It is common knowledge that the drinking age in the United States is 21. However, by age 13, one third of boys and about one fourth of girls have tasted alcohol. Even scarier, excessive alcohol consumption leads to more than 4,300 deaths annually among people under 21.
As a parent, the trick to preventing excessive alcohol consumption is understanding what puts your child at risk. Parental or sibling substance use, trouble interacting with others, poor self-control, aggression and hyperactivity may contribute to alcohol use. Other risk factors include co-occurring depression, attention deficit hyperactivity disorder, anxiety or other substance use, because teenagers may use alcohol as a way of coping with underlying depression or anxiety.
Once a teenager starts to use alcohol or other substances regularly, pathways in the brain are turned on that encourage further use and less self-control. If a teenager uses alcohol daily, the body becomes accustomed to that level of alcohol, and eventually your teen will need to consume more alcohol to get the same effects.
While you likely have a good handle on what your teenager is up to, there are some signs that will help you recognize if your child is abusing alcohol. Physical symptoms of alcohol intoxication include impaired balance, slurred speech and blackouts. Personality changes, worsening grades, new friends, discipline problems and irresponsible behaviors are all warning signs, and some teenagers might become aggressive or impulsive. Additionally, be on the lookout for behavioral changes at home or changes in schoolwork or attendance.
You might also become aware of an alcohol abuse problem if your child begins showing withdrawal symptoms, including nausea, tremor, headache, intense anxiety, hearing voices or seeing things that are not there. If your teenager complains that they have pins or needles in their hands or feet, or if they develop high blood pressure with a high pulse, it could be a sign of abrupt discontinuation of alcohol. In extreme withdrawal, seizures, coma or death are possible, so if you suspect your child is experiencing withdrawal, seek medical attention.
Even if your teen has some of the risk factors identified above or is experimenting with alcohol, hope is not lost. A stable family, good relationships with parents, adequate parental supervision and positive peer groups can all reduce the risk of alcohol use in minors.
Your family physician is another line of defense. Most pediatricians start screening for alcohol use when the patient is about 11. Alcohol use disorders are diagnosed through interview, laboratory results and by obtaining collateral information.
Treatment of alcohol use disorders varies depending on the severity. Teenagers can be treated as an outpatient if use is not severe. Examples of outpatient programs include 12-step programs, like Alcoholics Anonymous, and outpatient clinics.
If use is severe, your teenager may need a more intense program to help gradually decrease their alcohol use. He or she may need to be hospitalized and monitored by a physician with access to other forms of medical care. Treatment may also include identification and management of possible underlying psychiatric issues, such as depression or anxiety, which are leading to the alcohol use. Your child’s pediatrician can refer him or her to a child psychiatrist and together you can decide if therapy or medication is necessary.
The goal is not only to treat the alcohol abuse, but also to prevent alcohol from becoming a gateway drug to other substances such as cocaine or marijuana. Additionally, regular alcohol use can interfere with normal growth and development, and it leads to a greater risk for suicide and assault and alcohol-related injuries, such as car crashes, falls and drowning. According to the Centers for Disease Control and Prevention, children who begin drinking before 15 face six times the risk of having alcohol dependence when they are older than people who start drinking at or over the age of 21.
Alcohol use can be a serious problem in teenagers, but early intervention can prevent negative consequences and dependency. If you suspect your child has an alcohol abuse problem, contact your pediatrician, or call 305-243-6400 to schedule an appointment with a pediatric psychiatrist.
Julie Furst, M.D., and Samantha Saltz, M.D., are psychiatry residents and Judith Regan, M.D., is a child and adolescent psychiatrist at the University of Miami Health System. For more information, visit UHealthSystem.com/patients/pediatrics.