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Ask the Pediatrician: Just how dangerous is underage drinking?
With so many other issues affecting young people right now, teen alcohol use may not seem like that big of a deal. You might recall your own early experiences and figure that some drinking can be expected. But when we look at alcohol's effect on a child's developing brain, the risks become clearer.
It's helpful to realize that the human brain continues to grow and develop until age 25. Frequent alcohol use can have a negative impact on regions of the brain that handle learning, memory and speech, as well as visual and spatial thinking.
Alcohol's impact on the brain—not to mention its immediate effects on everyday functioning—may explain why kids who drink usually have serious difficulties in school. Young people who admit to binge drinking are 4 to 6 times more likely than nondrinkers to skip classes. High-schoolers who drink regularly are 5 times more likely to drop out. Drinking is related to 40% of all academic problems in college—and 28% of kids who leave before getting their degrees cite problem drinking as one cause.
Because it changes the way people think and act, alcohol is also closely related to behaviors that can seriously harm your child or cause harm to others. For example, alcohol use in young people can increase their chances of engaging in unprotected sex, exposing them to sexually transmitted diseases and risks for unwanted pregnancies. Incidents of physical and sexual violence often involve young people who are under the influence of alcohol. Unintentional injury-related deaths, especially car accidents, frequently involve drunk drivers.
Young people who drink also face higher risks of depression and suicide.
Several factors might motivate kids and teens to drink, including peer pressure, stress, environment, family history, or bias and discrimination.
But there's good news here. Kids care very much about what their parents think—and are much more open to talking about alcohol use than you might imagine. In fact, research shows that parents are the No. 1 reason kids decide not to drink. This is just one reason the American Academy of Pediatrics recommends you talk to your child early and often about underage drinking.
Here are suggestions for starting a meaningful and supportive conversation with your child:
- Start talking about alcohol with your child when they are around 9 years old. This gives you the opportunity to help shape your child's thoughts and actions around alcohol as they move toward adolescence.
- Bring the subject up in a relaxed, nonjudgmental way. Avoid condemning all people who drink, which might confuse your child. Instead, ask what thoughts they have about alcohol. Do their friends talk about it? Do they have any feelings about the way adults around them use alcohol? Try to listen as much as you talk, especially with teens.
- Find the right moments. Times when your child is present, engaged, and not rushed are best—for example, quiet mealtimes, or moments when their younger siblings aren't around and distracting them. Put your phone away and make sure the television is turned off.
- Consider sharing your own stories. Kids appreciate honesty, especially when you're talking about difficult subjects. Without overwhelming your child, you might touch on times when you saw alcohol hurt people. "My father used to get drunk a lot. It wasn't good for his health and it definitely made things hard for him at work. I'm hoping I can help you avoid what happened to him."
- Normalize nonuse. Tell your teen often and repeatedly that it's perfectly normal not to drink. You might acknowledge that, even though many kids do develop drinking problems, national studies show most teens stay away from alcohol during high school. In fact, the percentage of teens that don't drink has been steadily rising for two decades.
- Set clear expectations and guidelines based on age. Don't be afraid to state that young children should not drink, period. As your child approaches junior high and high school, tell them you know they might feel pressured to try alcohol. Set clear limits and be prepared for pushback. "You don't have to like my rules, but I have to create them because I'm your parent and I care about you."
- Offer to pick them up, no questions asked. If kids find themselves in a situation where they or others are drinking, they should call you immediately. Make sure they know you'll give them a ride home anytime, day or night. (Depending on your work and family commitments, you'll need to have backup when you can't be available.) Bring them home, give them time to recover, then discuss the issue with them when everyone feels calmer and more rested.
Be calm, loving and supportive and ask your pediatrician for support. Seek out specialized resources if you need them. For example, you may want to review the list of mental health resources for families of color published by the Mental Health Coalition. If you are parenting a child who identifies as LGBTQ+, The Trevor Project offers in-depth resources.
Make it safe for your child to tell you anything. Try not to overreact when your child tries alcohol, even if they get very drunk. You don't have to pretend you're not disappointed, but staying away from shame and blame will signal that your child can trust you when things go wrong and they need you the most.
Don't end the conversation when your child moves out or goes to college. Encourage them to come to you anytime they need perspective and support.
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