High-intensity drinking (HID) is associated with numerous negative short- and long-term consequences. HID is usually initiated in late high school, and it is estimated that by young adulthood, about 1 in every 10 individuals report HID in the past two weeks. Earlier HID initiation is associated with greater alcohol consumption, more frequent HID, and symptoms of alcohol use disorder (AUD) at age 20. Not much is known about when HID initiation occurs with other substances and how it correlates with subsequent substance use. This study aims to examine when HID initiation occurs relative to the initiation of nicotine use and marijuana use and the relationship between HID initiation and other substances.
This study consisted of 468 participants ages 19-22. Participants reported initiating HID by age 20. The year of initiation was measured by asking questions such as when participants ever drank ten or more drinks in a row, when they first smoked a cigarette, and the first time for other substances. Nicotine use initiation, symptoms of AUD, other substance use outcomes, and social demographics such as race/ethnicity, biological sex, and sexual orientation were measured in this study. This study aimed to answer three research questions. One, when does HID initiation occur relative to the initiation of nicotine use and marijuana use? Two, how is the year of HID initiation associated with AUD symptoms and other substance use at age 20? Three, how is initiating HID before nicotine use and initiating HID before marijuana use associated with AUD symptoms and other substance use at age 20?
Results of this study showed that earlier HID initiation was associated with higher AUD symptoms and higher odds of all substance use outcomes at age 20, but not associated with past 30-day marijuana use and past 12 months of other illicit drug use. Overall, this study suggests that regardless of what substance is initiated first, delayed initiation of HID is a critical protective factor for alcohol and other substance use.
Takeaway: Regardless of what substance is initiated first (alcohol, nicotine, marijuana, etc.), delayed initiation of HID is a critical protective factor for alcohol and other substance use.