Health Care and Underage Drinking

When adults abuse alcohol, bad things happen. And when teens drink, even worse things happen. Underage drinking is a problem in America, and has been one of the leading causes of death in the country among those under the age of 21--the legal age in most states to consume alcoholic beverages. Since 1982, according to the Century Council, alcohol-impaired driving fatalities on our nation's roadways have decreased 44%, and among persons under 21 these fatalities have decreased 71%. Though progress is being made, underage drinking remains a persistent problem among youth. According to the 2008 National Survey on Drug Use and Health, about 10.1 million Americans between ages 12-20 report current alcohol consumption; this represents about 26% of this age group for whom alcohol use is illegal. Among 12-20 year olds, reported rates of past month consumption, binge drinking and heavy alcohol use declined between 2002 and 2008.

Tragic health, social, and economic problems result from the use of alcohol by youth. Underage drinking is a causal factor in a host of serious problems, including homicide, suicide, traumatic injury, drowning, burns, violent and property crime, high risk sex, fetal alcohol syndrome, alcohol poisoning, and need for treatment for alcohol abuse and dependence. According to the Pacific Institute for Research and Evaluation, underage drinking cost the citizens of the United States $68.0 billion in 2007. These costs include medical care, work loss, and pain and suffering associated with the multiple problems resulting from the use of alcohol by youth.  Excluding pain and suffering from these costs, the direct costs of underage drinking incurred through medical care and loss of work cost the United States $22.3 billion each year. Youth violence (homicide, suicide, aggravated assault) and traffic crashes attributable to alcohol use by underage youth in the United States represent the largest costs for the State. However, a host of other problems contribute substantially to the overall cost. Among teen mothers, fetal alcohol syndrome (FAS) alone costs the United States $1.2 billion. Young people who begin drinking before age 15 are four times more likely to develop alcohol dependence and are two and a half times more likely to become abusers of alcohol than those who begin drinking at age 21.  

According to the Centers for Disease Control (CDC), alcohol use by persons under age 21 years is a major public health problem. Alcohol is the most commonly used and abused drug among youth in the United States, more than tobacco and illicit drugs. Although drinking by persons under the age of 21 is illegal, people aged 12 to 20 years drink 11% of all alcohol consumed in the United States. More than 90% of this alcohol is consumed in the form of binge drinks. On average, underage drinkers consume more drinks per drinking occasion than adult drinkers. In 2008, there were approximately 190,000 emergency rooms visits by persons under age 21 for injuries and other conditions linked to alcohol. Youth who drink alcohol are more likely to experience the following consequences:

•School problems, such as higher absence and poor or failing grades.
•Social problems, such as fighting and lack of participation in youth activities.
•Legal problems, such as arrest for driving or physically hurting someone while drunk.
•Physical problems, such as hangovers or illnesses.
•Unwanted, unplanned, and unprotected sexual activity.
•Disruption of normal growth and sexual development.
•Physical and sexual assault.
•Higher risk for suicide and homicide.
•Alcohol-related car crashes and other unintentional injuries, such as burns, falls, and drowning.
•Memory problems.
•Abuse of other drugs.
•Changes in brain development that may have life-long effects.
•Death from alcohol poisoning.

Reducing underage drinking will require community-based efforts to monitor the activities of youth and decrease youth access to alcohol. Recent publications by the Surgeon General and the Institute of Medicine outlined many prevention strategies that will require actions on the national, state, and local levels, such as enforcement of minimum legal drinking age laws, national media campaigns targeting youth and adults, increasing alcohol excise taxes, reducing youth exposure to alcohol advertising, and development of comprehensive community-based programs.

However, parental involvement remains the single biggest deterrant to teens who want to abuse alcohol. When parents are engaged actively in the life of their teenagers, the likelihood of alcohol abuse decreases. Peers play a major role in teen drug use, but parents also play a big part by influencing who their children hang out with as well monitoring their activities, according to WebMD. Researchers found that when parents were tolerant about drug use, their children were more likely to have friends who used drugs. But children who felt their parents were closely monitoring their activities were less likely to use drugs or alcohol.

According to the Substance Abuse and Mental Health Services Administration, talking with a child about the dangers of substance use and showing disapproval of such behavior is a key factor. It’s also essential to stay involved in a child’s day-to-day activities. See the report online at this address:  http://www.oas.samhsa.gov/2k9/159/ParentInvolvementHTML.pdf .

Parents have good intentions, thinking the teenagers won't drink and drive, that they are safer staying at home, but it sends the wrong message. Adolescents interpret this behavior as an approval to drink alcoholic beverages. Teenagers whose parents provided alcoholic beverages for their children and their peers at a party were two times more likely to binge drink and to use alcohol within a 30 day period. Strict consequences of breaking the house rules regarding drinking also helped deter underage drinking among teens. If a teen thinks he or she will receive severe punishment (as perceived by the teen) if they are caught drinking, they are less likely to consume alcoholic beverages.

Also, according to the Journal of Youth and Adolescence, parents’ knowledge or awareness of what’s going on in their child’s life at college is associated with fewer risky behaviors. Specifically, students who said their fathers were in the loop had a lower likelihood of doing drugs or engaging in risky sexual behaviors. When mothers were in the know, students were less likely to drink alcohol. The protective effect of mothers’ awareness was more pronounced when the students also felt close to their mom. Under those circumstances, the researchers found that students were less likely to be involved in any of the three risk behavior categories studied: drugs, alcohol and risky sexual activity. Relationships between parents and children continue to be important during the transition to adulthood.

Children and teens need supervision when it comes to alcohol abuse and underage drinking. Parents and guardians are the most influential at younger ages, but peers tend to be more involved when kids get older into the mid to late teen years. Along with other substance abuse, like drugs and tobacco, adolescents can fall into alcoholic patterns caused by a variety of sources. Personal, family, and community factors increase a teen's risk for using substances and possibly developing a substance abuse problem, according to Health.com. Much more detail about these issues can be found at this website: http://www.health.com/health/library/topic/0,,tp17749_uq2425,00.html .

Underage alcohol consumption is dangerous, and it can be prevented. However, there needs to be strong diligence on the part of those who supervise adolescents. However, when children and teens choose to break the law or to violate the trust of those responsible for them, the consequences are severe. They can be deadly in some cases if the abuse is beyond the norms of health care standards for safe consumption. With children, that bar is set very high by law and by the ethical, moral responsibility of their caretakers. Kids should not drink, for multiple reasons. Parents must be involved. Society knows the cost. Underage drinking most often leads to tragic results. Don't let your kids be the lead story on the nightly news because they were guilty of alcohol abuse or drinking under the legal age.

Until next time. Let me know what you think.