Is It Important to Prevent Early Exposure to Drugs and Alcohol Among Adolescents?

TLDR

Early adolescent exposure to alcohol and illicit drugs is linked to adverse adult outcomes, though it is unclear whether this effect is independent of pre‑existing conduct problems. The study aimed to determine whether early substance exposure causally predicts future adverse outcomes in adolescents. A 30‑year prospective cohort with propensity‑score matching was used to assess the causal impact of early substance exposure. After matching, early exposure was associated with higher risk of adult substance dependence, herpes infection, early pregnancy, and crime, even among those without prior conduct problems, indicating that preventing or delaying exposure could avert many adult health problems.

Abstract

Exposure to alcohol and illicit drugs during early adolescence has been associated with poor outcomes in adulthood. However, many adolescents with exposure to these substances also have a history of conduct problems, which raises the question of whether early exposure to alcohol and drugs leads to poor outcomes only for those adolescents who are already at risk. In a 30-year prospective study, we tested whether there was evidence that early substance exposure can be a causal factor for adolescents' future lives. After propensity-score matching, early-exposed adolescents remained at an increased risk for a number of poor outcomes. Approximately 50% of adolescents exposed to alcohol and illicit drugs prior to age 15 had no conduct-problem history, yet were still at an increased risk for adult substance dependence, herpes infection, early pregnancy, and crime. Efforts to reduce or delay early substance exposure may prevent a wide range of adult health problems and should not be restricted to adolescents who are already at risk.