An early age at first drink combined with stressful life events can lead to heavy drinking

Results will be published in the June 2011 issue of Alcoholism: Clinical & Experimental Research and are currently available at Early View.

"It has long been known that an early beginning of alcohol use is associated with more drinking in general, and with more severe problems resulting from this alcohol use, one of which would be alcoholism," said Dorothea Blomeyer, a senior researcher at the Central Institute of Mental Health and first author of the study.

"In addition," said Rainer Spanagel, a professor of pharmacology at the University of Heidelberg, "several epidemiological studies indicate that the association of an early AFD and the later development of alcohol use disorders might be particularly relevant in the context of stressful life events."

Blomeyer and her colleagues examined participants drawn from the ongoing Mannheim Study of Children at Risk, a longitudinal study of the outcome of early risk factors from infancy into young adulthood. For this study, 306 participants (166 females, 140 males) were asked about their AFD, stressful life events during the preceding three years, daily hassles in the preceding month, and drinking behaviors at 22 years of age. Participants were also asked about amount of alcohol consumed, and drinking frequency/drinking days, in the preceding month. Given that the researchers regularly assessed the participants during adolescence, their responses were assumed to be more reliable than those of an adult sample looking back in time.

"We found that the impact of stressful life events on drinking behavior depends on the age at first drink," said Blomeyer. "The earliest AFD in our sample was eight years; about half of the study participants had initiated alcohol drinking before they were 14 years old. The earlier they start with alcohol use, the stronger the association between life stress and drinking in young adults. We found this interaction effect only for the variable 'total amount of alcohol,' not for the number of drinking days. This fits to the pattern of stress-related drinking, which is characterized by a higher number of drinks, and not so much by frequent drinking."

"This relationship seemed to occur only when individuals suffered from stressful life events such as severe job problems," noted Spanagel, "but not after daily hassles that produce an everyday stress load."

"We suppose that those with earlier AFDs learn to use alcohol in stressful situations during adolescence," said Blomeyer, "because research indicates that during adolescence, drinking is particularly rewarding under stressful circumstances. Perhaps there are some life events of higher impact on alcohol use than others. However, in our study, every single event was counted equally to form the sum score, so this question has to be answered by following research."

"This study extends our knowledge on how the connection between AFD and later drinking problems might develop," said Blomeyer. "The hypothesis that the association between AFD and stress on drinking behavior emerges at young age was previously assumed by other authors, but not yet proven. Conversely, our study shows that the interaction effect does not only rely on a 'forward-feeding' effect from heavier drinking in late adolescence, which usually is associated with more stressful life events later on."

"Large epidemiological studies indicate that each year adolescents start earlier with having their first drink," said Spanagel. "This social problem has to be resolved. The primary aim of each prevention program should be to raise the age of adolescents for having their first real drinking occasion. However, a few sips of an alcoholic beverage -- just to taste it -- do not count as a first drink; a first drink can only be considered as a first real drinking occasion if the individual gets intoxicated."

"It is very important to protract AFD as long as possible in order to prevent heavy drinking and alcohol use disorders," concurred Blomeyer.