Risk factors for relapse to problem drinking among current and former US military personnel: A prospective study of the Millennium Cohort

Background Military service members may be prone to relapse to problem drinking after remission, given a culture of alcohol use as a coping mechanism for stressful or traumatic events associated with military duties or exposures. However, the prevalence and correlates of relapse are unknown. We sought to identify socio-demographic, military, behavioral, and health characteristics associated with relapse among current and former military members with remittent problem drinking. Methods Participants in the longitudinal Millennium Cohort Study who reported problem drinking at baseline (2001–2003) and were remittent at first follow-up (2004–2006) were included ( n = 6909). Logistic regression models identified demographic, military service, behavioral, and health characteristics that predicted relapse (report of ≥1 past-year alcohol-related problem on the validated Patient Health Questionnaire) at the second follow-up (2007–2008). Results Sixteen percent of those with remittent problem drinking relapsed. Reserve/National Guard members compared with active-duty members (odds ratio [OR] = 1.71, 95% confidence interval [CI]: 1.45–2.01), members separated from the military during follow-up (OR = 1.46, 95% CI: 1.16–1.83), and deployers who reported combat exposure (OR = 1.32, 95% CI: 1.07–1.62, relative to non-deployers) were significantly more likely to relapse. Those with multiple deployments were significantly less likely to relapse (OR = 0.73, 95% CI: 0.58–0.92). Behavioral factors and mental health conditions also predicted relapse. Conclusion Relapse was common and associated with military and non-military factors. Targeted intervention to prevent relapse may be indicated for military personnel in particular subgroups, such as Reservists, veterans, and those who deploy with combat exposure.