D I S C U S S
A L C O H O L
A Resource for Parents & Mentors to Talk to Teens About Alcohol
underage
drinking
T A L K S
O N
A L C O H O L
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.
• It’s available. It’s illegal for kids to
consume alcohol, but it’s often offered
to them, especially during celebrations.
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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 significant adult role
models are more resilient and better able to resist risky or unsafe behaviors. It’s
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
doesn’t, initiate the conversation yourself — and do it more than once.
The best evidence says that these conversations need to be repeated, as a teen’s
psychological readiness to hear what adults have to say isn’t always apparent. It’s
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.
Alcohol slows all brain function. Since adolescent
brains are still developing, this can lead to a decrease
in thinking ability.
why shouldn’t
adolescents
drink?
Add alcohol into this volatile mix and
you get life-changing and even lifethreatening consequences, such as:
• Unplanned and unprotected sexual
Most adolescents are at a stage in life
experiences: Alcohol use among
when they have a healthy need to test
adolescents is associated with not only
limits, challenge authority and find
high-risk sexual behaviors but also
their footing as adults. Unfortunately,
sexual assault and rape.
they also feel omnipotent and rarely
appreciate the possibility that their
behavior might have negative outcomes.
• Driving while intoxicated or riding with
an intoxicated driver: Car accidents
involving alcohol are a leading cause
of death among people aged 15 to 20.
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.
• School failure, truancy and theft
• Experimentation with drugs and
cigarettes
• Fights
• Vandalism
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T A L K S
O N
A L C O H O L
how common is underage drinking?
Teen drinking has declined in the past ten years, but it’s still common:
• By the time they reach eighth grade, 26 percent of teens have had at least one drink,
and almost 11 percent report having been drunk.
• By senior year in high school, 64 percent of adolescents have tried alcohol, and
almost half say they have been drunk.
• Thirty five percent of high school seniors say they’ve had at least one drink in the
past month. And 25 percent say they’ve binged—had four or five drinks at a time—
within in the previous month.
how do peers affect teen drinking?
Adolescents are influenced by their social
Peer pressure can be active or passive:
groups. This is often healthy— they can be
Peers might ask a teen explicitly to do
prompted by their friends to study harder
something wrong or dangerous, to have a
or to pursue sports or the arts.
friendly drink, or to drink to avoid being
made fun of. Or teens might participate
But if their friends are
drinking or engaging in other
risky behavior, pressure to go
along can lead to problems.
in things they know are wrong in hopes
of fitting in—joining a drinking game at a
party, for instance.
who’s 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.
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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 adult’s blood alcohol concentration(BAC)
past the legal driving limit. And a mixed drink or an ill-poured glass of wine or shot
may contain multiple servings 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.
Many adolescents who have been drinking may not have
the obvious signs of ‘being drunk’ but can still suffer
physical and psychological effects.
Blood alcohol
levels above .40%
can be lethal.
how do you start
a conversation
with a teen about
alcohol?
There’s no magic opening. Be direct. Use
facts. Listen. Expect resistance. Repeat.
The only sure way to fail is to not
try. Don’t 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 confidence to
manage tricky situations.
For age-specific conversation starters,
visit healthallianceonalcohol.com
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references
Johnston, L. D., O’Malley, P. M., Miech, R. A., Bachman, J. G., & Schulenberg, J. E. (2016). Monitoring the Future
national survey results on drug use, 1975-2015: Overview, key findings on adolescent drug use. Ann Arbor:
Institute for Social Research, The University of Michigan.
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.
Center for Behavioral Health Statistics and Quality. (2015). Behavioral health trends in the United States: Results
from the 2014 National Survey on Drug Use and Health (HHS Publication No. SMA 15-4927, NSDUH Series H-50).
Retrieved from http://www.samhsa.gov/data/ on 12/15/2016.
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: What’s 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):240–248, 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.
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alcohol & the teenage body
The Heart
The Brain
• During intoxication, adolescents may
experience low heart rate and blood
pressure.
• Alcohol slows all brain function.
Since adolescent brains are still
developing, this can lead to a
decrease in thinking ability.
• Long-term chronic use may result in
cardiomyopathy, a weakness of the
heart muscles, and hypertension.
The Blood
• Chronic alcohol use may result in
anemia, or low blood count, due
to blood loss from bleeding and
inflammation of the stomach
lining, as well as nutrient and
vitamin deficiency.
• 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.
• Low platelets from alcohol’s
toxic effect on the bone marrow
can result in easy bruising and
bleeding.
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.
The Pancreas
• Chronic alcohol use can result in
pancreatitis, a toxic inflammation
of the pancreas, which can lead
to weight loss and malnutrition.
Symptoms of pancreatitis include
nausea, vomiting and pain when
eating.
The Stomach
• Overconsumption of alcohol is
dangerous to the stomach lining,
and may result aain inflammation
or severe ulcers.
• 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.
• 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.”
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levels of intoxication
BAC 0.05 – 0.10
Alcohol’s primary effect is on the brain, leading to intoxication.
0.05
Initial effects:
•L
owered inhibitions
•M
any adolescents report that alcohol relieves tension and makes them
feel more socially at ease, however, judgment and physical reactions
may already be impaired
0.10
BAC 0.10 – 0.20
0.15
0.20
Most teenagers now are visibly drunk, which can include staggering and
trouble with verbal expression.
Common symptoms:
• Impaired coordination
• Delayed reflex time
• Irritability
• Nausea and vomiting
• Slurred speech
• Loud and aggressive behavior
• Poor balance
Many adolescents who have been drinking may not have the obvious signs
of “being drunk,” but can still suffer physical and psychological effects.
0.25
BAC 0.20 – 0.30
As more alcohol is ingested, people become sleepier and slower; basic
functions, including breathing, can become dangerously depressed.
Red flags of severe alcohol intoxication:
0.30
• Extreme sleepiness
• Slow, shallow breathing
• An inability to be awoken
Immediate medical attention may be necessary at this stage.
0.35
BAC 0.30 and above
At or above alcohol levels of 0.30 percent, people may:
• Become severely dehydrated
0.40
• Have pinpoint pupils and slow breathing
• Have low blood pressure and decreased heart rate
• Vomit and then choke on the vomit and suffocate
• Enter coma state
0.45
BLOOD ALCOHOL LEVELS ABOVE 0.40 PERCENT CAN BE LETHAL.
THIS IS CALLED ALCOHOL POISONING.
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A U T H O R
Karen Soren, MD
Associate Professor of Pediatrics and
Public Health
Columbia University Medical Center
Director of Adolescent Medicine
New York-Presbyterian Morgan Stanley
Children’s Hospital
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