Alcohol (Underage Drinking)

Why is underage binge drinking so dangerous? Binge drinking is unhealthy and dangerous for all ages, not just kids. However, many parents don't know if or when their child is drinking or consider talking to their kids about it. Many parents are in denial that their kid would do such a thing. Many are concerned that if they talk about it with their kid, then their child might be more interested or more likely to drink, kind of like opening pandora's box.

As a clinical psychologist who specializes in working with teens, most of them are talking about it, experimenting, and trying alcohol way before their parents think it is happening. Here is the thing, kids are going to hear and/or talk about it with peers and friends. Do you want to be the one to help control the narrative, provide accurate information, and guide your child in making healthier choices?

Teen Drinking Facts

Teens drink because of peer pressure, stress, and/or to feel more independent and autonomous. Based on the Center for Disease Control and Prevention (CDC, 2022), “It is the most common used substance among young people.” In March 2023, the National Institute of Alcohol Abuse and Alcoholism (NIAAA)stated, “People ages 12 to 20 drink 3.4% of all alcohol consumed in the United States. Although youth drink less often than adults, when they do drink, they drink more. More than 90% of all alcohol drinks consumed by youth are consumed through binge drinking.”

NIAAA reported, “In 2021, 3.2 million youth ages 12 to 20 reported binge drinking at least once in the past month.”
The NIAAA indicated, “In 2021, approximately 613,000 youth ages 12 to 20 reported binge drinking on 5 or more days over the past month.”

Consequences of Underage Drinking

It is important caregivers and teens understand the facts and risk associated with underage drinking. Their brains are still developing, which makes them more susceptible to the effects of alcohol, based on NIAAA and CDC. Their brains and bodies process alcohol differently than adults. Without education, many teens don't know how much alcohol they can consume per hour for their body weight/age before feeling the effects. Furthermore, most parents and teens don’t know that there are real neurological risks with underage drinking. Below are some risks.

What are the consequences:

Neurological damage
Problems with learning in school (e.g., more school absences or lower grades.)

Causes death. Based on the CDC, “Underage drinking is a significant public health problem in the U.S. Excessive drinking is responsible for more than 3,900 deaths and 225,000 years of potential life lost among people under age 21 each year.”
Causes injury
Increases risk of alcohol poisoning
Increases the risk of sexual and physical violence
Increases risk to developing alcohol abuse and alcoholism as an adult
Increase risk with problems in school and/or the law
It can also increase the likelihood of developing underlying or more dormant psychological problems like schizophrenia or bipolar disorder

Alcohol Awareness

It is important to talk to kids about alcohol. If you don’t, they will learn it from the internet and their peers. Provide them education about what is considered drinking and binge drinking as well as the risks. According to the NIAAA, “This typically happens if a woman has 4 or more drinks, or a man has 5 or more drinks, within about 2 hours. Research shows that fewer drinks in the same timeframe result in the same BAC in youth: only 3 drinks for girls, and 3 to 5 drinks for boys, depending on their age and size. Hopefully, they will make wise decisions to refrain from underage drinking; however, teaching them the consequences, risks, and the effects is more important than believing they would never do such as thing. As a psychologist who works almost exclusively with teens, most parents think their child doesn’t drink.

Teach how much alcohol is in a drink like a wine glass, beer, or cocktail. Explain how some bartenders may put more alcohol in a singe drink.
Encourage someone to drink lots of water, and perhaps eat.
Wait an hour before considering having another drink.
Talk to your teen about having an app, like Uber, on their phone or calling a parent if they are ever drunk or in trouble. Teens are potentially less likely to call an adult for help because of fear of getting caught or trouble even when someone might be in serious trouble. The CDC reported, “7% rode with a driver who had been drinking alcohol.”
Explain rationale about never getting into a car with someone who has been drinking no matter what, even if they say they are fine or only had one drink.
Share why you never allow someone to pour you a drink at a party.
Help your teen understand the reasons you always carry your drink with you at a party or event. Explain the risks of people spiking their drink with harmful substances.

What Are the Signs of Underage Drinking?

It can be really hard to tell in the beginning. Some signs:

Decline in grades
Poor motivation to go to school or get up in the morning
Spend more time or spend the night at a friends house where there is more privacy and less parental supervision
You notice advil or pain relievers missing the next morning or day
You observe that their appetite is gone the next day or report feeling sick after a party or being out with friends
Teens may try to sleep more or isolate because they are not feeling well. This is tricky because a lot of teens do this for reasons other than drinking.
You noticed any alcohol missing from the fridge or lower levels in your liquor bottles.

