Drinking Alone as a Young Person Linked to Later Alcohol Use Disorder

Drinking alone during adolescence and young adulthood is associated with a higher risk of alcohol use disorder (AUD) later in life, and this risk is especially high for women, according to a new study published on July 11 in Drug and Alcohol Dependence.

“When young people drink alone, it’s a red flag that predicts future alcohol problems,” says the study's lead author, Kasey Creswell, PhD, an associate professor of psychology at Carnegie Mellon University in Pittsburgh.

“Most young people who drink alcohol only do so with others in social settings — with friends and at parties. Drinking alone as a young person may signify a problematic relationship with alcohol, in which drinking is used as way to cope with negative emotions,” says Dr. Creswell.

About 3 in 10 High School Students Report Drinking Alcohol

Underage drinking is common in the United States, according to the Centers for Disease Control and Prevention (CDC). In a 2019 survey of high school students, 29 percent reported drinking alcohol in the prior 30 days, and 14 percent said they had engaged in binge drinking. Binge drinking is defined as drinking enough to bring one’s blood alcohol concentration to .08 percent or more. That typically corresponds to five or more drinks for men or four or more drinks for women, generally within about two hours.

Although doctors often screen young people for risky alcohol use, their questions typically focus on the frequency and quantity of alcohol consumed, according to the authors. Creswell believes the social context in which young people drink is a critical but often overlooked indicator of future alcohol misuse.

What Is Alcohol Use Disorder?

Alcohol use disorder, or AUD (previously referred to as alcoholism), is a chronic brain disease that can go into remission but cannot be cured. In 2019, an estimated 14.1 million people in the United States had AUD, according to the National Institute on Alcohol Abuse and Alcoholism.

In the short term, binge drinking can result in injuries, accidents, alcohol poisoning, risky sexual behaviors, and violence, per the CDC. Over time, drinking too much alcohol is linked to an increased risk of liver disease, certain types of cancer, and heart disease. Excessive drinking impacts mental health too, and heightens the risk of depression, anxiety, and sleep problems.

Drinking Alone ‘Is an Early Warning Sign’

Investigators used data from the Monitoring the Future study, an ongoing epidemiological study of drug and alcohol use among American youth that continues to follow them into adulthood. The 4,464 participants were 18 years old (referred to as adolescents in the study) when they completed the survey, which included questions about their patterns of alcohol use and whether they consumed alcohol while alone.

These participants were then followed for 17 years, and answered questions about their alcohol use and drinking alone in young adulthood (ages 23 or 24) and their drinking habits, including any AUD symptoms, in adulthood, at age 35.

Researchers found that about 25 percent of adolescents and 40 percent of young adults reported drinking alone, and these individuals were at increased risk of AUD symptoms in adulthood compared with people of the same age who drank only in social settings.

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After controlling for other factors that could influence future alcohol use problems, researchers found that the odds of having alcohol use disorder symptoms in adulthood were 35 percent higher for adolescents who drank alone, and 60 percent higher for young adults who drank alone, compared with social-only drinkers.

“It’s remarkable that solitary drinking continued to predict increased risk above and beyond earlier binge drinking, frequency of alcohol use, and a host of demographic variables like male sex and lower socioeconomic status. Drinking alone as a young person is an early warning sign that we should pay attention to,” says Creswell.

Drinking alone may place youth on a trajectory of increased drinking and increased risk of alcohol problems, she says. “Adolescent females who drink alone seem to be at particular risk, perhaps because they are more likely to self-medicate with alcohol. More research needs to be done to explore why young females are at increased risk.”

Pandemic Drinking Habits May Lead to Increased Alcohol Problems

Although the data used in this study was collected pre-pandemic, drinking patterns reported in the era of COVID-19 could mean more or different alcohol issues in the future, says Creswell. “Studies have shown an increase in solitary drinking among young people due to bar and restaurant closures and stay-at-home directives, and in the presence of increased stress and negative emotions due to the pandemic, this could perhaps create opportunities to foster a different relationship with alcohol — one of self-medication, which has been consistently linked to increased alcohol problems,” she says.

Creswell adds: “With concurrent increases in pandemic-related depression and anxiety, we may very well see an increase in alcohol problems among the nation's youth.”

If you’re concerned that your child has an alcohol use disorder or is exhibiting problematic drinking habits that seem to go beyond “just experimenting,” the Partnership to End Addiction recommends getting an assessment from a professional.

To learn more about AUD and where to get help, Creswell recommends the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and Rethinking Drinking.

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