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Intro -- INDIAN TRIBAL LEADERS DIRECTORY -- INDIAN TRIBAL LEADERS DIRECTORY -- CONTENTS -- PREFACE -- Chapter 1 INDIAN TRIBAL LEADERS DIRECTORY - SUMMER 2010 -- BUREAU OF INDIAN AFFAIRS 1849 C STREET, N.W. MS-4606-MIB WASHINGTON, D.C. 20240 TELEPHONE AREA CODE: (202) -- Regional Directors -- TRIBAL LEADERS AND BIA REPRESENTATIVES -- Alaska Region -- Eastern Region -- Great Plains Region -- Midwest Region -- Navajo Region -- Northwest Region -- Pacific Region -- Rocky Mountain Region -- Southern Plains Region -- Southwest Region -- Western Region -- TRIBAL ENTITIES LISTED BY STATE -- NAME INDEX - TRIBAL LEADERS AND BIA REPRESENTATIVES -- INDEX - TRIBAL ENTITIES -- INDEX

Military personnel engage in unhealthy alcohol use at rates higher than their same age, civilian peers, resulting in negative consequences for the individual and jeopardized force readiness for the armed services. Among those returning from combat deployment, unhealthy drinking may be exacerbated by acute stress reactions and injury, including traumatic brain injury (TBI). Combat-acquired TBI is common among personnel in the current conflicts. Although research suggests that impairments due to TBI leads to an increased risk for unhealthy drinking and consequences among civilians, there has been little research to examine whether TBI influences drinking behaviors among military personnel. This article examines TBI and drinking in both civilian and military populations and discusses implications for clinical care and policy.

This study used the 2008 Department of Defense Survey of Health Related Behaviors among Active Duty Military Personnel to determine whether traumatic brain injury (TBI) is associated with past year drinking-related consequences. The study sample included currently-drinking personnel who had a combat deployment in the past year and were home for ≥6 months (N = 3,350). Negative binomial regression models were used to assess the incidence rate ratios of consequences, by TBI-level. Experiencing a TBI with a loss of consciousness >20 minutes was significantly associated with consequences independent of demographics, combat exposure, posttraumatic stress disorder, and binge drinking. The study's limitations are noted.

OBJECTIVE: To investigate associations of lifetime traumatic brain injury (LT-TBI) prior to an index deployment, and/or deployment-acquired TBI (DA-TBI), with post-deployment binge and heavy drinking. SETTING: Soldiers from 3 Brigade Combat Teams deployed to Afghanistan in 2012. PARTICIPANTS: 4,645 Soldiers who participated in the Army STARRS Pre/Post Deployment Study and completed 4 assessments: T0 (1–2 months pre-deployment), T1 (upon return to U.S.), T2 (3-months post-deployment), and T3 (9-months post-deployment). DESIGN: Prospective, longitudinal study controlling for baseline binge drinking. MAIN MEASURES: Self-reported past month binge drinking (5+ alcoholic beverages on the same day) and past month heavy drinking (binge drinking at least weekly) at T2 and T3. RESULTS: 34.3% screened positive for LT-TBI, and 19.2% screened positive for DA-TBI. At T2 only, LT-TBI, but not DA-TBI, was associated with increased odds of binge drinking [adjusted odds ratio (AOR) = 1.39, 95% CI 1.20–1.60, p < .001] and heavy drinking [AOR = 1.28, 95% CI 1.09–1.49, p = .007]. Among the subgroup with LT-TBI, also having DA-TBI was associated with increased risk of heavy drinking at T3 [AOR = 1.42. 95% CI 1.03–1.95, p = 0.047]. CONCLUSION: Routine screening for LT-TBI may help target efforts to prevent alcohol misuse among military members.