According to new research, drinking alone in youth is a significant predictor of problematic alcohol use later in life.

A recent longitudinal study following over 9,000 U.S. high school students for 17 years showed that solitary drinking in adolescence and young adulthood was strongly linked to binge drinking and potentially predicted alcohol use disorder (AUD) at the age of 35 years. Moreover, the risk of developing AUD was higher for women. Specifically, the study showed that the odds of 18-year-old women having alcohol use disorder symptoms at the age of 35 was 86% higher than for teens who reported drinking only in social settings. However, for 18-year-old men, the odds were only 8% higher.

“Drinking alone is a red flag for young people, and it is predictive of future alcohol problems above and beyond other well-established risk factors, like binge drinking, frequency of alcohol use, socioeconomic status, and male gender,” said the study’s lead author, Dr. Kasey G. Creswell, in her interview with Medscape Medical News.

In addition, Dr. Creswell added that while many alcohol screening tools contain only questions about the frequency and quantity of drinking, the social context in which adolescents and young adults consume alcohol is a risk factor that needs to be considered.

Dr. Christoph Correll, professor of child and adolescent psychiatry at Charité Universitätsmedizin in Berlin, Germany, added that these research findings show that clinicians who examine teenagers should be alert for any solitary use of alcohol, and that caregivers and school personnel should be alerted that solitary drinking is a particular risk factor for increasing alcohol use problems in the future. Therefore, clinicians should inquire about the type and frequency of substance use in adolescents, as well as about the context of alcohol and substance consumption.

“Most young people who drink alcohol only do it with their friends in social settings, at parties, and so on. Some researchers have even said social use of alcohol among young people is a marker for social well-being, but when young people are drinking alone, that’s where we think the problem lies,” added Dr. Creswell.

“We need to ask about the context that these young people are drinking in; and if we do identify people at risk early on, that’s hugely beneficial because interventions for alcohol problems work the best when you catch it early,” she added. “This could be a way to catch potentially problematic drinking early.”