Substance Use in Military Personnel: Associations with Combat Exposure, Moral Injury, Posttraumatic Stress Disorder and Pain
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| Title: | Substance Use in Military Personnel: Associations with Combat Exposure, Moral Injury, Posttraumatic Stress Disorder and Pain |
|---|---|
| Language: | English |
| Authors: | Michelle L. Kelley (ORCID |
| Source: | Journal of Drug Education. 2026 55(1):3-20. |
| Availability: | SAGE Publications. 2455 Teller Road, Thousand Oaks, CA 91320. Tel: 800-818-7243; Tel: 805-499-9774; Fax: 800-583-2665; e-mail: journals@sagepub.com; Web site: https://sagepub.com |
| Peer Reviewed: | Y |
| Page Count: | 18 |
| Publication Date: | 2026 |
| Document Type: | Journal Articles Reports - Research |
| Descriptors: | Substance Abuse, Posttraumatic Stress Disorder, Pain, Military Personnel, Psychological Patterns |
| DOI: | 10.1177/00472379251394435 |
| ISSN: | 0047-2379 1541-4159 |
| Abstract: | Background: Prior research suggests that military personnel endorse higher rates of prescription drug misuse, cannabis, and heavy alcohol use than civilians. Factors related to substance use may differ for military personnel compared to civilians. In the present study, we examined whether combat exposure, moral injury, posttraumatic stress disorder (PTSD), and pain were associated with military personnel's self-reports of misuse of prescription opiates, prescription sedatives, both prescription opiates and sedatives, cannabis use, and hazardous alcohol consumption. Method: Participants were a community sample of 238 U.S. military personnel who had deployed one or more times (71.0% males; M =33.3 years; SD =3.2). Results: In our sample, rates of past week misuse were as follows: 21.0% prescription opiates, 25.6% prescription sedatives, 16.4% both prescription opiates and sedative medications. With respect to cannabis use and alcohol consumption, 14.7% reported past-week cannabis use and 46.2% participants reported hazardous alcohol consumption above suggested clinical cut-offs. In multivariable multinomial logistic regression analyses, combat exposure and moral injury were uniquely associated with a greater likelihood of misusing prescription opiates, sedatives, and both opiates and sedatives versus no misuse. Higher PTSD symptoms scores were uniquely associated with past week cannabis use versus no use. Further, greater combat exposure was uniquely associated with a greater likelihood of engaging in hazardous alcohol use. Conclusions: These results suggest that distinct psychosocial factors may differentially impact substance use among military personnel. Findings indicate the importance of assessing combat exposure, moral injury, PTSD, and pain to better understand substance use and treatment of military personnel. |
| Abstractor: | As Provided |
| Entry Date: | 2026 |
| Accession Number: | EJ1496388 |
| Database: | ERIC |
| FullText | Text: Availability: 0 |
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| Header | DbId: eric DbLabel: ERIC An: EJ1496388 AccessLevel: 3 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
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| Items | – Name: Title Label: Title Group: Ti Data: Substance Use in Military Personnel: Associations with Combat Exposure, Moral Injury, Posttraumatic Stress Disorder and Pain – Name: Language Label: Language Group: Lang Data: English – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Michelle+L%2E+Kelley%22">Michelle L. Kelley</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0003-3643-0419">0000-0003-3643-0419</externalLink>)<br /><searchLink fieldCode="AR" term="%22Jeffrey+M%2E+Gabelmann%22">Jeffrey M. Gabelmann</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-3376-8134">0000-0002-3376-8134</externalLink>)<br /><searchLink fieldCode="AR" term="%22Megan+Strowger%22">Megan Strowger</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-8476-5099">0000-0002-8476-5099</externalLink>)<br /><searchLink fieldCode="AR" term="%22John+Hearton%22">John Hearton</searchLink> (ORCID <externalLink term="https://orcid.org/0009-0002-8918-9550">0009-0002-8918-9550</externalLink>)<br /><searchLink fieldCode="AR" term="%22Folly+Folivi%22">Folly Folivi</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0003-1419-980X">0000-0003-1419-980X</externalLink>)<br /><searchLink fieldCode="AR" term="%22Adrian+J%2E+Bravo%22">Adrian J. Bravo</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-4630-6449">0000-0002-4630-6449</externalLink>)<br /><searchLink fieldCode="AR" term="%22Jinjoo+Noh%22">Jinjoo Noh</searchLink><br /><searchLink fieldCode="AR" term="%22Kristin+Kuskye%22">Kristin Kuskye</searchLink><br /><searchLink fieldCode="AR" term="%22William+Haber%22">William Haber</searchLink><br /><searchLink fieldCode="AR" term="%22Adam+P%2E+McGuire%22">Adam P. McGuire</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-4512-1207">0000-0002-4512-1207</externalLink>) – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="SO" term="%22Journal+of+Drug+Education%22"><i>Journal of Drug Education</i></searchLink>. 