Early drinking linked to alcohol dependence risk

NEW YORK (Reuters Health) - People who try alcohol for the first time before age 15 are more likely to become dependent on it, new research shows.

These individuals also run a higher risk of abusing alcohol, report Dr. Deborah A. Dawson and colleagues at the National Institute on Alcohol Abuse and Alcoholism at the National Institutes of Health in Bethesda, Maryland.

These problems didn't appear to be rooted in a person's inability to control their drinking, Dawson and her team found, but seemed instead to be due to "willful misuse of alcohol." This suggests, they say, that early drinkers might have "impaired executive cognitive function," or difficulty with tasks requiring them to plan, make decisions, and resist temptation.

There is already evidence that an early start on drinking boosts a person's risk of later problems with alcohol, but research to date has been unable to pin down whether such people simply have an underlying risk of addictive behavior that accounts for both trying alcohol early and developing alcohol problems, the researchers explain in the medical journal Alcoholism: Clinical and Experimental Research.

To investigate, Dawson and her team followed 22,316 men and women 18 and older, all of whom used alcohol, for three years. About 7 percent had started drinking before the age of 15, 24 percent had tried alcohol for the first time when they were 15, 16 or 17; and 69 percent had waited until age 18 or later.

After accounting for childhood risk factors, family history of alcohol and drug problems, the amount of alcohol people drank, and other factors, the researchers found that people who began drinking before their fifteenth birthday were 38 percent more likely to become dependent on alcohol than those who waited until age 18 or later.

Among those who had their first drink when they were 15 to 17, the risk of dependence was 54 percent greater for women, but not for men.

People who began drinking before age 15 were also 52 percent more likely to abuse alcohol, while those who started drinking at 15 to 17 years of age showed a 30 percent increased risk.

When the researchers looked at a subgroup of study participants with no risk factors such as family history for alcohol problems, the link between early drinking and later abuse and dependence was much stronger; they were nearly four times as likely to become dependent on alcohol, and almost three times as likely to keep drinking despite physical and psychological problems.

The researchers found that early drinkers actually tended to be less likely to lose control and to have an easier time stopping when they want to. The fact that they risk becoming heavy drinkers may reflect poorer decision making rather than an inherent vulnerability to becoming addicted to alcohol, Dawson and her colleagues suggest.

More research is needed, they conclude, to determine if early drinking actually causes later alcohol problems, and if so what mechanisms are involved.

SOURCE: Alcoholism: Clinical and Experimental Research, December 2008.