AAP: Docs needed in the fight to stop teen drinking

John Knight, MD

Last week, the American Academy of Pediatrics (AAP) released a policy statement calling on pediatricians nationwide to be knowledgeable about teenage drinking, preventative measures to stop it and treatment options for adolescent substance abuse. The statement included information on how alcohol can interfere with the developing teenage brain, and the strong correlation between early alcohol consumption and alcoholism later in life.

John Knight, MD, director at the Center for Adolescent Substance Abuse Research (CeASAR) at Children’s Hospital Boston, says both parents and pediatricians should do more to combat adolescent alcohol use— especially in the coming months as the weather gets warmer and the prom/graduation season starts for many of the country’s teenagers.

“We have data that suggest if doctors spend if one or two minutes discussing the negative effects of alcohol with their adolescent patients, there is a dramatic decrease in the number of kids who start drinking. You can reduce the prevalence of drinking from 40 percent to 20 percent,” he says.

“But parents have a lot of influence over their children too, even if they think they don’t, and therefore they need to set a model of behavior, especially with younger kids.”

Knight says that very young children understand the concept of alcohol, but not the subtleties of its use, and therefore may misinterpret their parents’ drinking, even when done in moderation. To prevent sending the wrong messages to young children, Knight suggests parents model a zero tolerance policy for drinking and driving when consuming alcohol around young kids.

“Younger children don’t understand how much alcohol it takes to get someone drunk and if they see a parent drink, even one drink, and then drive a car it sends the message that drinking and driving is ok,” he says. “I tell parents no driving after drinking alcohol in front of their kids; always let one parent act as the designated driver, that way they are sending a clear message early on that drunk driving is unacceptable.”

Doctor and Patient on ComputerFor children 14 and up Knight suggests pediatricians have their teenage patients take a screening test called CRAFFT, (Car, Relax, Alone, Forget, Friends, Trouble) a brief questionnaire that gauges the teen’s controlled substance use, and its potential dangers. If a parent would like their child’s pediatrician to administer the CRAFFT, Knight suggests contacting the doctor prior to their child’s appointment.

“When kids screen negative on the CRAFFT, meaning they’ve haven’t been drinking, they should get positive reinforcement,” he says. “But even with negative scores doctors should still mention the risks of teenage drinking and the effects alcohol has on the developing brain, and urge them not to start drinking.”

Because the developing teenage brain and body is affected differently by alcohol than those of adults, Knight stresses that teenage drinking is often more harmful than adult consumption, which is still considered dangerous when done in excess.

“Adults are more susceptible to the soporific effects of alcohol, meaning they get sleepy when they’ve had too much. If you’re asleep you can’t do a lot of damage. But when adolescents become drunk they don’t get sleepy, they remain wide awake,” he says.

“Teens are also more susceptible to the impairing effects of alcohol like distorted vision, poor coordination, and impaired judgment. So their brain is more impaired and they don’t fall asleep— they’re wide awake and usually drunker, and that’s where a lot of problems come from with alcohol and adolescents.”

Over the next few months Knight will spearhead a Children’s Hospital Boston campaign to raise awareness among teens and parents about the dangers of adolescent drinking, and tips on how to avoid it. Keep a close watch on Thrive for new information from Dr. Knight on ways you can help keep your teen safe from the many dangers associated with adolescent drinking.