College alcohol misuse

Addiction Treatment: Change

Misuse of alcohol in college is often considered a part of the college experience. Parents, professors, college administrators and teenagers ought to look at the science before enacting a wink and nod policy. I know that most parents, professors and administrators are realistic, liberal-minded and it’s unsophisticated to expect teenagers in college to stay away from alcohol, but facts are facts, and it helps if you’re armed with facts before making decisions that can have grave consequences.

I doubt that many, if hardly any,  students know how alcohol affects the brain. Many doctors go through years of medical training with only a quick review of addiction and alcohol misuse. You don’t have to be a scientist to know that the adolescent brain is not fully formed, especially in the areas dealing with emotion, judgment and impulse control. If you’ve parented teenagers, you know. If you’re interested, the link above presents a lot of information on how alcohol negatively affects the development of the adolescent brain.

There are also statistics to show how serious this problem can become. According to NIAAA, researchers estimate that around 1825 college students between the ages of 18 and 24 die from alcohol-related unintentional injuries. About 696,000 students between the ages of 18 and 24 are assaulted by another student who has been drinking. About 97,000 students between the ages of 18 and 24 report experiencing alcohol-related sexual assault or date-rape.

In treatment facilities, hospitals, jails and funeral homes, our society deals with the consequences of untreated addiction and unaddressed drug misuse. Comprehensive prevention efforts will stop many of these consequences from coming to fruition, but it will take a concerted and well-funded effort. The time for prevention efforts is when a person is young, before they start drinking alcohol, smoking pot, popping pills or snorting cocaine. If kids know only 25% as much about the effects of alcohol and other drugs as they do about music, they’ll likely make better choices. If kids learn at an early age that drinking alcohol is not expected, and that choosing to not drink or use other drugs is a valid, healthy choice, maybe they won’t feel so pressured in their teens. They can at least learn that teens are at very high risk because of their less than fully developed brain.



Too young and smart to be an alcoholic

Too young to be an alcoholic

stages of addiction

I suppose the language we use to describe alcohol and drug problems will continue to evolve, but I hope the language evolves toward clarity nor obscurity. As I wrote a week or so ago, there are many old ideas about alcohol and drug problems that persist in spite of all the things we know about alcohol/drug misuse and addiction. Calling someone an alcoholic or drug addict has become derogatory, so, many therapists now use the new terms – Alcohol Use Disorder or Substance Use Disorders.

I don’t know if this is an improvement. It all depends on how we think about alcohol and other drug problems. If we look at addiction as a chronic brain disease that progresses in stages, then it really doesn’t matter what we call it, as long as we understand what it is. It’s particularly difficult, even for many therapists, to call someone young, smart and from a good home an alcoholic or drug addict, or to say they suffer from substance use disorders.

When, say, a smart, young female from an upper middle class or wealthy family presents with a history of heavy drinking, most therapists will look for the psychological cause of the heavy drinking — they see a smart, young female who must be terribly bothered by something in her life to drink this much. Most people will think she is too young and smart to be an alcoholic. The therapist thoroughly trained in addiction treatment with plenty of direct experience dealing with alcoholics and drug addicts will first rule in or rule out addiction, because they know that addiction doesn’t pick and choose among classes or age or gender or intelligence. The addiction specialist also knows that addiction can develop and progress without any underlying trauma or emotional disorder that’s causing the heavy drinking — it can be as simple as the person started drinking and is susceptible to addiction and is now in the early stages of addiction. Among all the therapists who see clients such as the one described above, few have been thoroughly trained to recognize and treat addiction.

Young females like the one above will likely go through a few months of counseling once a week. Although the therapist will surely talk to them about their drinking, the discussion will often relate to risk involved in heavy drinking, thus the implication that drinking in moderation is good and heavy drinking is risky. But, the main focus of the therapist will likely be, with the cooperation of the client, to deal with the underlying mental and emotional problems so that the heavy drinking subsides when the young female is mentally and emotionally healthier after the counseling sessions and has seen how the heavy drinking is dangerous and unhealthy.

If the young female is, indeed, drinking heavy because of some unresolved mental/emotional problems, then the counseling can generate positive change — however, if the young female is in the early stages of addiction, chances are the counseling will have no positive, lasting effect on the addiction problem. In a short while the young female’s addiction will continue to progress and the problem will get worse. This is how addiction continues undetected for years with many people. If the person presenting for an assessment doesn’t look the part, then it’s difficult for most therapists to call addiction for what it is. There are also philosophical differences, and many therapists don’t really buy into the chronic brain disease concept of addiction. This is unfortunate, because the science is on the side of chronic brain disease.

Young people don’t die from many causes, but the number one cause of death among young people is related to alcohol and drugs. No teenager or young adult is too young and smart to be an alcoholic. If a young person is showing signs and symptoms of an alcohol or drug problem, addiction/substance use disorder should be ruled in or out by a well trained addiction specialist. The consequences of inattention and denial are too great.

Young people and alcohol

Teenage binge drinking

Teenage drinking

For many teenagers, drinking is experimentation, a chance to get a thrill, a means of partying, a way to have fun. Our society is lenient on young people and alcohol, because alcohol is a socially accepted drug. Most parents will not want their teenage kids to drink alcohol, but they’ll accept drinking over cocaine use, or heroin use, or even pot smoking — although some parents might think smoking marijuana is preferable to drinking alcohol, if they have to experiment with a drug. The problem with teenage drinking is that it’s usually done in binges and to excess creating myriad risks that can change the course of a life or end a life. It’s unreasonable to expect teenagers to never experiment, but it’s not unreasonable to address the potential problem in a smart and authentic way that truly gets the message to the young person. A wink, a nod and a slap on the wrist for excessive drinking behavior will not likely send the right message to teenagers. They need to know all the facts.

This is from NIAAA:

Every year in the United States, about 5,000 young people under age 21 die as a result of underage drinking.5 This includes:

  • 1,900 deaths from motor vehicle crashes
  • 1,600 from homicides
  • 1,200 from alcohol poisoning, falls, burns, and drowning
  • 300 from suicides

Causes many injuries

In 2008 alone, about 190,000 people under age 21 visited an emergency room for alcohol-related injuries.

Impairs judgment

Drinking can lead to poor decisions about engaging in risky behavior, including drinking and driving, sexual activity (such as unprotected sex), and aggressive or violent behavior.

Increases the risk of physical and sexual assault

Underage drinkers are more likely to carry out or be the victim of a physical or sexual assault after drinking than others their age who do not drink.

Can lead to other problems

Drinking may cause youth to have trouble in school or with the law. Drinking alcohol also is associated with the use of other drugs.

Increases the risk of alcohol problems later in life

Research shows that people who start drinking before the age of 15 are four times more likely to meet the criteria for alcohol dependence at some point in their lives.

Interferes with brain development

Research shows that young people’s brains keep developing well into their 20s. Alcohol can alter this development, potentially affecting both brain structure and function. This may cause cognitive or learning problems and/or make the brain more prone to alcohol dependence. This is especially a risk when people start drinking young and drink heavily.

I know it’s hard to talk to teenagers about anything, and especially drinking and sex and their behavior with friends, but teenagers aren’t adults and their mental functioning is still in transition, so it’s best they know everything about alcohol before going wild on binges and putting their lives at risk.