New study ties exposure to armed conflict violence in childhood with subsequent alcohol use disorder

September 27, 2023

Exposure to nearby violence has been shown to increase the onset of alcohol use disorders (AUD), especially in young people. In new research, William Axinn, Ford School professor and research professor at the Survey Research Center and Population Studies Center, directed a study that was able to delve deeply into a setting in Nepal that had been the scene of a civil conflict from 2000-2006. Axinn and colleagues analyzed measures from the Chitwan Valley Family Study, which has been collecting data in the area for nearly 30 years. In their publication in the journal Addiction, they report on the association between community exposure to armed conflict and subsequent onset of alcohol use disorder (AUD) among males in Nepal during and after the conflict. 

They examined reports of beatings in the community during the conflict, including the date and distance from respondents, which had been compiled from neighborhood reports, geolocation and official resources, then linked to respondents’ life histories of alcohol use and associated behaviors (collected in 2016–2018). Results reveal those who were age 14 or younger during the armed conflict were the most influenced by this violence.

“Within the youngest cohort of those interviewed (born 1992–2001), those living in neighborhoods where armed conflict beatings occurred were more likely to develop AUD compared with those in other neighborhoods. The post-conflict incidence of AUD for those living in neighborhoods with any armed conflict beatings was 9.5% compared with 5.3% in the matched sample with no beatings,” they write. 

This strong evidence that links individual-level experiences of community violence to the onset of AUD supports the hypothesis that interventions to reduce community-level violence may improve health outcomes. 

The results have implications for policy makers. “Understanding how exposure to violence affects the extent to which individuals experience the onset of AUD in this setting will provide basic, but essential health data that can guide governments and clinicians to proactively plan sustainable healthcare frameworks. It will also help address several limitations regarding the understanding of how community (and not personal) exposure to violence is associated with subsequent onset of AUD.”

Three main findings stand out. First, respondents who consumed alcohol and who experienced beatings within 1 km had 66% increased odds of making the transition to the onset AUD, but this increased risk was statistically significant only in the youngest cohort (i.e. those who experienced the armed conflict as children). Second, this association was independent of the presence of either personal exposure to beatings (as opposed to community) or a mental disorder (other than AUD). Both of these factors are significant predictors of AUD across cohorts, with large effects in the youngest cohort. Third, respondents in the youngest cohort who completed 10 or more years of schooling had significantly lower odds of experiencing AUD. 

“The health consequences of exposure to violence lasts long after the violent conflicts have ended. This result is particularly important for understanding the potential long-term consequences of childhood exposure to armed conflict violence,” they conclude.

You can read the study here.