There is a lot of variability in how adolescents initiate and progress in their consumption of alcohol. Are there patterns that we can learn from to predict whether a teenager will have problems with alcohol consumption as an adult? Yuen et al (10.1542/peds.2020-0440) have investigated this question in a study being released this month in our journal. The authors looked at survey data reported longitudinally over 4 years in 1,813 Australian adolescents and define trajectories of alcohol use from the reports of those in the cohort. Four trajectories were identified, categorized as abstaining, late-onset moderate drinking, early-onset moderate drinking, and early-onset heavy drinking. In addition, the authors evaluated other factors such as parental influence and peer pressure regarding how they affected these four trajectories. The results are well worth the time spent reading.
One of the most notable findings from this study are the factors that can predict the risk of alcohol use disorder (AUD) occurring in adulthood. For example, parenting factors and peer influences play a key role in modifying these risks. Just how much modification can occur relative to the trajectory adolescents are on is why this article sheds additional light on opportunities for intervention. Caution is raised about adolescents who start early using alcohol or rapidly escalate since these trajectories carry the highest risk of continuing on to have a serious alcohol problem in adulthood. If anything, this study re-emphasizes why we should do all that we can in counseling our adolescent patients to delay initiation of alcohol. In addition, if we find that alcohol is being used by a teen patient, it is a good time to reassess the parent and peer factors that could increase or reduce the risk of heavier drinking in adolescence and in turn lead to alcohol-related problems continuing into adulthood. This article has lots to offer regarding how we might adjust our conversations based on which trajectory best fits our adolescent patients. Link to this article and learn more.
