This study investigates the occurrence of clinical features of alcohol  dependence and socially-maladaptive drinking during the first 24 months after  the onset of alcohol use.  
 Data for this study are from the  nationally representative 2004-2007 National Surveys on Drug Use and Health  (NSDUH). 
 General population of the US, aged 12 years and  older. Participants: Newly-onset alcohol users (NOAUs) were drinkers  who started to drink alcohol within 24 months of the NSDUH assessment and  consumed alcohol during the last 12 months.  
 The NSDUH  assessed for clinical features of alcohol dependence and socially-maladaptive  drinking, 
consistent with the DSM-IV. 
 NOAUs frequently  experienced problems relating to self-reported tolerance, spending a lot of time  getting over the effects of alcohol, and unsuccessful attempts at cutting down  on drinking. The likelihood of experiencing the clinical features steadily  increased in the first nine months after use, but appeared to plateau or only  gradually increase thereafter. 
Strong evidence emerged that the clinical  features measured a single latent dimensional of ‘alcohol use disorder’ (AUD) in  this sample. 
The majority of the clinical features were good indicators of the  underlying AUD continuum in the two years after first drinking onset. 
 There may be a period of time during the second year of  alcohol use when level of alcohol use disorder fluctuates rather than increases.  Public health and safety efforts designed to target problematic alcohol use in  the earliest stages of alcohol involvement could be useful in preventing the  escalation of alcohol problems in this group of drinkers.
Request Reprint E-Mail: o.mcbride@ulster.ac.uk  
 
