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discuss alcohol

A Resource for Parents & Mentors to Talk to Teens About Alcohol

Underage Drinking

talks on alcohol

talking to teens about drinking

As you likely remember, adolescence is a time of transition packed with exciting new experiences. Experimenting with alcohol is often one of them. However, drinking is illegal for those under 21 and can be especially dangerous for young people. Despite this fact, many teens are attracted to it anyway, for reasons not unlike those that draw adults to alcohol:

They feel awkward. Alcohol relaxes them and can make them feel more comfortable in their changing bodies and in
social situations.

Their friends are doing it. They want to go along with their peers. Its available. Its illegal for kids to consume alcohol, but its often offered to them, especially during celebrations.

why bother to discuss alcohol with a teen?

Teenagers may appear scornful of adult advice and even roll their eyes. But studies show that teens who engage in conversation with parents and signicant adult role models are more resilient and better able to resist risky or unsafe behaviors. Its crucial for adults to talk to them about making smart decisions.

Some teenagers may open the door for discussion by asking a question. If yours doesnt, initiate the conversation yourselfand do it more than once.
The best evidence says that these conversations need to be repeated, as a teens psychological readiness to hear what adults have to say isnt always apparent. Its also important to have facts on hand, to make your points stick. So be patient, be ready to encounter some resistance and be willing to do it all over again later.

why shouldnt adolescents drink?

Most adolescents are at a stage in life when they have a healthy need to test limits, challenge authority and nd their footing as adults. Unfortunately, they also feel omnipotent and rarely appreciate the possibility that their behavior might have negative outcomes. Add alcohol into this volatile mix and you get life-changing and even life-threatening consequences, such as:

Unplanned and unprotected sexual experiences: Alcohol use among

adolescents is associated with not only high-risk sexual behaviors but also sexual assault and rape.

Driving while intoxicated or riding with an intoxicated driver: Car ac-

Alcohol slows all brain function. Since adolescent brains are still developing, this can lead to a decrease in thinking ability.

cidents involving alcohol are a leading cause of death among people aged 15 to 20.

School failure, truancy and theft Experimentation with drugs and cigarettes Fights Vandalism
Teens who drink but avoid these problems can still permanently hurt their brains. Data shows that drinking alcohol at a young age can lead to a propensity for dependence on it later in life.

how common is underage drinking?

Teen drinking has declined in the past ten years, but its still common:

By the time they reach eighth grade, 29 percent of teens have had at
least one drink, and almost 13 percent report having been drunk.

By senior year in high school, 69 percent of adolescents have tried

alcohol, and over half say they have been drunk.

41 percent of high school seniors say theyve had at least one drink
in the past month. And 24 percent say theyve bingedhad four or ve drinks at a timewithin in the previous two weeks.

how do peers affect teen drinking?

Adolescents are inuenced by their social groups. This is often healthy they can be prompted by their friends to study harder or to pursue sports or the arts.

But if their friends are drinking or engaging in other risky behavior, pressure to go along can lead to problems.
Peer pressure can be active or passive: Peers might ask a teen explicitly to do something wrong or dangerous, to have a friendly drink, or to drink to avoid being made fun of. Or teens might participate in things they know are wrong in hopes of tting injoining a drinking game at a party, for instance.

whos at risk for problem drinking?

People who are the children of alcoholics are more likely to experience problem drinking and experiment with alcohol at a younger age. Teens with psychiatric disorders also tend to have more serious problems with alcohol, possibly using alcohol to treat discomforting symptoms.

Many adolescents who have been drinking may not have the obvious signs of being drunk but can still suffer physical and psychological effects.

how much alcohol does it take to affect a teen?

Teens can be easily affected by alcohol. Depending on a number of factors, just one or two standard drinks in an hour can boost an adults blood alcohol concentration (BAC) past the legal driving limit. And a mixed drink or an Blood alcohol ill-poured glass of wine or shot levels above .40% may contain multiple servings can be lethal in one glass. Teens, however, may think of one drink as the contents of one glass of any size.

Teens also often get intoxicated much more quickly than adults, because they have lower tolerance for alcohol, less body mass, drink on an empty stomach, drink too quickly or experiment with stronger alcohol mixes.

how do you start a conversation with a teen about alcohol?

