Alcohol Use Patterns During and After the COVID-19 Pandemic Among Veterans in the United States

BACKGROUND: Veterans may be especially susceptible to increased alcohol consumption following the COVID-19 pandemic. We aim to evaluate trends in alcohol use among US Veterans prior to, during, and following the onset of the COVID-19 pandemic. METHODS: All US Veterans utilizing Veterans Affairs health care facilities in the United States from March 1, 2018 to February 28, 2023 with >= 1 AUDIT -C score were categorized into 1) No alcohol use (AUDIT -C= 0), 2) Low -risk alcohol use (AUDIT -C 1-2 for women, 1-3 for men), and 3) High -risk alcohol use (AUDIT -C >= 3 for women, >= 4 for men). Trends in the proportion of Veterans reporting high -risk alcohol use, stratified by sex, age, race/ethnicity, and urbanicity were evaluated. RESULTS: Among a cohort of 2.15 to 2.60 million Veterans, 15.5% reported high -risk alcohol use during March 2018 -February 2019, which decreased to 14.6% during the first year of the pandemic, increased to 15.2% in the second year, and then decreased to 14.9% from March 2022 -February 2023. Among non -Hispanic whites, African Americans, Asians, and Hispanics, the proportion of women reporting high -risk alcohol use surpassed that of men during the onset of the pandemic and beyond. The greatest proportion of high -risk alcohol use was observed among young Veterans ages 18-39 years (17%-27%), which was consistent across all race/ethnic groups. CONCLUSIONS: High -risk alcohol use among US Veterans has increased since the COVID-19 pandemic onset, and in the third year following pandemic onset, 15% of Veterans overall and over 20% of young Veterans ages 18-39 years reported high -risk alcohol use.