Women, alcohol, and the military: cultural changes and reductions in later alcohol problems among female veterans

Women working in traditionally male-dominated environments are at higher risk for alcohol use disorders (AUDs). The male-dominated U.S. military has additional risk factors associated with problem drinking, including isolation from family and exposure to life-threatening stressors. In the 1980s, the military conformed to all U.S. states' 21-year minimum legal drinking age (MLDA), and established prevention and intervention policies for abusive drinking.

Using a serial cross-sectional design, we explored trends in annual alcohol treatment rates among female veterans versus civilians. From the Department of Health's Treatment Episode Data Set, we extracted AUD admissions from years 1992-2003 for female veterans and civilians in four age categories. Using age-specific population figures, we calculated annual AUD treatment rates and odds ratios for female veterans versus civilians. We used time-series analyses to examine trends in annual AUD treatment for female veterans and civilians across the years examined.

In 1992, odds ratios of alcohol treatment episodes for female veterans compared to civilians ranged from 1.9 for 25-29-year-olds to 4.2 for 40-44-year-olds (all p < 0.01). Female veterans' annual alcohol treatment rates dropped substantially from 1992 to 2003, while rates for female civilians ages 25-34 dropped marginally and those for civilians ages 35-44 increased. Time-series analysis showed a statistically significant drop in rates for veterans from 1992 to 2003 and a significant difference between veterans' and civilians' rates, but demonstrated that female civilian annual treatment rates remained static from 1992 to 2003.

Prior to the military's efforts to reduce underage and problem drinking, female veterans' alcohol treatment rates exceeded those of same-age civilians. However, with increasing exposure to an environment that discourages abusive drinking, female veterans' annual rates of alcohol treatment fell to below those for same-age civilians.