HMN 2026: How Drinking behavior in early adulthood predicts likelihood of alcohol use disorder symptoms at age 35

A person’s drinking patterns at age 18 predict the trajectory of their drinking behavior into adulthood, and that trajectory may predict the likelihood of having symptoms of alcohol dependence at age 35, according to a study published in Alcohol: Clinical and Experimental Research. Study data, collected over 40 years, also revealed that more recent generations are drinking less at age 18, but are more likely to move toward higher risk drinking or toward abstinence than prior generations. The findings suggest that identifying high-risk drinking patterns in teens and young adults may help them avoid problems with alcohol in midlife.

The study followed research participants for 17 years, beginning in 12th grade, and observed how their drinking patterns changed over time and which participants developed symptoms of alcohol misuse.

Most participants maintained stable patterns of drinking from age 18 to age 30, suggesting patterns of drinking in early adulthood are established in late adolescence: 28% of participants maintained a pattern of lower risk drinking, 19% engaged steadily in higher-risk drinking, and 7% remained abstinent from alcohol. However, more than half of the participants reported at least one period of higher-risk drinking during that timeframe, which put them at increased risk for symptoms of alcohol use disorder.

More than 40% of participants changed their drinking patterns between ages 18 and 30, with these changes typically occurring around ages 23 to 24. Of those, approximately 30% reduced their drinking, while 1 in 5 increased it. Any period of higher risk drinking, even if temporary, increased the likelihood of alcohol use disorder at age 35, and the higher the severity and longer the duration of higher-risk drinking, the greater the likelihood.

Any amount of alcohol use conferred a higher risk of alcohol misuse at age 35 compared to not drinking. Study participants born more recently were more likely to engage in lower risk drinking at age 18 and increase to higher risk drinking than earlier-born participants.

The study authors recommend future research to explore the factors influencing high-risk, low-risk, and abstinence from drinking.

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