Military service and risk of subsequent drug use disorders among Swedish men.
Drug use disorder
Instrumental variable
Military service
Registry data
Journal
Social psychiatry and psychiatric epidemiology
ISSN: 1433-9285
Titre abrégé: Soc Psychiatry Psychiatr Epidemiol
Pays: Germany
ID NLM: 8804358
Informations de publication
Date de publication:
Jul 2023
Jul 2023
Historique:
received:
03
03
2022
accepted:
12
01
2023
medline:
14
6
2023
pubmed:
22
1
2023
entrez:
21
1
2023
Statut:
ppublish
Résumé
Environmental factors contribute substantially to risk for drug use disorders (DUD). The current study applies multiple methods to empirically test whether military service is associated with subsequent DUD, as previous findings are inconsistent. Longitudinal Swedish national registry data on a cohort of male conscripts born 1972-1987 (maximum N = 485,900) were used to test the association between military service and subsequent registration for DUD. Cox proportional hazard models were used in preliminary analyses, followed by three methods that enable causal inference: propensity score models, co-relative models, and instrumental variable analysis. Across all methods, military service was causally associated with lower risk of DUD. Hazard ratios ranged from HR = 0.43 (95% confidence intervals [CI] 0.37; 0.50) in the instrumental variable analysis to 0.77 (0.75; 0.79) in the multivariate propensity score matching analysis. This effect diminished across time. In the model including a propensity score, HRs remained below 1 across the observation period, while confidence intervals included 1 after ~ 11 years in the co-relative analysis and after ~ 21 years in the instrumental variable analysis. In this cohort of Swedish men, complementary methods indicate that military service conferred substantial but time-limited protection against subsequent DUD. The observed effect could be due to reduced opportunity for substance use during service, social cohesion experienced during and after service, and/or socioeconomic advantages among veterans. Additional research is necessary to clarify these protective mechanisms and determine how other environmental contexts can provide similar benefits.
Identifiants
pubmed: 36680575
doi: 10.1007/s00127-023-02426-y
pii: 10.1007/s00127-023-02426-y
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1039-1048Subventions
Organisme : NIDA NIH HHS
ID : R01 DA030005
Pays : United States
Organisme : NIAAA NIH HHS
ID : AA027522
Pays : United States
Organisme : NIDA NIH HHS
ID : DA030005
Pays : United States
Organisme : NIAAA NIH HHS
ID : AA023534
Pays : United States
Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.
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