In this sample of urban police officers we found by NIAAA standards that approximately 11% of males and 16% of females had engaged in at-risk levels of alcohol use during the previous week, while over one third of male and female officers reported a binge drinking episode at some time during the past month. A noteworthy 3.4% of male and 3.7% of female officers reported consuming more than 28 drinks in the past week. In addition, 18% of males and 16% of females reported significant lifetime histories of adverse social and interpersonal consequences related to alcohol use, with 7.5 % reporting MAST scores consistent with a lifetime DSM-IV diagnosis of alcohol abuse or dependence. As expected, alcohol use and MAST scores were related, with those in the current at-risk alcohol use category having experienced more lifetime negative consequences from alcohol.
Overall, these data suggest that the police officers in this sample were more likely to engage in a binge-drinking episode than the general population, with female officers being two to three times as likely. Much caution should be taken when making comparisons between these data obtained from large urban centers on the coasts and national epidemiology data, as location, urban/rural living, and sampling strategies may confound the gender patterns with other demographic variables. However, it is interesting to contrast these results with findings in the general population where females report lower levels of drinking than males and have lower rates of alcohol use disorders. Data from the 1999 National Household Survey on Drug Abuse33
indicated that 57% of males and 42% of females aged 26 or older reported “any alcohol use” in the past month
, compared to the 61% of male officers and 58% of female officers in this sample who reported any alcohol use in the past week
. Despite the shorter time frame in the current study, female officers were more likely to report any alcohol use than the women in the NHSDA (χ2
= 82) = 6.12, p
< .05). Although the NHSDA did not assess number of drinks per week, an epidemiological study34
classified approximately 12% of males and 3% of females over the age of 18 as at-risk drinkers, using a greater than 14 drinks per week standard for both males and females. Male officers in the current study had similar rates (11%), but female officers were 1.6 times more likely to have had greater than 14 drinks in the past week (5%).
Contrary to our hypotheses, for the sample as a whole neither cumulative duty-related critical incident exposure nor current PTSD symptom levels were associated with current alcohol use. In fact, in the combined sample, only educational attainment was significantly related to either at-risk alcohol use in the past week or binge drinking in the past month. We did find a positive association between cumulative PTSD symptoms to the officers' single most disturbing critical incident as assessed by the Mississippi Scale and greater lifetime alcohol-related problems as determined by the MAST. It is possible that the MAST may have been more sensitive to the cumulative effects of career PTSD symptoms in police service than our measures of current drinking. Alternatively, alcohol-related problems occurring prior to police service (e.g., during high school) are also captured by the MAST and might constitute a risk factor for later critical incident stress-related PTSD symptoms during police service. Prospective studies of police academy recruits, assessed for alcohol-related problems prior to police service, and followed longitudinally for emergent alcohol- related problems and PTSD symptoms during police service, are required to clarify this question.
Because our findings suggest that female officers drink more than women in the general population, we examined current alcohol use separately by gender. For males, we found lower educational attainment to be the only significant predictor of at-risk alcohol use, while no such relationship was found for female officers. A gender-specific relationship between alcohol use and lower educational attainment in males is consistent with previous findings in the substance abuse literature.35
Conversely, routine workplace stress did not predict drinking levels in male officers but female officers were significantly less
likely to drink under conditions of greater
workplace stress. A review of the literature on occupational risk factors for drinking reported that alcohol availability, job dissatisfaction, job stress, and a subculture that views at-risk drinking as an acceptable norm have all been found to be significant predictors of alcohol use.36
In a study of working adults, dangerous working conditions and a culture endorsing and facilitating drinking were the most significant predictors of having an alcohol problem.36
Job stress was a lesser, but also significant predictor. Besides the possibility of gender differences in utilizing different coping mechanisms, female police officers are working in a traditionally male-dominated environment where drinking may be an acceptable or culturally influenced norm. The current study's finding of increased drinking in female officers with lower workplace stress may reflect an interesting paradox: lower workplace stress may be associated with greater acculturation within a work environment in which social drinking among coworkers is not only accepted but may be actively encouraged as a rite of membership. Women officers who rate their work environment as less stressful may be those who are more strongly acculturated to male officer norms, including drinking. Police psychologists and veteran officers have provided anecdotal evidence of culturally facilitated after-work ritual social drinking.37
This finding may have important implications for female police officers struggling for acceptance in a male-dominated occupation. Alternatively, in a male-oriented work culture, women officers may perceive themselves to be under greater pressure to prove their competence. As workplace demands increase they may decrease their drinking to ensure that performance does not suffer. It is equally possible that as work stress increases, female officers decrease their social interactions with male counterparts out of concern that they will be perceived as “weak.” Prospective studies of alcohol use patterns in male and female officers are required to clarify this finding.
Although there are ample anecdotal and theoretical reasons to suspect that alcohol is a problem among police officers, the scientific literature is underdeveloped. While the present study was designed to address methodological concerns raised by earlier studies, our study has several important limitations as well. As noted above, the study is cross-sectional in design, limiting causal inference. We did not employ a national probability sampling strategy for all Americans in law enforcement, limiting generalizability of our findings to police officers working in diverse settings and limiting inferences in comparing our findings with published surveys of drinking patterns in the general population. We also do not have data on the number of officers who declined to participate, which prevents us from reporting overall response rate.
Response rates to the substance use questionnaires and the limited geographical area sampled limits the degree to which we can infer that the sample reflects the total police officer population. In addition, approximately half of the current alcohol use data were missing in the sample due to the low response rates to the SUI. Although the instructions for the SUI specifically asked the participants to fill in “0” if they had not used alcohol or drugs in the time period specified, it is possible that some abstainers may have simply skipped the questionnaire completely. It is also possible that some officers either did not consider themselves to have a problem, or were reluctant to answer detailed questions regarding their current drug and alcohol use out of concern for confidentiality, and made a conscious decision to skip this portion of the survey. The low response to the SUI compared to the high response to the MAST may indicate an openness to disclose lifetime consequences due to alcohol use, but a reluctance to respond to questions about current alcohol use embedded in a questionnaire that also asked about current illicit drug use. Low response rates are a common problem for research in assessing drinking levels,38
with underestimation and underreporting of current drinking levels likely being the rule rather than the exception. This is particularly true for groups like air traffic controllers, pilots, physicians, active duty military personnel, police officers and others who may be concerned about damaging their careers by disclosing current alcohol and drug use, even with stringent safeguards and assurances of confidentiality.
Clearly, more research is needed to delineate the patterns and predictors of alcohol use in police officers. In order to disentangle cause and effect relationships obscured in cross-sectional studies, such as work stress related gender differences in drinking patterns, we require prospective studies of police academy recruits as they enter police service, coupled with longitudinal designs permitting repeat assessments during police service in addition to surveying drinking behavior prior to joining the police force. The current findings strongly suggest that alcohol use in female officers is as an area for future study. The present study also underscores the importance of education, screening, and early intervention to help police officers manage work environment stressors and general psychiatric distress, in order to minimize their reliance on alcohol to cope with the formidable challenges of a high-risk occupation.