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Research Summary

Adolescent Substance Use and Later Alcohol and Drug Dependence

In cross-sectional surveys, early use of alcohol has been associated with an increased risk of alcohol use disorders in adulthood. But questions remain about whether early use plays a causal role in this risk. To assess the impact of substance use in early adolescence, researchers surveyed boys entering middle school in Miami-Dade County and then interviewed a random sample of these boys (942) approximately 7–10 years later (mean age of 20 years at follow-up).

  • Both experimenters (1–9 lifetime drinks; no more than 1 lifetime use of illicit drugs) and regular users (alcohol use on >=10 occasions; illicit drug use on >6 occasions) during early adolescence were significantly more likely than abstainers to meet criteria for alcohol abuse (odds ratios, ORs, 1.7 and 2.5, respectively), alcohol dependence (ORs 2.3 and 3.7, respectively), and any substance use disorder (ORs 2.1 and 4.1, respectively) as adults.
  • African Americans had the lowest prevalence of substance use during early adolescence. However, African Americans who were early users had significantly higher odds, than did Whites or Hispanics, of having a substance use disorder in adulthood.
  • Early substance users were also significantly more likely to have a psychiatric disorder in adulthood.


These prospectively collected data suggest that early substance use is associated with later abuse and dependence. However, they do not definitively answer whether early use is a marker for the risk, or a cause, of a later problem. The study also suggests that an ethnic group with a lower prevalence of early substance use is not necessarily protected from the development of dependence.

Richard Saitz, MD, MPH


Gil AG, Wagner EF, Tubman JG. Associations between early-adolescent substance use and subsequent young-adult substance use disorders and psychiatric disorders among a multiethnic male sample in South Florida. Am J Pub Health. 2004;94(9):1603–1609.
(view abstract)