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Keywords:

  • Adolescent;
  • drinking initiation;
  • milestones;
  • onset of alcohol use;
  • progression;
  • treatment

ABSTRACT

Aims  Research using nationally representative and community samples demonstrates a robust association between early onset of drinking and increased likelihood of numerous adverse outcomes. However, little is known about the subsequent drinking that occurs early in the drinking career. The present study dissects the transition from any alcohol use to treatment entry by taking a fine-grained approach to examining the attainment and progression of drinking events in a sample of adolescents in substance use treatment.

Design/Setting  Data were taken from the Drug Abuse Treatment Outcome Study for Adolescents (DATOS-A), a multi-site, community-based study of adolescents entering treatment.

Participants  Respondents included 3331 youth aged 12–18 years (mean = 15.75) admitted to treatment in 1993–95 (74% male, 52% white, 24% African American, 20% Hispanic).

Measurements  Age of attainment was obtained for five drinking-related milestones, including first drink of alcohol, first time drunk, first monthly drinking, first drank five or more drinks/day on a weekly basis and first drank five or more drinks/day on a daily basis.

Findings  Most milestones were attained at a very early age, and average progression through adjacent drinking events was relatively swift, Movement through early drinking milestones was accelerated in girls and white youth. Youth who reported their first drink at an early age (age 10 or younger) showed slower progression, suggesting the existence of distinct processes underlying early use and drinking transitions within an individual.

Conclusions  This study provides data relevant to understanding drinking progression/natural history in a large clinical sample, especially for differences by gender and ethnicity. The findings have implications for the identification of intermediate stages that might benefit from selected intervention programs.