Document Type

Poster

Date

4-9-2026

Keywords

Substance use, Suicide, Veterans

Campus Community

Center for Health Behavior Research and Innovation; College of Arts and Sciences; Veteran and Military Behavioral Health Collaborative; D'Aniello Institute for Veterans and Military Families; Syracuse University

Language

English

Funder(s)

Center for Health Behavior Research & Innovation, D'Aniello Institute of Veterans and Military Families at Syracuse University, Veteran & Military Health Collaborative

Disciplines

Military and Veterans Studies

Description/Abstract

Background: U.S. Military veterans are at disproportionate risk for suicide. Substance use disorders (SUDs) are prevalent and are strongly associated with suicide risk among veterans, yet less is known about whether increasing SUD severity is associated with greater risk for suicidal thoughts and behaviors among veterans. Methods: Data were drawn from the National Survey on Drug Use and Health (NSDUH) 2021-2024 and included (n = 9,172) veterans. Analyses utilized survey weights to produce nationally representative estimates. Logistic regression tested associations between SUD severity (classified consistent with DSM-5 criteria for substances endorsed during the previous year; 0=no SUD (< 2 criteria), 1=mild (2-3 criteria), 2=moderate (2-5 criteria), 3=severe (≥ 6 criteria)) and odds of (1) past-year suicide ideation (SI), (2) suicide planning (SP), and (3) suicide attempt (SA), adjusted for age and sex. Results: Findings indicated that 3.7% of veterans endorsed SI, 1% SP, and 0.5% SA. Additionally, 10% endorsed symptoms consistent with mild SUD, 4% moderate SUD, and 3% severe SUD. The prevalence of SI increased from 2.4% among veterans without SUD to 16.7% among those with severe SUD. In adjusted models, compared to veterans without SUD, severe SUD was associated with higher odds of SI (AOR=6.00, 95% CI: 3.82–9.43, p < .001), SP (AOR=10.40, 95% CI: 5.06–21.37, p < .001), and SA (AOR=15.26, 95% CI: 6.22–37.42, p < .001). Discussion: SUD severity was associated with progressively greater odds of suicidal ideation, planning, and attempts among U.S. veterans. Suicidal thoughts and behaviors increased in a graded pattern across SUD severity levels. Future work should elucidate the temporality of such relations to identify whether SUD severity precedes suicidal thoughts and behaviors, or alternatively, if suicidal thoughts and behaviors may precede increases in SUD severity. Results support integrated screening and intervention efforts targeting substance use and suicidality among veterans.

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