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Marijuana use, peer and parental influences and other factors influence transition to alcohol use disorders

To better understand the development of alcohol use disorder, researchers looked at four transitions in a large, ethnically diverse sample of adolescents and young adults. They found several significant influences on development of a disorder, including marijuana use and peer and parental influences. Having a mother with an alcohol use disorder was especially linked to initiation of drinking and some later transitional stages. While initiation of drinking has been given much attention, all stages of development of a disorder have not been well-studied, the authors wrote. They studied young people at higher risk based on family history, using the Prospective Study of the Collaborative Study on the Genetics of Alcoholism, or COGA, which began in 1989 at multiple U.S. sites. At baseline, the study included 3,573 adolescents and young adults who were 16 years old on average. Data collected from those adolescents and young adults over the years were used to study four transitions:  Time to first drink, first drink to first problem, first drink to first diagnosis and first problem to first diagnosis. Then they compared associations of parental alcohol use disorder, parental separation, peer substance use, marijuana use, trauma exposures and internalizing and externalizing psychopathology across those transitional periods. Transition risks were elevated for those who had ever used cannabis, those who attributed substance use to their peers, those with externalizing disorders and those with parents with alcohol use disorder. Trauma that did not include an assault was associated only with early initiation. Assaultive trauma was not linked to any transition, which came as a surprise to the researchers, they wrote. 

Take away: Prevention and intervention efforts should take into consideration risk factors that elevate the chances higher-risk individuals will develop a disorder. In particular, the relationship between marijuana use and development of alcohol use disorders should be considered:  The researchers wrote that, “in light of the increasingly permissive legal and social stances toward cannabis in the United States, the marked elevations of all alcohol outcomes observed for cannabis use underscore the importance of studying the underpinnings of this relationship.”

Bucholz K, McCutcheon V, Agrawal A et al. (2017) Comparison of Parent, Peer, Psychiatric, and Cannabis Use Influences Across Stages of Offspring Alcohol Involvement:  Evidence from the COGA Prospective Study, Alcoholism:  Clinical and Experimental Research, 1-16

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