Alcohol and Development in Youth : Consequences

by National Institute of Health

(Page 2 of 5)

Most of what we know about underage drinking derives from studies of youth ages 12 to 21. To address alcohol- related problems as developmental phenomena, we will need to understand more about what happens before age 12 with regard to alcohol consumption, alcohol awareness, and alcohol expectancies among children who have started to drink and among those who have not. A recent Medline search found a dearth of studies addressing drinking by younger children, and the few existing studies that turned up in this search were conducted among non-U.S. populations. Two national data sets, however, address alcohol use by children in sixth grade or below (typically age 12 and younger), albeit imperfectly and far from comprehensively. One is the Partnership Attitude Tracking Study, carried out for the Partnership for a Drug-Free America in 1993, and annually from 1995 through 1999. The other is the collection of PRIDE surveys carried out during the academic years 1997-1998 through 2001-2002. PATS data reveal a tripling of alcohol experience between fourth and sixth grade: 9.8 percent of fourth graders, 16.1 percent of fifth graders, and 29.4 percent of sixth graders report trying more than a sip of alcohol. PRIDE data show similar rates of use in this population. Despite methodological problems with these data sets, PATS and PRIDE show that a nontrivial level of alcohol consumption occurs among a significant proportion of the 12-and-under population.

Consequences

Underage drinking can result in a range of adverse short-term and long-term consequences, including:

• Academic problems
• Social problems
• Physical problems such as hangovers or medical illnesses
• Unwanted, unintended, and unprotected sexual activity
• Physical and sexual assault
• Memory problems
• Increased risk for suicide and homicide
• Alcohol-related car crashes and other unintentional injuries such as burns, falls, and drownings
• Death from alcohol poisoning
• Alterations in brain development that may have consequences reaching far beyond adolescence.

Alcohol is a leading contributor to injury death, the main cause of death for people under age 21. Annually, about 5,000 youth under age 21 die from alcohol-related injuries that involve underage drinking. This includes injuries sustained in motor vehicle crashes, homicides (about 1,600), and suicides (about 300), as well as unintentional injuries not related to motor vehicle crashes. Furthermore, the role of alcohol in both fatalities and injuries may be significantly underreported, in part because in many States, alcohol involvement in an injury relieves insurance providers of liability for medical expenses, so health care providers may not ask victims about, or report, alcohol use.

Numerous cases of alcohol poisoning, the result of the acute toxic effects of alcohol that can range from gastritis to severe gastrointestinal bleeding to respiratory arrest and death, have been reported in the news media. Although many of these tragedies occur on college campuses, especially striking was the recent report of two 11-year-old boys found dead of alcohol poisoning in a snowy field on the Flathead Indian Reservation in Montana, with blood alcohol concentration levels of 0.20 percent and 0.50 percent. Although alcohol poisoning is by no means a major cause of death among youth, reports such as this underscore the tragic influence that hazardous drinking can wield over youth culture.

In the National Longitudinal Alcohol Epidemiologic Survey of people ages 18 and older in the United States, people who reported starting to drink before the age of 15 were four times more likely to also report meeting the criteria for dependence at some point in their lives. This survey also shows that children who drink at age 14 or younger are much more likely during their lifetimes to sustain unintentional injuries, to get into physical fights, and to become involved in motor vehicle crashes after drinking.

Similarly, other survey data indicate that the younger children and adolescents are when they start to drink, the more likely they are to engage in behaviors that can harm themselves and others. Those who start to drink before age 13, for example, are nine times more likely to binge1 drink frequently (five or more drinks on an occasion at least six times per month) as high school students than those who begin drinking later. (SAMHSA's definitions of binge and heavy drinking: binge drinkers report that they had consumed five or more drinks on the same occasion at least once in the past 30 days; heavy drinkers report that they had consumed five or more drinks on the same occasion on at least 5 different days in the past 30 days. The National Institute on Alcohol Abuse and Alcoholism's definition of binge drinking: a "binge" is a pattern of drinking alcohol that brings blood alcohol concentration to 0.08 grams percent or above. For the typical adult, this pattern corresponds to consuming five or more drinks, or four or more drinks (women), in about 2 hours. Binge drinking is clearly dangerous for the drinker and for society. And compared with nondrinkers, a greater proportion of frequent binge drinkers (nearly 1 million high school students nationwide) engaged in other risky behavior in the past 30 days, including carrying a gun (22 percent vs. 3 percent), using marijuana (73 percent vs. 7 percent), using cocaine (26 percent vs. 0 percent), and having sex with six or more partners (31 percent vs. 4 percent). In addition, these youth were more likely than abstainers to earn grades that are mostly Ds or Fs in school (15 percent vs. 5 percent), be injured in a fight (13 percent vs. 2 percent), or be injured in a suicide attempt (9 percent vs. 1 percent). The extent to which alcohol use per se makes these other outcomes more likely is yet to be determined. However, the longitudinal evidence is very strong that the risk factors predicting earlier alcohol use also are strong predictors of virtually all of these other consequences.

About the Author

NIH is the nation's medical research agency - making important medical discoveries that improve health and save lives. The National Institutes of Health (NIH), a part of the U.S. Department of Health and Human Services, is the primary Federal agency for conducting and supporting medical research.