How to Talk to Teenagers About Alcohol

It is important to teach your child about alcohol when both people are calm. If parents sound like they are lecturing, then your teen will likely tune you out. Create a inviting environment for your teen to ask you questions. Please avoid doing this talk when you, the caregiver, are mad or scared...or any heightened emotion.

It is important to provide warmth and nurturance, while also expressing concern. It is important to provide boundaries as well, and then get them professional help. Talk with your child's pediatrician or family doctor. There is often underlying stressors that cause kids to binge drink. They may be facing family problems, school issues, social stressors, and/or mental health challenges. There is usually a combination of factors.

Consult with professionals. Lock away or get rid of all alcohol in the home. Find out how or with whom they are drinking with and how they get the alcohol. You might consider talking with other parents. It is important to create open dialogue without shaming. You can place boundaries and protective measures without guilt-tripping and shaming your child.

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References

Center for Disease Control and Prevention, Last Reviewed: October 26, 2022. Available from: https://www.cdc.gov/alcohol/fact-sheets/underage-drinking.htm
Chung T, Creswell KG, Bachrach R, Clark DB, Martin CS. Adolescent binge drinking: developmental context and opportunities for prevention. Alcohol Res. 2018;39(1):5–15. PubMed PMID: 30557142
Calculated using past 30-day quantity and frequency of alcohol use and past 30-day frequency of binge drinking (4+ drinks for females and 5+ drinks for males on the same occasion) from the 2021 NSDUH public-use data file. SAMHSA, CBHSQ [Internet]. 2021 National Survey on Drug Use and Health (NSDUH-2021-DS0001). Public-use file dataset. [cited 2023 Mar 6]. Available from: https://www.datafiles.samhsa.gov/dataset/national-survey-drug-use-and-health-2021-nsduh-2021-ds0001

NIAAA. Defining binge drinking. What colleges need to know now. Bethesda (MD): National Institutes of Health; 2007 Nov [cited 2023 Feb 20]. Available from: https://www.collegedrinkingprevention.gov/media/1College_Bulletin-508_361C4E.pdf

NIAAA. Underage Drinking. Updated, March 2023. Available from: https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/underage-drinking

SAMHSA, CBHSQ. The DAWN Report: Alcohol and drug combinations are more likely to have a serious outcome than alcohol alone in emergency department visits involving underage drinking. Rockville, MD: SAMHSA; 2014 [cited 2023 Feb 20]. Available from: https://www.samhsa.gov/data/sites/default/files/spot143-underage-drinking-2014/spot143-underage-drinking-2014/spot143-underage-drinking-2014.pdf
Waterman EA, Lee KDM, Edwards KM. Longitudinal associations of binge drinking with interpersonal violence among adolescents. J Youth Adolesc. 2019 Jul;48:1342–52, 2019. PubMed PMID: 31079263
The comparison of risk for AUD between different ages at drinking onset is based on the prevalence ratio; the comparison of the increased risk between genders is based on the ratio of the prevalence ratios. The estimates are weighted by the person-level analysis weight and derived from the CBHSQ 2021 National Survey on Drug Use and Health (NSDUH-2021-DS0001) public-use file dataset. Age at drinking onset: age when first drank an alcohol beverage (a can or bottle of beer, a glass of wine or a wine cooler, a shot of liquor, or a mixed drink with liquor in it), not counting a sip or two from a drink. AUD: having met two or more of the 11 AUD diagnostic criteria in the past-year according to the American Psychiatric Association (APA) Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). [cited 2023 Feb 28]. Available from: https://www.datafiles.samhsa.gov/dataset/national-survey-drug-use-and-health-2021-nsduh-2021-ds0001
Squeglia LM, Tapert SF, Sullivan EV, Jacobus J, Meloy MJ, Rohlfing T, Pfefferbaum A. Brain development in heavy-drinking adolescents. Am J Psychiatry. 2015 Jun;172(6):531–42, 2015. PubMed PMID: 25982660
Pfefferbaum A, Kwon D, Brumback T, Thompson WK, Cummins K, Tapert SF, Brown SA, Colrain IM, Baker FC, Prouty D, De Bellis MD, Clark DB, Nagel BJ, Chu W, Park SH, Pohl KM, Sullivan EV. Altered brain developmental trajectories in adolescents after initiating drinking. Am J Psychiatry. 2018 Apr;175(4):370–80. PubMed PMID: 29084454