Social and Situational Party Characteristics Associated with High-Intensity Alcohol Use Among Youth and Young Adults

Introduction: High-intensity drinking (HID), broadly defined as alcohol consumption at two or more times the binge drinking threshold, results in acute intoxication levels that heighten risk for severe physical and social consequences. Research has documented an alarming increase in HID prevalence in recent years that escalates in adolescents and peaks in young adulthood. The setting in which HID takes place, including its social and situational characteristics, represents important modifiable environmental factors for preventive interventions. This study examined characteristics of parties with alcohol that may increase risk for HID among youth and young adults ages 15-20.

Methods: Data were drawn from a survey of youth and young adults ages 15-20 (N=2442; 55% female, 25% non-White, 14% Hispanic) from 24 communities across the US participating in a randomized community trial to prevent underage drinking parties. Reporting on the last party they attended in which alcohol was present, participants indicated the number of drinks they consumed and six party characteristics: 1) size of party, 2) gender composition, 3) whether the majority of attendees were 21 and over, 4) parental supervision, 5) party location, and 6) witnessing others getting drunk. Based on gender-specific definitions of binge drinking (4+ females/5+ males), level of drinking was defined as under binge threshold (0), 1-2 times binge threshold (1), and high intensity drinking of 2+ binge levels (2). Multivariable multinomial logistic regression was used to predict level of drinking from party characteristics, controlling for demographics, data collection year, and study condition (intervention or delayed intervention community).

Results: Larger party size (AOR: 1.4, 95% CI: 1.1, 1.9) and having a majority of males at the party vs evenly mixed gender (AOR: 1.8, 95% CI: 1.01, 3.4) increased risk for HID as compared to those who consumed alcohol at the standard 1-2 times binge threshold. Compared to those who drank under the binge threshold, majority females at the party vs mixed gender (AOR: 2.3, 95% CI: 1.3, 4.3) and witnessing others who are drunk (AOR: 8.1, 95% CI: 4.5, 14.8) increased the odds of HID, while parental supervision reduced the odds of HID (AOR: 0.4, 95% CI: 0.2, 0.9).

Conclusions: Specific aspects of the drinking context are associated with high-intensity drinking by youth and young adults. Specifically, larger parties, single-gender parties, and the presence of intoxicated individuals increase risk for HID among underage drinkers, while parental supervision reduces risk for excessive consumption. These findings illuminate environmental circumstances that can be incorporated into multilevel interventions to reduce the frequency and harms associated with high intensity alcohol use.