Drinking Too Much, Too Often? A Parents’ Guide to Alcohol Use in Teenagers and Young Adults
Alcohol use in teenagers and young adults continues to rise. Young people are starting to drink at an earlier age and are drinking more than ever before. With many young people having their first drink at home, we take a look at the dangers of drinking alcohol for children, teenagers, and young adults.
Alcohol is the most widely used substance by teens and adolescents. Almost 11% of 11–17-year-olds report drinking alcohol in the past thirty days. All report being ‘drunk’.
Interestingly, 61% of teens who drink alcohol do not buy alcohol. Many report taking the alcohol without permission from their parents, stealing it, or asking an adult to buy it for them.
Is Drinking Alcohol Dangerous for Teens?
Drinking alcohol as a teenager poses many risks. Drinking alcohol before the age of 15 significantly increases a young person’s risk of long-term consequences, including mental illness, substance use disorder, and medical consequences.
Teens who drink alcohol are statistically more likely to be involved in criminal activities, fatal accidents and are at increased risk of being victims of violent crime.
Drinking alcohol impairs judgment in everyone, not only teenagers. Underage drinking is responsible for 4,300 deaths each year in the USA alone.
Teen Brains: The Neurobiological Transition to Adulthood
Alcohol use in teenagers and young adults is particularly worrying as the long-term effects on memory, learning, and brain development are compromised.
Brain development in young people, from teens through to mid-’20s, is incredibly important. It is, in fact, the most rapid phase of development since very early childhood. Alcohol use can affect the development of the parts of the brain associated with decision-making, memory, and reasoning. Delaying alcohol use until adulthood has many protective factors.
Parents can help teens make better decisions around alcohol use by explaining the basics in teenage brain development and helping young people to make informed choices about their drinking behaviours.
Underage Alcohol Use Around the World
One of the most striking statistics for alcohol use and young people is that 96 countries have no minimum age for the consumption of alcohol. Drinking at any age is permitted. There are some surprising countries appearing on the list of ‘no minimum age for drinking alcohol’, including New Zealand, Hong Kong, Italy, Greece, Spain, Portugal, Bahrain, and Lebanon.
- Worldwide, the average age of young people who try alcohol for the first time is 12-years-old. The World Health Organisation (WHO) estimates that 80% of the world’s 15-year-olds have experimented with alcohol.
- In England, school pupils age 11–15 who consume alcohol report drinking an average of 10.3 units per week.
- In England and Wales, 14% of 11-year-olds report drinking alcohol and being ‘drunk’. This rises to 70% amongst 15-year-olds taking part in the same study.
- In Scotland, approximately 51,000 children live with a parent who is dependent on alcohol.
- In Singapore, 13.7% of young people binge drink regularly. One in 19 Singaporeans under the age of 34 is diagnosed with Alcohol Use Disorder.
- In Malaysia, 45% of teenagers and young people under the age of 21 describe using alcohol regularly. Alcohol use is one of the major concerns for parents of teenagers in Malaysia.
What Causes Teen Alcohol Addiction?
Adolescence is a period of rapid change. The teenage brain is naturally inquisitive and more prone to risk-taking than it is during the first decade of life. However, not all teens who drink will become addicted.
AUD is a highly complex condition and there is no single cause that determines if a young person will become addicted. However, there are several risk factors known to play a role in the development of alcohol use disorders, including:
- Family history
- Personality Traits/Characteristics
- Sensitivity to Alcohol
- Mental Health Concerns or Co-occurring Conditions (e.g. ADHD, depression, anxiety, eating disorders and mood disorders).
Children and teenagers may be more at risk of developing a problem with alcohol use if there is a family history of alcohol use disorder.
Children who grow up in families with parental addiction issues are 4–10 times more likely to be diagnosed with addiction than their peers.
