Substance use over the military–veteran life course: An analysis of a sample of OEF/OIF veterans returning to low-income predominately minority communities

•Substance use varied substantially over the military–veteran career.•Respondent driven sampling (RDS) was used to obtain unbiased estimates.•In the military, alcohol was the drug of choice, nearly half were heavy drinkers.•While deployed and after separation 6%–7% misused prescription opioids.•After separation, many returned to marijuana use, most stopped heavy drinking.

This paper presents an overview of substance use patterns of recent veterans returning to low-income predominately minority communities over four periods of the military–veteran career. Respondent driven sampling (RDS) was used so that unbiased estimates could be obtained for the characteristics of the target population. The majority of participants had used marijuana but no other illegal drugs. In the military, marijuana use was substantially lower and alcohol was the drug of choice; the majority were binge drinkers and nearly half were heavy drinkers. While deployed, alcohol and marijuana use were both lower, though some participants (6%) initiated the misuse of prescription painkillers. After separating from the military and returning to civilian life, heavy drinking was much lower, marijuana use increased, and some veterans misused prescription painkillers (7%). Further research based on these data will examine these distinct periods of substance use, contexts of use, related substance and mental health problems, treatment use and avoidance, and civilian reintegration.