Substance abuse patterns in our sample resemble trends reported for 2,930 high school students in Cape Town demonstrating a preference for alcohol (31%), followed by cigarettes (27%) and cannabis (7%) (Flisher et al., 2003). Onset age of between 12 and 13 years for drinking, smoking and using other drugs appears to be similar to international findings. In our sample, the age of first intoxication tends to mark the onset of regular drinking, which occurs towards the end of the 12th year. Our South African AD sample consumed less alcohol (78 units per month) than a sample of American adolescents who reportedly consumed 131 units in an average drinking month (Tapert and Brown, 1999); the latter sample, however, encompassed a wider age range (13–19 years) and included individuals with more comorbid drug use and externalizing behaviors. Our adolescent ADs indulged in a similar pattern of weekend binge-drinking found in the US (Moss et al., 1994). Although more AD participants than controls in our sample used tobacco (83% compared to 69%), comorbid substance use was substantially lower than in US adolescent AUD
