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J Addict Med. 2008 Mar;2(1):22-30. doi: 10.1097/ADM.0b013e3181565e14.

Early Age-of-onset Drinking Predicts Prescription Drug Misuse Among Teenagers and Young Adults: Results from a National Survey.

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From the Youth Alcohol Prevention Center (JAH, MRW, TCH, RWH), Department of Social and Behavioral Sciences (JAH, RWH), and Department of Biostatistics (MRW, TCH), Boston University School of Public Health, Boston, MA; and Division of Epidemiology and Prevention (RWH), National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD.


Early age-of-onset drinking is associated with alcohol problems and related, high-risk behaviors. We analyzed data from 18- to 34-year-old respondents from the 2001 to 2002 National Epidemiological Survey on Alcohol and Related Conditions (NESARC) to determine to what extent early age-of-onset drinking increased risks for prescription drug misuse (PDM), defined as 1 or more positive responses to: "ever having misused sedatives, tranquilizers, painkillers or stimulants, obtained either as prescriptions or from indirect sources." Lifetime prevalence of PDM was 15.4% among 8306 "drinkers" and 3% among 4652 "nondrinkers." Unadjusted odds for PDM for both men and women increased with each successively younger drinking age-of-onset, reaching a 10-fold risk at <14 years (odds ratio [OR], 10.7; 95% confidence interval [CI], 7.43-15.3) for men and women combined). In adjusted analyses, early age-of-onset marijuana use among drinkers reduced these odds and independently increased the risks for PDM 2-fold (adjusted OR, 2.07; 95% CI, 1.17-3.64). Lifetime alcohol dependence independently predicted PDM (adjusted OR, 2.43; 95% CI, 2-2.96) and obscured the association of early drinking, but not of early marijuana use, with PDM. This finding suggests a specific mediating effect of alcohol dependence between early drinking and PDM. Findings support the need for effective programs to prevent and reduce harm from early-onset drinking and from the associated risk of alcohol dependence and prescription drug misuse.

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