May 16, 2006
Underage Drinking
Amy Movius, MD
Alcohol is the drug most often abused by children and adolescents. Indeed alcohol use in adolescence is often perceived as normal. If you are a parent your child will have or already has had the opportunity to use alcohol. Most parents probably don’t realize HOW common underage alcohol use is or HOW young children are starting to drink alcohol. The following statistics speak for themselves:
1. In a 2001 survey of 12 to 17 year olds, the average first use of alcohol was 13.1 years.
2. Alcohol use is increasing in children as young as 9 yrs.
3. 52% of 8th graders have used alcohol; more than 80% of high school seniors have.
4. Of seniors who drink alcohol 31% have drunk “heavily” (>5 drinks/time) in the last 2 weeks; 1/6 have experienced “black outs”; 40% binge drink.
5. 30% of 4th to 6th graders (approx 9 to 11 y.o.) report having a “lot of pressure” to drink beer.
6. More than 90% of 10th graders report alcohol is “very easy” to get.
The home is the primary source.
There are many reasons to do all you can to discourage your child from following this pattern. Alcohol use has health risks, alcoholism being the most obvious. People who begin drinking alcohol before age 15 yrs are 4X more likely to become alcoholics than people who start at age 21yrs. This is in part because the time it takes to develop alcohol dependance is much shorter in children than adults.
Children who are not alcoholics, or even frequent drinkers are still in danger. Risk of accidental injury or death in childhood and adolescence is greatly increased with alcohol use. The motor vehicle fatalities in children < 21 yrs dropped significantly when the drinking age was increased to 21yrs in all 50 states. The incidence of drowning, ATV or snow mobile injury, virtually ANY type of accident increases when alcohol is involved. The same is true for teenage homicide and suicide.
Children who use alcohol are more likely to have sex and less likely to use precautions against pregnancy and sexually transmitted disease. Sexual assault and date rape are much more common when alcohol use is present, as well.
Adolescents who abuse alcohol have impaired relationships with friends and families, worse school performance (kids who get D/F grades are 3X more likely to drink than those with As), more opposition to authority and involvement with gangs and illegal activities.
While all children are likely to be exposed to alcohol, some children are more vulnerable to alcohol abuse. Children of alcoholics are much more likely to become alcoholics themselves. Children who have behavioral issues, poor self esteem, are isolated or depressed, or have friends who use alcohol (or other drugs) are also more likely to drink. In addition to this,we live in a culture which glorifies alcohol use in the form of media and internet advertisements. Our children know it too - in the opinion of 56% of 5th to 12th graders these advertisements are designed to encourage them to drink alcohol.
There are some tools that may help you identify is you/your child has an alcohol problem. The CRAFFT tool below is one such example.
CRAFFT: Questions to Identify Adolescents With Substance Abuse Problems
C Have you ever ridden in a car driven by someone (including yourself) who was “high” or had been using alcohol or drugs?
R Do you ever use alcohol or drugs to relax, feel better about yourself, or fit in?
A Do you ever use alcohol or drugs while you are by yourself, or alone?
F Do you ever forget things you did while using alcohol or drugs?
F Do your family or friends ever tell you that you should cut down on your drinking or drug use?
T Have you ever gotten into trouble while you were using alcohol or drugs?
Two or more “yes” answers suggest that the adolescent may have a serious problem with substance abuse, and additional assessment is warranted.
What treatment or intervention a child with alcohol abuse needs depends on the circumstances. Drug treatment program, detoxification, couseling or even an environemental change such as moving schools or houses may be appropriate. Contacting you primary care provider is a useful first step to identifying and activating the resouces your family may need.
References:
1. Tobacco, Alcohol and Other Drugs: The Role of the Pediatrician in Prevention, Identification and Management of Substance Abuse. American Academy of Pediatrics Committee on Substance Abuse. March 2005
2. Alcohol Use and Abuse: A Pediatric Concern. American Academy of Pediatrics Committee on Substance Abuse. July 2001