Substance Use, Financial Stress, Employment Disruptions, and Anxiety among [US] Veterans during the COVID-19 Pandemic


This study compares the substance use behaviors of US veterans who screened positive for an anxiety disorder prior to the start of the pandemic (in February 2020) to veterans who screened negative for an anxiety disorder. 1230 veterans completed an online survey. The study found that veterans with pre-existing anxiety disorder may be likely to use substances at higher rates than veterans without pre-pandemic anxiety. Recommendations for  prevention and/or intervention to mitigate any potential negative consequences of substance use are made.


The COVID-19 pandemic has resulted in financial, employment, and mental health challenges. In general, American veterans report high rates of substance use, which may be influenced by the COVID-19 pandemic. Those with pre-existing mental health problems, employment disruptions, or financial stress may be particularly vulnerable. We examined the relationships between pre-existing self-report screens for a probable anxiety disorder, COVID-19-related financial stress, employment disruption (e.g., lost job, reduced hours), and alcohol, cannabis, and cigarette use during the pandemic among 1230 veterans (Mage = 34.5; 89% male). Participants were recruited through various social media sites and completed an online survey 1 month prior to implementation of the nationwide physical distancing guidelines in the United States (February 2020). Six months later (August 2020), they completed a follow-up survey. Compared to veterans who screened negative for anxiety prior to the pandemic, veterans who screened positive reported consuming more drinks per week (b = 3.05), were more likely to use cannabis (OR = 6.53), and smoked more cigarettes (b = 2.06) during the first 6 months of the pandemic. Financial stress was positively associated with alcohol (b = 1.09) and cannabis use (OR = 1.90). Alcohol use was heaviest among veterans with a positive pre-existing anxiety screen and high financial stress. Moreover, veterans who experienced employment disruption due to the pandemic consumed less alcohol but were more likely to use cannabis during the pandemic. Veterans with pre-pandemic anxiety and pandemic-related financial stress may be using substances at higher rates and may benefit from intervention to mitigate negative substance use-related outcomes. Findings also enhance our understanding of veteran substance use behaviors following disruptions in employment due to the pandemic.

Full Reference

Tran DD, Fitzke RE, Wang J, Davis JP, Pedersen ER. Substance Use, Financial Stress, Employment Disruptions, and Anxiety among Veterans during the COVID-19 Pandemic. Psychological Reports. March 2022. doi:10.1177/00332941221080413