Maladjustment after leaving the military may contribute to poor health outcomes, including increased risk for substance use and dependence. The authors examined differences in substance use and dependence on the basis of military involvement in a large nationally representative sample. Data are from a subset of the 2010-2014 waves of the National Survey on Drug Use and Health (n = 5,608). The sample included men (81.9%) and women (18.1%) aged 20-49 years who had either separated/retired from the military (n = 4,862) or were a current reserve service member (n = 746). The sample was 70.8% Non-Hispanic White with a median family income between $50,000 and $74,999. Those who were separated/retired from the military had a higher odds of past month smoking (adjusted odds ratio [AOR] = 1.73, 95% confidence interval [CI]: 1.27, 2.36; p = 0.001), nonmedical use of prescription painkillers (AOR = 4.07, 95% CI: 1.88, 8.83; p < 0.001), illicit drug use (AOR = 2.75, 95% CI: 1.79, 4.24; p < 0.001), alcohol dependence (AOR = 2.17, 95% CI: 1.20, 3.93; p = 0.011), nicotine dependence (AOR = 2.03, 95% CI: 1.25, 3.28; p = 0.004), and illicit drug dependence (AOR = 5.89; 95% CI: 2.19, 15.85; p = 0.001), compared to current reserve service members, controlling for sex, age, race, and income. Service members are leaving the military at an increasing rate and substance use may increase after separation. Across a range of substances, those who are separated/retired from the military have a higher likelihood of substance use/dependence than current reserve service members. Care models that assist in the transition from discharge to civilian life should be considered.
Keywords: Alcohol; illicit drugs; military; prescription painkillers; tobacco.