Predictors of Change in Substance Abuse Status in Soldiers

BACKGROUND Military service is a stressful task that influences the life style of army personnel. Several factors can make soldiers less capable of coping with stressful events; so they may try to start drug abuse or increase in the amount or diversity of substance abuse. Understanding factors responsible for this misbehavior among soldiers is crucial for their commanders to modify these factors. OBJECTIVES This study aimed to determine the predictors of change in substance abuse status in soldiers. PATIENTS AND METHODS This cross-sectional research was conducted to evaluate the substance abuse status among Iranian soldiers in 2010. The target population was the soldiers who had spent at least 3 months of their military service. Cluster sampling was done from army service garrisons in 12 provinces in Iran. A total of 3960 soldiers were selected with different levels of education and age. Data gathering was done with demographic questionnaires, Texas Christian university (TCU) drug screen II and ASI questionnaire (fifth edition). Four types of dependent variables were defined: "improvement", "without change", "deterioration", and "severe deterioration". Backward ordinal regression analysis was done and P values, OR, and SE were calculated by SPSS19 software. RESULTS Totally, 6.7% of soldiers improved, 82% remained without change, 6.1% deteriorated, and 5.2% severely deteriorated with regard to their substance abuse. Modifiable predictors were distance from home lower than 200 km (OR =1.54), bad relationship with commanders (OR = 1.88), service place dissatisfaction (OR = 1.39), and always feeling lonely (OR = 1.83). Non-modifiable factors were alcohol use within family and friends (P = 0.000); psychiatric drug use history (OR = 1.72); suicidal attempt history (OR = 1.31); divorce, separation, and extramarital contact (P = 0.001); unemployment (P = 0.019); leisure time dissatisfaction (P = 0.004); living alone (OR = 2.43); and substance abuse onset before age 15 (OR = 1.71). CONCLUSIONS Considering non-modifiable risk factors, leaders and commanders may recognize more vulnerable soldiers and try to resolve modifiable factors and decrease the risk of getting worse (with respect to substance abuse) about 7.3 times.