Greater than the Sum of its Parts: The Combined Effect of Early Alcohol Use and Violence on Alcohol Abuse and Violence in Adulthood.

Background: Alcohol abuse and violence are key contributors to leading causes of death among youth. Yet, the relationship between violence and alcohol use is complex and the developmental impact of this association merits further investigation. The current study used prospective data from the National Longitudinal Study of Adolescent Health (Add Health) to investigate how violence and alcohol use coexist in adolescence and how this coexistence predicts alcohol abuse and violence in adulthood.

Methods: The sample consisted of 9421 adolescents ranging from ages 11-32. The effects of alcohol use and violence on alcohol abuse and violent behavior were modeled by means of survey logistic regression. Racial/ethnic differences were tested using Chi-squared analyses.

Results: Independently, alcohol and violence during adolescence were not significantly associated with violent behavior among young adults (Wave IV). Racial/ethnic differences emerged in the relationship between alcohol use and violence, and the overlap between the two in predicting alcohol abuse in adulthood. Among Whites and Blacks, violence and alcohol during adolescence were also associated with alcohol abuse among young adults (Whites: OR=2.59; Blacks: OR=4.23). Alcohol use and violence was not associated with increased alcohol abuse among Hispanics. Results indicate that coexistent alcohol use and violence pose a risk for alcohol abuse in adulthood, beyond the independent effects of alcohol and violence. Combining both alcohol and violence prevention in adolescent populations may prevent the abuse of alcohol and participation in violence in adulthood.