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.
Comments:
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
Reference:
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)