Problem drinking is an umbrella term covering binge drinking, heavy drinking, and alcohol use disorder (AUD) – a pattern of compulsive alcohol consumption, loss of control over how much alcohol the person consumes, and withdrawal symptoms, especially negative emotional state and intense cravings when the person does not consume alcohol. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) reports that 16 million people in the United States struggle with AUD, as of 2015. While most of the people reporting AUD or symptoms of AUD in the survey were adults, about 623,000 adolescents between the ages of 12 and 17 were believed to have AUD.
It illegal for anyone in the US who is under the age of 21 to consume alcohol. Abusing alcohol at an early age can lead to serious long-term consequences for the person’s health. Alcohol abuse as a teenager increases the risk of other substance abuse and addiction patterns, leads to problems in brain development, and harms internal organs like the liver. It is important to know how to help teens who may struggle with alcohol use disorder by recognizing the signs and finding appropriate treatment options.
The Harm of Adolescent Alcohol Abuse
Teenagers who begin abusing alcohol in their formative years are very likely to suffer from serious health and legal consequences. For example, consuming alcohol while underage puts the person at risk for struggling with heavy alcohol use and alcohol dependence later in life; heavy drinking increases the risk of heart disease, stroke, mood disorders, liver disease, and many cancers.
Underage drinking is one of the major contributors to death from injuries among adolescents. About 5,000 people under the age of 21 die every year due to the consequences of alcohol abuse:
- 1,900 deaths involving motor vehicle crashes because one person drove while intoxicated
- 1,600 homicide deaths after consuming too much alcohol
- 300 suicides after drinking too much
People who begin drinking before the age of 15 are at much greater risk for developing other substance abuse problems and struggling with polydrug abuse; engaging in risky sexual behaviors or becoming the victim of sexual assault; or getting into serious accidents, especially car crashes or physical fights.
During adolescence, brain development rapidly increases. Neuroscientists call this period a time of heightened neuroplasticity, when the brain, especially the prefrontal cortex, grows rapidly and develops millions of new connections. Alcohol inhibits the function of some areas in the brain, which can damage their structure, leading to reduced neuroplasticity, changes to the shape of some areas in the brain, poor memory, reduced cognition, and reduced ability to learn new things. This damage also increases the risk of mood disorders and some other mental illnesses.
How to Help Others Struggling with Alcohol
Statistics on Teenage Alcohol Abuse
Although teenage drug and alcohol abuse is a serious problem, with serious long-term consequences, rates of substance abuse in general among kids ages 12-17 are going down. Alcohol is the second most abused substance among this age group, with about 5.8% of adolescents reportedly binge drinking at least once on the month before the survey conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA) in 2015. The most popular drug among adolescents is marijuana, with about 7% of teens reportedly abusing this substance at least once in the prior month. These rates are lower than the previous teen drug abuse survey conducted in 2011.
The Monitoring the Future Survey (MTF) for 2016 reports similar statistics for students in grades 8, 10, and 12. MTF found that, overall, past-year reported alcohol use was:
- 6% for 8th graders in 2016 compared to 26.9% in 2011
- 3% for 10th graders in 2016 compared to 49.8% in 2011
- 6% for 12th graders in 2016 63.5% in 2011
Daily alcohol consumption among 12th grade students, a pattern of drinking that denotes a potential AUD, reportedly decreased about 1.3% since 2011; among 8th grade students, binge drinking decreased by about 3.4%. Since 1994, 60% fewer high school students report alcohol abuse or initiating alcohol consumption.
Falling rates of alcohol abuse suggest that prevention and education programs put into place in prior years are working; however, many children and teenagers still initiate problematic patterns of drinking and other drug use while in middle and high school. Parents and guardians must know the signs of alcohol abuse or AUD in their teenager in order to help them get treatment to overcome addiction.
