Substance use and misuse in the aftermath of terrorism. A Bayesian meta-analysis

Authors

  • Charles DiMaggio,

    Corresponding author
    1. Department of Epidemiology, Columbia University, Mailman School of Public Health, New York, NY, USA,
    2. Department of Anesthesiology, Columbia University, College of Physicians and Surgeons, New York, NY, USA
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  • Sandro Galea,

    1. Department of Epidemiology, Columbia University, Mailman School of Public Health, New York, NY, USA,
    2. and Center for Social Epidemiology and Population Health, University of Michigan, Ann Arbor MI, USA
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  • Guohua Li

    1. Department of Epidemiology, Columbia University, Mailman School of Public Health, New York, NY, USA,
    2. Department of Anesthesiology, Columbia University, College of Physicians and Surgeons, New York, NY, USA
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  • Charles DiMaggio originated the study, conducted the analyses and wrote the first draft of the report. Sandro Galea and Guohua Li suggested and guided analyses, and contributed to the interpretation of the data. All authors contributed to drafting and critical revision of the manuscript for important intellectual content.

Charles DiMaggio, Department of Epidemiology, Mailman School of Public Health, 722 West 168 St, Room 1117, New York, NY 10032, USA. E-mail: cjd11@columbia.edu

ABSTRACT

Aim  To conduct a comprehensive analysis of the conflicting evidence on substance use and misuse following mass traumas such as terrorist incidents.

Methods  We reviewed and synthesized evidence from 31 population-based studies using Bayesian meta-analysis and meta-regression.

Results  The majority of the studied were conducted in the aftermath of the terrorist attacks of 11 September 2001. Controlling for exposure, type of incident and time since the event occurred, 7.3% [95% credible interval (CrI) 1.1–32.5%] of a population can be expected to report increased alcohol consumption in the first 2 years following a terrorist event. There is, however, a 20% probability that the prevalence will be as high as 14%. The unadjusted prevalence of increased cigarette smoking following a terrorist event is 6.8% (95% Cr I 2.6–16.5%). Unadjusted reports of mixed drug use (including narcotics and prescription medications) was 16.3% (95% Cr I 1.3–72.5%).

Conclusions  These results underscore the potentially pervasive behavioral health effects of mass terrorism, and suggest that public health interventions may usefully consider substance use as an area of focus after such events.

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