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Initiation of and Escalation to High-Intensity Drinking in Young Adults

Question  When is high-intensity drinking (HID) (≥10 drinks in a row) initiated, who initiates earlier, and are earlier HID initiation of and speed of escalation to HID associated with young adult alcohol use in the US?

Findings  In this cohort study of 451 individuals, HID was initiated, on average, in late high school, and adolescents escalated from first drink to HID in 2 years. Family history of alcohol problems was associated with earlier HID initiation, and earlier HID initiation was associated with greater alcohol consumption, more frequent HID, and symptoms of alcohol use disorder at age 20 years.

Meaning  Early initiation of and quick escalation to HID may be markers for later negative outcomes among young adults and can inform screening and prevention.

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