University of Oulu

Maarit K Koivisto, Jouko Miettunen, Jonna Levola, Antti Mustonen, Anni-Emilia Alakokkare, Caroline L Salom, Solja Niemelä, Alcohol use in adolescence as a risk factor for overdose in the 1986 Northern Finland Birth Cohort Study, European Journal of Public Health, Volume 32, Issue 5, October 2022, Pages 753–759,

Alcohol use in adolescence as a risk factor for overdose in the 1986 Northern Finland Birth Cohort Study

Saved in:
Author: Koivisto, Maarit K.1,2; Miettunen, Jouko3,4; Levola, Jonna5;
Organizations: 1Department of Psychiatry, University of Turku, Turku, Finland
2Emergency services, TYKS Acute, Turku University Hospital, Turku, Finland
3Center for Life Course Health Research, University of Oulu, Oulu, Finland
4Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
5Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
6Faculty of Medicine and Health Technology, University Consortium of Seinäjoki, Tampere University, Tampere, Finland
7Department of Psychiatry, Seinäjoki Central Hospital, Seinäjoki, Finland
8Institute for Social Science Research, The University of Queensland, Brisbane, Australia
9Addiction Psychiatry Unit, Department of Psychiatry, Hospital District of South-West Finland, Turku, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.5 MB)
Persistent link:
Language: English
Published: Oxford University Press, 2022
Publish Date: 2022-12-29


Background: Overdoses and poisonings are among the most common causes of death in young adults. Adolescent problem drinking has been associated with psychiatric morbidity in young adulthood as well as with elevated risk for suicide attempts. There is limited knowledge on adolescent alcohol use as a risk factor for alcohol and/or drug overdoses in later life.

Methods: Here, data from The Northern Finland Birth Cohort 1986 study with a follow-up from adolescence to early adulthood were used to assess the associations between adolescent alcohol use and subsequent alcohol or drug overdose. Three predictors were used: age of first intoxication, self-reported alcohol tolerance and frequency of alcohol intoxication in adolescence. ICD-10-coded overdose diagnoses were obtained from nationwide registers. Use of illicit drugs or misuse of medication, Youth Self Report total score, family structure and mother’s education in adolescence were used as covariates.

Results: In multivariate analyses, early age of first alcohol intoxication [hazard ratios (HR) 4.5, 95% confidence intervals (CI) 2.2–9.2, P < 0.001], high alcohol tolerance (HR 3.1, 95% CI 1.6–6.0, P = 0.001) and frequent alcohol intoxication (HR 1.9, 95% CI 1.0–3.4, P = 0.035) all associated with the risk of overdoses. Early age of first intoxication (HR 5.2, 95% CI 1.9–14.7, P = 0.002) and high alcohol tolerance (HR 4.4, 95% CI 1.7–11.5, P = 0.002) also associated with intentional overdoses.

Conclusions: Alcohol use in adolescence associated prospectively with increased risk of overdose in later life. Early age of first intoxication, high alcohol tolerance and frequent alcohol intoxication are all predictors of overdoses.

see all

Series: European journal of public health
ISSN: 1101-1262
ISSN-E: 1464-360X
ISSN-L: 1101-1262
Volume: 32
Issue: 5
Pages: 753 - 759
DOI: 10.1093/eurpub/ckac099
Type of Publication: A1 Journal article – refereed
Field of Science: 3142 Public health care science, environmental and occupational health
3124 Neurology and psychiatry
Funding: This work was supported by Juho Vainio Foundation and The Päivikki and Sakari Sohlberg Foundation.
Dataset Reference: Supplementary data are available at EURPUB online.
Copyright information: © The Author(s) 2022. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.