How to Determine if an Adolescent May Be Abusing Alcohol
Physical signs that a teenager is abusing alcohol are like those for adults abusing alcohol. They include:
- Bloodshot eyes
- Smaller pupils
- Changes in appetite or sleep patterns
- Deterioration in appearance
- Being exhausted or sick often
- Impaired coordination, or displaying bruises, cuts, or other injuries from accidents like falling
- Smelling like alcohol
- Appearing drunk
- Empty bottles in the teen’s room or in the garbage
- Faltering academic success
- Developing truancy problems
- Lowered participation in events or hobbies that were once enjoyed, such as sports, extracurricular activities, reading, etc.
- Changes in social groups
- Becoming isolated or withdrawn
- Acting suspicious
- Demanding privacy and clashing with family over this condition
- Stealing money
- Lying, or becoming defensive, about potential alcohol abuse
- Other changes in personality, behavior, habits, or grooming
- Sudden mood changes
When to Intervene
Concerned family members can stage an intervention for a teenager just like they can for an adult; however, a teen’s parents or guardians have the legal ability to force their child into treatment, so an intervention may not be necessary. The National Institute on Drug Abuse (NIDA) states, in their Principles of Effective Treatment, that going into detox and rehabilitation does not need to be voluntary to work. In fact, in Principles of Adolescent Substance Use Disorder Treatment, NIDA reports that pressure from family or legal interventions can be effective in getting adolescents into treatment and encouraging them to stay there.
Treatment should, however, be available in both inpatient and outpatient options, with a focus on unique programs for many personalities; adolescents benefit from this approach, just like adults do. Treatment should also address the needs of the whole person rather than just focusing on the teen’s substance abuse. These needs include academic, social, creative, and personal issues.
The Best Treatment Approaches for Adolescents
Many adolescent-focused alcohol rehabilitation programs are outpatient because the child is safe in the home as long as parents can help them stay away from alcohol or other drugs, and outpatient treatment allows the teenager to remain in school during regular school hours. While inpatient treatment can work well for teens who have co-occurring mental illness or serious addiction issues, options that keep teenagers in school while in recovery are often the focus.
One study found that brief interventions work well to help many adolescents reduce or end substance abuse problems. Teens who abuse drugs, drink heavily, or frequently binge drink, but who do not meet the criteria for addiction or physical dependence, were found to benefit from working twice with a behavioral therapist; many participants also had a third session, for parents only, which helped reinforce and solidify the teenager’s long-term goals to manage substance abuse. Students who participated in the survey were able to remain sober for longer periods of time, binged alcohol less often, and reduced other forms of drug abuse.
Since many adolescent-focused recovery programs are outpatient, this allows room for the teen to continue attending school and doing homework; however, if the adolescent must attend inpatient treatment for any reason, that treatment program should offer accredited classes, which meet local or state education requirements. If there is a question about meeting education requirements, contact the rehabilitation program and ask for certification information, and speak with school board members who may know which programs work with which schools, professional teachers, or other educational services.
Going to College Does Not Mean Relapse
When a teenager has recovered from a condition like alcohol use disorder, their life is on the right track, but sending them off to college may be frightening; they will be on their own, and college campuses are notorious for binge drinking events and parties. With stress from making new friends, living in a new place, and meeting academic requirements, it may be the perfect storm that leads to relapse.
Fortunately, many colleges are finding ways to support students who are recovering from AUD or other forms of substance abuse. Two major groups, Students for Recovery and the Association of Recovery in Higher Education, promote groups of sober students getting together for social events that do not involve alcohol or drugs. On-campus recovery centers also help students find resources for treatment and recovery. Many colleges have on-campus psychologists, therapists, and medical professionals who can refer students to programs off campus that support teens and young adults, so they can receive peer support.
Supporting a Teen through Recovery
The first step to supporting an adolescent or young adult through the recovery process is to get educated about teenage substance abuse. Learning how to talk about the risks of drug and alcohol abuse, support sobriety in the home, and distinguish myth from fact during this turbulent time of growth are all important steps. If the child needs treatment, SAMHSA and the Department of Health and Human Services (HHS) provide many resources to getting kids the best possible treatment.