Age at First Alcohol Use as a Possible Risk Factor for Adolescent Acute Alcohol Intoxication Hospital Admission in the Netherlands

Abstract

BackgroundThe primary objective of this study is to determine whether age at first alcohol use is a determinant for adolescent acute alcohol intoxication characteristics, such as age at first acute alcohol intoxication and blood alcohol concentration (BAC) at hospital admission. Around the world, as in the Netherlands, a key aim of alcohol policy is to postpone the age at first alcohol use. This is based on cohort studies that indicate a relationship between a younger age at first alcohol use and subsequent adult alcohol use disorders.MethodsThis study was conducted using a cohort of data comprising individuals under 18 years of age. Data were collected between 2007 and 2017 by the Dutch Pediatric Surveillance System (NSCK) in order to monitor trends in admissions for acute alcohol intoxication. Multivariate linear regression analyses were used to determine the association between age at first alcohol use and acute alcohol intoxication characteristics, such as age at first acute alcohol intoxication and BAC at admission.ResultsThis study indicates that among adolescents admitted for acute alcohol intoxication, adolescents who started drinking at ≤ 14 years of age are significantly more often female, lower educated, and raised in nontraditional family structures than adolescents who started drinking between 15 and 18 years of age. Multiple linear regression analyses indicated that age at first alcohol use, corrected for covariates, significantly predicted the age at acute alcohol intoxication and BAC at admission. The association between age at first alcohol use and age at intoxication was also found to be clinically relevant.ConclusionsAlthough causation cannot be implied based on the results of these analyses, the results of this study suggest that interventions delaying the age at first alcohol use could be successful in increasing the average age that adolescents are admitted to the hospital for acute alcohol intoxication.

Additional psychoactive substance use in adolescents hospitalised with acute alcohol intoxication

“…In the Netherlands between 2007-2016, almost five thousand adolescents were admitted to hospital due to alcohol intoxication and of these patients more than half started drinking before 14 years of age. Females, adolescents with lower educational background and adolescents raised in nontraditional family structures are at higher risk of being admitted with AAI at a younger age [5]. However, recent developments, like raising the minimum age for obtaining low-alcohol drinks, more awareness of the consequences of alcohol use and the opening of outpatient alcohol clinics, seems to decrease the number of hospital admissions.…”

“…In particular, simultaneous use of alcohol and drugs, due to its additive and interactive effects, is considered to be an additional risk for the health and well-being of adolescents [2][3][4]. In the Netherlands, a number of studies have been performed to describe the risk factors and epidemiology of AAI amongst adolescents [5]. However, to date, there is no information regarding the incidence and risk factors of simultaneous AAI and illicit substance use in general populations of adolescents.…”

Time of day as indicator of adolescent alcohol intoxication emergency department presentations

“…1 Contrary to these trends, the number of underage patients who are admitted to a hospital with alcohol intoxication characteristics is an ongoing and stable health concern in the country. 2 Knowledge about what time of day patients are brought into the hospital is important for the development of efficient prevention policies. The primary aim of this repeated cross-sectional study was to investigate how time of day variation (morning, afternoon, evening and night) was associated with patient and intoxication characteristics in Dutch adolescents admitted for alcohol intoxication.…”

Is Early‐Onset Alcohol Use an Indicator of Problematic Alcohol Use Later in Life? Lessons Belgium can Learn From the Netherlands

“…In 2018, there were 116 such cases, which is the highest absolute number since the registration started in 2008 (IMA, http://atlas.ima-aim.be/databanken). However, these IMA figures are based on administrative reimbursement data and in that sense are less “accurate” than the data gathered in the Netherlands by the Dutch Pediatric Surveillance System (De Veld et al, ). For instance, administrative reimbursement data can yield information on the number of blood alcohol concentration (BAC) analyses that have been performed but not on the outcome of these analyses (was it a “positive” test or not).…”

“…With their article, “Age at first alcohol use as a possible risk factor for adolescent acute alcohol intoxication hospital admission in the Netherlands,” in this journal, De Veld and colleagues clearly demonstrated that the age at first alcohol use strongly correlated with the age at acute alcohol intoxication and the blood alcohol concentration at hospital admission (De Veld et al, ). Since this study is based on an impressive, unprecedented, and rich dataset, the results can be considered as trustworthy and are adding again important supporting evidence showing that also in the context of the Netherlands, drinking alcohol at a (very) young age can be very harmful, that the younger one starts drinking alcohol, the more problems with alcohol use there will often be in later life, and that delaying the age at first alcohol use might be successful in increasing the average age at which adolescents are confronted with problems due to their alcohol use.…”