ALCOHOL
ABUSE IN ADOLESCENTS
by Nick Varriano
Alcohol use among adolescents
has been on the rise since the 1950’s, mostly as a means for youth to
manifest their rebelliousness. Other reasons adolescents indulge in alcohol
consumption are to have a good time with friends, escape family problems, and
reduce stress and anxiety. Today, alcohol is the substance most commonly misused
by teenagers and a major cause of accidents and death among young people.
Adolescent alcohol abuse has social, psychological, economic, and medical consequences.
Alcohol-related motor vehicle accidents are responsible for a large number of
highway crashes and fatalities. In many cases, suicide and violent crimes, the
second and third leading causes of death among young people, are alcohol-related.
Alcohol use is frequently involved when adolescents have early sexual intercourse,
resulting in unplanned pregnancies and contributing to alcohol-related birth
detects. Alcohol contributes to family violence. Youths who abuse alcohol are
much less likely to complete high school and find and maintain steady employment.
The definition of the problem drinker varies among experts, but usually includes
youths (or adults) whose behavior becomes troublesome when they are drinking
or who use alcohol to avoid dealing with problems. The National Institute in
Alcohol Abuse and Alcoholism estimates that 20 percent of young people 14 to
17 years of age are problem drinkers.
In the United States, the average age of alcohol use outside the family is 11.9
years for boys and 12.7 years for girls. A study of high school seniors found
that 92 percent had used alcohol at least once, with about 69 percent reporting
alcohol use in the previous month. Males drank more frequently and consumed
larger amounts than their female peers. Forty-five percent of males and 28 percent
of females reported excessive use (more than five drinks in one occasion) in
the previous month.
The causes of alcoholism are generally believed to be both genetic and environmental.
A family history will help determine if a person has a predisposition for alcoholism.
Information needed to assess the seriousness of an alcohol problem in a young
person falls into three categories: drinking behavior, medical problems associated
with drinking, and psychosocial problems associated with drinking.
Drinking behavior includes: the frequency of drinking, the presence or absence
of peers on drinking occasions, and the tendency of certain friends to be consistent
drinking partners. The drink of choice among adolescents is beer, with wine
coolers pre-mixed drinks gaining in popularity. A drinking problem should be
suspected for teenagers who list bourbon or vodka as their preference in alcohol.
Medical problems associated with alcoholism; such as chronic liver disease that
resulted in the death of baseball great Mickey Mantle are seldom seen in person’s
under 20 years of age. Adolescents do show signs of physical dependence of alcohol:
increased tolerance, withdrawal symptoms in response to abstinence, blackouts,
a compulsive pattern of use (same setting, same kind of drink, etc.), and deceased
control over intake.
Psychosocial problems are the indicators that parents of adolescents use in
make the decision to seek help in a clinical setting. Indicators of alcohol
abuse in adolescents include: declining school performance, increased problems
with family members and peers, alcohol-related traffic violations and other
problems with the law, anxiety and depression, and employment difficulties.
When questioned about the behavioral consequences of alcoholism, teenagers often
blame parents or other authority figures for their difficulties or fail to see
drinking-related problems as serious. They believe that adults are overreacting.
Denial or unwillingness to consider alcohol abuse a problem then becomes another
piece of supporting diagnostic information.
Adolescents who abuse alcohol are more likely to be regular smokers, to be sexually
active without using birth control, to be experiencing problems both at home
and at school, to have friends who drink regularly and to avoid participation
in religious activities.
Most treatment programs for adolescents are based on the Twelve Step program
of Alcoholic Anonymous. Upon completion of treatment, serious consideration
should be given to whether it is beneficial or counterproductive for the adolescent
to return to the social environment that may have encouraged early patterns
of alcohol use and abuse.
The most effective prevention efforts provide education to both parents and
young people. Prevention of adolescent alcoholism must begin with the following
measures:
1) giving dear messages about the importance of abstinence from alcohol as a
health issue rather than a moral issue; 2) encouraging parents and other adults
to be role models for responsible, low-risk use of alcohol if they do drink;
3) identifying youth-at-risk: those with family histories of alcoholism, those
of abusive or disruptive families, those with low self-esteem, and those with
early histories of problem behavior; 4) promoting and encouraging health-enhancing
behavior among adolescents, such as exercise, education, safe diving, and nutritional
fitness; 5) providing referral or counseling for families in crisis; and 6)
challenging media portrayals of adult drinking behavior as sophisticated and
desirable, or of drinking as a rite of passage for teenagers.
Alcoholism has been described as the nation’s number one health problem.
Beware that alcoholism usually begins in adolescence or early adulthood, not
in middle age when it is most commonly diagnosed.