Prevalence of Lifetime and Recent Substance Use Among Military and Non-Military Connected Youth

Purpose: The wars in Iraq and Afghanistan are adversely affecting the psychological and behavioral outcomes of children in military families. Of the studies that have explored the relationship between deployment and the behavioral health of adolescents, most have focused on assessing mental health and wellbeing. The stressors associated with being a military-connected youth, however, can predispose youth to internalizing and externalizing behaviors, including substance use. While substance use in adolescence predisposes youth to numerous negative academic, health and/or social outcomes, few studies on military-connected adolescents have focused specifically on substance use as an outcome. To our knowledge, no large-scale normative studies of adolescent substance use have been published that focus exclusively on military and non-military connected youth. The purpose of the present study is to examine the prevalence and correlates of lifetime and current substance use by military connectedness.

Methods: Data for this study were obtained from the California Healthy Kids Survey (N=14,149). Current military affiliation (no one serves, parent serves, sibling serves), number of deployments (none, one, two or more), gender, race/ethnicity, and grade were included as covariates while substance use served as the outcome of interest. Both lifetime and recent (within the last 30 days) use were dichotomized and subjected to multivariate analysis.

Results: The bivariate results indicate military-connected youth with a sibling serving in the military had higher rates of lifetime use of alcohol (45.8%), marijuana (30.1%), and prescription drugs (21.7%) compared to those with a parent serving in the military (37.5%, 23.6%, and 17.2%, respectively) and non-military connected (41.3%, 26.7%, and 17.7%, respectively).  Additionally, increasing number of family member deployments in the past 10 years was associated with increased likelihood of use in both the lifetime and recent substance use models. For lifetime use, it contributed at least a 14% increase in likelihood of drug use (prescription drugs; OR = 1.14, CI = 1.06-1.24) to a maximum of a 25% increase (other drug; OR = 1.25, CI=1.15-1.35). For recent use, it contributed at least an 18% increase in likelihood of drug use (marijuana; OR = 1.18, CI=1.08-1.28) to a maximum of a 34% increase (other drugs; OR=1.34, CI=1.20-1.50).  

Conclusion: The results show that overall, military-connected youth have a higher prevalence of substance use. The prevalence of lifetime use of alcohol, tobacco, marijuana, other drugs, and prescription drugs was consistently highest among those with a sibling in the military. These results may reflect increased stress of having a deployed sibling, role-modeling of substance use behaviors by military-connected siblings, or increased access to alcohol and other substances either directly, or inadvertently because of military-connected siblings’ use. In addition, increasing number of family member deployments was associated with all substance use categories except for lifetime smoking. These findings indicate that it may be the experiences associated with prolonged war that increases behavioral health stresses on military-connected youth and their families. The combined results are critical because they identify a potential target for clinicians and school service personnel.