Page last updated: Tuesday, November 18, 2008
Age of onset and risk of alcohol dependence
Data from a survey of 43,000 U.S. adults published in the July issue of Archives of Pediatrics & Adolescent Medicine.suggests those who began drinking in their early teens are at greater risk of developing alcohol dependence at some point in their lives, of developing dependence more quickly and at younger ages, and of developing chronic, relapsing dependence. Among all respondents who developed alcoholism at some point, 47% met the diagnostic criteria for alcohol dependence (alcoholism) by age 21.

Scientists at the Boston University School of Public Health and Youth Alcohol Prevention Center, led by Dr. Ralph Hingson, carried out the analysis using data from the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a representative survey of the 43,000 U.S. civilians aged 18 years and older.

Of the individuals who began drinking before age 14, 47% experienced dependence at some point, vs. 9% of those who began drinking at age 21 or older. While one quarter of all drinkers in the survey started drinking by age 16, 46% of drinkers who developed alcohol dependence began drinking at age 16 or younger.

The findings showed that among all drinkers, early drinking was associated not only with a higher risk of developing alcoholism at some point, but also within 10 years of first starting to drink, before age 25, and within any year of adult life. Early drinking was also associated with increased risk of having multiple episodes of alcoholism. Further, among respondents who had had alcohol dependence at some point, those who began drinking young had episodes of longer duration and with a wider range of symptoms than those who started later.

Previous research has established the link between early onset of drinking and lifetime diagnosis of alcoholism. Key to understanding the relationship between early drinking and alcoholism risk is whether the act of drinking while young raises lifetime risk, or whether early drinking reflects an underlying predisposition for risky behaviour in particular young people.

Investigators attempted to account for factors known to be associated with higher risk such as family history of alcoholism, childhood antisocial behavior and depression, and smoking and drug use. Even controlling for a number of risk factors and the effects of age differences among respondents, early drinking was associated with an increased risk of lifetime alcohol diagnosis.

Source: Hingson RW et al. Age at Drinking Onset and Alcohol Dependence. Age at Onset, Duration, and Severity. Arch Pediatr Adolesc Med 2006;160:739-46.

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