The impact of military service and traumatic brain injury on the substance use norms of Army Reserve and National Guard Soldiers and their spouses

•Previous work on substance use norms in the military has been limited.•Explored impact of brain injury (TBI) & service status on substance use norms•Male USAR/NG soldiers disapproved of NMUPD, illicit drug use and tobacco use.•Former soldiers are more accepting of substance use if they experience TBI.•Partners of former soldiers are more accepting of use if their soldier had TBI.

IntroductionTraumatic brain injury (TBI) and substance use are highly prevalent conditions among military populations. There is a significant body of evidence that suggests greater approval of substance use (i.e., norms) is related to increased substance use. The objective of this work is to understand the impact of TBI and military service on substance use norms of soldiers and their partners. Data are from the baseline assessment of Operation: SAFETY, an ongoing, longitudinal study of US Army Reserve/National Guard (USAR/NG) soldiers and their partners.MethodsMultiple regression models examined associations between alcohol, tobacco, illicit drug use, and non-medical use of prescription drug (NMUPD) norms within and across partners based on current military status (CMS) and TBI.ResultsMale USAR/NG soldiers disapproved of NMUPD, illicit drug use and tobacco use. There was no relation between military status and alcohol use. Among females, there was no relation between CMS and norms. The NMUPD norms of wives were more likely to be approving if their husbands reported TBI symptoms and had separated from the military. Husbands of soldiers who separated from the military with TBI had greater approval of the use of tobacco, NMUPD, and illicit drugs.ConclusionOverall, there is evidence to suggest that, while generally disapproving of substance use, soldiers and partners become more accepting of use if they also experience TBI and separate from the military. Future research should examine the longitudinal influence of TBI on substance use norms and subsequent changes in substance use over time.