• Robert J Wong, Zeyuan Yang, Michael Ostacher, Wei Zhang, Derek Satre, Alexander Monto, Mandana Khalili, Ashwani K Singal, and Ramsey Cheung.
• Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Palo Alto, CA; Gastroenterology and Hepatology Section, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA. Electronic address: Rwong123@stanford.edu.
• Am. J. Med. 2024 Mar 1; 137 (3): 236239.e2236-239.e2.

BackgroundVeterans 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.MethodsAll 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.ResultsAmong 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.ConclusionsHigh-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.Published by Elsevier Inc.

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