 2022 | N/A |
| Percentage decrease in accidental deaths in the US military since 1980 | 83% |
| Percentage increase in US military deaths caused by self-inflicted injuries since 1980 | 44.1% |
| Percentage decrease in US military deaths from other causes such as homicides between 1980 and 2022 | 65% |
| US military deaths during World War II | 1,076,245 |
| US military deaths during the American Civil War | 498,332 |
| US military personnel spend days drinking alcohol per year | 130 |
| US military personnel spend days binge-drinking per year | 41 |
| Percentage of US troops who reported being binge drinkers in 2015 | 30% |
| Percentage of US service members who met the criteria for hazardous drinking or possible alcohol use disorder in 2015 | 33% |
| Estimated cost of excessive drinking to the US Defense Department per year | $1.1 billion |
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What You'll Learn
- Military personnel are more likely to binge-drink than people in other industries
- PTSD and alcohol misuse are linked in military personnel
- Combat stress and dangerous deployments increase alcohol misuse
- Socialising plays a role in heavy drinking among military personnel
- Alcohol-related deaths in the military are often due to accidents
Military personnel are more likely to binge-drink than people in other industries
Alcohol misuse in military populations has been associated with a negative impact on social, physical, and psychological health. Research has independently linked stress experienced by military personnel to both alcohol use and post-traumatic stress disorder (PTSD). Military personnel are more likely to binge drink than people in other industries. A review of the Centers for Disease Control and Prevention's survey data from 2013 to 2017 found that military personnel spent more days a year consuming alcohol than people in any other industry. They also binge-drink more, consuming at least four or five alcoholic beverages a day in one sitting at least 41 days a year.
Binge drinking is defined as drinking on a single occasion with at least five drinks for men or at least four drinks for women. It is a common risk behaviour among US adults that is associated with adverse health and social consequences. In 2005, 43.2% of active-duty military personnel (ADMP) reported past-month binge drinking, resulting in 29.7 episodes per person per year. Heavy drinkers, who made up 19.8% of ADMP, were responsible for 71.5% of binge-drinking episodes and had the highest number of annual per-capita episodes of binge drinking (112.6 episodes).
Binge drinking is prevalent in military populations across the UK, US, Germany, Angola, and Nigeria. Literature suggests that in the UK, drinking levels are higher in the Army than in other branches of the military. Different subcultures of drinking within individual branches have been attributed to these variations across the military, especially under circumstances that involve personnel taking part in team activities where peer pressure to drink may be present. These situations that involve socialising and alcohol use are a common feature of Armed Forces life, particularly in the Royal Navy, where significant degrees of harmful drinking have been reported.
Skipper et al. suggested that serving personnel who are part of 'special forces' are at a higher risk of problematic drinking if they are involved in hostile warfare. Browne et al. also argued that personnel who deployed with their parent unit, whose role was outside their training or experience, and who experienced poor in-theatre unit leadership were more likely to be heavy drinkers. Additionally, individuals who have experienced combat or military sexual trauma may turn to alcohol as a means of "self-medicating" their symptoms.
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PTSD and alcohol misuse are linked in military personnel
Alcohol misuse is prevalent among military personnel and veterans, and this can be detrimental to their health and well-being. Various studies have found a significant link between PTSD and alcohol misuse in military personnel and veterans. PTSD, or post-traumatic stress disorder, is a mental health condition that arises when someone has experienced or witnessed a traumatic or life-threatening event, such as military combat, a traumatic injury, or physical or sexual abuse. Military sexual trauma (MST) is a specific type of trauma that can lead to PTSD and other mental health conditions, such as depression.
Research has shown that veterans with PTSD may turn to alcohol to cope with their symptoms, such as re-experiencing traumatic events, hyperarousal, and avoidance behaviours. Alcohol provides immediate and short-term relief from these distressing symptoms, which can lead to frequent and excessive use, resulting in the development of alcohol use disorders. This self-medicating behaviour is one of the proposed mechanisms underlying the relationship between PTSD and alcohol misuse.
Furthermore, it has been found that military trauma increases the likelihood of developing stress-related mental health disorders such as PTSD. The stress reactions associated with PTSD can also lead to alcohol misuse. This overlap between stress reactions and alcohol use is particularly notable in individuals who have experienced combat or MST. The co-occurrence of PTSD and alcohol misuse can be challenging to untangle and treat effectively.
Additionally, alcohol misuse can have complex interactions with traumatic brain injuries (TBIs). Heavy drinking may predispose individuals to experiencing a TBI, and it can also worsen the symptoms and increase the risk of further alcohol-related TBIs. This further complicates the relationship between traumatic events and alcohol misuse in military personnel.
The link between PTSD and alcohol misuse in military personnel and veterans is well-established, and it is crucial to address this issue to improve their overall health and well-being. Treatment options, such as cognitive-behavioural therapy (CBT) and Eye Movement Desensitization and Reprocessing (EMDR), can help veterans with co-occurring PTSD and alcohol use disorders manage their symptoms and lead healthier lives.
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Combat stress and dangerous deployments increase alcohol misuse
Military life is associated with high-stress situations, traumatic experiences, and prolonged deployments, which can all take a toll on mental health. The relationship between alcohol misuse and trauma or stress is complex and bidirectional. Research has linked the stress experienced by military personnel to alcohol misuse and post-traumatic stress disorder (PTSD). Combat stress and dangerous deployments can indeed increase alcohol misuse for various reasons.
Firstly, traumatic events during deployments can lead to the development of psychiatric disorders such as PTSD or depression. Individuals with these conditions may then turn to alcohol as a means of self-medication or a coping mechanism to alleviate their symptoms. This is supported by studies showing that military veterans with PTSD reported using alcohol to cope with re-experiencing and hyperarousal symptoms. The negative reinforcement provided by alcohol's short-term relief can lead to frequent and excessive drinking, resulting in alcohol misuse.
