Teens & Alcohol: What You Need to Know
Pretty much all Blue Devil fans, Duke students and parents of teens and young adults have an opinion about the incident last November when a young teen passed out in a portable toilet during a popular on-campus boozy pre-game event, known as Tailgate. For football fans and students, the incident was probably aggravating because it led the university administration to ban future Tailgate festivities. But for parents, it served as a wake-up call.
Luckily, the teen recovered, even though he was sent to a hospital emergency room, presumably for alcohol poisoning. However, it was a nasty, well-publicized reminder about how dangerous underage drinking can be. And parents - even those with children who do well in school and spend their spare time volunteering in nursing homes or knitting caps for Third World orphans - should share a collective spinal shiver: this child could have been our own.
Underage drinking is a seemingly ever-present and widespread problem.
"I teach high school, and I see and hear the conversations the students have. I imagine there are many parents who don't realize how much this is affecting their teens," says Marylu Ringwood, a teacher and mother of grown children from Johnston County.
Youth alcohol use
The good news is reported alcohol use among youth has dropped from 1979, the peak year for underage drinking, according to the National Institutes of Health. This year saw a decrease of about 1 percent, while reported use of drugs like marijuana and ecstasy have increased by about 2 and 1 percent, respectively. Nonetheless, many more kids admit to drinking alcohol than using all of the other illicit drugs combined. And the alcohol numbers are still high.
According to the 2009 Youth Risk Behavior Survey statistics for North Carolina, 41 percent of eighth-graders surveyed have had more than a few sips of alcohol. One in four ninth-graders and almost 44 percent of high school seniors said they had at least one drink in the month before the survey. For many high school students, it's not a just a drink here and there. Almost a quarter of the seniors surveyed said they had five or more drinks in a row, within a couple of hours, on one or more occasions in the previous month.
If anything can be gleaned from these statistics and incidents like the one at Duke, it's that you need to start protecting your children from alcohol before there is a problem.
It's clear from the scientific literature, especially brain studies from the past decade or so, that adolescents should never drink alcohol. But keeping them away from it is easier said than done.
You should start a conversation about alcohol at about age 10, says Jeffrey Georgi, a licensed clinical addiction specialist affiliated with Duke University and former director of the Duke Medical Center Alcoholism and Addictions Program who also is the director of recovery maintenance and substance abuse prevention at the Carlbrook School in Halifax, Va. The premise should be that children should not drink, period.
Teen brains react differently
To buttress the argument, parents can outline some of the scientific evidence about alcohol and teens in a fairly dispassionate manner, so they will at least intellectually understand the dangers.
"You need to have a productive non-emotional scientifically based conversation with your child, where they come to understand that their brain is different, their brain responds very differently to alcohol in ways that can endanger them, endanger their friends, and endanger their future," says Dr. Scott Swartzwelder, a clinical professor of psychiatry, psychology and neuroscience at Duke University.
There are many scientific studies available, and more to come, as researchers only started looking into the effects of alcohol on the teen brain in earnest about 15 years ago. But overall, it's clear that adolescents react very differently to alcohol than do adults.
For one, alcohol is more attractive to teens than older people. That's partly because, teens are, in general, motivated by things that give them pleasure, Swartzwelder says. In contrast, adults are most likely to try to avoid pain. Alcohol and other substances that can make people temporarily feel good are a siren call to teens.
Another consideration is the frontal lobe of a teen's brain is undeveloped, and won't be fully mature until about age 25. "And so, they tend not to inhibit their behavior as well as they will when they are adults," Swartzwelder explains. "They take more risks."
The adolescent brain also somehow shuts down its internal ability to generate excitement, Georgi says. So where a 5-year-old child may be fascinated by something as mundane as a trip to the grocery store with mom or dad, teens find pretty much everything ordinary to be a snore.
At the same time, "they can't tolerate being bored," Georgi says, "so they go out and do things." For example, in the Stone Age they would climb rocks or climb trees "and now, sadly, in our culture, there are things like alcohol and drugs," he says.
Delaying the first sip makes a difference
One of the clearest findings in recent years is that kids who drink alcohol at an early age are more likely to struggle with long-term alcohol problems than kids who don't take a first sip until they're older.
