Alcohol and Special Populations: Unique Problems and Considerations That Apply to the Military The military is a special population that has its own culture and its own code of ethics. Its veterans have their own VA hospital and society recognizes a distinct difference between civilian and military life. The effect of alcohol on the military, therefore, requires unique consideration outside the realm of investigations on the effects of alcohol on mainstream America. This paper will describe the effect of alcohol on the military, identify unique problems and considerations that apply to the military, and compare and contrast the military to the overall U.S. population in terms of the problem of alcohol. It will conclude with a description of the best treatment practices for specific issues relevant to the military.

The Effect of Alcohol on the Military

The military population is not without its weakness for alcohol consumption. As Pemberton et al. (2011) note, "the U.S. military has traditionally had high rates of alcohol misuse and alcohol-related problems" (p. 480). Why this should be so, however, is less clear. There are a number of related factors that add to the stresses of military life, in combat zones as well as in bases both abroad and domestic. Together they combine with a culture that is substantially different from civilian life (with its own military tribunals, laws, barracks, etc.) to give soldiers and military personnel a challenging time when it comes to managing sobriety. The expansion of theaters of war since 9/11 and constant state of alert of the U.S. military also plays a role in the effect that alcohol has on military personnel. With no end in sight to recent conflicts, and, on the contrary, growing tensions between Russia and the West as multiple countries now attempt to "weigh in" on Syria and the terrorist threat running through Turkey, it appears that alcohol misuse has multiplied and gives no sign of abating.

Bray, Brown and Williams (2013) show that over a ten-year span from 1998 to 2008, military personnel "showed significant increases in heavy drinking (15% to 20%) and binge drinking (35% to 47%)" (p. 799). The impact on individuals participating in such heavy/binge drinking has been significant as well, with 9% of binge drinkers experiencing "serious consequences" and 19% of heavy drinkers suffering from sort of negative ramification as a result of over-consumption (p. 799). Moreover, personnel with high combat exposure are reported as having even higher rates of binge and heavy drinking, indicating that alcohol consumption patterns are aggravated by a history of combat for military personnel. The "serious consequences" range from social to physical to psychological issues that can develop over time to localized incidents/accidents, such as fighting, injury to self, or physical sickness. Furthermore, such consumption establishes a dependency upon alcohol while in the military that can stay with a member of the service even after he leaves the military and makes the transition back into civilian life, thus complicating the transition and adding to the sense of the isolation that the ex-serviceman can experience while attempting to navigate a new world with a different culture and customs than what he is used to in the military.

Yet, these habits are not always picked up in the military: sometimes they are brought into the military and simply made worse there as a result of having too much down time and not enough outlets or cultural stimulation for pursuits unrelated to alcohol consumption. Hanwella, Silva and Jayasekera (2012) note that "alcohol misuse is more prevalent among military populations" because military personnel are "significantly influenced by alcohol consumption patterns among the general population" and also have "access to alcohol and attitudes about alcohol use" that are impacted by "poorer psychological health and functional impairment" (p. 1). In other words, the military can act as a haven for degenerate behaviors and habits already established in individuals prior to acceptance into the military. Indeed, the study by Hanwella et al. (2012) identifies a number of unique considerations that must be understood when attempting to contextualize the problem of alcohol in the military.

Unique Problems and Considerations

The considerations that must be made are as Hanwella et al. (2012) note related to several factors. First off is the "general trend" of alcohol consumption in society. Considering that military personnel come from civilian life where these trends are already well-established, it is helpful to realize that these individuals come into the military already ingrained with alcohol consumption patterns. Secondly, these patterns...

Thirdly, access to alcohol is a major factor in the military's abuse of alcohol (if it is not as readily available there is likely to be less abuse). Fourthly, personnel may suffer from psychological problems that aggravate the issue of alcohol use/misuse; these issues can range from anything as simple as immaturity to anything as complex as post-traumatic syndrome disorder (PTSD) or military sexual trauma (MST) (Johnson, 2012). Likewise, there is correlation between PTSD and heavy drinking (Hanwella et al., 2012), which illustrates how military culture has a unique impact on alcohol use as it is directly related to the role of active combat participation. Jakupcak et al. (2010) find that PTSD symptoms develop in relationship to alcohol abuse in veterans of Middle East combat. Their study concludes with the assessment that there is a degree of "emotional numbing" that coincides with the alcohol abuse (p. 840). In short, the precise military environment is what aggravates the problem of alcohol misuse within the military population -- though there are considerably more factors as well, such as the effects of depression following re-entry into civilian life, or the effects of early childhood trauma, which can lead to situations in which individuals seek admission to the military as a way of escaping a poor civilian environment (Lutwak, 2014).
Moreover, that same culture plays a role in the link between alcohol misuse and intimate partner violence (Foran et al., 2012). The cultivation of violent perceptions, as manifested in the expectations of military combat soldiers to kill the enemy, are extended to interpersonal relationships which can breed volatility especially when alcohol consumption is factored into the equation. When coupled with the already inherent tendency towards abuse by a significant percentage of the military population the risk of intimate partner violence trends upward. Indeed there is a distinct dulling of sensitivity as part of the course of training of combatants who are taught to adopt a kill or be killed way of thinking, albeit one that incorporates safety practices, caution, and norms of behavior regarding engagement, etc. At the same time, the military culture promotes a herd mentality, which helps to explain why the percentage rates of heavy and binge drinkers are so high compared to the overall U.S. population.

The Military Compared to the Overall U.S. Population

The study by Hoerster et al. (2012) reports that the military population is more likely to engage in heavy drinking than the civilian population and the same goes for veterans as well. The reasons for this disparity are numerous. First of all, there is a significantly larger problem impacting the health of civilians, which is related to eating -- not drinking. Among the civilian population, however, obesity is the top problem as it relates to cardiovascular disease and diabetes (Tabish, 2007). Second of all, civilian lifestyles are far more conducive to accommodating stress relievers (such as vacations) that military life cannot accommodate for obvious reasons. The civilian life is centered around work and pleasure and is essentially consumerist, with a focus on achieving wealth, prosperity, comfort and leisure.

Military life is almost the complete opposite. It is centered around a devotion to duty in which one's life is at risk; it centers on the inevitable conflict between persons on opposing sides, in which enemy fire is exchanged. This duty is inherently self-sacrificing and dependent upon the collective doing its job as a single entity or unit. There is no sense of the individualism that suffuses civilian life and allows for persons to quite when they want, leave when they want, join when they want or pursue their own course or agenda when they want. In the military, orders are always given and expected to be obeyed. This rigid populace, driven by selflessness is also driven by a sense of senselessness and meaninglessness. In centuries past before materialism and consumerism became the dominating ethos of modern society, military personnel had something of a noble reason to enlist. Today, the nobility is more difficult to effect as a sense of patriotism, nationalism, pride and social or religious belief have dissipated over the years, with many military personnel doubting the capacity for leadership of their elected officials. Civilians must worry less about such issues, as in the end their lives are not on the line the same…