Asking kids two simple questions about alcohol use can have considerable power in the medical setting to help reduce the rate of underage drinking.
Of the many professionals who work with teens, clinicians are in one of the best positions to spot when a young patient’s drinking behavior might be headed in an unsafe direction. Up until now, however, time constraints often have kept pediatricians and family doctors from asking kids about their alcohol use.
Look for this to start changing. The National Institute on Alcoholism and Alcohol Abuse recently published a guide for clinicians on how to identify and intervene with teens at risk of problem drinking. It isn’t every day that a screening comes along that’s both quick and effective, but this seems to be one of them.
The two questions:
1. Do you have any friends who drank beer, wine or any beverage containing alcohol in the past year?
2. How about you – in the past year, on how many days have you had more than a few sips of beer, wine or any beverage containing alcohol?
How kids respond can indicate their level of risk for problems related to alcohol. Hanging out with friends who drink is strongly associated with risk of future drinking, according to the NIAAA. Among teens who already drink, the amount of alcohol they consume and how often they consume it can help predict how likely they are to get into trouble because of their alcohol use.
Drinking tends to be seen as a rite of passage for American adolescents. But it’s a path that also can send them in an ultimately harmful direction.
There’s been a fair amount of research on underage drinking, and the statistics aren’t encouraging. The teen years are when many kids start experimenting with alcohol; nationally, the number of youths who have more than one sip goes up dramatically with age, from 7 percent of 12-year-olds to almost three-fourths of 17-year-olds.
Evidence suggests that when kids start drinking at age 15 or younger, they may have a higher risk of developing alcohol-related problems in adulthood than kids who waited until 21 to start drinking. Underage alcohol use also is frequently a marker for other issues such as poor performance in school, social difficulties, and risk of injury or death.
Some factors appear to make adolescents more susceptible to underage alcohol use. Kids who smoke cigarettes, for instance, are also more likely to drink. Conditions such as depression, anxiety, ADD/ADHD or conduct problems are associated as well with a higher risk of underage drinking.
The NIAAA’s guide for clinicians was developed with the help of the American Academy of Pediatrics, researchers and health professionals with expertise in substance abuse and adolescent health. It’s designed to be used in any number of clinical settings – routine doctor visits, an urgent care clinic, even the emergency room.
What makes it especially innovative is a “youth risk estimator” – a chart that helps classify young patients into low, moderate or high risk of alcohol-related problems. The guide also gives clinicians some tools for how to talk to kids in ways that are sympathetic and nonjudgmental yet nudge them toward quitting their alcohol use, or at least reducing the riskiest drinking behavior.
I don’t think underage drinking has ever been considered OK. But these days we know so much more about the impact of alcohol on kids, including what it can do to their still-developing brains. There seem to be fewer and fewer reasons to tolerate it as “kids will be kids” and more reasons than ever to address teen drinking sooner rather than later.
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