1- Intro to alcohol use and mental health
2- Alcohol use in veterans with disabilities
3- Previous literature
4- Our project
The Centers for Disease Control and Prevention (CDC) reported that between 2011 and 2015, excessive alcohol use led to approximately 95,000 deaths costing the United States $249 billion between loss of workplace productivity, healthcare costs, and legal costs (CDC, 2021). Excessive alcohol consumption poses both long-term and short-term risks. Short-term or immediate dangers of excessive alcohol consumption include injuries from auto accidents, falls, and drowning as well as alcohol poisoning and becoming a victim of violence or homicide. Long-term risks include developing chronic diseases such as high blood pressure, heart disease, memory loss, and mental health issues to include depression and anxiety (CDC, 2021). The CDC defines Excessive drinking as binge drinking, heavy drinking, and any drinking by pregnant women or people younger than age 21. Binge drinking is defined as consuming 4 or more drinks for a woman or 5 or more drinks for a man on an occasion during the past 30 days (CDC, 2021).
To better understand the issue of alcohol use in veterans with disabilities as it relates to mental health, we first decided to briefly observe alcohol related challenges faced by each group (veterans and people with disabilities) independently. This is to provide us with some context into the background of both populations while simultaneously providing insight to the uniqueness of the challenges faced by veterans and people with disabilities.
The American with Disabilities ACT (ADA) defines a person with a disability as a person who has a physical or mental impairment which substantially limits one or more major life activities, a person who has a history or record of such an impairment, or a person who is perceived by others as having such an impairment (ADA.gov, 2020).
People with disabilities
The CDC highlights that attitude barriers such as stigma, prejudice, and stereotyping along with program barriers (like Inconvenient scheduling, Lack of accessible equipment, lack of well-informed providers) make functional living exceptionally difficult for people with disabilities (CDC, 2020). These issues, compounded with social barriers such as ack of employment, communication barriers, and policy barriers add to the continuing difficulties faced by people living with disabilities (CDC, 2020).
Individuals with disabilities are affected by higher rates of alcohol abuse and addiction for several reasons (Smith, 2019). Stress factors associated with limited accessibility, lack of alternative activities, and physical pain related to a disability (or disabilities) are some of the many factors leading to the higher rates of alcohol use among people with disabilities (Smith, 2019). It is also mentioned that a high number of people with disabilities are less likely to seek out and obtain effective treatment due to financial issues and social barriers (Smith, 2019).
Excessive alcohol consumption has become a major concern across military branches in the United States. Challenges related to the stress and unpredictability of military life such as deployments, being away from home, and increased risks of injury create situations where alcohol is sometimes used as a coping mechanism (Galbisek, 2021). In addition, since many on active duty view drinking and alcohol consumption as part of military culture, service members, specially males, are more likely to abuse (NIDA, 2019). Furthermore, increased combat exposure involving violence and trauma experienced by those who serve has led to an increased risk of problematic drinking (NIDA, 2019).
According to the 2015 Health Related Behaviors Survey (HRBS), 30% of service members were binge drinkers and 1 in 3 service members met the criteria for alcohol use disorder or hazardous drinking (Meadows et al., 2015). The HRBS study also highlighted that binge, heavy, and hazardous drinking were most frequent in the Marine Corps, where it occurred among approximately half of service members (Meadows et al., 2015). Another study found that veterans overall were more likely to use alcohol (56.6% vs 50.8% in a 1-month period) when compared to non-veterans (Teeters et al, 2017). The study also found that veterans reported heavy use of alcohol (7.5% vs 6.5% in a 1-month period) than non-veterans (Teeters et al, 2017).
Environmental stressors including deployment, combat exposure, and military-civilian reintegration challenges, have been linked to increased risk of alcohol and substance use disorders among military personnel and veterans (NIDA, 2019). Approximately 37% and 50 % of Afghanistan and Iraq War veterans have been diagnosed with mental health disorders such as Post traumatic Stress Syndrome (PTSD), depression, and sleep disorders (SAMHSA, 2012).
Alcohol and substance use disorders are prevalent among those with psychiatric problems, have vocational impairments, and those with increased the rates of suicidal ideation and attempts (Teeters et al, 2017). Since 2003, Approximately 30% of suicides and 45% of suicide attempts among servicemembers involved alcohol or drug use, and 20% of high-risk behavior deaths were attributed to alcohol or drug overdose (NIDA, 2019).
Previous literature shows the circumstances of people with disabilities and their elevated risk of alcohol abuse. In addition, our literature review shows the increased number of barriers faced by people with disabilities when seeking appropriate treatment for alcohol disorders. In conjunction, we found several studies highlighting the issues of excessive alcohol use in veterans and the unique circumstances they face with mental health issues.
Based on the literature reviews, we understand the issues faced by veterans and people with disabilities. Our project aims to examine whether there is an association between alcohol use and mental health outcomes in veterans with disabilities. In addition, this project will also allow us to further examine other factors that could play a role in veterans mental health.