Early Onset of Drinking:
What Research Says &
What Anti-Alcohol Activists Say It Says
The National Institute on Alcohol Abuse and Alcoholism (NIAAA)
accurately summarizes the research on the relationship between the
onset of drinking at an early age and alcohol dependence later in
People who begin drinking before age 15 are four times more
likely to develop alcohol dependence at some time in their lives
compared with those who have their first drink at age 20 or older
(25). It is not clear whether starting to drink at an early
age actually causes alcoholism or whether it simply indicates
an existing vulnerability to alcohol use disorders (26). For example,
both early drinking and alcoholism have been linked to personality
characteristics such as strong tendencies to act impulsively and
to seek out new experiences and sensations (27). Some evidence
indicates that genetic factors may contribute to the relationship
between early drinking and subsequent alcoholism (28,29).
Anti-alcohol activists tend to refer to the relationship (early
age of first drink associated with greater risk of dependence later
in life) found in some research and say this means that if we keep
young people from drinking until age 20 or older, they will be less
likely to become alcohol dependent. 2
The research says no such thing. It only states a relationship
found in limited research, which may or may not be correct. But
even if the relationship really does exist, it doesn’t mean
that keeping young people from drinking will reduce their risk of
Activists conveniently ignore NIAAA’s very important suggestion,
based on research evidence, that early age of first drink may well
not be the cause of subsequent dependence. Both early onset of drinking
and alcohol dependence may be caused by underlying personality characteristics
such as impulsivity or sensation seeking, or from genetic factors.
For example, sensation-seeking personalities may drink at an early
age, engage in unprotected sex, gamble, drive recklessly, abuse
alcohol, etc. Preventing them from engaging in any one of these
behaviors would have absolutely no effect on any of the others.
Similarly, preventing early drinking would have no effect whatsoever
on a person’s genetic makeup, which may be the cause of alcohol
Does early onset of drinking increase the risk of alcohol dependence?
Probably not. Those groups and societies in which young people are
introduced to the consumption of alcohol at an early age (for example,
Jews, Italians, Greeks, Spaniards, and Portuguese) tend to have
low rates of alcohol dependence and fewer alcohol-related problems.
Needless to say, alcohol activists never mention the research evidence
that those who begin drinking later than most of their peers are
also more likely to experience drinking and alcohol-related problems.
That wouldn’t support their agenda.
- 1. National Institute on Alcohol
Abuse and Alcoholism (NIAAA). Alcohol Alert, #59, April,
2003. The references cited in the NIAAA quote are: (25) Grant, B.F.,
and Dawson, D.A. Age of onset of alcohol use and its association
with DSM–IV alcohol abuse and dependence: Results from the
National Longitudinal Alcohol Epidemiological Survey. Journal
of Substance Abuse 9:103–110, 1997. (26) Dawson, D.A.
The link between family history and early onset alcoholism: Earlier
initiation of drinking or more rapid development of dependence?
Journal of Studies on Alcoholism 61(5): 637–646,
2000. (27) Rose, R.J. A developmental behavior–genetic perspective
on alcoholism risk. Alcohol Health & Research World
22(2): 131–143, 1998. (28) Virkkunen, M., and Linnoila, M.
Serotonin in early–onset alcoholism. In: Galanter, M., ed.
Recent Developments in Alcoholism. Vol 13: Alcohol and Violence.
New York: Plenum Press, 1997. pp. 173–189. (29) Kono, Y.;
Yoneda, H.; Sakai, T.; et al. Association between early–onset
alcoholism and the dopamine D2 receptor gene. American Journal
of Medical Genetics (Neuropsychiatric Genetics) 74(2): 179–182,
- 2. For example, Joseph Califano,
head of the Center on Addiction and Substance Abuse (CASA) misleadingly
asserts that “teen drinking is the number one source of adult
alcoholism. Children who begin drinking before age 21 are more than
twice as likely to develop alcohol-related problems. Those who begin
drinking before age 15 are four times likelier to become alcoholics
than those who do not drink before age 21” (Califano, Joseph.
Teen Tipplers: America’s Underage Drinking Epidemic. Center
on Addiction and Substance Abuse (CASA) pres release, 2-26-02. Similarly,
a Drug Abuse Resistance Education (DARE) official falsely asserts
that “research tells us if we can keep the kids off cigarettes
and alcohol, by the time they graduate (presumably the official
means from high school) there’s almost zero percent chance
they will abuse any other type of drug” Schultz, Sean. Alcohol
education falls to new generation. Green Bay Press-Gazette,
- 3. Federally funded research continues
to seriously question whether early age of first drink has any effect
upon later alcohol dependence or alcohol-related problems. McGue,
M., et al. Origins and Consequences of Age at First Drink.
