title: Recognition and management of alcohol misuse in OEF/OIF and other veterans in the VA: a cross-sectional study.
abstract: BACKGROUND
  Mental health problems have been identified among soldiers serving in Operations Enduring Freedom and Iraqi Freedom (OEF/OIF), but little is known about the prevalence and management of alcohol misuse in OEF/OIF veterans seen in the Veterans Administration health care system (VA).
  
  
  METHODS
  We identified 12,092 veterans (n=2009 women) 55 and younger and screened for alcohol misuse in FY2007 from a cross-sectional national sample of VA outpatients randomly selected for standardized medical record review for quality monitoring. Alcohol misuse was assessed with the Alcohol Use Disorders Identification Test Consumption questions (AUDIT-C > or =5). Based on medical record reviews, brief alcohol interventions (BI) were defined as documented (1) advice to abstain or drink within recommended limits or (2) feedback about health risks associated with drinking.
  
  
  RESULTS
  Adjusted prevalence of alcohol misuse was higher in OEF/OIF men than non-OEF/OIF men [21.8% vs. 10.5%, adjusted odds ratio (AOR)=2.37 (95% CI: 1.88-2.99)], but did not differ reliably between OEF/OIF and non-OEF/OIF women [4.7% vs. 2.9%, AOR=1.68 (0.74-3.79)]. Adjusted rates of documented advice or feedback [31.6% vs. 34.6%, AOR=0.87 (0.58-1.21)] and referral [24.1% vs. 28.9%, AOR=0.78 (0.47-1.30)] were not significantly different between OEF/OIF and non-OEF/OIF men who screened positive for alcohol misuse.
  
  
  CONCLUSIONS
  OEF/OIF men were more likely to screen positive for alcohol misuse than non-OEF/OIF men. Overall, approximately half of those with alcohol misuse had documented BI and/or referral to alcohol treatment suggesting a need for improvement in addressing alcohol misuse in OEF/OIF and other veterans.
authors.affiliation: Health Services Research & Development, VA Puget Sound Health Care System, Seattle, WA 98108, USA. Eric.Hawkins@va.gov
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Hawkins
authors.forename: Gwendolyn T
authors.initials: GT
authors.lastname: Lapham
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Kivlahan
authors.forename: Katharine A
authors.initials: KA
authors.lastname: Bradley
mesh_terms: D000328:Adult; D000367:Age Factors; D000437:Alcoholism / Q000453:epidemiology* / Q000534:rehabilitation; D003430:Cross-Sectional Studies; D003625:Data Collection; D016208:Databases, Factual; D005260:Female; D047830:Gulf War; D006801:Humans; D007406:Interview, Psychological; D054542:Iraq War, 2003-2011; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology; D008875:Middle Aged; D018570:Risk Assessment; D012737:Sex Factors; D014481:United States / Q000453:epidemiology; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000706:statistics & numerical data*; D055815:Young Adult