Rapid transition from drinking to alcohol dependence among adolescent and young-adult newly incident drinkers in the United States, 2002-2013

•We studied the rapid transition from 1st full drink to alcohol dependence.•In estimated male-female differences, we discovered an adolescent female excess.•Among females, the estimated transition probability declines with age at first drink.•Among males, there are no appreciable differences in relation to age at first drink.•This study's focus on newly incident drinkers helps constrain recall bias.

BackgroundTo study male-female and age differences in estimates of rapid transition from first full drink to alcohol dependence among youthful newly incident drinkers in the United States (US).MethodThe study population included 12-to-25-year-old non-institutionalized US civilian residents, sampled for US National Surveys on Drug Use and Health 2002-2013, with assessments via confidential computer assisted self-interviews. Newly incident drinkers are those who had their first full drink soon before the assessment (n = 32,562 12-to-25- year- olds). Alcohol dependence (AD) criteria are from DSM-IV.ResultsFor 12-to-25-year-old females, the peak risk for making a rapid transition from first full drink to alcohol dependence is seen during adolescence, followed by declining estimates (meta-analysis summary = 3% at 12-17 years of age, 95% CI = 2%, 3%). Among males, corresponding estimates fluctuate around 2%, with no appreciable differences across age strata. Among 12-to-17-year-old newly incident drinkers, there is a female excess in the rapid transition to alcohol dependence; a male excess is observed among young adult newly incident drinkers. Evaluated cohort-wise, using an epidemiological mutoscope view, individual cohorts show a congruent pattern, with age at first drink held constant.ConclusionsStudying multiple replication samples of young newly incident drinkers, we discovered a clear female excess in the risk of a rapid transition from first full drink to alcohol dependence among adolescents, with age patterns differing across males and females.