Probable alcohol use disorder in the U.S. Veteran population: Results from the 2025–2026 National Health and Resilience in Veterans study

Background Alcohol use disorder (AUD) is a pervasive public health problem in the United States, and military veterans are at elevated risk. A prior wave of the National Health and Resilience in Veterans Study (NHRVS) estimated the prevalence of past-year probable AUD at 10.5 % in 2019-2020. Updated national surveillance data are needed given demographic shifts in the veteran population and evolving drinking patterns in the post-pandemic era.Methods Using data from the 2025-2026 NHRVS (N = 2,620), we estimated the weighted prevalence of probable AUD and compared it to that of the prior NHRVS wave. Multivariable analyses examined sociodemographic, military, trauma and mental health characteristics associated with probable AUD.Results The weighted prevalence of probable AUD in 2025-2026 was 12.1 %, compared with 10.5 % in 2019-2020 (difference, 1.6 percentage points; 95 % CI, -0.6 to 3.8), a difference that was not statistically significant. Independent correlates of probable AUD included younger age, unpartnered status, homelessness history, higher household income, and more adverse childhood experiences. When all lifetime psychiatric diagnoses were examined simultaneously, self-reported provider-diagnosed attention-deficit/hyperactivity disorder (ADHD) remained significantly associated with probable AUD (OR = 2.40). Veterans with probable AUD also had significantly greater odds of past-year suicidal ideation (OR = 2.02; 31.6 % vs. 11.7 %) and lifetime suicide attempt (OR = 1.67; 11.8 % vs. 4.0 %).Conclusions The prevalence of probable AUD among U.S. veterans remains elevated and is characterized by early adversity, co-occurring psychiatric conditions, and elevated suicide risk. Enhanced screening for social determinants of health and psychiatric concerns, including routine ADHD assessment in AUD treatment settings, alongside targeted outreach and integrated approaches are essential to address this complex and important problem.