Characteristics of drinking events associated with heavy episodic drinking among adolescents in the United States

Purpose To examine associations between characteristics of drinking events and the quantity of alcohol consumed by adolescents in the United States. Methods Analyses relied on 2011–2015 data from the National Survey on Drug Use and Health (NSDUH). The study sample included 8110 adolescents, ages 12–17 years old, who drank alcohol in the past 30 days. A logistic regression model, weighted for national estimation, was constructed to examine factors associated with heavy episodic drinking (HED; 5+ drinks for males, 4+ drinks for females) during the underage drinker's most recent drinking event. These models were adjusted for study year and individual characteristics, including past year drinking frequency, age of drinking onset, and demographic variables. Results Buying alcohol off-premise or from another person and being given alcohol from non-parent social sources were associated with greater odds of HED compared to being given alcohol by one of their parents. Drinking alcohol at someone else's house or multiple locations were associated with heavier alcohol consumption compared to drinking at one's own home. Being older and an earlier age of alcohol onset were associated with greater odds of HED. Conclusions This study identifies contextual factors associated with HED by adolescents. Compared to global association studies, the findings from these event-specific analyses provide strong evidence of the environmental conditions that contribute to HED in American adolescents. Although no level of alcohol consumption is safe for adolescents, knowledge of event-level risk factors can inform targeted interventions.