Drug use and hazardous drinking are associated with PTSD symptoms and symptom clusters in US Army Reserve/National Guard Soldiers

Background and Objectives: There is strong evidence of the association between Posttraumatic Stress Disorder (PTSD) symptoms and substance use. Previous work has found sex differences in these associations. With revisions to the DSM, it is important to understand how overall PTSD symptoms and the new symptom clusters relate to substance use among Reserve/Guard soldiers—a high risk group. Methods: Data are from the baseline assessment of Operation: SAFETY (Soldiers and Families Excelling Through the Years), a longitudinal study of US Army Reserve/National Guard (USAR/NG) soldiers (N = 389 males, N = 84 females). We examined associations between current substance use (drug use, hazardous drinking, and smoking) and overall PTSD symptoms, and symptom clusters. Additionally, we examined PTSD by sex interactions. Results: Greater overall PTSD symptoms were associated with higher odds of drug use (OR = 1.08; 95%CI: 1.05, 1.12) and hazardous drinking (OR = 1.04; 95%CI: 1.02, 1.07). Greater individual symptom cluster scores were associated with higher odds of drug use (ps <.001) and hazardous drinking (ps <.01). Interaction models revealed no differences in these associations on the basis sex (ps >.05). There were no associations between PTSD symptoms or symptom clusters on smoking (ps >.05). Discussion and Conclusion: Soldiers experiencing PTSD symptoms are reporting current drug and hazardous alcohol use, suggestive of self-medication. Scientific Significance: It is imperative to consider the impact of PTSD on substance use broadly, as this work shows that overall symptoms and symptom clusters have an impact on male and female USAR/NG soldiers. (Am J Addict 2019;28:22–28).