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American Academy of Pediatrics: Talk to Kids About Alcohol When They Are Nine

September 18, 2015  |  Falmouth Enterprise

Dr. Michael Bihari

In a recently published clinical report on binge drinking, the Committee on Substance Abuse of the American Academy of Pediatrics (AAP) noted that pediatricians and parents should start talking to children about alcohol use at age nine. 

According to the report, “Drinking levels that may cause little or no problem for adults may be dangerous for adolescents.”  Alcohol use during this period of rapid growth may interfere with some of the key processes of a teen’s brain  development, possibly leading to learning impairment and an increased risk of developing a chronic alcohol use disorder (alcoholism). Specifically, alcohol interferes with the brain’s ability to make long-term memories from short-term memories and experiences.

Some Sobering Stats

High school is a time when drinking rates increase significantly. The APP report outlines the amount of underage drinking and heavy alcohol consumption among youth in the United States, underscoring the need for early intervention:

  • 21% of teens acknowledge having had more than a sip of alcohol before age 13; almost 80% have done so by 12th grade
  • between 36% and 50% of high school students currently drink alcohol, and more than 28% report binge drinking

What about Falmouth? One important measure is a teen’s use of alcohol in the past 30 days. The good news for Falmouth is the significant decrease in the 30-day use of alcohol between 2009 and 2013. Specifically, for Falmouth High School students the 30-day use of alcohol was down from 50.9% in 2009 to 43.4% in 2011 to 35.1% in 2013. Interestingly, at the same time our teens’ perception of the risk of heavy drinking has also risen from 70% in 2009 to 84% in 2013.

Underage Drinking = Adverse Outcomes

According to the AAP report, alcohol is associated with numerous adverse outcomes in underage drinkers, and binge drinking increases these risks, including:

  • impairment of driving ability, among teens ages15 to 20 nearly a third of all fatal automobile crashes involve alcohol
  • increased risk of suicide and attempted suicide
  • elevated risk for non-automobile accidents such as head injuries and drowning; in the US, 50% of all head injuries in adolescents are associated with alcohol use
  • blackouts, hangovers, and acute alcohol poisoning, which can be fatal
  • higher rates of liver disease, hypertension, heart disease, stroke, and breast and other cancers in the future

Teens who start drinking before the age of 15 are four times more likely to develop alcohol dependence as those who start drinking after age 20; and, are more likely to use other substances at a younger age. In some adolescents heavy alcohol use affects school performance by impairing study habits; and, teens who engage in binge drinking tend to have lower grade point averages.

Also, some research studies document that teens who drink heavily engage in sexual activity at a younger age and are more likely to have multiple sexual partners, which may be related to higher rates of unwanted and teenage pregnancy, and sexually transmitted infections. And, when binge drinking, teens are at higher risk of becoming the victims of unwanted sexual activity.

Underage Drinking Prevention

According to the AAP report, “As with any high-risk behavior, prevention plays a more important role than later intervention and has been shown to be more effective.” This is consistent with the mission of the Falmouth Prevention Partnership, which has worked in the community since 2008 to help prevent underage drinking and drug abuse among Falmouth youth.  

The AAP report was written for pediatricians and discusses ways in which physicians can provide guidance for teens and their parents: “Surveys indicate that children start to think positively about alcohol between ages 9 and 13 years. The more young people are exposed to alcohol advertising and marketing, the more likely they are to drink, and if they are already drinking, this exposure leads them to drink more. Therefore, it is very important to start talking to children about the dangers of drinking as early as 9 years of age.” 

The AAP also recommends that physicians “inform parents that 80% of teenagers say their parents are the biggest influence on their decision whether to drink…parental communication on alcohol use before college entry was more likely to prevent nondrinking students from transitioning to heavy drinking status and was also 20 times more likely to reduce heavy drinking patterns among those who had started this drinking pattern before college entry than among students who did not receive parental advice.

One major resource recommended by the Academy is the Talk. They Hear You program from the federal Substance Abuse and Mental Health Services Administration (www.samhsa.gov/underage-drinking). This program has been referenced in several Risky Business articles earlier this year and can be read on this website. The Talk.They Hear You website is a great resource to help you start—and keep up—the conversation about the dangers of drinking alcohol at a young age. 

A new feature of the program is an app available on desktop computers and on-the-go from the Apple Store (iTunes), Google Play, and the Windows Store. The app is like a video game that helps you learn the do's and don'ts of talking to kids about underage drinking. Using avatars, you can practice bringing up the topic of alcohol, learn the questions to ask, and get ideas for keeping the conversation going. You decide what to say, see it play out, and adjust your approach with help from your built-in app coaches.


Binge Drinking: Full Clinical Report from the American Academy of Pediatrics

MedlinePlus-Underage Drinking: Access excellent information about underage drinking from reliable sources that is accurate and up-to-date.

What to Say to Your 9-12 Year Old: A scripts to help you get conversations going with your 9-to-12-year-old child

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