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Race/ethnicity and sex differences in progression from drinking initiation to the development of alcohol dependence.
Division of General Internal Medicine, Johns Hopkins University School of Medicine, 1830 East Monument Street, Room 8047a, Baltimore, MD 21205, USA. email@example.com
Drug and alcohol dependence 2011;118(2-3):375-82.
BACKGROUND: Prior studies on the course of alcohol use disorders have reported a "telescoping" effect with women progressing from drinking initiation to alcohol dependence faster than men. However, there is a paucity of population-based analyses that have examined progression to alcohol dependence comparing race/ethnicity subgroups, and little is known about whether the telescoping effect for women varies by race/ethnicity. We examined whether a telescoping effect is present in the general population comparing race/ethnicity subgroups and comparing men and women stratified by race. METHODS: This study uses data from Wave I of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) to compare a nationally representative sample of White, Black and Hispanic adults 18-44 years of age (n=21,106). Time to event analyses compare the risk of alcohol initiation, onset of alcohol dependence, and the transition from initial use to onset of alcohol dependence in the three race/ethnicity groups and for males and females in each race/ethnicity group. RESULTS: Whites were younger than Blacks and Hispanics of the same sex at drinking onset and progressed to alcohol dependence at a faster rate than both Blacks and Hispanics. In addition, we found no evidence of a telescoping effect in women for any race/ethnicity group. CONCLUSIONS: The present study illustrates differences in the course of transition from alcohol initiation to the development of dependence by race/ethnicity but not sex. Our findings highlight the need for additional study of factors resulting in race/ethnicity differences in order to inform culturally relevant prevention and intervention initiatives.
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