Alcohol and Your Child: What Parents Need to Know

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One of the most abused drugs in the United States is alcohol. It’s also a drug that many people start using at a very young age. Though it’s illegal for people younger than 21 years to drink, many children are introduced to alcohol well before they reach that age. The earlier they begin using alcohol, the higher risk they will have for problems with it later in life. Here is information from the American Academy of Pediatrics to help parents understand the dangers of alcohol and how to prevent alcohol use.

Why parents should worry

  • Between 36% and 50% of high school students drink alcohol, and 28% to 60% report binge drinking.

  • In 2014, half of 12th graders and one in nine 8th graders reported having been drunk at least once in their life.

  • More than 4,300 people younger than 21 years die each year as a result of underage drinking.

  • Adolescents who start drinking before 15 years of age are at 4 times the risk of developing alcohol use disorder as those who start drinking after 20 years of age.

  • 80% of adolescents say their parents are the biggest influence on their decision to drink or not.

Alcohol is often the first drug that young people try. Since alcohol is legal for those older than 21 years and found in most American homes, it’s often easy for children to be around alcohol and its use. Some parents may feel relieved when they find out their teen is “only” drinking ­alcohol. They may even think it isn’t dangerous. Not true! Alcohol can harm your child’s normal brain growth and development. Also, if young people like the feeling they get from alcohol, they may be interested in trying other drugs as well.

Risks linked to alcohol use

Even if a person drinks alcohol only occasionally, it can play a part in a variety of risky behaviors. Just one drink can impair decision-making and slow down reaction time. Underage drinking is not legal and is also linked to

  • Early sexual activity, multiple partners, unintended pregnancy, and sexually transmitted infections, including AIDS.

  • Drunk driving. Among 15- to 20-year-olds, nearly a third of all fatal automobile crashes involve alcohol.

  • Use of other drugs, such as marijuana or cocaine.

  • Health concerns like stunting brain growth, liver damage, hormone imbalances, and ­addiction to alcohol.

  • School problems, such as poor grades and dropping out.

  • Injuries that can be deadly or cause long-term problems.

  • Crime, violence, and safety concerns.

Why young people drink

Here are some reasons why young people drink.

  • Out of curiosity. They have heard that getting drunk is fun, and they want to find out for themselves.

  • As a rite of passage. They see drinking as “something everyone does on the way to adulthood.”

  • To get drunk. This explains why teens drink until they are out of control. Binge drinking (having at least 4–5 drinks within 2 hours) is alarmingly common.

  • To “fit in” with friends who drink.

  • To feel relaxed and more confident.

  • To escape problems, such as depressed ­feelings, family conflicts, or trouble in school or with a boyfriend or girlfriend.

Stages of alcohol use

The same pattern of use exists for alcohol as with other drugs, such as marijuana or cocaine. The following table shows how experts explain the stages of alcohol use. Keep in mind that even if your child doesn’t meet criteria for substance use disorder (SUD), all underage drinking is risky. For example, binge drinking, at any stage of use, is very dangerous and should not be condoned.

Stage Description
Abstinence The time before an individual has ever used alcohol more than a few sips.
Substance use ­without a disorder Very limited use that does not meet the definition of an SUD. The most common problems associated with adolescent substance use (car crashes, unintentional ­injuries, sexual trauma) can all occur with limited use in teens without an alcohol use disorder.
Mild-moderate SUD Use in high-risk situations, such as when driving or with strangers. Use associated with a problem such as a fight, arrest, or school suspension. Use for emotional ­coping, such as to relieve stress or depression. Defined as meeting 2–5 of the 11 ­criteria for an SUD in DSM-5.*
Severe SUD Loss of control or compulsive drug use associated with neurologic changes in the reward system of the brain. Defined as meeting 6 or more of the 11 criteria for an SUD in DSM-5.*

*Doctors use the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition ) to assist in diagnosing mental disorders, including SUD (substance use disorder).

How can I tell if my child is drinking?

Certain symptoms and behaviors are warning signs for alcohol use. Look for

  • Alcohol odors on your child’s breath or clothing

  • Alcohol in your child’s room or backpack

  • Obvious intoxication, dizziness, or bizarre behavior

  • Changes in dress and grooming

  • Changes in choice of friends; alcohol use by your child’s friends

  • Frequent arguments, sudden mood changes, and unexplained violent actions

  • Changes in eating and sleeping patterns

  • Loss of interest in activities

  • School problems, such as declining or failing grades, poor attendance, and recent discipline problems

  • Runaway and delinquent behavior

  • Talk about depression or suicide; suicide attempts

How to prevent alcohol use

Here are ways parents can help their children resist alcohol use.