I. Associations with Substance-Use Disorders, Disinhibitory Behavior
and Psychopathology, and P3 Amplitude. Alcoholism: Clinical
& Experimental Research. 25(8): 1156-1165, August 2001.
The authors found that “AFD (age at first drink) is not specifically
associated with alcoholism but rather is correlated with a broad
range of indicators of disinhibited behavior and psychopathology.
Moreover, individuals who first drink at a relatively early age
manifest elevated rates of disinhibitory behavior and psychopathology
before they first try alcohol. Taken together, these findings suggest
that the association of AFD with alcoholism reflects, at least in
part, a common underlying vulnerability to disinhibitory behavior.
Whether an early AFD directly influences risk of adult alcoholism
remains unclear.” They also report that “problems seen
in adulthood among early drinkers existed prior to their taking
that first drink, which suggests that developmental processes were
already disrupted prior to that first drink. Thus, an early AFD
is more likely a 'symptom' of an underlying vulnerability of disinhibitory
processes rather than a 'cause' of increased rates of alcoholism"
(Age at First Drink: What Does It Really Mean? University of Minnesota/Virginia
Commonwealth University pres release, 8-14-01).
- Researcher Helene White explains that
- age of onset may simply be a marker of an already existing syndrome
of problem behaviors (Glantz & Leshner, 2000). Studies have
consistently found that early disruptive behaviors (e.g., conduct
disorder) are related to later substance use and abuse, and that
the onset of disruptive behaviors often occurs prior to alcohol
use initiation (e.g., Costello et al., 1999). McGue and colleagues
(2001b) found that those who first started drinking before age
15 compared to those who started later were at much higher risk
for developing alcohol dependence as well as other drug dependence
and other externalizing disorders. They argued that all of these
outcomes are manifestations of disinhibitory behavior or psychopathology,
and that early onset of alcohol use may reflect a vulnerability
to disinhibitory behavior. Furthermore, they found that several
indicators of disinhibitory behavior actually preceded age of
onset. Therefore, their findings refuted a causal path from age
of onset to later alcoholism. In a subsequent study, McGue and
colleagues (2001a) concluded that a common inherited vulnerability
model appears to explain the association of early age of onset
and later alcoholism. Prescott and Kendler (1999) also showed
that the association between age of onset and later alcoholism
was mediated by common genetic factors and, thus, they refuted
any causal association. (White, Helene. Age at First Consumption
and Future Alcohol- Related Problems. Invited Opinion. International
Center for Alcohol Policies, n.d.
- References cited by Dr. White are Costello, J., Erkanli, A., Federman,
E., & Angold, A. (1999). Development of psychiatric comorbidity
with substance abuse in adolescents: Effects of timing and sex.
Journal of Clinical Child Psychology, 28, 298-311; Glantz,
M.D., & Leshner, A.I. (2000) Drug abuse and developmental psychopathology.
Development and Psychopathology, 12, 795-814; McGue, M.,
Iacono, W.G., Legrand, L.N., & Elkins, I. (2001a). Origins and
consequences of age at first drink. II. Familial risk and heritability.
Alcoholism: Clinical and Experimental Research, 25, 1166-1173;
McGue, M., Iacono, W.G., Legrand, L.N., Malone, S., & Elkins,
I. (2001b). Origins and consequences of age at first drink. I. Associations
with substance-use disorders, disinhibitory behavior and psychopathology,
and p3 amplitude. Alcoholism: Clinical and Experimental Research,
25, 1156-1165; and Prescott, C.A., & Kendler, K.S. (1999). Age
of first drink and risk for alcoholism: A noncausal association.
Alcoholism: Clinical and Experimental Research, 23,101-107.
- See also, for example, Dougherty, D. M., et al. Age at
First Drink Relates to Behavioral Measures of Impulsivity: The Immediate
and Delayed Memory Tasks.
- Alcoholism: Clinical & Experimental Research. 28(3):
408-414, March 2004, Justus, Alicia N., et al. P300, Disinhibited
Personality, and Early-Onset Alcohol Problems.
- Alcoholism: Clinical & Experimental Research. 25(10):
1457-1466, October 2001; Dick, D. M., and Foroud, T. Candidate Genes
for Alcohol Dependence: A Review of Genetic Evidence From Human
Studies. Alcoholism: Clinical & Experimental Research.
27(5): 868-879, May 2003.