Research & Resources

In this study, researchers sought to identify when individuals initiate high-intensity drinking (HID)—i.e., 10 or more drinks in a row—and the speed of escalation from first drink and first binge to first HID; characteristics associated with initiation and escalation; and whether these characteristics are associated with weekly alcohol consumption, HID frequency, and symptoms of alcohol use disorder at age 20. The study analyzed web-based survey data from 451 respondents in the U.S. who reported alcohol use in the past 30 days. The researchers recruited respondents who were in the 12th grade during the 2018 Monitoring the Future study and surveyed them again in 2020, at modal age 20 years, in the Young Adult Daily Life Study. On average, first drink, first binge, and first HID were initiated during high school. The mean time of escalation from first drink to first HID was 1.9 years; from first binge to first HID was 0.7 years. Same-year escalation from first binge to first HID was associated with higher HID frequency at age 20. These findings expand the understanding of HID initiation when it comes to ages, patterns, escalation, and association with the risk of alcohol use disorder. The findings could facilitate alcohol use disorder screening for adolescents and young adults.

This paper, “Initiation of and escalation to high-intensity drinking in young adults,” was funded by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and the National Institute on Drug Abuse (NIDA) and published in the journal JAMA pediatrics.