Teenage Drinking: What You Need to Know A HELPGUIDE.ORG Educational Supplement from Harvard Health Publications

Underage drinking is a widespread problem with grave consequences. Young people who drink are more likely to be the victims of violent crime, to be involved in alcohol-related traffic accidents, and to have depression and anxiety.

Other risky behaviors are also linked to early drinking. Young people who start using alcohol before age 21 are more likely to:

• be involved in violent behaviors
• attempt suicide
• engage in unprotected sex or have multiple sex partners.

What’s also troubling is that young people are beginning to drink at earlier ages than ever before.

A national survey found that slightly more than half of young adults between the ages of 12 and 20 have consumed alcohol at least once in their lifetime.

In past generations, boys were much more likely than girls to experiment with alcohol in their teens, but girls are catching up. In 2009, 58% of all males ages 12 and older were current drinkers, higher than the rate for females (47%). But in the youngest subset (ages 12 to 17), the percentage of current drinkers was nearly the same (15% of boys, 14% of girls)

Young adults risk becoming problem drinkers

The years between 18 and 25 are a time of considerable change, as teenagers spread their wings and leave home, many for the first time. While these may be exciting years, studies of alcohol use indicate they may also be risky years.

According to data from the 2009 National Survey on Drug Use and Health, the highest prevalence of problem drinking occurs among young adults ages 18 to 25. Nearly 42% reported binge drinking at least once during the past month. (Binge drinking involves the consumption of five or more drinks at a sitting, often in rapid succession).

It’s not all bad news, though. While most young adults drink at least sometimes, one-third say they don’t use alcohol at all, and the majority do not drink heavily.

Factors affecting risk of developing a drinking problem

A number of factors influence a young adult’s drinking behavior and whether it will become a problem. These include:

• race and ethnicity
• genetics
• the presence of mental health disorders
• personality traits
• influence of family and peers
• gender. Men are more likely to drink heavily than women, but women become addicted at lower levels and shorter duration of use. See Women and Alcohol.

Dangers of drinking while young

College is typically thought of as the setting where older teens and younger 20-somethings drink to excess. Yet several studies show that heavy drinking is widespread among young adults whether or not they attend college. College students tend to drink less often than nonstudents, but when they do imbibe — at parties, for example — they tend to drink more.

This trend is alarming for a number of reasons.

• Alcohol is a major factor in fatal automobile crashes. About one-third of drivers ages 21 to 24 who died in a car crash in 2009 had a blood alcohol level that was over the legal limit.
• Drinking may have lasting health effects. Some researchers believe that heavy drinking at this age, when the brain is still developing, may cause lasting impairments in brain functions such as memory, coordination, and motor skills — at least among susceptible individuals.
• Drinking can lead to sexual assaults and rape. Each year, approximately 97,000 students between the ages of 18 and 24 are victims of alcohol-related sexual assault or date rape.

Binge drinking and alcohol poisoning

Although many young adults drink responsibly or abstain altogether, excessive drinking is still a problem. Deaths from alcohol poisoning on college campuses have spotlighted the dangers of binge drinking (the consumption of five or more drinks at a sitting, often in rapid succession).

While teens as young as age 13 admit to this practice, it becomes more popular in mid-adolescence and peaks in the college years. College students between the ages of 18 and 22 are more likely to report binge drinking than non-students of the same age (44% vs. 38%).

Binge drinkers are eight times more likely than other college students to:

• miss classes
• fall behind in schoolwork
• be injured
• damage property

Binge drinkers also face the grim consequences of alcohol poisoning, a severe and potentially fatal reaction to an alcohol overdose.

How to recognize and treat alcohol poisoning

Because alcohol is a central nervous system depressant, drinking too much, too fast, slows some bodily functions (such as heart rate, blood pressure, and breathing) to a dangerous level, causing the drinker to lose consciousness.

Possible signs of alcohol poisoning include:

• unconsciousness or semiconsciousness
• slow respiration — eight or fewer breaths per minute, or lapses between breaths of more than eight seconds
• cold, clammy, pale, or bluish skin
• a strong odor of alcohol on the breath and coming from the skin.

How to talk to kids about responsible drinking

As a parent, grandparent, teacher, or friend, you have a major impact on the choices that the children in your life make, especially during the preteen and early teen years. Talking to young people openly and honestly about drinking will help them steer clear of these dangers.

Delaying the age at which young people take their first drink lowers their risk of becoming problem drinkers. That’s reason enough to talk to the teenagers in your life about alcohol, but it’s not the only one. These are some of the most important reasons:

• Alcohol has harmful effects on developing brains and bodies.
• For adolescents ages 15 to 20, alcohol is implicated in more than a third of driver fatalities resulting from automobile accidents and about two-fifths of drownings.
• Drinking interferes with good judgment, leading young people into risky behavior and making them vulnerable to sexual coercion.
• Teenagers who use alcohol and tobacco are at greater risk of using other drugs.
• Teenagers who drink are more likely to develop behavioral problems, including stealing, fighting, and skipping school.
• Underage drinking is illegal.

Start the conversation early

While most people recognize the importance of discussing alcohol with kids, they aren’t always sure when to initiate this discussion. Adolescents are often nervous and confused as they face their first opportunities to try alcohol and are often interested to hear your thoughts on the subject.

Set the stage early by letting your teenager know that he or she can talk to you about anything, without judgment or lecturing.

Open up and listen

Ask open-ended questions, and listen to the answers without interrupting.

• Talk openly about your family history. If your family has had problems with alcohol, your child should know about it. Be open about your own experiences, too.
• Set clear expectations, and communicate your values. Youngsters are less likely to drink when they know that parents and other important adults in their lives have strong feelings about it.
• Control your emotions. If you hear something that upsets you, take a few deep breaths and express your feelings in a positive way.
• Ask about your teenager’s friends. Express an interest in getting to know them better. Getting to know these friends and their parents will help you understand your teenager’s world.

Adapted with permission from Alcohol Use and Abuse, a special health report published by Harvard Health Publications.