The adolescent origins of substance use disorders

Abstract

Although early use of alcohol during adolescence has been consistently associated with increased risk of alcoholism in adulthood, the specific mechanisms that underlie this association remain unclear. We describe a program of epidemiological twin-family research that shows that early use of alcohol is best conceptualized as an indicator of a more general propensity to engage in adolescent problem behavior. Adolescent problem behavior, in turn, is a risk factor for a broad range of adult externalizing disorders, of which alcoholism is but one manifestation. These findings are shown to be consistent with a dual-process model whereby early adolescent problem behavior is associated with increased risk of adult psychopathology because both are indicators of a common inherited liability and because early adolescent problem behavior increases the likelihood an adolescent is exposed to high-risk environments. We conclude with a discussion of the importance of cross-cultural research, which may be especially informative for identifying the consequences of early adolescent drinking.Keywords adolescent drinking; disinhibitory psychopathology; adolescent problem behavior; cross-cultural alcohol researchOne of the most robust findings in the alcohol research field is the association between an early initiation of alcohol use and risk of alcohol dependence. In a highly cited influential study on a large US epidemiological sample, Grant and Dawson (1997) reported that individuals who retrospectively report that they had first tried alcohol prior to age 15 were four times more likely to have a lifetime diagnosis of alcohol dependence than individuals you first tried alcohol after the age of 20. This finding has been replicated in several retrospective studies (Dewit et al., 2000;Hingson et al., 2006;McGue et al., 2001a;Prescott and Kendler, 1999) and at least one prospective study (Keyes et al., 2006). Unfortunately, however, all of these studies have been based on US samples, an important limitation to which we will return later.The consistency and strength of the association between early alcohol use and alcoholism suggest that it has implications for efforts to prevent alcoholism onset. The nature of these implications, however, necessarily depends on the specific mechanisms that underlie the association. Two alternative mechanisms have been proposed. First, early use of alcohol may increase alcoholism risk by altering the course of adolescent development (Dewit et al., 2000). Adolescent alcohol use could alter the course of development by decreasing the Alternatively, others have suggested that the association of early alcohol use with alcoholism risk is spurious, arising because early use of alcohol in adolescence and alcoholism in adulthood are both manifestations of a general inherited liability to disinhibitory psychopathology Young et al., 2000). Support for this proposition came initially from a study of nearly 9000 twins, which showed that early use of alcohol was heritable and its association with alcoholism...

Examining Explanatory Mechanisms of the Effects of Early Alcohol Use on Young Adult Alcohol Dependence

“…For example, individual variations in the dopaminergic, serotonergic, or GABAergic systems might give rise to both early onset of alcohol use and alcohol problems in adulthood (van der Zwaluw and Engels, 2009). The link between early alcohol use and later alcohol problems could also arise from a common genetic liability to disinhibitory psychopathology (McGue and Iacono, 2008;Young et al, 2000). Furthermore, in the Mason et al (2011) study described above, alcohol use at age 13, although unrelated to the change in self-regulation later in adolescence, was related to low self-regulation at baseline, suggesting the possibility of a common neurobehavioral disinhibitory antecedent.…”

“…Under this view, early alcohol use may simply be a marker or a symptom of risk factors that are salient predictors of adult alcohol problems (King and Chassin, 2007;McGue and Iacono, 2008;White, 1992). In other words, both adult alcohol dependence and early age at drinking onset may arise from a common vulnerability to alcohol problems such as shared familial vulnerability (genetic or environmental; Prescott and Kendler, 1999).…”

Analyses of factors that influence alcohol use among children: a prospective path analysis / Análisis de factores que influyen sobre el uso de alcohol de niños: un path análisis prospectivo

“…Considerando las consecuencias negativas asociadas al inicio temprano del consumo de alcohol (McGue y Iacono, 2008), estos resultados señalan la importancia de retrasar la edad en la que los niños comienzan a tomar alcohol.…”

“…Por ejemplo, el uso y abuso temprano de alcohol puede alterar funciones cerebrales u otros aspectos del desarrollo, todo lo cual seguramente disminuirá las probabilidades de éxito en la vida académica, laboral, de pareja y tendrá un impacto en la salud (Masten et al, 2009). Por otro lado, el inicio temprano del uso de alcohol se asocia de manera marcada con la aparición de problemas por el consumo de alcohol (Mcgue y Iacono, 2008). Esto ha llevado a un incremento del número de investigaciones centradas en el inicio del consumo en niños menores de 12 años.…”

The Factors Related to Substance Use among Korean Adolescents: Focusing on Sexual Experiences and Risky Sexual Behaviors

“…People who use substances at early ages are more likely to be addicted to drugs when they reach adulthood [3]. Early sexual engagement of adolescents hampers normal physical development and is linked to smoking, drinking, running away from home [4].…”