Is Drinking Alone an Early Warning Sign?

The rooms of Alcoholics Anonymous are full of stories, many of them about early drinking days. The vast majority of alcoholics first experimented with drinking as teenagers, and usually for social reasons -- to fit in with their friends, to overcome shyness and feel more comfortable in gatherings, and so forth. But every once in a while, someone will tell a different sort of tale -- an often wrenching tale of drinking alone from the very beginning, without friends, without social pleasure, just to drink. Such early, solitary drinking is rare, but not unheard of.

Of course, most people start drinking for social purposes, and most of those go on to lives of moderate social drinking. Only a fraction of them become alcoholic as adults. But what about those early outliers, the ones without a party to go to, or friends to meet? Do they follow a different trajectory?

Psychological scientist Kasey Creswell of Carnegie Mellon University was intrigued by these disengaged teenage drinkers. She and her colleagues suspected that solitary drinkers might be a distinct type of adolescent drinker -- one at greater risk for heaving drinking and alcoholism later on in life. If true, Creswell reasoned, understanding these lone drinkers might illuminate the pathways of risk for problematic drinking.

Other researchers have shown that solitary drinking is linked to heavier drinking and more alcohol-related problems. But it's not clear what comes first. That is, does drinking alone lead to drinking more, or do heavy drinkers tend to isolate themselves? It's also not clear why there teenagers choose to drink alone. What are they looking for?

Creswell suspected that solitary drinkers might be more likely to self-medicate -- to use booze to salve negative feelings. To find out, she ran a longitudinal study, the first of its kind, following a large group of teenage drinkers into early adulthood. They found some of the teenagers in rehab facilities, and others in the community at large, so they had a mix of drinking patterns and histories.

The teens were between 12 and 18 years old at the start, and all were studied until age 25. They went through exhaustive assessments over this time, which included drinking frequency and consumption, frequency of solitary and social drinking, and so forth. The scientists also interviewed the subjects about the kind of situations that preceded episodes of heavy drinking: Do you drink a lot when you're lonely? After a quarrel with a friend? To celebrate something good? And so forth. Finally, they kept track of who eventually developed alcohol disorders.

Solitary teenage drinkers are indeed unique, and not vanishingly rare. As reported in an article in the journal Psychological Science, about 60 percent of the subjects reported never having a drink alone. They only ever drank in social settings. But the others -- nearly four in ten -- said that they did drink alone at least on occasion. This is higher than the usual estimate of solitary drinking, and the rate of solitary drinking was much higher in the teens with early symptoms of alcohol abuse. The solitary drinkers also drank more often than the other teenage drinkers, and they drank more when they drank. They were also younger when they got started drinking.

Perhaps most important, Creswell's survey revealed that teenagers tended to drink alone when they were in unpleasant situations, suggesting that these teenagers were probably self-medicating in order to cope with their negative feelings. And these solitary teen drinkers were much more likely to develop serious alcohol problems, including alcohol dependence, by age 25.

It's sad to think of these youngsters sitting alone at home, using intoxication as a tool to deal with their demons, whatever those demons are. But these findings could help to identify these especially vulnerable teenagers sooner, perhaps even before they end up telling their woeful tales in the rooms of AA.

Follow Wray Herbert's reporting on the science of addiction on Twitter at @wrayherbert.