By John Messmer
Penn State Family & Community Medicine
Penn State Milton S. Hershey Medical Center
Penn State College of Medicine
With school back in session, we have begun to see reports of alcohol and drug use among college and high school students. A recent article on a Penn State football rally quoted a student as saying about the crowd that "95 percent are wasted." It is unlikely that everyone in the group to which he referred was 21 and older.
Some of us might have done the same thing in college so we minimize the significance of drinking by college students. Others may accept it if they don't drink and drive, thinking alcohol is safer than smoking crack or methamphetamine. Such opinions do not help to deal with the problem of alcohol and drug abuse among youth.
Children are different when it comes to mood-altering substances. The brain is developing until a person is in his or her 20s. Drugs and alcohol affect the developing brain differently. For those who are genetically predisposed to addiction, exposure to mood-altering substances in youth leads to addiction more rapidly than for adults. Starting to drink under age 14 increases the risk of problem-drinking two- to four-fold compared to a first drink after age 21. It's a significant problem since as many as one-third of all children have had their first drink (more than a few sips of alcohol) by age 13. One in five eighth-graders have had alcohol in the preceding month and about 7 percent have been drunk.
Children are more likely to be impulsive and responsive to peer pressure and may not realize the risks involved. Acute alcohol poisoning is more likely in youth and one-third of high school students have ridden in a car driven by someone under the influence of alcohol in the preceding 30 days. Regular alcohol use is associated with other risky behaviors, such as smoking, sexual activity and use of other drugs.
Besides such short-term risks of alcohol or drug use as accidental death or injury, the risk of long-term problem alcohol and drug use is high. So far, there is no reliable predictor of who will develop addiction. It tends to be genetic so a family history of substance abuse problems increases one's chance of developing addiction.
In addiction, the affected person seeks one or more chemicals that cause a psychological effect or euphoria. The addict is driven to do this above all else due to maladaptive brain chemistry that causes a response to mood-altering substances that is different than the non-addict. This behavior is set in motion upon exposure to a mood-altering chemical and the process is much faster in children. For this reason it is critical that children not have access to drugs or alcohol.
Most people would accept that children should be kept away from so-called hard drugs, such as heroin, cocaine, methamphetamine and so on, but what about softer drugs, such as marijuana and alcohol? Is it such a problem to let a child share a glass of wine with the family at dinner? They do it in Europe, after all.
European youth have even more problems with alcohol than do ours. Alcohol-related health problems are more common in countries in which drinking starts at lower ages. Children who are allowed to have alcohol at home, even if under the strict supervision of their parents, are more likely to drink outside the home, and regular drinking of alcohol increases the likelihood of other drug use. A parent may think his or her child will do fine, but the truth is, there is no way one can really know until he or she has been allowed to drink since no one can predict in advance who will develop an addiction.
Some parents have tolerated drinking at parties if the adolescent children turn in their car keys. Besides being illegal to do this, it is highly unlikely that every child can be supervised at all times. Even if one prevents drinking and driving, condoning drinking in one setting gives tacit approval to drink at other times. Any child with a predisposition to alcohol or drug problems who is thus exposed is much more likely to develop the problem.
Alcohol is only for adults age 21 and older. It is the law in all states, so we don't have to negotiate this with our children, even if we feel ambivalent about it. Education about the risk of addiction should begin early in middle school. We should clearly express our opinion about drugs and alcohol use to our children regularly and ask them what they see and hear outside the home about drugs and alcohol. Although we may wish to respect their privacy, it is our obligation as parents to know where they are going and who will be there. Find out if someone's parent will be supervising activities and talk to other parents about their attitudes. Don't be afraid to set limits and curfews or to visit a party personally to check up on things.
If a child's school performance or behavior changes or he or she takes up with a completely different group of friends suddenly, it may be necessary to forget privacy rights and search the child's room thoroughly for evidence of drugs or alcohol. This is a very difficult step because it is unpleasant to consider our child may have a drug or alcohol problem, but ignoring it, like ignoring any illness, will only allow it to get worse.
As a society, all of us must accept that drinking is unacceptable for anyone in any circumstance before age 21. The fact that 18-year-olds can vote and die for our country is irrelevant. Having the physical prowess to fight a war or intellectual ability to make political judgments does not change the fact that the young brain is more susceptible to the influence of drugs.
It is fairly easy to be consistent in our message to our children that drug use will not be tolerated, but it's not easy to maintain a consistent message of avoidance of alcohol. We might think it's a mixed message, particularly if we consume alcohol ourselves. The fact is alcohol affects kids differently. It's up to us as adults to keep it away from them.