Stress Under Fire: Unpacking the Differential Effects of Combat Strain on Recent Substance Use Among Soldiers

The U.S. military is a unique and understudied population. An inherent occupational stress of the military, combat deployment, exposes soldiers to perilous conditions. The physical demands and role expectations of military service, in conjunction with the psychological harms of combat experiences, can exact a negative toll on servicemember well-being. Faced with noxious circumstances and desires for physical/emotional relief, soldiers may be more likely to cope by using drugs. While existing literature has supported the association between drug use and combat exposure, much is still unknown about the impact of specific combat experiences on soldiers’ substance use. The current study uses the U.S. Army’s Study to Assess Risk and Resilience in Servicemembers (STARRS) data to explore the impact of 15 deployment-related traumas on soldiers’ recent use of alcohol, tobacco, binge drinking, cannabis, other drugs, and prescription pills. The results indicate that certain combat traumas are more widely experienced during Army careers and confirm the importance of combat traumas’ association with substance use. Additionally, the current study’s findings highlight the differential toll soldiers may face when witnessing or being exposed to certain circumstances of war/combat. These findings can better direct treatment of substance use among servicemembers and potentially refine trauma-informed care.