The longer the amount of time between the first time someone drinks and gets drunk, the lower the likelihood of becoming alcohol-dependent, a new Yale study, “First Drink to First Drunk,” has found.
The age at which an individual first drinks alcohol, also known as the age of onset (AO), is one of the most researched risk factors for heavy drinking later in life. But researchers have spent less time examining the relationship between AO and the age of first intoxication (AI) — the first time someone gets drunk.
The time between AO and AI is known as “delay to intoxication.” The shorter this delay and the earlier the AO, the higher the future risk of binge drinking, according to the study — which will be published in the October issue of Alcoholism: Clinical & Experimental Research.
“Looking at age of onset and delay to intoxication simultaneously is a more informative way to understand early intoxication and future risk,” said Megan Morean, a psychiatry professor at the Yale School of Medicine and the lead author of the study. “It allows you to decompose the problem into its different parts.”
Although many researchers contend that an early AO is closely related to subsequent heavy drinking, research findings have been inconsistent, Morean said. In 2012, when Morean and her colleagues were researching AO in college students, she realized that delay to intoxication was a risk factor. The current study replicates those findings, but with a study population of high school students, as opposed to college students. It also extends the research focus to the delay of intoxication. It also extends the research focus to delay of intoxication.
“It was important to demonstrate a similar pattern of results in adolescence to rule out the possibility that recall bias — which is when people inaccurately recall events or experiences — might have impacted the results when college students were retrospectively reporting on their behavior in adolescence,” said Arizona State University psychology professor William Corbin, who reviewed the article.
To study the age of intoxication, the researchers administered surveys to 295 adolescent drinkers in high school. The participants who were predominantly Caucasian and whose average age was 16 years old — self-reported the first time they had consumed alcohol, the first time they had gotten drunk and their drinking habits in an anonymous survey.
The results were not a surprise — the researchers’ 2012 study had shown the same — but they were significant nonetheless, researchers interviewed said.
“This study corroborated the previous findings using a younger sample,” said Grace Kong, a researcher in the Yale School of Medicine psychiatry department and one of the study’s authors. “Now we are more confident that the delay between AO and AI is important to consider as we think about alcohol prevention for young people.”
The study also highlights how prevalent heavy drinking is among high school students, Morean said. She added that 80 percent of high schoolers have tried alcohol, a sign that current methods of prevention are not effective.
Many alcohol and drug prevention programs focus on preventing initiation of use, but the study’s authors contend that the progression between initial drink to first intoxication is equally important.
As a result, the study could have very important implications for prevention efforts, Morean said. The study suggests that prevention efforts should emphasize the importance of delaying both initiation of alcohol use and drinking to intoxication, instructor in adolescent medicine and contributing study author Deepa Camenga wrote in an email to the News.
“Efforts to prevent progression from any use to heavy use may also have a substantial impact,” Corbin wrote. “If we can identify early users and engage in targeted efforts to reduce their risk for progression to heavy drinking, we may be able to alter their long-term trajectory of alcohol use.”
Both Morean and Corbin stated that the research has important implications for the education of high schoolers and their parents. Letting people know that drinking and getting drunk earlier increase risk of alcohol dependence later in life could deter high school students from starting to drink or binge drink, Corbin wrote in an email.
Morean said that future research should attempt to mitigate the ambiguity of “drunkenness,” and the inevitable subjectivity of the survey by establishing a “more concrete definition of intoxication.” She also hopes to examine what kind of variables influence delay to intoxication. She cited impulsive behavior and hereditary factors as potential contributors.
Gong and Morean also stated that it would be informative to collect more information regarding the survey participants’ first drinking encounters. Whether their first experience was positive or negative may determine their decision to engage in problematic drinking in the future, they said.
According to Ralph Hingson, director of the division of epidemiology and prevention research at the National Institute on Alcohol Abuse and Alcoholism — a division of the National Institutes of Health — future research ought to move beyond just alcohol and ask the same questions of tobacco, marijuana and other substance use.
Peg Calder, President and Founder of The Foundation for Alcoholism Research, Inc., suggested a parallel study that uses fMRI technology to establish correlations between drinking behaviors and brain activity.
According to a Yale Daily News Class of 2018 freshman survey, 75 percent of incoming freshmen had consumed alcohol prior to arriving at Yale.