Addressing alcohol use disorders in military psychiatry: From awareness to comprehensive care

Background: Alcohol consumption has long been embedded in the social traditions of the Armed Forces, often linked to camaraderie and regimental culture. While moderate use is common and socially accepted, recent trends point to a growing burden of alcohol use disorders (AUDs). These disorders affect not only the health and performance of soldiers but also family relationships, unit morale, and operational readiness. However, the problem is under-recognized due to stigma and limited systematic research.

Methods: This abstract draws on published studies, official defence health reports, and secondary data from military medical services between 2000 and 2024. The focus was on four key domains of prevalence of alcohol use and AUDs among serving personnel, occupational and psychosocial risk factors, consequences for health and military functioning, and the scope and limitations of existing prevention and treatment measures.

Results: Available studies estimate that hazardous drinking among Army personnel ranges from 12–20%, with higher rates in combat units and among those deployed in high-stress or insurgency-prone areas. Identified risk factors include long separations from family, combat exposure, cultural normalization of alcohol, and co-existing mental health problems such as depression and post-traumatic stress disorder. Consequences are wide-ranging: increased disciplinary problems, injuries, accidents, domestic strain, and premature medical discharge. While the Army has developed awareness programs and maintains de-addiction centres, these services are often limited to crisis management. Relapse prevention, confidential counselling, and long-term psychosocial support remain underdeveloped. International best practices—such as peer-support programs, digital self-help tools, and evidence-based therapies—are only beginning to find traction.

Conclusions: Alcohol use disorders represent a significant but modifiable challenge for the Indian Army. Current systems provide immediate medical relief but fall short in long-term rehabilitation and stigma reduction. Strengthening care will require routine screening, confidential counselling services, trained mental health professionals, and integration of culturally sensitive relapse-prevention strategies. Learning from international defence forces could guide reforms. A shift from reactive to comprehensive, continuous care will help preserve soldier well-being, enhance family resilience, and sustain operational effectiveness.

Dr. Shradha Khatri, MBBS, MD, DNB (Psychiatry), is a serving Psychiatrist in the Indian Army with over five years of clinical experience in military psychiatry. Currently posted in a high-stress operational area with prevalent substance use, she manages a wide spectrum of cases including alcohol and drug use disorders, stress-related conditions, and comorbid psychiatric illnesses. He has been actively involved in prevention programs, awareness campaigns, and rehabilitation initiatives aimed at reducing stigma and promoting mental health among soldiers. His professional interests include addiction psychiatry, resilience building, and community-based mental health care in armed forces settings.