Secondly, pre-existing alcohol misuse before deployment may be a risk factor for the development of PTSD following combat exposure. Soldiers who misuse alcohol prior to deployment may be more prone to continue or worsen their alcohol abuse post-deployment. This can create a vicious cycle where alcohol misuse exacerbates PTSD symptoms, leading to further alcohol misuse as a means of avoidance and self-medication.
Additionally, demographic factors also play a role. Studies have found higher rates of heavy drinking among male and female military personnel compared to their civilian counterparts, especially in the younger age groups. This suggests that military service, with its unique stressors and cultural influences, may contribute to higher rates of alcohol misuse.
Furthermore, specific deployment experiences, such as personal threats, fighting, and exposure to warzone stressors, have been significantly associated with alcohol misuse. The increase in alcohol use following deployment was found to be more pronounced for Active-Duty personnel in a US cohort, indicating that the demands and stressors of active duty may play a role in alcohol misuse.
Finally, the longstanding drinking culture within the military, easy access to alcohol, social influences, and the availability of alcohol during military "decompression" periods can all contribute to a higher risk of alcohol misuse among those with combat stress and dangerous deployments.
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Socialising plays a role in heavy drinking among military personnel
While it is unclear whether more people die in the military or from alcohol, excessive alcohol consumption is a serious issue in the military. Military personnel are more likely to binge drink and drink heavily compared to civilians. Socialising and peer pressure play a significant role in heavy drinking among military personnel.
Binge drinking is defined as consuming at least five drinks for men and at least four drinks for women on the same occasion. Heavy drinking is classified as binge drinking at least one or two days a week in the past 30 days. According to the 2018 Health Related Behaviors Survey, both binge drinking and heavy drinking are prevalent in the military.
Socialising and peer pressure are key factors contributing to the high rates of alcohol consumption among military personnel. Literature suggests that drinking is often viewed as a way to relax and bond with peers in the military. This is particularly true for team activities, where there may be pressure to drink to fit in and prove oneself to the group. Young military personnel or those new to a unit are especially susceptible to this pressure.
Additionally, military personnel may use alcohol to cope with the stress and trauma of combat experiences. Research has found a significant overlap between stress reactions, post-traumatic stress disorder (PTSD), and alcohol use in veterans and active-duty service members. Traumatic events can lead to psychiatric disorders such as PTSD or depression, and individuals may turn to alcohol as a means of self-medication.
The culture of drinking in the military is a complex issue influenced by various factors, including socialising, peer pressure, stress, and trauma. Addressing these underlying factors is crucial to mitigating the negative consequences of excessive alcohol consumption among military personnel.
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Alcohol-related deaths in the military are often due to accidents
The relationship between alcohol misuse and traumatic brain injuries (TBIs) is complex. Alcohol misuse can increase the risk of experiencing a TBI, and it can also worsen the symptoms and complications of existing TBIs. Military personnel may turn to alcohol as a means of self-medication to cope with the symptoms of PTSD, such as re-experiencing traumatic events, hyperarousal, and avoidance behaviours. The negative reinforcement provided by alcohol can lead to frequent and excessive drinking, resulting in the development of alcohol use disorders.
Combat stress, particularly in regions like Iraq and Afghanistan, has been associated with alcohol misuse. Deployed soldiers who engage in heavy drinking are at a higher risk of developing anxiety, affective, and sleep disorders. The impact of deployment on military personnel's alcohol use is evident, with higher levels of drinking associated with increased PTSD symptom severity and lower levels of positive emotionality. The hazardous drinking culture within the military, especially in the Marine Corps, has resulted in negative consequences, including risky behaviour, missed workdays, and serious personal problems.
From 1980 to 2022, there were 60,770 recorded deaths in the US military, of which 28,995 were due to accidents, including vehicle crashes and alcohol or substance abuse. While accidental deaths have decreased by 83% since 1980, they still account for a significant number of fatalities within the military. The high prevalence of alcohol misuse and its contribution to accidental deaths highlight the need for interventions and support to address this issue within the military.
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Frequently asked questions
It is difficult to provide an exact figure for deaths caused by alcohol, but we do have statistics for US military deaths. Between 1775 and 1991, there were a total of 1.19 million US military fatalities. From 1980 to 2022, there were 60,770 recorded deaths. While alcohol misuse and binge drinking are prevalent in the military, it is safe to assume that more people have died in the military than directly from alcohol.
The US military has recorded deaths in various categories, including accidents, illnesses, homicides, and self-inflicted wounds. Since 1980, accidental deaths have decreased by 83%, while deaths by suicide have increased by 44.1%, becoming the most common cause of death in the military.
Alcohol misuse and binge drinking are prevalent in the US military. A survey found that troops binge drink on about a third of the days they consume alcohol, with members of the military drinking alcohol 130 days out of the year on average. This has cost the Defense Department an estimated $1.1 billion per year. Alcohol use is also linked to PTSD, with deployed soldiers exhibiting higher levels of drinking and PTSD symptoms.
The American Civil War holds the record for the highest casualty rate, with 498,332 deaths and 281,881 wounded. World War II resulted in 1,076,245 dead and wounded Americans, accounting for 41% of US military casualties between 1775 and 1991.
Alcohol misuse is linked to an increased risk of anxiety, affective and sleep disorders, and substance use disorder. It is also associated with PTSD, with soldiers reporting high alcohol use more likely to consider or attempt suicide. Socializing plays a role in military drinking, with pressure to drink heavily coming from peers.
