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Teenage drinking and the onset of alcohol dependence: a cohort study over seven years.

Bonomo YA, Bowes G, Coffey C, Carlin JB, Patton GC

Centre for Adolescent Health, Murdoch Children's Research Institute. ybonomo@bigpond.com <ybonomo@bigpond.com>

AIM: To determine whether adolescent alcohol use and/or other adolescent health risk behaviour predisposes to alcohol dependence in young adulthood. DESIGN: Seven-wave cohort study over 6 years. PARTICIPANT: A community sample of almost two thousand individuals followed from ages 14-15 to 20-21 years. OUTCOME MEASURE: Diagnostic and Statistical Manual volume IV (DSM-IV) alcohol dependence in participants aged 20-21 years and drinking three or more times a week. FINDINGS: Approximately 90% of participants consumed alcohol by age 20 years, 4.7% fulfilling DSM-IV alcohol dependence criteria. Alcohol dependence in young adults was preceded by higher persisting teenage rates of frequent drinking [odds ratio (OR) 8.1, 95% confidence interval (CI) 4.2, 16], binge drinking (OR 6.7, 95% CI 3.6, 12), alcohol-related injuries (OR 4.5 95% CI 1.9, 11), intense drinking (OR 4.8, 95% CI 2.6, 8.7), high dose tobacco use (OR 5.5, 95% CI 2.3, 13) and antisocial behaviour (OR 5.9, 95% CI 3.3, 11). After adjustment for other teenage predictors frequent drinking (OR 3.1, 95% CI 1.2, 7.7) and antisocial behaviour (OR 2.4, 95% CI 1.2, 5.1) held persisting independent associations with later alcohol dependence. There were no prospective associations found with emotional disturbance in adolescence. CONCLUSION: Teenage drinking patterns and other health risk behaviours in adolescence predicted alcohol dependence in adulthood. Prevention and early intervention initiatives to reduce longer-term alcohol-related harm therefore need to address the factors, including alcohol supply, that influence teenage consumption and in particular high-risk drinking patterns.

Published 8 December 2004 in Addiction, 99(12): 1520-8.
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