Moral injury is “a transgression of morals or values that are held personally or collectively, and may negatively affect emotional, functional (e.g., relationships, work) and spiritual domains.” Moral injury is something that has become a major concern among veterans. This article aims to examine the relationship between exposure to potentially morally injurious events (PMIEs) and SUDs in a nationally representative sample of US combat war veterans. This article examines and attempts to quantify the importance of each type of moral injury exposure concerning SUDs.
This study consisted of 1321 veterans; that data was analyzed from the 2019-2020 National Health and Resilience in Veterans Study (NHRVS). For this study, the veterans had to have exposure to combat or a war zone. The participants’ sociodemographic and military characteristics were gathered, and participants completed a 50-minute online survey. The study also assessed for potentially morally injurious experiences, posttraumatic stress disorder, alcohol use disorder, drug use disorder, substance use disorder, combat exposure, and trauma exposure. It was found that distinct forms of PMIEs were associated differently with lifetime and past-year SUDs.
This study also found that exposure to PMIEs caused by perpetration is mostly associated with alcohol use disorder. In contrast, exposure to PMIEs by witnessing was associated more with drug use disorder. One of the limitations of this study was that its participants were mostly from older generations, so if more research was done, it would possibly want to focus on gathering information from veterans from more recent wars. Exposures to PMIEs are not usually assessed when screening for substance use disorder, but this article shows the important of assessing PMIEs, especially with veterans. Knowing the type of PMIE the veteran was exposed to could help in developing a treatment plan for that individual.
Takeaway: This study shows that exposure to PMIE is a strong contribute to SUD among veterans and that screening for previous exposure during treatment could help with developing a treatment plan.