Alcohol initiation and progression to use, heavy episodic use, and alcohol use disorder among young adolescents ages 12-14 living in US households
Objective: This study examined the prevalence and correlates of past-year alcohol initiation among young adolescents ages 12-14 and, among recent initiates, progression to current use, heavy episodic use, and alcohol use disorder (AUD). Method: The 2004-2013 data from the annual cross-sectional National Survey of Drug Use and Health among 12- to 14-year-olds living in civilian U.S. households (n = 87,470) were used to estimate the prevalence and correlates of alcohol initiation. Results: Lifetime prevalence of alcohol use was 19.9%; 14.1% reported past-year initiation. Among those with past-year initiation, 39.7% reported past-month use, 17.9% reported past-month heavy episodic use, and 10.4% met criteria for past-year AUD. Each alcohol estimate was higher among females than among males. Alcohol initiation increased with age; however, among past-year initiates, age was not associated with past-month use, heavy episodic use, or past-year AUD. In adjusted models, tobacco and illicit drug use were associated with each alcohol indicator tested; depression was associated with alcohol initiation and AUD among recent initiates. Conclusions: Progression from initiation to heavy episodic use and development of AUD happened rapidly for some young adolescents, including those who used other substances. Our results suggest the need for targeted clinical and public health efforts to prevent and reduce the burden of drinking and harmful drinking among this age group, especially among females, whose use and prevalence of use and misuse exceeded those of males.