Age at First Alcoholic Drink and Later Alcohol-Related Problems

There is a correlation between the age at which a person first drinks and subsequent alcohol-related problems. This had led many to conclude that an early age of onset of drinking causes alcohol problems.

A Drug Abuse Resistance Education (DARE) official has asserted that "research tells us if we can keep the kids off cigarettes and alcohol, by the time they graduate there's almost zero percent chance they will abuse any other type of drug." 1

Public alcohol policy in the U.S. is largely based on such an assumption. However, federally funded research continues to question the belief that age of first drink has any effect upon later alcohol dependence or alcohol-related problems. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) has analyzed the research on the relationship between the onset of drinking at an early age and alcohol dependence later in life and concludes that "It is not clear whether starting to drink at an early age actually causes alcoholism or whether it simply indicates an existing vulnerability to alcohol use disorders." 2

Common sense also raises questions about any such causal connection. Drowning increases when ice cream consumption increases. But eating ice cream doesn't cause people to drown. Summer increases both ice cream consumption and swimming - and more people swimming leads to more drowning.

Enter impulsivity, disinhibition, and sensation-seeking. Sensation seeking is a trait describing the tendency to seek novel, varied, complex, and intense sensations and experiences and the willingness to take risks for the sake of such experience.

These and other personality traits have been linked with both early onset of drinking and with heavy drinking and alcohol-related problems later in life. Such early-appearing personality characteristics can apparently cause both drinking at an early age and subsequent alcohol problems.

Researcher Dr. Helene White explains that

age of onset may simply be a marker of an already existing syndrome of problem behaviors (Glantz & Leshner, 2000). Studies have consistently found that early disruptive behaviors (e.g., conduct disorder) are related to later substance use and abuse, and that the onset of disruptive behaviors often occurs prior to alcohol use initiation (e.g., Costello et al., 1999). McGue and colleagues (2001b) found that those who first started drinking before age 15 compared to those who started later were at much higher risk for developing alcohol dependence as well as other drug dependence and other externalizing disorders. They argued that all of these outcomes are manifestations of disinhibitory behavior or psychopathology, and that early onset of alcohol use may reflect a vulnerability to disinhibitory behavior. Furthermore, they found that several indicators of disinhibitory behavior actually preceded age of onset. Therefore, their findings refuted a causal path from age of onset to later alcoholism. In a subsequent study, McGue and colleagues (2001a) concluded that a common inherited vulnerability model appears to explain the association of early age of onset and later alcoholism. Prescott and Kendler (1999) also showed that the association between age of onset and later alcoholism was mediated by common genetic factors and, thus, they refuted any causal association. 3

That's why psychologists have been able to observe the behavior of pre-school children and predict, on the basis of their interaction with others, which children will later become problem drinkers.

If we could stop children from drinking alcohol at an early age that wouldn't change their personalities so that they would begin deferring gratification and avoiding excitement such as speeding, engaging in sex, or playing body-contact sports. And if we stopped them from engaging in those activities, that wouldn't make them become safer drivers or alcohol abstainers.

If alcohol policies are based on false assumptions, they are likely to be ineffective and a waste of effort and resources.

 

Readings:

  • Dawson, D.A. The link between family history and early onset alcoholism: Earlier initiation of drinking or more rapid development of dependence? Journal of Studies on Alcoholism 61(5): 637–646, 2000.
  • Grant, B.F., and Dawson, D.A. Age of onset of alcohol use and its association with DSM–IV alcohol abuse and dependence: Results from the National Longitudinal Alcohol Epidemiological Survey. Journal of Substance Abuse 9:103–110, 1997.
  • Kono, Y.; Yoneda, H.; Sakai, T.; et al. Association between early–onset alcoholism and the dopamine D2 receptor gene. American Journal of Medical Genetics (Neuropsychiatric Genetics) 74(2): 179–182, 1997.
  • McGue, M. et al. Origins and consequences of age at first drink. I. Associations with substance-use disorders, disinhibitory behavior and psychopathology, and P3 amblitude. Alcoholism: Clinical and Experimental Research, 2001, 8, 1156-1165.
  • Prescott, C.A., and Kendler, K. Age at first drink and risk for alcoholism: A noncausal association. Alcoholism: Clinical and Experimental Research, 1999, 23(1), 101-107. (In spite of its title, this report examines alcohol problems in addition to alcoholism.)
  • Rose, R.J. A developmental behavior–genetic perspective on alcoholism risk. Alcohol Health & Research World 22(2): 131–143, 1998.
  • Virkkunen, M., and Linnoila, M. Serotonin in early–onset alcoholism. In: Galanter, M., ed. Recent Developments in Alcoholism. Vol 13: Alcohol and Violence. New York: Plenum Press, 1997. pp. 173–189.
  • Wong, P. M., et al. Behavioral control and resiliency in the onset of alcohol and illicit drug use: A prospective study from preschool to adolescence. Child Development, 2006, 77(4), 1016-1033.

References:

  • 1. Schultz, Sean. Alcohol education falls to new generation. Green Bay Press-Gazette, 5-18-04.
  • 2. National Institute on Alcohol Abuse and Alcoholism (NIAAA). Alcohol Alert, #59, April, 2003.
  • 3. White, Helene. Age at First Consumption and Future Alcohol- Related Problems. Invited Opinion. International Center for Alcohol Policies, n.d. References cited by Dr. White are Costello, J., Erkanli, A., Federman, E., & Angold, A. (1999). Development of psychiatric comorbidity with substance abuse in adolescents: Effects of timing and sex. Journal of Clinical Child Psychology, 28, 298-311; Glantz, M.D., & Leshner, A.I. (2000) Drug abuse and developmental psychopathology. Development and Psychopathology, 12, 795-814; McGue, M., Iacono, W.G., Legrand, L.N., & Elkins, I. (2001a). Origins and consequences of age at first drink. II. Familial risk and heritability. Alcoholism: Clinical and Experimental Research, 25, 1166-1173; McGue, M., Iacono, W.G., Legrand, L.N., Malone, S., & Elkins, I. (2001b). Origins and consequences of age at first drink. I. Associations with substance-use disorders, disinhibitory behavior and psychopathology, and p3 amplitude. Alcoholism: Clinical and Experimental Research, 25, 1156-1165; and Prescott, C.A., & Kendler, K.S. (1999). Age of first drink and risk for alcoholism: A noncausal association. Alcoholism: Clinical and Experimental Research, 23,101-107.

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