Pediatricians should discourage youth drinking

Pediatricians should step up their efforts to discourage children and teenagers from drinking alcohol because it can damage their developing brains, increase their risk of dependence and cause accidents that lead to early death, it is stated in a new policy statement from the American Academy of Pediatrics.

According to the statement, alcohol use continues to be a major problem from preadolescence through young adulthood in the United States, particularly in view of the results of recent neuroscience research which have substantiated the deleterious effects of alcohol on adolescent brain development and added even more evidence to support the call to prevent and reduce under-aged drinking.

The statement calls for pediatricians to be knowledgeable about substance abuse and to be able to recognize risk factors for alcohol and other substance abuse among youth, to screen for use, provide appropriate brief interventions, and refer to treatment.

The statement adds that the integration of alcohol use prevention programs in the community and the US educational system from elementary school through college should be promoted by pediatricians and the health care community. Promotion of media responsibility to connect alcohol consumption with realistic consequences should also be supported by pediatricians. Additional research into the prevention, screening and identification, brief intervention, and management and treatment of alcohol and other substance use by adolescents continues to be needed to improve evidencebased practices

Long term consequences

The Pediatricians point to the results of recent research which have demonstrated that brain development continues well into early adulthood, and that alcohol consumption can interfere with such development. These indicate, they say, that alcohol use by youth is an even greater pediatric health concern than was previously recognized.

The statement explains that the deleterious effects of youth drinking are not restricted to the short-term. Use of alcohol at an early age is associated with future alcohol-related problems. Data from the US National Longitudinal Alcohol Epidemiologic Study substantiated that the prevalence of both lifetime alcohol dependence and alcohol abuse show a striking decrease with increasing age at onset of use. For those aged 12 years or younger at first use, the prevalence of lifetime alcohol dependence was 40.6%, whereas those who initiated at 18 years was 16.6% and at 21 years was 10.6%. Similarly, the prevalence of lifetime alcohol abuse was 8.3% for those who initiated use at 12 years or younger, 7.8% for those who initiated at 18 years, and 4.8% for those who initiated at 21 years. The contribution of age at alcohol use initiation to the odds of lifetime dependence and abuse varied little across gender and racial subgroups in the study. Early alcohol initiation has also been associated with greater sexual risk-taking (unprotected sexual intercourse, multiple partners, being drunk or high during sexual intercourse, and pregnancy); academic problems; other substance use; and delinquent behavior in mid to later adolescence. By young adulthood, early alcohol use is associated with employment problems, other substance abuse, and criminal and violent behavior.

Committee on Substance Abuse Policy Statement Alcohol Use by Youth and Adolescents: A Pediatric Concern. American Academy of Pediatrics 2010