The association of engagement in substance use treatment with negative separation from the military among soldiers with post-deployment alcohol use disorder

•Among soldiers with post-deployment AUD, 40 % initiated and 24 % engaged in treatment.•35 % of soldiers with AUD had a negative separation from the military.•Engagement in SUD treatment was associated with increased negative separation.•To improve retention, SUD treatment should be offered earlier...

Full description

Saved in:
Bibliographic Details
Published in:Drug and alcohol dependence 2021-04, Vol.221, p.108647-108647, Article 108647
Main Authors: Gray, Joshua C., Larson, Mary Jo, Moresco, Natalie, Ritter, Grant A., Dufour, Steven, Milliken, Charles S., Adams, Rachel Sayko
Format: Article
Language:English
Subjects:
Adolescent
Adult
Afghan Campaign 2001
Alcohol related disorders
Alcohol use
Alcohol use disorder
Alcoholism
Alcoholism - diagnosis
Alcoholism - psychology
Alcoholism - therapy
Armed forces
Careers
Criteria
Deployment
Diagnosis
Disability
Drug use
Engagement
Female
Follow-Up Studies
Health care
Humans
Iraq War, 2003-2011
Male
Medical diagnosis
Medical treatment
Military
Military deployment
Military health system
Military personnel
Military Personnel - psychology
Misconduct
Patient Participation - methods
Patient Participation - psychology
Retention
Separation
Soldiers
Substance abuse
Substance use
Surveys and Questionnaires
Treatment
Treatment Outcome
Young Adult
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:•Among soldiers with post-deployment AUD, 40 % initiated and 24 % engaged in treatment.•35 % of soldiers with AUD had a negative separation from the military.•Engagement in SUD treatment was associated with increased negative separation.•To improve retention, SUD treatment should be offered earlier to soldiers with AUD. Alcohol use disorder (AUD) reduces the health of soldiers and the readiness of the Armed Forces. It remains unknown if engagement in substance use treatment in the Military Health System improves retention in the military. The sample consisted of active duty soldiers returning from an Afghanistan/Iraq deployment in fiscal years 2008–2010 who received an AUD diagnosis within 150 days of completing a post-deployment health re-assessment survey (n = 4,726). A Heckman probit procedure was used to examine predictors of substance use treatment initiation and engagement in accordance with Healthcare Effectiveness Data and Information Set (HEDIS) criteria. Cox proportional hazard modeling was used to examine the association between treatment engagement and retention, defined as a negative separation for a non-routine cause (e.g., separation due to misconduct, poor performance, disability) from the military in the two years following the index AUD diagnosis. 40 % of soldiers meeting HEDIS AUD criteria initiated and 24 % engaged in substance use treatment. Among soldiers diagnosed with AUD, meeting criteria for treatment engagement was associated with a significantly higher hazard of having a negative separation compared to soldiers who did not engage in treatment. Rates of initiation and engagement in substance use treatment for post-deployment AUD were relatively low. Soldiers with AUD who engaged in substance use treatment were more likely to have a negative separation from the military than soldiers with AUD who did not engage. Our findings imply that in the study cohort, treatment did not mitigate negative career consequences of AUD.
ISSN:0376-8716
1879-0046
DOI:10.1016/j.drugalcdep.2021.108647