Alcohol dependence may be significantly more common among children of alcoholics who were diagnosed with ADHD or conduct disorder when they were younger, some of whom begin drinking at age 12 and are already alcoholics by age 14. These findings from researchers at the University of Iowa appear in the December 2001 issue of the American Journal of Psychiatry.
Samuel Kuperman, M.D, lead author of the study, told ADDitude that he was surprised at the early onset of drinking among the teens who participated in his study. Research of non-ADD children has shown that many people begin drinking around age 14. "These kids started drinking at a very early age," said Kuperman, adding that parents often times don't realize how much their children are drinking. "I knew that we could expect to find kids drinking at age 14, but I was surprised to find this kind of drinking at age 12," he said.
The research team interviewed 619 adolescents and members of their families to determine whether or not a relationship between ADHD, conduct disorder and alcohol dependence did in fact exist.
Of the 619 participants:
- 54 had a dependency on alcohol.
- 61 (10 percent of the original 619) of the adolescents had been diagnosed as having ADHD. Of these, nearly one-fourth (23 percent) were alcoholics, exhibiting symptoms of a dependency on alcohol, compared to 7.2 percent of those who were not ADHD.
- 121 had been diagnosed with conduct disorder. Over 30 percent of the teens diagnosed with conduct disorder also exhibited signs of alcoholism, compared to 3.2 percent of those who did not qualify for the conduct disorder diagnosis.
Kuperman's research was part of a genetic study on alcoholism sponsored by National Institute on Alcohol Abuse and Alcoholism. The research on ADHD children of alcoholic parents was only one part of the larger study. Because the focus of the study was on alcohol and genetics, 70 percent of the children involved came from families that had multiple adults with a history of alcohol dependency. The remaining 30 percent were community control families although one-third of these families also contained at least onealcoholic parent.
Kuperman understands that such a group may not be a representative sample of the typical family of a child that has ADHD. "It is unfair to say that every child who has ADHD will become an alcoholic," he said, adding that he believes that conduct disorder, particularly when aggression is present, is a greater predictor of potential substance abuse disorders than is ADHD. He would like to see more research on the full effects of conduct disorder over the life span.
In fact, a closer look at the 54 teens who were alcoholics shows the impact of conduct disorder on the lives of these young people:
- 72.2 percent (39 individuals) had a diagnosis of ADHD, conduct disorder, or both.
- 24 had conduct disorder without ADHD.
- 14 had both a conduct disorder and ADHD.
- 1 had ADHD only.
The University of Iowa professor of psychiatry points out that there is already a significant connection between ADHD and alcohol abuse: "While ADHD occurs in about 5 percent of the general population, the diagnosis occurs in about 20 percent of children of alcoholics."
Although all the adolescents in the study had been diagnosed with ADHD, conduct disorder, or both, the majority of the teenage drinkers were not receiving the recommended medical treatment. "Most were not taking medications. Those that were took them only sporadically," said Kuperman.
How early is too early to drink?
Fourteen years of age marks a significant point in research on drinking and alcoholism. Previous researchers had reported that 40 percent of all young adults who began drinking before the age of 15 were classified as alcohol dependent by age 29, whereas the rate of alcohol dependence was approximately 20 percent among those who began drinking after the age of 21. These numbers reflect research on the general population.
Kuperman's research is significant in that it found that drinking among children with ADHD and/or conduct disorders began as early as 12. By age 14, these kids were already alcoholics. "Parents need to monitor alcohol intake during their children's early adolescent years," warns Kuperman. According to Kuperman, 15 may be too late.