Excessive alcohol use is a leading lifestyle-related cause of death, attributable to approximately 88,000 deaths per year in the United States.[ Reference 1 ] The financial costs of excessive drinking are a significant impact to the American economy, estimated to cost the U.S. $249 billion in 2010. Most of that figure ($191 billion) was accounted for by binge drinking (five or more drinks per occasion for men; four or more drinks per occasion for women).[ Reference 2 ]
According to Key Substance Use and Mental Health Indicators in the United States: Results from the 2017 National Survey on Drug Use and Health, slightly more than half of Americans age 12 or older reported being current drinkers of alcohol with almost 37 percent of 18 to 25 year olds binge drinking in the 30 days prior to the survey.
In the military, alcohol misuse can impact mission readiness and productivity, in addition to service members’ physical and mental health. The Department of Defense (DoD) regularly tracks alcohol use in the military. Findings from the 2015 Department of Defense Health Related Behaviors Su rvey of Active Duty Military Personnel indicated that 30 percent of service members were engaged in binge drinking, 5.4 percent drank heavily (bing drinking on five or more days in the previous month), and 35 percent met criteria indicative of hazardous drinking or possible alcohol disorder. The percentage of all three behaviors was highest in the Marine Corps, and the Air Force had the lowest percentages of these drinking patterns.
Alcohol misuse can lead to:[ Reference 3 ]
- Medical issues with organs including the liver, pancreas, heart or brain, increased risk for certain cancers (mouth, esophagus, throat, liver, or breast)
- A weakened immune system
- Fetal alcohol exposure
- Increased risk for suicide
- Increased risk for other injuries
- Consuming larger amounts of alcohol over a longer period than intended
- Persistent desire or unsuccessful efforts to cut down or control alcohol use
- Significant time spent in activities necessary to obtain alcohol, use alcohol, or recover from its effects
- Cravings, or a strong desire to consume alcohol
- Recurrent use resulting in failures to fulfill obligations at work, school, or home
- Continued use despite having social or interpersonal problems caused by the effects of alcohol
- Important social, occupational, or recreational activities are given up because of alcohol use
- Recurrent use in situations in which it is physically hazardous
- Continued use despite knowledge of having a persistent physical or psychological problems likely to be caused or exacerbated by alcohol
- Tolerance to alcohol
- Withdrawal symptoms
Risk factors for alcohol misuse include physiological and personal factors. There are also military specific factors associated with increased risk or prevalence of alcohol misuse.
Physiological factors and personality Traits:
- Male gender[ Reference 4 ]
- Relative with alcohol use disorder; increased risk with more than one relative affected and the closer the genetic relationship[ Reference 5 ]
- Age 18-29 years old[ Reference 6 ]
- High levels of impulsivity, anger and risk taking and lower positive affect[ Reference 7 ]
- White and Native American ethnicity, as compared with ethnicities[ Reference 8 ]
- Within the military, being male in the Marine Corps and Army, white or Hispanic, having less than a college degree, being single or married but unaccompanied by their spouse, and in any pay grade except senior officers (O4-O10)[ Reference 9 ]
- Current mental health diagnosis[ Reference 10 ]
Personal stressors:
- Transitions[ Reference 11 ]
- Interpersonal Violence[ Reference 12 ]
Military-identified stressors:[ Reference 13 ]
- Financial problems
- Family member health problems
- Deployment and/or distance from family and friends
- Changes in workload
- Transition from military to civilian
- Service-related injuries
- Military culture – ritualized drinking, easy access to alcohol (on base) at reduced price[ Reference 14 ]