"The issue for parents that they've got to understand is that the age of onset is overwhelmingly important," Georgi warns. "The overarching message is delay, delay, delay. And do anything you have to, to make that happen."
According to a 1998 analysis in the Journal of Substance Abuse, kids who start drinking before age 15 are four times more likely to suffer from alcoholism and two times more likely to periodically abuse alcohol than someone who started drinking at 21. And the actual numbers are pretty shocking: 40 percent of kids who start drinking before age 15 will be addicted to alcohol at some time in their lives, compared to 24.5 percent of those who start at 17 and 10 percent who start at 21 or 22.
It's not yet clear whether kids who drink early do so because they're genetically more likely to find their way to the bottle, or if having an early taste changes their brain chemistry to make them want to drink more. But new evidence shows that delaying a first drink is actually protective regardless of genetic make-up.
Dr. Arpana Agrawal and researchers at Washington University School of Medicine looked at data from more than 6,000 twins. They found that even in identical twins, who have the exact same genetic make-up, the age of the first drink made a difference in later drinking behavior, especially when one of them started drinking before the age of 13 and the other waited.
Memory and learning are impaired
Another difference specific to this age group is that memory and learning are much more impaired by alcohol in teens than in adults. Swartzwelder's research in the 1990s compared adolescent and adult rats and found that alcohol caused all rats to have a hard time learning and remembering new information. But the younger rats needed about half as much alcohol as adults to have the same degree of impairment.
What about the effect of a single dose of alcohol on the brain? "One or two drinks are not going to turn an Einstein into an idiot, but it's shaving potential. We just don't know by how much," Georgi says.
Alcohol can actually stop new brain cells from being born, which happens at all ages. Again, though, the problem is significantly greater for teens than for older folks. And when you also factor in that teen brains are still developing, the potential damage is magnified.
What are the likely effects of stopping brain cell generation? According to Swartzwelder, brain cell birth is important for different things, but is probably best known as a way the body staves off depression.
Prone to damaging binge drinking
Interestingly, there are a few aspects of alcohol that teens actually tolerate better than their elders. Most important, it doesn't make them nearly as sleepy. Unfortunately, what this means is that they can physically drink a lot more at one sitting, with an average of five drinks per occasion. Indeed, statistics show that while teens drink less alcohol than adults overall, they tend to drink many more drinks at a time.
Drinking a lot all at once is called binge drinking, and it is more damaging to the brain than drinking the same amount in smaller doses more frequently. According to an article by Dr. Aaron White, a neuroscientist and professor at Duke University Medical Center, this is probably due to small seizures. When someone drinks a lot of alcohol all at once, they can go through a mini withdrawal when sobering up. So someone who binge drinks probably has a mini seizure after each binge. The string of little injuries can add up to significant brain damage.
Research by Dr. Susan Tapert of the University of California compared teenage teetotalers with binge drinking teens and found that the kids who drank heavily did much worse on thinking and memory tests, with boys having shorter attention spans and girls having problems understanding and interpreting visual information. Tapert scanned their brains and actually saw damage in the white matter (nerve tissue) of their brains, as compared to the kids who never drank.
"They appeared to have a number of little dings throughout their brains' white matter, indicating poor quality," she reported.
Equally disturbing is a study published last November in Neuroscience, led by Toni Pak at Loyola University. Pak looked at adolescent rats, and the results seemed to indicate that teenage binge drinkers will be less able to regulate stress hormones as adults compared with other teens. And this, in turn, sets them up for a higher risk of adult anxiety and depression.
"Our findings suggest that alcohol exposure during puberty permanently alters the system by which the brain triggers the body to produce stress hormones," Pak says. "This indicates that exposing young people to alcohol could permanently disrupt connections in the brain that are normally formed during puberty and are necessary to ensure healthy adult brain function."
Donna Nitzberg is a writer, health reporter and mother of teenagers.
For more current research and parent advice on Teens & Alcohol read:
Tips to keep Kids Alcohol-Free
Sharing a Beer With Your Teen?
Walk to Stop Drunk Driving
Chaperoning Your Tween or Teen?