Age at first alcohol use: A risk factor for the development of alcohol disorders

Objective: This study aimed to describe the natural course of DSM-III-R alc ohol disorders as a function of age at first alcohol use and to investigate the influence of early use as a risk factor for progression to the develop ment of alcohol disorders, exclusive of the effect of confounding influence s. Method: Data were obtained from a community sample (N=5,856) of lifetime dr inkers participating in the 1990-1991 Mental Health Supplement of the Ontar io Health Survey. Results: Survival analyses revealed a rapid progression to alcohol-related harm among those who reported having their first drink at ages 11-14. After 10 years, 13.5% of the subjects who began to drink at ages 11 and 12 met t he criteria for a diagnosis of alcohol abuse, and 15.9% had a diagnosis of dependence. Rates for subjects who began to drink at ages 13 and 14 were 13 .7% and 9.0%, respectively. In contrast, rates for those who started drinki ng at ages 19 and older were 2.0% and 1.0%. Unexpectedly, a delay in progre ssion to harm was observed for the youngest drinkers (ages 10 and under). H azard regression analyses revealed a nonlinear effect of age at first alcoh ol use, marked by an elevated risk of developing disorders among subjects f irst using alcohol at ages 11-14. Conclusions: First use of alcohol at ages 11-14 greatly heightens the risk of progression to the development of alcohol disorders and therefore is a r easonable target for intervention strategies that seek to delay first use a s a means of averting problems later in life.