Windle Michael, Zucker Robert A
Department of Behavioral Sciences and Health Education, Emory University, Atlanta, Georgia.
Alcohol Res Health. 2010;33(1-2):29-44.
Forty years ago, when the National Institute on Alcohol Abuse and Alcoholism (NIAAA) was founded, alcoholism was considered an adult disease driven principally by physiological determinants. As NIAAA expanded its research portfolio, new data and insights were obtained that led to an increased focus on underage and young adult drinking. Fostered by interdisciplinary research, etiologic models were developed that recognized the multiplicity of relevant genetic and environmental influences. This shift in conceptualizing alcohol use disorders also was based on findings from large-scale, national studies indicating that late adolescence and early young adulthood were peak periods for the development of alcohol dependence and that early initiation of alcohol use (i.e., before age 15) was associated with a fourfold increase in the probability of subsequently developing alcohol dependence. In recent years, developmental studies and models of the initiation, escalation, and adverse consequences of underage and early young adult drinking have helped us to understand how alcohol use may influence, and be influenced by, developmental transitions or turning points. Major risk and protective factors are being identified and integrated into screening, prevention, and treatment programs to optimize interventions designed to reduce drinking problems among adolescents and young adults. In addition, regulatory policies, such as the minimum drinking age and zero-tolerance laws, are being implemented and evaluated for their impact on public health.
四十年前，美国国立酒精滥用与酒精中毒研究所（NIAAA）成立之时，酗酒被视为一种主要由生理因素驱动的成人疾病。随着NIAAA扩大其研究范围，获得了新的数据和见解，这使得人们越来越关注未成年人和青年饮酒问题。在跨学科研究的推动下，病因模型得以发展，这些模型认识到相关遗传和环境影响的多样性。对酒精使用障碍概念的这种转变还基于大规模全国性研究的结果，这些研究表明，青春期后期和青年早期是酒精依赖发展的高峰期，而早期开始饮酒（即15岁之前）会使随后发展为酒精依赖的可能性增加四倍。近年来，关于未成年人和青年早期饮酒的起始、升级及不良后果的发展研究和模型，帮助我们理解了饮酒如何影响发育转变或转折点，以及如何受到这些因素的影响。主要的风险和保护因素正在被识别，并纳入筛查、预防和治疗项目中，以优化旨在减少青少年和青年饮酒问题的干预措施。此外，诸如最低饮酒年龄和零容忍法律等监管政策正在实施，并对其对公共卫生的影响进行评估。