Warning Signs and Symptoms of Alcohol Addiction in Teens and Young Adults
- Appearing drunk/intoxicated
- Alcohol on breath
- Periods of black out/loss of memory
- Vomiting/upset tummy
- Changes in mood and behaviours
- Increased angry outbursts, irritability, rage and rebelliousness
- Lying, manipulating, stealing from home
- Tearful, sad or low mood/depression
- Changes in friend groups
- Isolating or very few friends
- Missing school/problems at school
- Staying out later than agreed
- Alcohol missing/watered down/stolen from home
- Drinking in public areas
- Loss of appetite/changes in eating patterns
- Frequent headaches/lethargy/low energy
- Slurred speech/coordination problems/memory blanks
- Loss of interest in previously enjoyable activities.
Your teen does not need to exhibit all of the behaviours listed above. Just one or two could indicate a severe or escalating problem with alcohol.
What is Binge Drinking?
More than 90% of alcohol consumed by teenagers and young adults is during episodes of binge drinking.
Binge drinking refers to a pattern of drinking behaviours that can lead to serious medical consequences, including death.
Binge drinking describes a rapid drinking style that brings the blood alcohol concentration (BAC) to 0.08% or 0.08 grams of alcohol per decilitre (or higher). For a typical teenager or adolescent, binge drinking would mean approximately three alcoholic drinks in a 2-hour period (for girls), and approximately four alcoholic drinks in a 2-hour period (for boys); depending on their age, weight, and height.
Binge drinking increases the chance of risk-taking behaviours in teens. Drink-driving, violent behaviour, being involved in sexual assault and the risk of accidental death are all much higher in young people who engage in binge drinking.
*The National Institute on Alcohol Use and Alcoholism (NIAAA).
What is Drinking to ‘Black Out’?
Drinking can have significant effects on memory, particularly with how we transfer information to long-term memory storage. When memory is partially or completely blocked out, it is sometimes referred to as ‘black out’.
Adolescent brains respond differently from adult brains and are more susceptible to alcohol-related memory loss or blackouts.
In Australia, 32% of 16–17-year-olds report experiencing alcohol-induced blackouts on more than one occasion.
In the same survey, 100% of 12–15-year-olds reported memory loss after episodes of binge drinking.
Teen Boys or Teen Girls: Who Drinks the Most?
Historically, teen boys began drinking alcohol at an earlier age and consumed more alcohol than their female peers. This trend has somewhat reversed over the past few years. Teen girls now report drinking at an earlier age, drinking more often, and binge drinking more frequently than boys of the same age.
Teens, Alcohol and Sex: Know the Risks
Teenagers who regularly drink alcohol at an earlier age are more likely to be involved in early sexual experiences.
Alcohol is believed to be involved in approximately 20% of sexual assaults on middle and high school-aged children, rising to 29% of assaults at parties or gatherings where alcohol is consumed. This figure rises to almost 50% of college or university-aged students.
Teens who experiment with alcohol at an early age are at increased risk of sexually transmitted diseases, increased risk of unplanned pregnancy, typically have more sexual partners and partake in high-risk sexual behaviours.
Almost 50% of globally diagnosed sexually transmitted diseases (STDs) are reported in young adults aged 15–24 years.
Are Teens Who Vape More Likely to Drink Alcohol?
E-cigarettes and vapes use are increasing in teen and adolescent populations worldwide. Whilst research into the use of vapes is ongoing, the correlation between vapes, nicotine use and drinking alcohol have been noted.
Teens who regularly vape reported higher use of both traditional cigarettes and tobacco smoking and drinking alcohol. Teens in this group were more likely than their peers to binge drink, obtain alcohol and engage in other behaviours that are considered to be impulsive or risk-taking. A recent study in France concluded that 8.2% of children aged 12–18 years regularly used vapes or E-cigarettes.
Vape juice has many unlisted and listed ingredients. Alcohol or ethanol has been found to be present in many of the popular brands. A study by Yale University has presented findings that young people who use commercially available vape liquids with high alcohol content have significant impairment in their motor skills directly related to the alcohol content in the vape liquid.
Are Teens Who Drink Alcohol More Likely to Use Drugs?
Alcohol use and dependence on alcohol in teens is often linked with increased drug and substance use in the same group of young people.
