Solitary Alcohol Use in Adolescence Predicts Alcohol Problems in Adulthood: A 17-Year Longitudinal Study in a Large National Sample of Us High School Students
Abstract
Background
Identifying risk factors for alcohol use disorder (AUD) is important for public health.
The social context of alcohol use – such as using alcohol alone – may be an independent and robust early risk marker for AUD symptoms later in life.
This study evaluated whether solitary alcohol use in adolescence (age 18) and young adulthood (age 23/24) was concurrently associated with binge alcohol use and prospectively predicted age 35 AUD symptoms and whether associations differed by sex.
Methods
Longitudinal data were from the Monitoring the Future study.
Surveys were completed by adolescents in 12th grade at age 18 (1976–2002), young adults at age 23/24 (1981–2008), and adults at age 35 (1993–2019). Analyses included past 12-month alcohol users (n = 4464 for adolescent models; n = 4561 for young adult models).
Multivariable regression analyses tested whether adolescent and young adult solitary alcohol use was associated concurrently with binge alcohol use frequency and prospectively with age 35 AUD symptoms.
Results
Solitary alcohol use in adolescence and young adulthood was associated (a) concurrently with binge alcohol use and (b) prospectively with increased risk of age 35 AUD symptoms (even after controlling for earlier binge alcohol use, alcohol use frequency, and sociodemographic covariates).
Adolescent solitary alcohol use was associated with age 35 AUD symptoms particularly among females; no interaction was observed between sex and young adult solitary alcohol use in predicting age 35 AUD symptoms.
Conclusions
Adolescent and young adult solitary alcohol use was associated with increased adult AUD symptoms above and beyond other risk factors.
Adolescent female solitary alcohol users were especially at risk.
Study interpretation
This study found that consuming alcohol alone during adolescence predicts future alcohol use disorders, especially for women. This finding holds true even after controlling for other factors such as binge alcohol use, frequency of alcohol use, socioeconomic status, and gender.
The study found that about 25% of adolescents and 40% of young adults reported using alcohol alone.
The odds of having alcohol use disorder (AUD) symptoms at age 35 were 35% higher for adolescents who used alcohol alone and 60% higher for young adults who used alcohol alone, compared to those who consumed alcohol only in social settings.
When doctors screen young people for alcohol use they often ask questions regarding the frequency of use and amount consumed. However, these findings show the context of use whether alone or with others also matters.
The findings suggest that targeted interventions for these groups, specifically young women that inform them of the risks of solitary alcohol use can be helpful in preventing future alcohol use disorders.
According to previous research by Creswell and colleagues, young people mostly consume alcohol alone to cope with negative emotions.
The alcohol industry is promoting their products – especially targeting women – as coping tools to deal with negative emotions and stress.
This pattern of alcohol use has consistently been linked with developing alcohol problems. Since the pandemic young people are at even greater risk of developing alcohol use problems as their anxiety and depression levels have also gone up.
With concurrent increases in pandemic-related depression and anxiety, we may very well see an increase in alcohol problems among the nation’s youth,” said Kasey Creswell, associate professor of psychology at Carnegie Mellon University, and lead author of the study per Science Daily.
Kasey Creswell, associate professor of psychology, Carnegie Mellon University
