use disorder among adults decreases in midd le age, being greatest among individuals 18-
to 29-years-old (16.2%) and lowest among individuals age 65 years and older (1.5%).
Twelve-month prevalence varies markedly  across race/ethnic subgroups of the U.S.
population. For 12- to 17-year-olds, rates ar e greatest among Hispanics (6.0%) and Native
Americans and Alaska Natives (5.7%) relative to whites (5.0%), Afri can Americans (1.8%),
and Asian Americans and Pacific Islanders (1.6 %). In contrast, amon g adults, the 12-month
prevalence of alcohol use di sorder is clearly greater among Native Americans and Alaska
Natives (12.1%) than among whites (8.9%), Hispanics (7.9%), African Americans (6.9%),
and Asian Americans and Pacific Islanders (4.5%).
Development and Course
The first episode of alcohol into xication is likely to occur during the mid-teens. Alcohol-
related problems that do not m eet full criteria for a use disord er or isolated problems may
occur prior to age 20 years, but the age at onse t of an alcohol use disorder with two or more
of the criteria clustered together peaks in th e late teens or early to mid 20s. The large ma-
jority of individuals who develop alcohol-relate d disorders do so by their late 30s. The first
evidence of withdrawal is not likely to appear until after many other aspects of an alcohol
use disorder have developed. An  earlier onset of alcohol use disorder is observed in ado-
lescents with preexisting conduct problems and those with an earlier onset of intoxication.
Alcohol use disorder has a variable course th at is characterized by periods of remission