Early alcohol onset: clinical and demographic characteristics of service-seeking youth.

Background: Alcohol use in early adolescence is associated with increased health concerns and other negative consequences. Given the needs of this vulnerable population, it is critical to understand their risk factors and clinical characteristics. Objective: This cross-sectional study explores the clinical and demographic characteristics of service-seeking youth with and without early alcohol use onset. Method: 655 youth seeking services at a Canadian substance use and concurrent disorder service participated. Evaluations of mental health, substance use, demographic characteristics, and other risk factors were collected and compared among youth who reported an age of onset for alcohol use of under 14 years of age versus 14 years or older. Results: Youth who started using alcohol before age 14 were significantly more likely to report mental health difficulties, indicate use of a greater number of substances, and report experiencing more crime and violence problems. They also reported exposure to more types of trauma. Notably, more problems with crime and violence were significantly, and uniquely associated with an earlier age of alcohol use onset in a multivariate model. Conclusion: The present study identifies unique and clinically significant differences among youth who initiated alcohol use in early adolescence compared to later in adolescence. Stronger integrations between mental health and substance use services for youth with early alcohol use should be considered, given the vulnerability and concurrent difficulties they tend to face.