Comparison of Parent, Peer, Psychiatric, and Cannabis Use Influences Across Stages of Offspring Alcohol Involvement: Evidence from the COGA Prospective Study

Although the initiation of drinking has been a major area of research, other stages of alcohol use disorder (AUD) have not been as thoroughly investigated. It is not clear whether the same factors are associated with early and later periods of AUD development. The COGA family samples that have multiple members with AUD offer a special opportunity to examine the specific influences on each AUD stage.

Data from teenagers and young adults from families with and without problem drinkers were used to study how quickly these individuals developed problems with alcohol—time to: first drink, first drink to first alcohol problem, first drink to first AUD diagnosis, and first alcohol problem to AUD first diagnosis. Analyses targeted a number of possible predictors of these changes: parents’ AUD, parental separation/divorce in childhood/adolescence, friends’ substance use, and the individual’s own history of marijuana use, exposure to trauma, and internalizing (like depression)  and externalizing  problems (like ADHD, childhood behavioral problems like lying, starting fights, shoplifting, flouting rules ) The likelihoods of starting to drink, developing an alcohol  problem, or AUD were  higher for those who had ever used marijuana, had externalizing problems, and had parents with AUD, and friends who used alcohol or drugs.  In contrast, internalizing problems were associated only with the later stages of alcohol involvement such as developing an alcohol  problem or AUD, but not with starting to drink.