Alcohol and Teens 101: A Primer for Prom, Graduation Season

By Cristina Mestre

By the time teens graduate from high school, many have tried alcohol. With prom and graduation season quickly approaching, we sat down for Alcohol Awareness Month with Duncan Clark, M.D., Ph.D., associate professor of Psychiatry and Pharmaceutical Sciences at the University of Pittsburgh, to answer a few questions on alcohol and teens.

Q: How big is the problem of alcohol use in teens?
A: While there has been a lot of attention to teen cigarette and marijuana use in recent years, alcohol is still the most widely used substance among teens. By age 18, 70 percent of teens have tried alcohol. However, a statistic like this can be misleading. While a lot of teens have tried alcohol, only a minority regularly use alcohol. This is important to emphasize, since teens sometimes think that most of their peers drink. If they do not drink, they may feel they are unusual. If they do use alcohol, they may think “everybody does it,” and that is not true. High school proms and graduation parties are viewed by some teens as a time when alcohol is expected, so this presents an opportunity for parents and teens to talk about alcohol use.

Q: Has teen alcohol use increased in our society in recent years?
A: No, we have been making progress in reducing teen alcohol use. The rates of teen alcohol use are much lower now than they were 10 or 15 years ago.

Q: Is progress being made in understanding alcohol and teens?
A: While we have made progress in the past decade in reducing teen drinking, there are many unanswered questions. Our research program is developing prevention approaches for pediatricians and other health care practitioners, working on improving treatments, trying to determine short-term and long-term alcohol effects. For example, we have just started a research project on alcohol and teen brain development that involves our University of Pittsburgh team and four other research institutions.  

Q: At what point is alcohol use a problem for a teen?
A: For teens, I recommend discouraging any alcohol use. Most teens do not drink alcohol. Compared to those who wait until they are adults to start drinking, teens who do drink are at much greater risk of developing alcohol problems. Even relatively small quantities of alcohol can lead to impaired judgment and problems with coordination. Compared to adults, teens become more intoxicated after using less alcohol. Teens also often have difficulty controlling their alcohol use.

Q: What are some of the risks and consequences associated with this abuse?
A: Each year about 5,000 young people lose their lives because of underage drinking, primarily from car crashes. Alcohol intoxication can also lead to impaired judgment, injuries from accidents, or risky behaviors such as unprotected sex or intoxicated driving. Underage drinkers are also more likely to be assaulted or hurt others by violent acts. Young people who drink large quantities of alcohol can become poisoned by alcohol, and each year there are some young people who die from alcohol poisoning.

Q: What are alcohol abuse and alcohol dependence?
A: Some people who regularly drink alcohol will develop related problems. The definitions of alcohol abuse and dependence describe some of the consequences that can occur with alcohol use. Abuse often involves school problems and conflicts with parents about drinking. Dependence is more severe, and may involve teens spending an increasing about of their time drinking to the exclusion of more constructive activities. Many adults use alcohol occasionally without problems. For teens, there is a closer relationship between regular drinking and problems. This is one of the reasons that teens should be discouraged from drinking.

Q: What are some ways to prevent alcohol problems in teens?
A: I suggest that parents encourage their teens to wait until they are adults to experiment with drinking alcohol. Parent-teen involvement and communication are very important and can be challenging. Teens who feel they are supported by their parents are more likely to honestly discuss alcohol. Parent supervision of teens is important, and communication and supervision go together with teens. Also, parents who are struggling with alcohol problems need to get help for themselves.

Q: What should I do if I think my teen has an alcohol problem?
A: I suggest that parents who are concerned about their teen’s alcohol use get some help. There are many options for initiating assessment and treatment, including involving your teen’s pediatrician, counseling from a variety of sources, professional evaluation by a social worker or psychologist, or specialized evaluation at an alcohol treatment program.  Teens are sometimes more willing to discuss their alcohol use with a doctor or other professional, and the family can then work on a plan to address the problem.