Why might adverse childhood experiences lead to underage drinking among US youth? Findings from an emergency department-based qualitative pilot study.

Research suggests that adverse childhood experiences (e.g., child abuse, interparental violence) predispose youth to early drinking initiation, but specifics about how and why adolescents progress from these exposures to alcohol use are not well understood. This National Institute on Alcohol Abuse and Alcoholism supported study presents data from semistructured interviews with 22 adolescents who reported both initiating drinking ≤18 years old and ≥2 adverse childhood experiences. Data were collected in 2007 as part of a formative research effort for an emergency department-based intervention to reduce adolescent drinking. Findings suggest that prevention initiatives for youth from challenging environments may need to do more than address conformity and social motivations for underage alcohol initiation. Study limitations are noted and future research is suggested.