A characterization of illicit drug use among a national sample of veterans Restricted; Files Only
Averill, Hannah (Spring 2024)
Abstract
ABSTRACT
Introduction:
Among the ~19 million living veterans in the United States, there is an excessive burden of physical and mental morbidity, attributed to various factors including combat-related stress and illicit drug use.1-3 Limited research exists on predictors of illicit drug use among veterans, with higher rates observed among young veterans and specific demographic groups.4 Combat exposure, unique to veterans, has been independently linked to both mental illness and illicit drug use. 5,6,7 Although combat exposure is a known predictor of mental health and substance use, existing research overlooks the role of mental illness in contributing to combat’s influence on illicit drug use, limiting our understanding of its independent impact.
Methods:
We analyzed data from the National Survey on Drug Use and Health from the years 2020-2021, a cross-sectional national survey of the noninstitutionalized population aged 12 or older in the United States. Data analysis included participants who were self-identified as veterans. Prevalence of past year illicit drug use was estimated by calculating weighted and unweighted percentages. Correlates of past-year illicit drug use were identified by conducting feature selection with randomForest. Mediation analysis was conducted to look at the relationship between combat exposure, mental illness, and illicit drug use.
Results:
The prevalence of past year illicit drug use was 19.6% unweighted and 17.8% weighted in this sample. One-fifth of the sample was found to have some severity of mental illness (20.6%, n=876 unweighted; 14.6% weighted). More than half of the veterans in this sample reported having received combat pay during their enlistment (58.6%, n=1968 unweighted; 60.6% weighted).
Mental illness (OR: 3.20, [2.61, 3.91]), being enrolled in Medicaid/CHIP (OR: 1.69, [1.20, 2.35]), and identifying as a sexual minority (OR: 2.30, [1.63, 3.23]) were associated with higher odds of past-year-illicit drug use. Compared to veterans who identified as White, African American/ Black veterans (OR: 1.83, [1.38, 2.42]), Hispanic veterans (OR: 1.77, [1.27, 2.43]), and veterans who identified as another race (OR: [1.47, [1.20, 2.05]) all had increased odds of past-year illicit drug use. Being on active duty from 1990 to 2001 was associated with decreased odds of past-year illicit drug use compared to those not enlisted during this period.
There was no evidence of the relationship between combat exposure and illicit drug use in this sample. However, there was an indirect relationship in that combat exposure predicted mental illness which predicted illicit drug use.
Conclusion:
This thesis sheds light on the prevalence and predictors of illicit drug use among veterans, offering valuable insights for both research and practical applications. While combat exposure did not directly correlate with drug use, its influence through mental health implications is noteworthy. Future research should explore social positions among veterans that are at increased risk resulting from drug use. The relationship between combat exposure, mental illness, and illicit drug use should also be explored further using a more sensitive measure of combat.
Table of Contents
Table of Contents
ABSTRACT
CHAPTER 1: INTRODUCTION
Background
Problem Statement
Purpose Statement
Research Question
CHAPTER 2: LITERATURE REVIEW
Illicit Drug Use Among Veterans
Exposure to active combat may impact health decisions and outcomes
Theoretical Framework
Summary
CHAPTER 3: METHODS
Description of NSDUH Dataset:
Study Sample
Data Collection
Measures
Primary Predictors
Covariates
Statistical Analysis
Multivariable Analysis
Random Forest Overview:
Feature selection:
Mediation Analysis
CHAPTER 4: RESULTS
Results
Sample Description
Bivariate Analysis
Multivariate Analysis
Mediated Analysis
CHAPTER 5: DISCUSSION, PUBLIC HEALTH IMPLICATIONS, AND CONCLUSIONS
Prevalence of Past Year Illicit Drug Use
Predictors of Past Year Illicit Drug Use
Combat Exposure and Illicit Drug Use
Social Positions and the Risk Resulting from Drug Use
Racial Minorities and Risk from Drug Use:
Veterans who identify as LGBTQ+ and drug use:
Limitations
Strengths
Future directions in research
Implications for intervention, services, or policy
Conclusions
REFERENCES
About this Master's Thesis
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File download under embargo until 20 May 2026 | 2024-04-24 19:12:49 -0400 | File download under embargo until 20 May 2026 |
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