Alcohol Use Patterns in Adolescence Associated With Alcohol and Other Drug Overdose in Adulthood

Alcohol and other drug overdoses are a significant public health problem and a common cause of death among young adults. This study assessed whether alcohol use at age 15–16 years is a risk factor for alcohol or drug overdose, or poisoning requiring medical attention, by the age of 32–33 in a population-based Finnish cohort study. The study was limited to 7714 individuals with no history of overdose prior to the age of 15–16 years. Information on overdose was collected from nationwide registers.

  • By the age of 32–33, 183 overdose diagnoses were recorded among assessed individuals.
  • In adjusted analyses,* the following were associated with an increased risk of any overdose at age 32–33:
    • First alcohol intoxication at age ≤12 (hazard ratio [HR], 4.5).
    • First alcohol intoxication at age 13 or 14 (HR, 2.1).
    • High alcohol tolerance** (HR, 3.1).
    • Frequent alcohol intoxication (HR, 1.9).
  • First alcohol intoxication at age ≤12, and high alcohol tolerance were associated with an increased risk of intentional overdose (HR, 5.2 and 4.4, respectively).

* Analyses were adjusted for “behavioral and emotional problems,” non-medical drug use, and family background.

** Defined as number of standard drinks (12g ethanol) to become intoxicated (≥7 drinks for females or 9 for males).

† Defined as reporting being intoxicated ≥3 times in the last 30 days.

Comments: This cohort study suggests that specific alcohol use patterns in adolescence are associated with increased risk of alcohol and other drug-related overdose later in life. Overdose prevention efforts could include early identification and intervention during adolescence/young adulthood for people with early onset of alcohol consumption, frequent alcohol intoxication, and high alcohol tolerance.

Nicolas Bertholet, MD, MSc

Reference: Koivisto MK, Miettunen J, Levola J, et al. Alcohol use in adolescence as a risk factor for overdose in the 1986 Northern Finland Birth Cohort Study. Eur J Public Health. 2022;32(5):753–759.

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