King's College London

In the last decade just under 10 per cent of adults in England and Wales aged 16-59 consistently report having used illegal drugs in the last year. No known research has investigated illegal drug use following physical combat injury in UK Armed Forces personnel.

Researchers in this study sourced data from the The ArmeD SerVices TrAuma and RehabilitatioN OutComE (ADVANCE) study, which investigates the physical and psycho-social outcomes of battlefield casualties. 579 personnel who sustained serious physical combat injuries whilst on deployment to the conflict in Afghanistan and 566 – demographically similar personnel who did not sustain such injuries were surveyed on their illegal drug use.

The research, published in Addictive Behaviours, found that 16.3 per cent of injured personnel had reported illegal drug use in the last year, compared to 5.4 per cent of their non-injured counterparts. However, these rates become much more similar when investigating those who had left military service, with 21.7% of injured veterans and 26.0% of veterans in the cohort who sustained no injuries reporting illegal drug use in the past year.

Other investigations as part of the study found a greater prevalence of drug use in younger personnel, as well as those of lower rank, not in a relationship, and those who have reported suicidal ideation.

Researchers also looked at drug use within veterans specifically. While there was a marked difference in drug use in those still serving, this difference disappeared in the veterans. More than 20 per cent of both the injured and non-injured groups reported illegal drug use in the last year, with the highest prevalence found in personnel who had left the service at a young age, or who had served for a short period.

Researchers recommend that military and civilian medical practitioners routinely enquire about the mental health of individuals who were injured while serving to help those who might otherwise not seek help for substance abuse problems or turn to illegal drugs to alleviate their problems.

Professor Nicola Fear, Professor of Epidemiology at King’s College London and Director of KCMHR said, "Sustaining a serious injury while in combat can be life changing. Recovery can take time and can result in an individual being medically discharged. Our study found that illegal drug use – while not common – is much higher in injured personnel compared to their non injured counterparts. Cocaine was the most common reported drug used in the last year, followed by cannabis.”

Dr Daniel Dyball, a Research Associate at KCMHR and the study’s first author said, “It is possible that young men who leave military service relatively early, either due to sustaining an injury or other reasons, may experience a period of uncertainty regarding who they want to be, what career to take, and what they want to do with their life. During this time, they may be more willing to engage in risky behaviours, including taking illegal drugs.

“We hope this research will help individuals who might feel stigmatised due to their drug use understand that you are not alone and can reach out if you think you require help”

 

The ADVANCE study is funded through the ADVANCE Charity.

If you’re a veteran or a member of the UK Armed Forces struggling currently, the ADVANCE study provide a signposting booklet to link you to available services in the UK, which you can find here: https://www.advancestudydmrc.org.uk/signposting/

Illegal drug use amongst male UK military personnel who sustained physical combat injuries: The ADVANCE cohort study (DOI 10.1016/j.addbeh.2025.108269) (Daniel Dyball, Susie Schofield, Alexander N. Bennett, Christopher J. Boos d, Anthony M.J. Bull, Nicola T. Fear) was published in Addictive Behaviours.

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