How common is alcohol abuse among adolescents?

I don't think any parent nowadays needs to be told that a lot of teens are participating in underage drinking.

Experimentation with alcohol is common during adolescence. Teens have ready access to it in their homes, through older friends, or at parties. Many have watched their parents have a beer or a drink without adverse consequences, and they conclude that warnings about underage drinking are dramatically overblown. Furthermore, there's an awful lot of peer pressure to begin drinking at a young age.

In reality, however, underage drinking poses a large and serious problem. Many young people underestimate the effects of alcohol, and as a consequence, there are more than 10,000 alcohol-related motor vehicle deaths and 40,000 injuries each year. Further, young people are far more likely to engage in binge drinking, and the resulting acute levels of alcohol in the bloodstream can cause real damage to their brains and bodies. In fact, asphyxiation on vomit is a real risk, as is alcohol poisoning, which leads to death. And finally, some researchers believe that drinking at an early age increases the risk that a person will develop an addiction later in life and leads to use of other drugs.

By 1998, all states had adopted a minimum alcohol purchase and drinking age of 21. In spite of this—and some critics of these laws would argue, because of this—in 2007, 26% of high school students reported periodic binge drinking. In response, some parents have decided to host parties in their home where alcohol use by high school kids is allowed. These parents seem to feel that by taking this action, they are reducing the chances that their kids will be on the roads while either they, or their friends, are under the influence of alcohol.

Needless to say, however, these parents need to ask themselves whether this truly is the best approach to addressing the problem of underage drinking. They also need to realize that they are putting themselves in legal jeopardy. Just recently in Virginia, a mother who sponsored a party in her home where alcohol was freely served to teenagers was sent to prison for a number of months.

Drinking is a serious matter. You need to talk to your daughter about it, and you need to tell her directly about your views and expectations.

Brett says:

It is a natural part of high school and adolescent development to be confronted with the consumption of alcohol. I have personally had two experiences with alcohol abuse where fellow students ended up in the hospital. However, it is more important to learn from these mistakes than to focus on the illegality of drinking. It is important that teenagers understand that they have options if they ever drink and find themselves in a difficult position. I am lucky enough to have parents that understand the difficulties of peer pressure in high school and trust me enough to make the right decisions. Most importantly, my parents have given me the opportunity to call them in any situation if there is no sober driver.

Marijuana is the most commonly used illegal drug, and the average age of first use is 14.

What are the more common forms of drug abuse among adolescents?

In addition to alcohol, teens abuse many other drugs, both legal and illegal. Marijuana is the most commonly used illegal drug, and the average age of first use is 14. Other common drugs are cocaine, LSD, PCP, opiates, heroin, and designer drugs like ecstasy. In fact, the daughter of a good friend of mine told me recently that cocaine use is not uncommon in her high school, a high-achieving school in a very well-to-do area.

Abuse of prescription medications and over-the-counter medicines is also quite high among youths. The most commonly abused ones are pain relievers, tranquilizers, stimulants, and depressants. Cough and cold medicines seem to be a particular favorite. In addition, it's estimated that more than 2 million teens abuse prescriptions medications each year.

Drug use can have serious negative consequences, either through the direct effects on the person's body or brain, or through its effects on the person's judgment, which can lead to high-risk behaviors such as violence, accidents, unprotected sex, and suicide.

As a mother, you should be alert to the warning signs of alcohol use and drug use. As noted by the American Academy of Child and Adolescent Psychiatry, look for:

• Fatigue, chronic health complaints, red/glazed eyes, and a persistent cough

• Changes in personality, mood swings, irritability, poor judgment, and low self-esteem

• Depression

• Withdrawal from the family, starting arguments, and misbehaving

• Problems in school such as multiple absences, a lack of discipline, reduced focus, and low grades

• Changes in dress, music, and friends to less conventional choices

• Trouble with the law

If you suspect a problem, contact your pediatrician, who can refer you to the appropriate health care professional.

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