Theres no magic opening. Be direct. Use facts. Listen. Expect resistance. Repeat. The only sure way to fail is to not try. Dont forget to take
into account where that teen is psychologically and cognitively. Talking about alcohol before opportunities arise is an important way any parent or mentor can help a teen develop the skills and condence to manage tricky situations. For age-specic conversation starters, visit

Johnston, L. D., OMalley, P. M., Bachman, J. G., & Schulenberg, J. E. Monitoring the Future national results on adolescent drug use: Overview of key ndings, 2012. Ann Arbor: Institute for Social Research, The University of Michigan, 83, 2013. National Institute on Alcohol Abuse and Alcoholism. Underage Drinking: A Major Public Health Challenge, Alcohol Alert No. 59, April 2003. National Institute on Alcohol Abuse and Alcoholism, Youth Drinking: Risk Factors and Consequences, Alcohol Alert No. 37, July 1997. Alcohol Use and Delinquent Behaviors Among Youth. The NSDUH (National Survey on Drug Use and Health) Report, SAMHSA, April 1, 2005. Fishman, M., Bruner, A., Adger, H. Substance abuse among children and adolescents. Pediatrics in Review, Vol. 18, No. 11, 1997. Wechsler, H., MD. Binge Drinking and the American College Student: Whats Five Drinks? Psychology Addictive Behaviors, 15:287-291, 2001. Vachon, C.M., Cerhan, J.R., Vierkant, R.A. and Sellers, T.A. Investigation of an interaction of alcohol intake and family history on breast cancer risk in the Minnesota Breast Cancer Family Study. Cancer 92(2):240248, 2001. Hayes, R.B., Brown, L.M., Schoenberg, J.B., et al. Alcohol use and prostate cancer risk in U.S. blacks and whites. American Journal of Epidemiology, 143 (7): 692-697, 1996.


The Heart
During intoxication, adolescents may experience low heart rate and blood pressure. Long-term chronic use may result in cardiomyopathy, a weakness of the heart muscles, and hypertension.

The Brain
Alcohol slows all brain function. Since adolescent brains are still developing, this can lead to a decrease in thinking ability. Learning disabilities can result from damage to the hippocampus the part of the brain responsible for learning and memory. Excessive alcohol use has also been linked to short and long term memory problems, loss of balance, peripheral neuropathy (nerve problems causing numbness and pain) and dementia.

The Blood
Chronic alcohol use may result in anemia, or low blood count, due to blood loss from bleeding and inammation of the stomach lining, as well as nutrient and vitamin deciency. Low platelets from alcohols toxic eect on the bone marrow can result in easy bruising and bleeding.

The Stomach
Overconsumption of alcohol is dangerous to the stomach lining, and may result in inammation or severe ulcers.

The Liver
Alcohol is broken down in the liver. Excessive alcohol abuse has been linked to alcoholic hepatitis, fatty liver and cirrhosis, or scarring of the liver. Symptoms include abdominal pain, jaundice (yellow skin and eyes), bloated stomach and vomiting of blood.

Long-term abuse is associated with cancer of the esophagus.

The Reproductive System

Alcohol use has been related to inability to have an erection and decrease in sperm count.

The Pancreas
Chronic alcohol use can result in pancreatitis, a toxic inammation of the pancreas, which can lead to weight loss and malnutrition. Symptoms of pancreatitis include nausea, vomiting and pain when eating.

Some studies suggest that breast and prostate cancer may be associated with chronic alcohol use. Women who drink excessively while pregnant have a risk of bearing a child with a congenital problem called fetal alcohol syndrome.

BAC 0.05 0.10
Alcohols primary eect is on the brain, leading to intoxication. Initial effects:

Lowered inhibitions Many adolescents report that alcohol relieves tension and makes them feel more socially at ease, however, judgment and physical reactions may already be impaired.


BAC 0.10 0.20

Most teenagers now are visibly drunk, which can include staggering and trouble with verbal expression.

Common symptoms: Impaired coordination Irritability Slurred speech Poor balance Delayed reex time Nausea and vomiting Loud and aggressive behavior


Many adolescents who have been drinking may not have the obvious signs of being drunk, but can still suer physical and psychological eects.


BAC 0.20 0.30

As more alcohol is ingested, people become sleepier and slower; basic functions, including breathing, can become dangerously depressed. Red ags of severe alcohol intoxication:


Extreme sleepiness Slow, shallow breathing An inability to be awoken Immediate medical attention may be necessary at this stage.


BAC 0.30 and above

At or above alcohol levels of 0.30 percent, people may: Become severely dehydrated

Have pinpoint pupils and slow breathing Have low blood pressure and decreased heart rate Vomit and then choke on the vomit and suocate Enter coma state



Karen Soren, MD
Associate Professor of Pediatrics and Public Health Columbia University Medical Center Director of Adolescent Medicine NewYork-Presbyterian Morgan Stanley Childrens Hospital