Prevalence, risk and protective factors of alcohol use disorder during the COVID-19 pandemic in US military veterans

Background: There have been reports of increased alcohol consumption during the COVID-19 pandemic in the general population. However, little is known about the impact of the pandemic on the prevalence of alcohol use disorder (AUD), especially in high-risk samples such as U.S. military veterans. Methods: Data were analyzed from the 2019-2020 National Health and Resilience in Veterans Study, which surveyed a nationally representative, prospective cohort of 3078 U.S. veterans. Pre-pandemic and 1-year peripandemic risk and protective factors associated with incident and chronic probable AUD were examined. Results: A total of 6.9 % (n = 183) of veterans were classified as chronic probable AUD, 3.2 % (n = 85) as remitted from AUD, and 2.7 % (n = 71) as incident probable AUD during the pandemic; the prevalence of probable AUD in the full sample remained stable -10.1 % pre-pandemic and 9.6 % peri-pandemic. Younger age, greater pre-pandemic alcohol use severity, and COVID-related stressors were associated with incident AUD during the pandemic, whereas higher pre-pandemic household income was associated with lower risk of this outcome. Younger age, combat experience, lifetime substance use disorder, greater drug use severity, lower dispositional optimism, and more COVID-related worries and social restriction stress were associated with higher risk of chronic AUD. Conclusions: Nearly 1-in-10 US veterans screened positive for AUD 1-year into the pandemic; however, the preand 1-year peri-pandemic prevalence of probable AUD remained stable. Veterans who are younger, have served in combat roles, endorse more COVID-related stressors, and have fewer socioeconomic resources may be at higher risk for AUD during the pandemic.

Automated summary

During the COVID-19 pandemic, approximately 10% of US veterans were screened positive for alcohol use disorder (AUD), with younger age, combat experience, higher COVID-related stressors, and lower socioeconomic resources being potential risk factors for developing AUD. The prevalence of probable AUD remained stable from pre-pandemic to peri-pandemic, highlighting the impact of the pandemic on AUD among high-risk samples such as military veterans.