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Drop in teen use of alcohol is a good start

ALBUQUERQUE, N.M. — In the torrent of bad news about our nation and country, there seems to be a ray of hope: it seems that teen alcohol use is down. That is good news; why do you think that’s happening?

A: That certainly is good news. According to the New Mexico Youth Risk and Resiliency Survey (youthrisk.org), alcohol use has decreased significantly the past two years; in general, alcohol use is slightly lower in New Mexico than it is in the nation as a whole.

The YRRS asks a sampling of anonymous New Mexico high-schoolers about a number of factors that confer risk or help avoid bad consequences – risk factors include drug, tobacco (including vaping), and alcohol use, sexual activity, presence of a gun in the house, and depression and thoughts of suicide. On the other hands, resiliency factors queried include presence of a caring adult in the house, use of safety belts and bike helmets, attendance at religious and other group activities, and strong friendships. The YRRS is carried out by a consortium of the New Mexico Public Health Department and Health Department and the University of New Mexico Preventive Research Center.

New Mexico results from last year, compared to the previous biennial survey in 2013, show that fewer teens began using alcohol before age 13 (down 9.9 percent to 20.1 percent), have used alcohol within the past 30 days (down 9.7 percent to 26.1 percent) and report binge drinking (down 14.6 percent to 14.6 percent). Do these numbers surprise you? Are they higher or lower than you expected?

Alcohol use and abuse by man are older than recorded history; our teenage Neanderthal ancestors probably binged on some alcohol-containing moonshine with the same predictable consequences we see today. With some exceptions, of course: inebriated Neanderthal teens might have wandered out of their caves and gotten stomped by a mastodon or eaten by a saber-toothed tiger, but they didn’t turn a gun on themselves or others, or get into an automobile crash. We don’t have YRRS data for Neanderthal teens.

That “only” one in four teens in 2015 reported being a current alcohol user and “only” one in seven admitted to binge drinking in 2015 is certainly a move in the right direction, but the number of children at risk of the many ills of alcohol is still far higher than most would want.

A review of some of the ill effects of alcohol use by teens (and adults) may help to convince you to monitor your adolescent for signs of use of alcohol. Alcohol intoxication is certainly involved in many automobile accidents, and the same 2015 YRRS survey indicates that 19.7 percent of all teens admitted to having ridden in a car with a drinking driver over the past 30 days. (Have you asked your teen about this? Is s/he one of those at risk?)

Alcohol use is highly associated with interpersonal violence in teens and in adults. A large proportion of domestic violence cases involve alcohol, sometimes in combination with other drugs. Combined with the presence of guns in so many homes, the risk of death is markedly higher in those who are inebriated.

You may have read about the case of rape at Stanford, one of our elite universities. When I went off to college, I had the naive notion that anyone intelligent enough to get in there would have left drugs and alcohol behind. It didn’t take long for me to be rudely awakened to the facts. In any case, the well-publicized Stanford case involved a drunken young woman who had passed out and was sexually assaulted by a Stanford student who had almost certainly been using alcohol as well. In a subsequent survey, 4.7 percent of Stanford coeds admitted to having been raped, usually by another Stanford student and usually one or both of them was under the influence of alcohol. Another study in the past showed that 44 percent of college students admitted to binge drinking, putting them at high risk of committing or experiencing sexual assault. Have you asked your college student child/adult if s/he is at risk of either?

Alcohol is associated with sexual assault, then, and also with unwanted pregnancy. If the mother of a child has used alcohol during pregnancy, the child is at high risk of suffering severe brain and other problems – the facial features, the heart, growth, behavior, kidneys and limbs may all be affected.

As a nation and world, we have all been riveted by the effects of Zika infection, which can cause a child’s brain to develop poorly, leading to microcephaly, or small heads, with likely brain dysfunction later on. Alcohol during pregnancy does the same in many cases: alcohol is the most common cause of developmental defects – and microcephaly – in the United States, affecting as many as 4 percent of pregnancies, far more than Zika virus is likely to cause anytime in the near future.

In short, the ill effects of alcohol are legion. Health care providers should ask their teen patients about their alcohol use, and so should parents. Evidence that a teen is using alcohol, especially in excess, is an indication to get help. The fact that the prevalence of teen drinking has decreased is definitely a silver lining (among the many storm clouds), but we can’t rest – we need to keep asking the questions and taking action.

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