Associations between Audit Alcohol Problem Scores and Adult Functioning in Australia and the US: Relationships in Young Adulthood Under Different Policy Environments

Introduction:

Heavy alcohol use in adulthood is a leading cause of morbidity and mortality in the U.S. Heavy drinking also is associated with a range of problem behaviors and harms, including other drug use, risky driving, antisocial behavior, mental health problems, and lack of economic participation. National and local governments attempt to reduce the levels of and harms associated with alcohol use through policy and regulations. For example, in the US, alcohol policy is focused on abstinence for adolescents, whereas policy in Australia is oriented toward harm minimization. In prior work on the International Youth Development Study (IYDS), we have shown that the levels of risk and protective factors for adolescent drinking vary across Washington State (WA) and the State of Victoria (VIC) in Australia, but that their longitudinal prediction of drinking is largely similar despite these level differences. However, the degree to which national alcohol policy might mitigate the impact of heavy alcohol use in young adulthood on concurrent problem behaviors and harms is unclear. The present study asks whether problems like, risky driving, antisocial behavior, mental health problems, and lack of economic participation are equally associated with heavy alcohol use across two countries with different alcohol policy.

Methods:

Data are drawn from the IYDS, a gender-balanced, multiethnic, statewide representative sample of 7^th grade students in WA and VIC in 2002 (n = 1,958). This study used data collected at age 25 (87% retention). Alcohol use disorder at age 25 was measured using the Alcohol Use Disorders Identification Test (AUDIT).

Results:

In both countries, higher AUDIT scores at age 25 predicted greater conflict with family of origin, more conflict with partner, poorer general health, more depression/anxiety, more frequent driving drunk and riding with a drunk driver, and a higher probability of homelessness in the past year. The strength of these associations did not differ between the two countries. However, the levels of alcohol disorder were higher in Victoria compared to Washington.

Conclusions: Growing up in a harm reduction policy environment during adolescence did not appear to reduce alcohol disorder or its correlation with other problems associated with heavy alcohol use for young adults in VIC compared to young adults in WA. This finding implies that national and state-level policies aimed at reducing the prevalence and levels of alcohol use in adolescence may result in lower rates of risky driving, antisocial behavior, and mental health problems among young adults.