Problem drinking recognition among UK military personnel: prevalence and associations

PURPOSE: Despite the higher prevalence of problem drinking in the UK military compared to the general population, problem recognition appears to be low, and little is known about which groups are more likely to recognise a problem. This study examined prevalence of problem drinking recognition and its associations. METHODS: We analysed data from 6400 regular serving and ex-serving personnel, collected in phase 3 (2014–2016) of the King's Centre for Military Health Research cohort study. MEASUREMENTS: Participants provided sociodemographic, military, health and impairment, life experiences, problem drinking, and problem recognition information. Problem drinking was categorised as scores ≥ 16 in the AUDIT questionnaire. Associations with problem recognition were examined with weighted logistic regressions. FINDINGS: Among personnel meeting criteria for problem drinking, 49% recognised the problem. Recognition was most strongly associated (ORs ≥ 2.50) with experiencing probable PTSD (AOR = 2.86, 95% CI = 1.64–5.07), social impairment due to physical or mental health problems (AOR = 2.69, 95% CI = 1.51–4.79), adverse life events (AOR = 2.84, 95% CI = 1.70–4.75), ever being arrested (AOR = 2.99, CI = 1.43–6.25) and reporting symptoms of alcohol dependence (AOR = 3.68, 95% CI = 2.33–5.82). To a lesser extent, recognition was also statistically significantly associated with experiencing psychosomatic symptoms, feeling less healthy, probable common mental health disorders, and increased scores on the AUDIT. CONCLUSION: Half of UK military personnel experiencing problem drinking does not self-report their drinking behaviour as problematic. Greater problem drinking severity, poorer mental or physical health, and negative life experiences facilitate problem recognition. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00127-022-02306-x.