Introduction: Age of first drink is a key risk factor for adolescent high-risk alcohol use. The current study examined whether speed of escalation from first drink to first intoxication is an additional risk factor, and whether these two factors are associated with binge and high-intensity drinking among adolescents. Methods: Data collected in 2005–2017 from a nationally-representative sample of 11,100 U.S. 12th grade students participating in the Monitoring the Future study were coded to indicate grade of first drink, grade of first intoxication, and speed of escalation from first drink to first intoxication. Logistic regression models estimated bivariate and multivariable odds of past 2-week binge (5+ drinks in a row) and high-intensity (10+ drinks in a row) drinking in 12th grade. Results: Of those who reported intoxication by 12th grade, almost 60% reported first drunkenness in the same grade in which they first drank. The likelihoods of 12th grade binge and high-intensity drinking were significantly associated with both grade of first drink and speed of escalation to intoxication. Past two-week high-intensity drinking prevalence was 17.4% among those with immediate (same-grade) escalation from first drink to first intoxication; 15.8% among those with a 1-grade delay, and 12.6% among those with a 2+ grade delay to intoxication. Conclusions: The majority of students escalate quickly from having their first drink to being intoxicated for the first time. Both earlier age of first drink and a faster escalation from first drink to first intoxication are important indicators of binge and high-intensity drinking risk among adolescents.
Bibliographical noteFunding Information:
Development of this manuscript was supported by research grant R01AA023504 from the National Institute on Alcohol Abuse and Alcoholism to M. Patrick. Data collection and manuscript preparation were supported by research grants R01DA001411 and R01DA016575 from the National Institute on Drug Abuse . The study sponsors had no role in the study design, collection, analysis or interpretation of the data, writing of the manuscript, or the decision to submit the paper for publication. The content is solely the responsibility of the authors and does not necessarily represent the official views of the study sponsor.
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- Extreme binge drinking
- Heavy episodic drinking