Developmental and etiological patterns of substance use from adolescence to middle age: A longitudinal twin study

Background: The common liability to addiction framework suggests the tendency to use substances is largely a general heritable liability, but little is known about how expression of liability varies across development. We evaluated average developmental trajectories and covariation underlying commonly used substances using a genetically informative prospective design spanning three decades. Methods: Using a sample of 3762 twins across seven waves of assessment spanning ages 14–40, we modeled these relationships using two complementary approaches: piecewise latent growth and common factor modeling on four measures of alcohol, tobacco, and marijuana use Results: Average use increased across adolescence and either stabilized (alcohol frequency) or declined (all others) in adulthood. Trajectories were heritable (~.35–.75), and genetically correlated with one another (~.40–.80). The random intercepts, centered at age 16, exhibited shared environmental correlations across substances. We found moderate to large phenotypic (r_p~.3–.9) and genetic correlations (r_g~.3–1) among the longitudinally varying common factors loading on use of each substance at each age. The factor loadings declined with age, reflecting waning influence of common etiology in substance use. Conclusions: Trajectories of substance use were strongly correlated with each other and influenced primarily by genetic and non-shared environment. A heritable common factor accounted for co-occurring substance use from mid-adolescence to mid-adulthood, and greater substance specificity emerged with maturation. These results extend and reinforce prior work examining consumption and problem use, providing new evidence over a broad age range showing that substance use behaviors are influenced by a more general liability in adolescence and specificity increases across development.