Teen alcohol and drug use can sometimes be seen to go hand-in-hand. Some young people will try drugs or alcohol on a few occasions and decide that it is not something that they wish to continue. Some teenagers may find that experimenting leaves them with a desire or craving to use again. For some teenagers the psychological and physical craving may lead to continued use, increasing in frequency and amounts despite the negative consequences that result.
The latter group may develop the signs and symptoms associated with Substance Use Disorder (SUD). Teens with a history of adverse childhood experiences or traumatic events are seen to be at increased risk of experimenting with drugs and alcohol, which can lead to dependency, with related mental health issues.
Alcohol Use at University
Students and alcohol use at university is seen by some as a right of passage. The ‘drinking culture’ in universities is often seen as a phase of life. Hazardous alcohol consumption and related risks can pose a threat to the mental health and safety of young people living away from home for the first time.
In a recent UK study of university students, over 50% were described as using alcohol to levels that were high risk. High levels of alcohol consumption were normalised by students and described as ‘what others do’ and importantly, ‘what others approve of’.
Young people who had greater social and academic anxiety or who felt that they ‘needed to fit in or make friends are seen to have an increased susceptibility to high levels of alcohol use during their university years.
How to Know if My Teen Needs Addiction Treatment
Parents and carers rely on intuition for many things with their children. Parents may have a feeling that something is not quite right or may start noticing some of the signs and symptoms of the alcohol use disorder listed above.
Alcohol whilst readily available and, in some circles, socially acceptable can become dangerous and out of control quickly in teenagers and young adults.
It is useful to take advice as soon as possible from your family doctor, GP or Nurse Practitioner. Specialist addictions therapists or addiction psychiatrists may be able to refer you to a specialist intake assessment for the treatment of young people.
In the event of an emergency, please proceed immediately to your nearest Emergency Department.
Treatment Programs for Teen Alcohol Addiction
Teenagers and young adults need specialist residential care for issues relating to substance use disorder, addiction and mental health. Young people have very poor treatment outcomes when treated in programs or addiction treatment centres designed for the treatment of adults.
Young people have vastly increased recovery rates when they receive treatment in trauma-informed addiction treatment programs, designed specifically for young people.
Trauma-focused treatment programs for young people give them space to understand that alcohol use became a maladaptive strategy to numb pain or big emotions that they were unable or unequipped to deal with. Teen mental health programs should be developmentally appropriate, clinically excellent with competent medical support.
Detox for Teens: When Alcohol Use Requires Medical Intervention
Detox is a period of usually 3–5 days that takes place at the beginning of an in-patient treatment episode for drug or alcohol dependency.
Detox is a medically managed period, where the consultant psychiatrist – together with a team of doctors and nurses – work together in the intensive monitoring and management of withdrawal symptoms.
The need for medical detox for young people is relatively uncommon, however, a thorough intake assessment of substance use and detailed medical examination will inform the decision-making process.
Effective Teen Treatment: Do Addiction Programs Work?
Teen and young adult brains continue to refine and develop until around the age of 26, leaving young adults unable to process in the same way that older adults are able to. Changes and developments in the brain structure are of course a great thing to remember for families and young people, the opportunity to learn new adaptive ways to deal with addiction is possible and within reach.
Addiction programs for teens will vary in both their approach and successful outcomes. There are many types of teen and adolescent treatment programs, the majority of which are based in the USA, with a smaller number in Australia, Malaysia, and Europe.
Families choosing high-end private treatment for their children and teenagers may find they join the increasing number of international parents who fly to reach the destination treatment programs most suitable for their child. The international program selection has increased during the pandemic years when program places and bed spaces in London and the UK, in general, have been few and far between.
The most progressive treatment programs will be very careful not to prematurely label young people as ‘addicts’ or prescribe a harsh or punitive treatment regime. They simply do not work.
Teen treatment programs based on longer stays have substantially improved treatment outcomes than short-stay programs. Adolescent treatment, on the whole, requires significantly longer stays than adult treatment, although research conducted in both groups suggests that longer-term involvement in varying levels of care, improves treatment outcomes.
