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Research Summary

Adolescent Drinking Portends Early Adult Harms

Many people view teenage drinking as a stage adolescents will “mature out of,” despite the teen prevalence of binge drinking (up to one-third) and alcohol use disorders (up to 5%). Two recent prospective studies followed mid-adolescents into young adulthood to examine the relationships between teen drinking and later alcohol use disorders and psychosocial problems.

Bonomo et al assessed 1943 Australian teens, 1601 of whom were followed through age 20. They found that 5% of those who drank during adolescence met criteria for alcohol dependence by age 20 and that dependence was more likely among those who, as teens, had engaged in the following (analyses adjusted for sex, marital status, and parental alcohol use):

  • frequent drinking (>=3 days in the past week; odds ratio [OR] 3.1 compared with teens who had not drunk frequently)
  • antisocial behavior (>=2 incidents of property damage, interpersonal violence, or theft in the previous 6 months; OR 2.4 compared with teens without antisocial behavior)

Wells et al studied 953 New Zealand mid-adolescents and controlled for 32 potential confounders, including mental health disorders, socioeconomic status, family background, other drug use, risk taking, and other behavioral measures. They found that heavier drinking at age 16 independently predicted the following:

  • alcohol dependence at ages 16 through 21, but not ages 21 through 25
  • continued heavier drinking at ages 16 through 25
  • greater numbers of sexual partners and violent offenses at ages 16 through 25


Drinking in mid-adolescence is not a “phase,” but a marker for alcohol problems, HIV risk behaviors, and violence over the ensuing decade. Statistical control for various behavioral and familial factors lessened the association between early drinking and later dependence, suggesting that the former may be a harbinger—but not a sole cause—of dependence during adulthood. Nonetheless, unambiguous education and feedback about these potential harms should be part and parcel of counseling and prevention efforts for adolescents and young adults.

Peter D. Friedmann, MD, MPH


Bonomo YA, Bowes G, Coffey C, et al. Teenage drinking and the onset of alcohol dependence: a cohort study over seven years. Addiction. 2005;99(12):1520–1528.

Wells JE, Horwood LJ, Fergusson DM. Drinking patterns in mid-adolescence and psychosocial outcomes in late adolescence and early adulthood. Addiction. 2005;99(12):1529–1541.