A survey of active-duty veterans and National Guard and Reserve personnel has found that those who were exposed to combat in Iraq or Afghanistan are significantly more likely to engage in heavy drinking and report negative outcomes from drinking, Medical News Today reported Aug. 13.

Researchers led by Isabel G. Jacobson, M.P.H., of the Naval Health Research Center in San Diego examined data from the Millennium Cohort Study, looking at baseline health data collected from July 2001 to July 2003 and follow-up data from June 2004 to February 2006. A variety of inclusion and exclusion criteria generated a study sample of 48,481 individuals, 11.4 percent of whom were deployed to Iraq or Afghanistan and were exposed to combat there.

The researchers found that among active-duty personnel, deployed individuals were 31 percent more likely than non-deployed individuals to develop new-onset binge drinking at follow-up. Men were more likely than women to report new-onset or changes in binge drinking or alcohol-related problems (such as problems at work or school or inability to get along with others because of alcohol). But women were 1.2 times more likely to report new-onset heavy weekly drinking (defined as more than 7 drinks a week for women and more than 14 a week for men).

One of the researchers' recommendations is that the military establish stronger policies to ensure confidentiality when active-duty personnel pursue help for substance use problems, as concern about the effect coming forward will have on military careers often poses an obstacle.

Looking at Reserve and National Guard members in the survey cohort, the researchers found that those who were deployed with combat exposure were more likely than other groups to develop heavy weekly drinking, binge drinking, and problems related to alcohol. Younger age and a diagnosis of post-traumatic stress disorder (PTSD) were among the factors that increased the risk for alcohol-using behaviors and their consequences in this group.

The researchers said several factors could be at work in increasing the risk for new-onset alcohol problems in returning members of the Guard and Reserve, including the increased stress that comes with the transition between military and civilian occupations and the reduced access to support services in the community for these citizen-soldiers.

The researchers concluded, "These results are the first to prospectively quantify changes in alcohol use in relation to recent combat deployments. Interventions should focus on at-risk groups, including Reserve/Guard personnel, younger individuals, and those with previous or existing mental health disorders."

Survey results were published in the Aug. 13 issue of the Journal of the American Medical Association.