Impact of early drunkenness on increased mortality

Individuals who first become drunk in their adolescent years are at a higher risk of death, but that risk climbs substantially when the first drunk experience occurs before age 15 years, according to a recent report.

Individuals who got drunk at least once before age 15 years were 47% more likely to die over the course of the study period. Those who got drunk at or after age 15 years were 20% more likely to die from an alcohol-related death during the study period.

“Our study found an association between early onset of drunkenness and increased mortality risk. The results from our study need to be interpreted with caution,” says Hui Hu, PhD, research assistant scientist in the department of epidemiology at the University of Florida’s College of Public Health and Health Professions and College of Medicine in Gainesville and lead author of the report. “We only found an association, and it is too early to make any causal inference based on the study’s findings. That being said, our study showed that early onset of drunkenness has the potential to be used to identify high-risk individuals.”

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Although the findings are preliminary, Hu says because early onset of drunkenness can be potentially used to identify high-risk populations, early screenings by pediatricians may be helpful. More research would be needed to further determine a clinically meaningful age cutoff, he adds.

The new report, published in Drug and Alcohol Dependence analyzed data from nearly 15,000 individuals collected across several decades. Data were collected via interviews starting  from the early 1980s to the present, with most participants aged 18 to 44 years.

A total of 61% of those participants reported that they had been drunk in their lifetime, 13% admitted to becoming drunk for the first time prior to age 15 years. Thirty-seven percent of those who were first drunk before age 15 years had diagnosed alcohol use disorders (AUDs) at the onset of the study compared to the 11% of the remainder of the cohort whose first drunkenness occurred sometime after their fifteenth birthday.

By the end of the study period, 26% of the individuals in the group that had first been drunk before age 15 years had died, compared to 23% of individuals who were first drunk after age 15, and 19% who had never been drunk at all.

The research team notes that mortality rates were consistent in these groups regardless of a history of AUD. Study findings were also consistent with previous research that links age at first drunkenness to a variety of risky behaviors and drug problems, including AUD.

Researchers suggest that exploring earlier ages with greater discrimination for the exact age at first drunkenness may provide even more data. Further studies may also want to differentiate individuals who have never been drunk versus individuals who abstain from alcohol altogether as those groups were combined in this study.

Researchers chose to focus on age at first drunkenness to differentiate the effects between age at first drink versus age at first drunkenness and evaluate any differences between the 2.

“The effects of early drinking might be present only for drinkers who consumed alcohol to the point of intoxication and becoming drunk, but not among those who consume no more than a sip (or even a full drink over the course of a meal) and for whom there is no palpable sensation of intoxication,” the researchers note. “It is possible that using small quantities of alcohol at an early age, without intoxication, is an inert experience with respect to later risk of dying, unless the alcohol consumption involves intoxication and drunkenness.”

The study did not take into account other risk factors that could have contributed to early alcohol use or death, such as risk-taking behaviors, mental health problems, or lack of social and economic support, the authors note.

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“Although the causal relationship between early drunkenness and mortality needs to be further studied, many previous studies have shown that early drunkenness may lead to many other adverse outcomes such as AUDs, smoking, fighting, unplanned and unprotected sex, and low academic performance,” Hu says, adding that pediatricians should certainly educate patients and their families about the dangers of early drunkenness. “We hope that this study will lead to further investigations on the potential causal relationship between early drunkenness and mortality, as well as interventions to improve health outcomes among those with early drunkenness and to further guide clinical practice in the future.”