Aims
To analyze data from a large, contemporary, nationally representative sample of US veterans to evaluate: (1) the prevalence of life‐time alcohol use disorder (AUD) and past‐year AUD; (2) common psychiatric comorbidities associated with life‐time AUD; and (3) correlates of life‐time and past‐year probable AUD.
Design
Data were analyzed from the National Health and Resilience in Veterans Study (NHRVS), a web‐based survey of a random probability sample of a contemporary, nationally representative sample of US military veterans.
Setting
United States.
Participants
Nationally representative sample of 3157 US veterans aged 21 years and older.
Measurements
Life‐time alcohol abuse and dependence were assessed according to DSM‐IV diagnostic criteria using the Mini International Neuropsychiatric Interview, and combined into a single variable: AUD. Past‐year probable AUD was assessed using the Alcohol Use Disorders Identification Test‐Consumption (AUDIT‐C). Correlates of AUD, including psychiatric comorbidities, suicidality and demographic characteristics, were also assessed.
Findings
The prevalence of life‐time AUD and past‐year probable AUD was 42.2% [95% confidence interval (CI) = 40.5–43.9%)] and 14.8% (95% CI = 13.6–16.0%), respectively. Compared with veterans without AUD, those with life‐time AUD had substantially elevated rates of life‐time and current mood and anxiety disorders [odds ratios (ORs) = 2.6‐4.1], drug use disorder (OR = 10.7), life‐time suicide attempt (OR = 4.1) and current suicidal ideation (OR = 2.1). Younger age, male sex, lower education, lower annual household income and greater number of life‐time traumatic events were associated independently with life‐time AUD. Younger age, male sex, unpartnered marital status and a life‐time diagnosis of major depressive disorder were associated independently with past‐year probable AUD.
Conclusions
More than 40% of US military veterans have a life‐time history of alcohol use disorder. Veterans with a life‐time history of alcohol use disorder have substantial comorbid psychiatric burden, including elevated rates of suicidal ideation and attempts. Certain socio‐demographic (e.g. younger age, male sex, lower education) and clinical (e.g. trauma burden, history of depression) characteristics are associated with increased risk of AUD.