2026 55(1):3-20. – Name: Avail Label: Availability Group: Avail Data: SAGE Publications. 2455 Teller Road, Thousand Oaks, CA 91320. Tel: 800-818-7243; Tel: 805-499-9774; Fax: 800-583-2665; e-mail: journals@sagepub.com; Web site: https://sagepub.com – Name: PeerReviewed Label: Peer Reviewed Group: SrcInfo Data: Y – Name: Pages Label: Page Count Group: Src Data: 18 – Name: DatePubCY Label: Publication Date Group: Date Data: 2026 – Name: TypeDocument Label: Document Type Group: TypDoc Data: Journal Articles<br />Reports - Research – Name: Subject Label: Descriptors Group: Su Data: <searchLink fieldCode="DE" term="%22Substance+Abuse%22">Substance Abuse</searchLink><br /><searchLink fieldCode="DE" term="%22Posttraumatic+Stress+Disorder%22">Posttraumatic Stress Disorder</searchLink><br /><searchLink fieldCode="DE" term="%22Pain%22">Pain</searchLink><br /><searchLink fieldCode="DE" term="%22Military+Personnel%22">Military Personnel</searchLink><br /><searchLink fieldCode="DE" term="%22Psychological+Patterns%22">Psychological Patterns</searchLink> – Name: DOI Label: DOI Group: ID Data: 10.1177/00472379251394435 – Name: ISSN Label: ISSN Group: ISSN Data: 0047-2379<br />1541-4159 – Name: Abstract Label: Abstract Group: Ab Data: Background: Prior research suggests that military personnel endorse higher rates of prescription drug misuse, cannabis, and heavy alcohol use than civilians. Factors related to substance use may differ for military personnel compared to civilians. In the present study, we examined whether combat exposure, moral injury, posttraumatic stress disorder (PTSD), and pain were associated with military personnel's self-reports of misuse of prescription opiates, prescription sedatives, both prescription opiates and sedatives, cannabis use, and hazardous alcohol consumption. Method: Participants were a community sample of 238 U.S. military personnel who had deployed one or more times (71.0% males; M =33.3 years; SD =3.2). Results: In our sample, rates of past week misuse were as follows: 21.0% prescription opiates, 25.6% prescription sedatives, 16.4% both prescription opiates and sedative medications. With respect to cannabis use and alcohol consumption, 14.7% reported past-week cannabis use and 46.2% participants reported hazardous alcohol consumption above suggested clinical cut-offs. In multivariable multinomial logistic regression analyses, combat exposure and moral injury were uniquely associated with a greater likelihood of misusing prescription opiates, sedatives, and both opiates and sedatives versus no misuse. Higher PTSD symptoms scores were uniquely associated with past week cannabis use versus no use. Further, greater combat exposure was uniquely associated with a greater likelihood of engaging in hazardous alcohol use. Conclusions: These results suggest that distinct psychosocial factors may differentially impact substance use among military personnel. Findings indicate the importance of assessing combat exposure, moral injury, PTSD, and pain to better understand substance use and treatment of military personnel. – Name: AbstractInfo Label: Abstractor Group: Ab Data: As Provided – Name: DateEntry Label: Entry Date Group: Date Data: 2026 – Name: AN Label: Accession Number Group: ID Data: EJ1496388 |
| PLink | https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=eric&AN=EJ1496388 |
| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1177/00472379251394435 Languages: – Text: English PhysicalDescription: Pagination: PageCount: 18 StartPage: 3 Subjects: – SubjectFull: Substance Abuse Type: general – SubjectFull: Posttraumatic Stress Disorder Type: general – SubjectFull: Pain Type: general – SubjectFull: Military Personnel Type: general – SubjectFull: Psychological Patterns Type: general Titles: – TitleFull: Substance Use in Military Personnel: Associations with Combat Exposure, Moral Injury, Posttraumatic Stress Disorder and Pain Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Michelle L. Kelley – PersonEntity: Name: NameFull: Jeffrey M. Gabelmann – PersonEntity: Name: NameFull: Megan Strowger – PersonEntity: Name: NameFull: John Hearton – PersonEntity: Name: NameFull: Folly Folivi – PersonEntity: Name: NameFull: Adrian J. Bravo – PersonEntity: Name: NameFull: Jinjoo Noh – PersonEntity: Name: NameFull: Kristin Kuskye – PersonEntity: Name: NameFull: William Haber – PersonEntity: Name: NameFull: Adam P. McGuire IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 03 Type: published Y: 2026 Identifiers: – Type: issn-print Value: 0047-2379 – Type: issn-electronic Value: 1541-4159 Numbering: – Type: volume Value: 55 – Type: issue Value: 1 Titles: – TitleFull: Journal of Drug Education Type: main |
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