The sooner adolescents begin drinking, the more likely they are to develop alcohol use or dependence, according to an article in the Journal of Substance Abuse.
Bridget F. Grant of the National Institute on Alcohol Abuse and Alcoholism and colleagues examined age of drinking onset in two large cohorts of adolescents born between 1957 and 1964. They found that early-onset alcohol use strongly predicted alcohol use disorders in adolescents, and that for each year drinking onset was delayed, the likelihood of developing problems with alcohol was significantly reduced.
The study relied on data gathered through the National Longitudinal Survey of Labor Market Experience in Youth (NLSY), an ongoing survey initiated in 1979 of a representative sample (N=12,686) of adolescents who were 14 to 21 years old on January 1, 1979. The current study examined a subsample of adolescents who were questioned during the 1982 interview and responded to the question, "How old were you when you first started drinking? For example, having two or more drinks a week?"
Subjects who were abstainers or infrequent light drinkers (those who drank less than once or twice per week) were excluded from the analyses. Diagnoses of alcohol abuse or dependence were made based on DSM-IV criteria. Subjects were followed up in 1989 and again in 1994.
The investigators found that in 1989, the prevalence of alcohol abuse in the sample was 12.2 percent, while the prevalence of dependence was 4.7 percent; in 1994, rates were, respectively, 10 percent and 4.3 percent.
Linear logistic regression analyses for alcohol abuse and dependence in 1989 indicated that the odds of developing alcohol dependence decreased by five percent with each increasing year of age of drinking onset; however, odds of alcohol abuse were not significantly related to age at onset of drinking. Subjects were more likely to meet the criteria for dependence and abuse if they were young, male and nonblack; had never married, separated or divorced; had a family history of alcoholism; or reported using marijuana on 10 or more occasions.
Odds of developing abuse or dependence were two to four times greater in subjects who reported a history of engaging in antisocial behaviors (shoplifting, stealing, property damage, fighting, use of force, use of drugs and drug trafficking) compared to those who did not. Being a high school drop out also increased the odds of dependence but lowered the odds of abuse.
In the 1994 analyses, the age at drinking onset was significantly related to both alcohol abuse and dependence. The odds of dependence decreased by nine percent with each increasing year of age at onset of drinking, and odds of abuse decreased by seven percent for each year that onset was delayed.
The authors conclude that, consistent with the literature in this area, this study found a significant association between age at drinking onset and the odds of developing DSM-IV alcohol dependence seven to 12 years later. Odds of alcohol dependence were significantly increased among subjects who reported early antisocial behavior and marijuana use.
The authors recommend prospective studies of prevention and educational interventions designed to delay the onset of alcohol use among teens. There may also be a constellation of related factors, in addition to delay of onset, that reduces the risk for developing alcohol dependence.
Grant BF, Stinson FS, Harford TC: Age at onset of alcohol use and DSM-IV alcohol abuse and dependence: A 12-year follow-up. Journal of Substance Abuse 2001; 12: 493-504. Reprint requests to: Bridget F. Grant, Division of Biometry and Epidemiology, National Institute on Alcohol Abuse and Alcoholism, Suite 514, 6000 Executive Blvd., Bethesda, MD 20892.
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