Our work builds on previous work by documenting that parental AUD is a common risk factor for initiation of multiple substances and early sexual debut. Previous work has focused largely on the association between parental AUD and offspring risk for alcohol initiation and alcohol-related outcomes, with some recent attention to the association of parental AUD with offspring use of other substances (29, 30). Data from the National Epidemiological Study on Alcoholism and Related Conditions (NESARC) showed that subjects who began drinking before age 15 and from ages 15–17 reported more substance use problems in their parents than did subjects who began drinking at age 18 years and older (6). There is also evidence from twin and offspring-of-twin studies showing associations of parental alcohol problems with earlier age at alcohol use in offspring (22, 23, 56). Just one of these studies used diagnostic measures of parental AUD (23); the rest employed respondent reports of parent drinking behavior (6, 22, 56). The present study replicates and extends previous findings in its use of diagnostic measures by self-report in most parents or with family history measures of AUD.
