Onset of alcohol use disorder among alcohol initiates by raceethnicity.
Prevalence of alcohol use disorders (AUD) varies across racialethnic groups. It remains unclear whether rapid transition from first-time alcohol use to developing AUD varies by race and ethnicity. In this study, we investigate racialethnic differences in AUD onset among first-time alcohol drinkers and identify specific predictors of AUD onset by racialethnic group. The study population was non-institutionalized US residents aged 12 and older. Within four nationally representative probability samples (n ∼70,000year) drawn from the 2015-2018 National Surveys on Drug Use and Health, we identified 9,381 individuals who initiated alcohol use within 1-12 months prior to the survey. The probability of AUD after initiation was estimated for the entire sample, followed by racialethnic group stratification. Bivariate and multivariable logistic regression models were used to identify predictors of AUD onset among alcohol initiates. The overall incidence estimate of AUD among alcohol initiates was 3.7% (95% CI 3.0%, 4.6%). There was no significant variation in the incidence of AUD between racialethnic groups. Drug use, drug use disorders, and major depressive episode were significant predictors of AUD onset among all alcohol initiates. However, these predictors were not significant among non-HispanicLatinx Black individuals. Drug use and drug use disorders were strong predictors of AUD onset among alcohol initiates, except among non-HispanicLatinx Black individuals. These findings strengthen the importance of focusing on the co-use of alcohol and other drugs and the need to further investigate the risk profile differences between racialethnic groups.