Parenting: Preteenagers

A recent report released by the American Medical Association (AMA) dispels the myth that our youth are more resilient than adults to the adverse effects of alcohol on the brain. "Underage drinkers are at higher risk than adults," says Dr. J. Edward Hill, chairman of the AMA. "Actually the opposite is true. The effects are long-term and often permanent."

The report, Harmful Consequences of Alcohol Use on the Brains of Children, Adolescents, and College Students, is a comprehensive compilation of 20 years of research on how alcohol alters the developing brain and causes possible irreversible damage.

The Statistics
It may be surprising to some to learn that, on average, children are now experimenting with alcohol for the first time as young as 12 years old. "Nearly 20 percent of 12- to 20-year-olds report being binge drinkers," says Dr. Hill. (Binge drinking is considered to be having four to five drinks in a row.) "It' s not just kids being kids anymore – it's a public health crisis."

Dr. Richard Yoast, AMA's director of the office of alcohol and other drug abuse, says that 80 percent of students have consumed more than a few sips of alcohol by the time they finish high school. "Among youth 12 to 20, an estimated 10.1 million used alcohol," he says. "Of these, 6.8 million were binge drinkers and 2.1 million were heavy drinkers."

Dr. Yoast continues to illustrate the seriousness of the situation by pointing out that alcohol use among young people increased from 2000 to 2001, and the number of deaths due to drinking and driving increased. "Although there hadn't been much change in recent years, this upturn is cause for concern," he says. "Furthermore, the age at which youth first drink has steadily declined since 1965 – it's now about 12 – and the numbers who first drink, ages 12 to 17, has significantly increased from 2.2 million in 1995 to 3.1 million in 2000."

Dr. Yoast feels that we, as a nation, have paid little attention to the seriousness of underage drinking. "There have been no national media campaigns since the 1980s," he says. "We treat alcohol as only one among many drugs in prevention, although it is the most widely used drug by our youth. Many parents let underage drinking slip by as a 'normal' part of growing up. Meanwhile, alcohol advertising targeting youth has greatly increased."

That, coupled with the fact that alcohol is becoming more increasingly available at a greater number of locations, activities and events, is of great concern to many parents, educators and health professionals.

Cause and Effect
A recent nationwide poll conducted for the Robert Wood Johnson Foundation found that nearly 70 percent of Americans favor a ban on TV liquor ads and 59 percent support banning beer commercials on TV. "It's time TV executives and the alcohol industry stop profiting at the hands of those most harmed by drinking," says Dr. Hill. "This report reminds us of how important it is to protect our children during these crucial early years of development instead of filling their growing brains with the misleading notions that drinking is normal and without consequence."

The AMA report points out that adolescents, who typically have smaller bodies than adults, have not yet developed a physiological or behavioral tolerance to alcohol so that they don't have to drink very much to become intoxicated. Teens are more likely to become less controlled than adults, act out – even violently – and drink heavily until they are intoxicated. This is because their social, emotional control, thinking and decision-making skills are less developed than those of an adult.

Even more frightening, according to this recent report, each alcohol binge results in impaired thinking skills, impaired learning and memory. With chronic alcohol use, there are lasting changes to this system, leading to blackouts, amnesia, breakdown of the brain's motor coordination center and susceptibility to withdrawal seizures.

"Our brains go through important transformations during adolescence," says Sandra Brown, Ph.D., chief of psychology services at the Veterans Affair Medical Center in San Diego, Calif., whose brain research was included in the Harmful Consequences of Alcohol Use on the Brains of Children, Adolescents, and College Students report by the AMA. "This study shows that alcohol use during the adolescent years is associated with damage to memory and learning capabilities as well as to the decision-making and reasoning areas in the brain."

As described in the AMA report, here are some other serious and long-term effects of alcohol on the brain:

• Different toxic effects on adolescent brains than on those of adults
• Ten percent impairment of brain function and adolescent memory
• Poorer visual-spatial functioning
• Poorer retention and retrieval of verbal and nonverbal information
• Short-term or relatively moderate drinking impairs learning more than among adults
• Reduces students' academic performance
• Greater risk for falling further behind in school
• Greater risk of social problems
• Contributes to depression, suicide and violence
• Disturbed sleep cycles increase risk of memory and learning deficits, accidents, impaired social and occupational function

According to Brown, alcohol takes a greater toll on the brain development of those under 21 than on any other age group. It may be surprising to some to learn that adults would have to consume as much as twice the amount of alcohol to suffer the same damage to their brain as adolescents, and that even occasional heavy drinking injures young brains.

The AMA report also shows that teen drinkers scored worse than their non-drinking peers on vocabulary, visual-spatial and memory tests and were more likely to perform poorly in school as a whole. They were also noted to experience more social problems, increased incidence of depression and thoughts of suicide and violence.

"Research is showing more and more that drinking before age 21 – the approximate age when the brain becomes fully adult – can lead to permanent harm to a youth's brain, learning and development," says Dr. Yoast. "The earlier kids start to drink, the greater the likelihood they will have alcohol problems when they become adults."

Education Begins at Home
Dr. Yoast says the issue needs to be addressed at home and in the community. "In the home, parents can make sure alcohol is not easily available to their children and very clearly educate their children about what they expect and think about drinking," he says. "They can also teach their children to be media savvy – help them recognize how advertising is designed to falsely make drinking seem normal and harmless and appealing to youth."

As a community, we need to be sure that merchants and other adults comply with all the laws that ban provisions of alcohol to minor children. As parents, we need to be sure that adults are supervising our children during after school hours and at youth parties and get-togethers.

"Most of the education youth get is through the biases of alcohol advertising and from other youth," says Dr. Yoast. "While most schools now use prevention programs that include alcohol education, there is little in the mass media to educate children about the risks that alcohol poses to them. Many parents incorrectly assume there's nothing that can be done – that kids will drink, no matter what. They fail to educate their own children and to demand that the community work together to reduce underage drinking."

Dr. Yoast says that the problems with teenage drinking are serious, but points out that parents can really make all the difference. "Have clear, firm, consistent and explicit family rules and expectations regarding alcohol for each family member," he says. "Think about your own behaviors regarding alcohol and whether those present the model you want your children to adopt."