There has been a great volume of research on the characteristics of young people who do well in treatment. There is a correlation between young people who are engaged in some form of educational program or school curriculum and positive treatment outcomes. The Wave in Kuala Lumpur is one of the only treatment programs in the world able to facilitate vocational and academic learning opportunities in conjunction with intensive therapeutic programs.
The Role of The Family in Teen Alcohol Treatment Programs
The involvement of the family in treatment programs for young people is essential. Programs that are dedicated to the treatment of teenagers and young adults understand that family therapy plays an important part in the therapeutic journey.
Family Therapy should be a time that is dedicated to your family and your child.
The Wave Family Therapy Program is focused on just one family and one young person. The clinical team at The Wave believes that the family therapy intensives are one of the most life-changing treatment experiences for all members of the family. There is no time limit, no mention of co-dependency. The Wave Team believes that parents and young people benefit from working together from a family values-based system, looking at the non-negotiables and planning for a future firmly built on healing from the past.
Family Therapy builds on skills successfully mastered in treatment; decision-making, appropriate risk-taking, negotiation, empathic listening, problem-solving, and improved family communication skills.
Following therapy, families feel empowered and ready to embrace the next stage of the treatment journey.
Outpatient Therapy for Teen Alcohol Addiction
Attending individual and group counselling, either in person or online, can be beneficial for some young people struggling with dependency on substances or alcohol.
In order to get the most out of outpatient groups or online sessions, your therapist or mental health team will want to make sure that your teen is safe and able to participate without risk of further damage to themselves or others. Some young people are more suited to residential or inpatient environments in the early stages of treatment, progressing to outpatient as they gain skills and knowledge in recovery.
Talking to Your Teen About Alcohol
Parents are sometimes concerned about how to and when to approach their teen about the risks of underage drinking. The right time to approach the subject at home is now.
Communication is the key to education on the dangers of alcohol and drug use. Starting conversations in the pre-teen years can help children learn about staying safe and keeping their bodies and minds healthy.
Parents may fear alienating their teen by initiating the discussion, however, discussing the facts without blaming or shaming young people can lead to increased awareness and open the channels for further communication.
Talking to your teen about making good decisions and the development of the teenage brain is a great way to start the conversation. Age-appropriate information that covers the risks involved and the reasons that some young people feel the need to drink provide information and a vehicle that encourages independent thinking. Avoid using scare tactics – they rarely work.
- Ask for your teens views on alcohol use
- Be prepared to look at your own use of alcohol
- Discuss friendship circles and peer pressure
- Discuss responsible drinking
- Discuss ways that your teen can leave situations where they feel vulnerable
- Set family boundaries, what is and is not OK in your family.
Be prepared for plenty of questions and make sure you are informed. Be prepared to research and look for safe resources together that your teen can use as a reference point in the future.
References and Further Reading:
NHS Digital (2019). Smoking, Drinking and Drug Use among Young People in England in 2018.
Public Health England (2020). Local Alcohol Profile for England. Alcohol-Related NHS Admissions in England.
Information Services Division Scotland (2019). Alcohol-Related Hospital Statistics Scotland 2018/2019
Association between e-cigarette access and smoking and drinking in teenagers. BMI Public Health. K Hughes. Mark Bellis. Katie Pike.
Alcohol consumption among university students in the night-time economy in the UK: A three-wave longitudinal study. Drug and Alcohol Dependence. Volume 204. November 2019
Podcast for Parents:
Harvard Edcast: Raising Addiction-Free Kids. Jessica Lacey. www.gse.harvard.edu
Books for Younger Children
Fiona Yassin is the International Clinical Director at The Wave Clinic in Kuala Lumpur, working with teenagers, young adults and their families. Fiona is a UK registered Psychotherapist and Supervisor of Clinicians.
EMDR trained and a member of EMDRIA, Fiona recognises the role of complex trauma in eating disorders and is currently developing Trauma-Focused Eating Disorder Services in Asia and the Middle East. Fiona is an International Chapter member of IAEDP, CBT-E, and RO-DBT trained. Fiona is also a Fellow of APPCH.