The Interplay of Combat History, Inpatient Treatment for Substance Use Disorders, and Support Group Participation

Background/Purpose: Substance abuse is recognized as a significant public health crisis, particularly among veterans with combat experience. Exposure to traumatic events during military service significantly heightens the risk of developing mental health disorders such as PTSD and depression, which frequently occur alongside substance abuse. Veterans returning from combat deployments are especially at risk. Despite the high prevalence of mental health needs in this population, there is a low utilization of mental health services. The intricate relationship between trauma and substance use presents unique challenges for recovery, often necessitating individualized and comprehensive treatment strategies.

Inpatient rehabilitation programs provide a structured environment to address both addiction and the psychological distress that often underlies it. However, maintaining progress after discharge can be difficult, making continued support like peer-based groups (e.g., AA, NA) vital in sustaining recovery by offering ongoing encouragement and accountability. Still, the combined effects of combat exposure, inpatient treatment, and involvement in support groups on long-term recovery outcomes remain insufficiently explored

This study examines the moderating effect of social supports on the relationship between combat exposure and inpatient treatment for substance use, thus clarifying how these factors interact to influence recovery. Insights gained could guide more effective, individualized treatment approaches, reduce societal costs, and support veterans in their reintegration into civilian life. Understanding these dynamics is essential to improving care for this high-risk population.

Method: Data from the 2023 National Survey on Drug Use and Health (NSDUH) were used for analyses. The NSDUH is an annual survey of the civilian, noninstitutionalized population of the United States aged 12 years or older. It is the primary source of statistical information on the use and misuse of drugs and other substances among people in the population. Multivariate logistic regression with moderation was conducted using Haye’s Process macro to test the moderating relationship among study variables.

Result: Among the sample (n=56,705), 53.9% were female, 24% aged 18-25 years old, and 1.5% reported receiving inpatient treatment. The overall model was statistically significant (p < .001) and explained approximately 51% of the variance. Social support had a strong, positive effect on the outcome (p = .009), indicating higher odds of inpatient treatment for substance use among those receiving support. However, combat exposure (p = .717) was not a significant predictor, nor was the interaction term (p = .919), suggesting no moderation. Compared to Whites, being multiracial had over eight times higher odds of treatment use, and being Hispanic had nearly ten times higher odds of treatment use. Other covariates had no significant effects.

Conclusions and Implications: Findings suggest that social support significantly increases the odds of inpatient treatment for substance use regardless of combat status. This underscores the importance of community-based support systems, social networks, or formal programs that encourage or facilitate help-seeking while reducing barriers to care, especially post-deployment, for socially isolated veterans. The racial disparities in multiracial and Hispanic populations may reflect differences in need, access, cultural factors, or systemic barriers, and warrant further investigation.