Heavy drinking during teenage years begins taking a serious health toll by the time people are 24 years old

A University of Washington study has found that people who began binge drinking at age 13 and continued throughout adolescence were nearly four times as likely to be overweight or obese and almost 3½ times as likely to have high blood pressure when they were 24 years old than were people who never or rarely drank heavily during adolescence.

It also found four distinct patterns or trajectories of binge drinking among teenagers.

The study looked at young adult health consequences of adolescent binge drinking -- consuming five or more drinks on a single occasion -- between the ages of 13 and 18. Previous research has shown that adolescent binge drinking results in a number of immediate negative consequences, including involvement in fatal or injurious automobile accidents and engaging in risky sexual behavior. But little had been known about the effects of adolescent heavy drinking into young adulthood.

"In our analysis, we did look at whether people were currently binge drinking at age 24. We controlled for it, along with other factors, such as adolescent drug use, ethnicity, gender and family poverty, and we still saw different patterns of health outcomes depending on which trajectory of binge drinking teenagers followed," said Karl Hill, a co-author of the study and director of the Seattle Social Development Project.

"It is the pattern of early and on-going drinking that is the key."

The research team from the UW's Social Development Research Group in the School of Social Work found four categories of adolescent binge drinking. They are:

• Chronic binge drinkers (3 percent), who started at age 13 and continued to binge drink between three and five times a month through age 18.
• Escalators (4 percent), who began drinking around age 15 and their bingeing increased sharply and continuously until they were binge drinking nearly 10 times monthly by age 18.
• Late onsetters (23 percent), who started drinking after age 16 and averaged two bingeing episodes a month by age 18.
• Non-binge drinkers (70 percent) never or rarely engaged in binge drinking between ages 13 and 18.

The study used data from the on-going Seattle Social Development Project led by the UW's J. David Hawkins of more than 800 Seattle school children who are now adults. The participants were nearly equally divided between males and females. Forty-seven percent identified themselves as white, 23 percent as black, 21 percent as Asian-Americans, 6 percent as American Indians and 3 percent as being from another ethnic or racial group.

The participants were interviewed annually starting at age 13 through age 16 and again at ages 18, 21 and 24. They were asked about their alcohol, tobacco and drug use. At 24 they were asked about such health-related behaviors as safe driving, use of seat belts in automobiles and regular exercise. In addition, they had their blood pressure checked twice and were questioned about having any of 18 illnesses or health conditions, including asthma or emphysema, high blood pressure, arthritis, diabetes, cancer and heart disease, in the past year.

"Young adults who either did not binge drink or rarely did so during adolescence are the most likely to be healthy and engage in safe health-related behaviors," said Sabrina Oesterle, lead author of the study and a research associate in the UW's Social Development Research Group. "Being overweight or having hypertension can be linked to future problems such as heart disease, diabetes and cancer. What we are seeing are the first warning signs of more serious health problems. Young adults' history of binge drinking during the teenage years, irrespective of current levels of binge drinking, appears to have serious effects on their health by age 24."

The study also noted other differences among the groups.

Late onsetters were 50 percent more likely to have been ill in the past year as young adults who did not drink heavily as teens. They were also 50 percent more likely to drive drunk or high on drugs or to ride or drive with someone who was drunk or high than were non-heavy drinkers. Escalators, who reported the highest levels of binge drinking by age 18, also engaged in more unsafe driving practices, than non-heavy drinkers. This group also engaged in very high levels of anti-social behavior, including drug use and crime, according to an earlier study by the research team.

"Looking at patterns of drinking over time is more revealing than looking at drinking at a single time when some groups of people don't look that different from each other," said Hill. "Some people start heavy drinking early and continue, others start late and increase quickly, and each of these groups have different health outcomes. This suggests the importance of prevention programs that start early, in elementary school, and continue through high school to reach children who begin to use alcohol and drugs at different ages."

The research was funded by the National Institute on Drug Abuse, the National Institute on Alcohol Abuse and Alcoholism and the Robert Wood Johnson Foundation. Co-authors of the study were Hawkins and Richard Catalano, UW professors of social work and director and associate director of the Social Development Research Group, respectively; Robert Abbott, chairman of educational psychology at the UW; and Jie Guo, a former UW research scientist. The study was published in the Journal of Studies on Alcohol.