  • Boost confidence and self-worth by praising your child often for what she does well. Avoid constant criticism.

  • Listen to what your child says. Pay attention and really listen. Be helpful during periods of loneliness or doubt.

  • Know the facts and correct any wrong beliefs your child may have, such as “everybody drinks.”

  • Know who your child’s friends are, and set clear limits. Do not support friendships with others whose parents do not set similar limits. Real friends do not urge their friends to break the rules, such as drinking alcohol, or reject them if they don’t. Insist that a ­parent be at any party your child attends. Don’t let your teen go to parties where ­alcohol is served.

  • Make promises. Have your child promise never to get in a car when the driver has been drinking. You must promise your child that you will always be willing to pick him up, no questions asked, when a safe ride home is needed. Promise each other you will talk about it the next day.

  • Help your child deal with emotions. Let her know that strong emotions are normal. She can express strong emotions in healthy ways. Talk about concerns and problems. Assure your child that everything has an upside, and things do not stay “bad” forever. Be a good role model in the ways you express, control, or relieve stress, pain, or tension.

  • Talk about things that are temptations and those that are important to your child. Talk about school and your child’s need for peer-group acceptance. Discuss life goals and desires. Talk about the risk of using alcohol and drugs and how that might prevent reaching those goals. Teach children exactly how you expect them to respond if someone offers them alcohol.

  • Encourage healthy ways to have fun. Family activities, sports and physical activities, interests in the arts, and hobbies can all be good uses of leisure time.

  • Use teachable moments. Discuss tragedies resulting from alcohol use that are reported in the news. Ask your child what he thinks happened in the story and how tragedy could have been prevented.

  • Join your child in learning all you can about preventing alcohol abuse. Programs offered in schools, churches, and youth groups can help you both learn more about alcohol abuse.

  • Your child’s doctor understands that good communication between parents and children is one of the best ways to prevent ­alcohol use. If talking with your child about alcohol is difficult, your child’s doctor may be able to help open the lines of communication. If you suspect your child is using alcohol or any other drug, ask your child’s doctor for advice and help.

Alcohol and the media

No matter how often they hear how dangerous it is to drink alcohol, many young people today still think it’s cool. A big reason for this is the media. Alcohol companies spend billions of dollars every year promoting their products on TV, in movies and magazines, on billboards, and at sporting events. In fact, alcohol products are among the most advertised products in the nation.

Alcohol ads never mention the dangers, such as alcoholism and drinking and driving, or how it ­affects an unborn infant (fetal alcohol ­syndrome). Most ads show drinkers as healthy, energetic, sexy, and successful. Ads are trying to boost sales of a product, so this ­product—alcohol—is made to look as appealing as ­possible!

Here are tips on how parents can address ­issues related to alcohol and the media.

  • Talk about ads with your children. Help them understand the sales pitch—the real messages in these ads.

  • Teach your children to be wary consumers and not to believe everything they see and hear on TV.

  • Make sure the TV shows and movies your ­children watch do not show drinking alcohol as cool or glamorous.

  • Don’t let your children wear T-shirts, jackets, or hats that promote alcohol products.

  • Talk with your children’s school about starting a media education program.

Parents who drink alcohol

Parents who drink should be careful how alcohol is used at home. Having a drink should never be shown as a way to cope with problems. Don’t drink in unsafe conditions—before or while driving a car, mowing the lawn, boating, etc. Don’t ­encourage your child to drink or join you in having a drink. Parents who are problem drinkers or who use alcohol often and in large amounts place their children at increased risk of alcohol dependence. Studies show that alcoholism runs in the family, so children of alcoholic parents are more likely to ­become ­alcoholics.

About teen ­confidentiality

All teens should be screened for alcohol and other drug use as part of routine medical care. Your child’s doctor will want to ask questions about alcohol in private to get honest answers. If your child reports alcohol use, the doctor will determine whether your child needs very brief advice, a return visit, or a referral to a specialist. Every doctor will have his or her own policy about what information must be shared with a parent and what will stay confidential (between the patient and the doctor), but most doctors will protect a teen’s confidentiality if they believe the teen’s drug use is not an immediate safety risk to the child or others. It is important for you to respect the doctor’s decisions about confidentiality to encourage your child to have an open and honest discussion with the doctor.

The persons whose photographs are depicted in this publication are professional models. They have no relation to the issues discussed. Any characters they are portraying are fictional.

The information contained in this publication should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

© 2015 American Academy of Pediatrics. All rights reserved.