Roi Eliashar and colleagues’ recent paper, “Reported Increase in Substance Use Following Mass Terrorism and the Role of Psychosocial Factors,” published in JAMA Network Open, provides a comprehensive analysis of the factors associated with increased substance use (ISU) following mass terrorism. Conducted one month after the October 7, 2023, terrorist attack in Israel, the study explores the complex interplay between different types of exposure to the event, psychological distress, and previous mental health difficulties in relation to ISU.
The study surveyed 968 Jewish adults aged 18-70 years, revealing that ISU was notably higher among individuals exposed directly, indirectly, or through media coverage of the attack. The findings indicate that psychological distress partially mediated the relationship between indirect and media exposure and ISU, regardless of whether participants had prior mental health issues. This highlights the significant role of psychological distress in driving substance use as a coping mechanism following traumatic events.
Eliashar et al. underscore that exposure to mass terrorism through direct experience, indirect connections, or media consumption significantly influences the likelihood of reporting increased substance use. Direct exposure had the strongest association with ISU, with participants who were directly exposed being 5.75 times more likely to report increased use. Indirect exposure and media exposure also showed significant associations, albeit to a lesser extent. The study found that psychological distress, a common aftermath of such traumatic events, was a crucial mediator in the relationship between indirect and media exposure and ISU.
Interestingly, the study did not find evidence supporting the idea that pre-existing mental health difficulties moderated the indirect effects of exposure on ISU. This suggests that the psychological impact of mass terrorism is profound enough to affect substance use behaviours broadly, irrespective of prior mental health conditions. The research also identified older age and female sex as factors associated with higher reports of ISU after accounting for exposure and mental health measures. This finding contrasts with typical substance use patterns, where younger individuals and males are often more prevalent users, suggesting unique dynamics in the aftermath of such events.
Eliashar and colleagues’ study offers critical insights into the pathways by which exposure to mass terrorism leads to increased substance use. These findings have important policy implications, particularly for the development of targeted interventions and health services aimed at mitigating the impact of psychological distress following terrorist attacks. Ensuring that support systems and preventive measures are in place to address the heightened risk of substance use in the wake of such events is essential for public health and safety.