Substance use disorders, traumatic brain injury (TBI), and posttraumatic stress disorder (PTSD) are common in military and civilian populations, and often occur together. A substantial proportion of military personnel misuse alcohol. A study of the UK armed forces1 reported that 67% of men and 49% of women had scores of 8 or higher, defined as hazardous drinking, on the Alcohol Use Disorders Identification Test, compared with 38% of men and 16% of women in the general population. In a population-based cohort of US soldiers returning from service in Iraq,2 11.8% reported alcohol misuse on a 2-item alcohol screening test. Recent military service is also associated with TBI, PTSD, and depression. In a 2008 survey,3 19.5% of US armed services personnel returning from service in Afghanistan and Iraq reported experiencing a possible TBI, 18.5% met criteria for PTSD or depression, and 7.3% both reported a possible TBI and met criteria for PTSD or depression. By comparison, the lifetime prevalence of PTSD estimated for the general US population is 7.8%, and of those 51.9% of men and 27.9% of women have a lifetime prevalence of both PTSD and alcohol abuse or dependence.4
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