Age at First Alcohol Use: A Risk Factor for the Development of Alcohol Disorders

TLDR

Age at first alcohol use has a nonlinear effect on later disorder risk, with early use (ages 11–14) markedly increasing the likelihood of developing abuse or dependence. The study aimed to describe how age at first drink predicts the natural course of DSM‑III‑R alcohol disorders and to evaluate early use as an independent risk factor. Using a community sample of 5,856 lifetime drinkers from the 1990‑1991 Ontario Health Survey, the authors performed survival analyses to assess progression to alcohol‑related harm by age at first use. After 10 years, 13.5 % of those who began drinking at ages 11–12 met criteria for abuse and 15.9 % for dependence, similar rates were 13.7 % and 9.0 % for ages 13–14, whereas only 2.0 % and 1.0 % of those who started at 19+ met criteria, and unexpectedly the youngest drinkers (≤10) showed delayed progression.

Abstract

This study aimed to describe the natural course of DSM-III-R alcohol disorders as a function of age at first alcohol use and to investigate the influence of early use as a risk factor for progression to the development of alcohol disorders, exclusive of the effect of confounding influences.Data were obtained from a community sample (N=5,856) of lifetime drinkers participating in the 1990-1991 Mental Health Supplement of the Ontario Health Survey.Survival analyses revealed a rapid progression to alcohol-related harm among those who reported having their first drink at ages 11-14. After 10 years, 13.5% of the subjects who began to drink at ages 11 and 12 met the criteria for a diagnosis of alcohol abuse, and 15.9% had a diagnosis of dependence. Rates for subjects who began to drink at ages 13 and 14 were 13.7% and 9.0%, respectively. In contrast, rates for those who started drinking at ages 19 and older were 2.0% and 1.0%. Unexpectedly, a delay in progression to harm was observed for the youngest drinkers (ages 10 and under). Hazard regression analyses revealed a nonlinear effect of age at first alcohol use, marked by an elevated risk of developing disorders among subjects first using alcohol at ages 11-14.First use of alcohol at ages 11-14 greatly heightens the risk of progression to the development of alcohol disorders and therefore is a reasonable target for intervention strategies that seek to delay first use as a means of averting problems later in life.