Giving Kids a "Sip" of Alcohol Can Send the Wrong Message About Drinking

That little sip of wine or beer that some parents offer their kids at a wedding or on New Year’s Eve may muddle messages about alcohol, according to a new study by researchers at the Center for Alcohol and Addiction Studies at Brown University. The scientists surveyed middle school students for three years to learn whether even a taste in early childhood was a predictor of risky behavior in high school.

The Internet-based study, published in the April 1^st issue of the Journal of Studies on Alcohol and Drugs, included more than 500 Rhode Island school students. More than one-third of the kids surveyed reported trying their first sip of alcohol by the sixth grade, and most said that their first taste took place at home. Wine and beer were the most commonly tried beverages, usually at a special occasion, such as a wedding or a holiday, and adults were the primary source of the alcohol. Nearly three-quarters of the children were offered sips by their own mom or dad.

The study also showed that kids who sipped alcohol by the sixth grade were five times more likely to down a full alcoholic beverage by the time they reached 9^th grade—26% of sippers consumed a full drink versus 5.5% of non-sippers. The earlier sippers were also four times more likely to get drunk or binge drink by early high school, and trying alcoholic beverages earlier in life also raised a child’s risk for trying other substances.

Even when the researchers controlled for other factors, such as risk-taking behavior, the drinking habits of parents, and a history of alcoholism in a parent, kids who’d sipped before sixth grade had higher odds of alcohol use by their freshman year of high school.

The take-home message: Offering a child a sip of your beverage may send the wrong message, says study author Kristina Jackson, Ph.D., associate professor in the Department of Behavioral and Social Sciences at Brown School of Public Health.

"Parents should provide clear, consistent messages about the unacceptability of alcohol consumption for youth,” Jackson advises. “Younger teens and tweens may be unable to understand the difference between drinking a sip and drinking one or more drinks. Certainly there are exceptions, such as religious occasions, so the most important thing is to make sure that children know when drinking alcohol is acceptable and when it is not.”

The context of alcohol use is important, says Oscar G. Bukstein, M.D., M.P.H., medical director at DePelchin Children’s Center and a clinical professor of psychiatry at Baylor College of Medicine and the University of Texas Health Science Center-Houston, who was not involved in the research. “Often, by allowing children to sip or try alcohol on ‘special occasions’, the message delivered may be one of ‘this is how we celebrate’, we drink,” Buckstein says.

He says that sipping may be associated with increased access to alcohol, too, or more lax parent attitudes and that undermines any anti-drinking messages kids hear.

April 21^st is the national day to talk with your kids about alcohol. Visit Mothers Against Drunk Driving’s (MADD) Power of Parents page to learn more.

by Mary Brophy Marcus, health writer, APA

Addiction: A Real Disease with Effective Treatments

By Amanda von Horn, Medical Student

Reviewed by Claudia L. Reardon, M.D.

For September's National Recovery Month, let's discuss recovery from alcohol / drug addiction. Odds are that you or someone you know has struggled with addiction, whether it be alcohol, street drugs, or prescription medications. Unfortunately, many believe that those who struggle with addiction are simply weak, lacking morals, or don’t have the desire or will-power to stop using. The fact is that addiction is a chronic brain disease with real physical and psychological symptoms. People may voluntarily use drugs or alcohol initially, but the drugs themselves can change the brain and make it extremely difficult to stop using, even if they have a strong desire to quit. 

This post answers some commonly asked questions about the disease of addiction. Hopefully you will share the information so others understand that with treatment and support, people do recover.

What actually is addiction?

Addiction is a long-term, often relapsing brain disease that results in repetitive and compulsive substance use despite harmful effects or consequences. 

 

Why is it so hard to stop using drugs/alcohol?

With long-term drug/alcohol use, there are significant changes in the “reward” pathways of the brain. These changes can result in needing more and more drugs just to feel normal. Stopping the drug often causes withdrawal, with symptoms such as intense nausea/vomiting, fevers and chills, horrible depression and/or anxiety, and in some cases even life-threatening seizures. 

Why does addiction affect some people more than others?

Addiction can be caused by many factors, and it is hard to predict individuals who are more vulnerable to the disease. A person’s biology and genetics can play a big role; for example, if a parent abuses drugs/alcohol, the child has a higher chance of having the same problem than does a child of parents who don’t use. 

I am struggling with addiction. What kind of treatment is available?

No one treatment is appropriate for everyone. Effective treatment often involves a combination of medication, counseling, behavioral therapy, and 12-step programs such as Alcoholics Anonymous and Narcotics Anonymous. In many cases, a person may need hospitalization to treat the physical symptoms of withdrawal in the early stages of recovery. 

The recovery plan must address not only the patient’s addiction but all aspects of his or her life in order for treatment to be effective long-term. Since relapse is often a part of the recovery process, it is important to identify “triggers” (people, places, or things that set off an alcohol or drug craving for someone in recovery) and how to cope with these triggers without the use of alcohol or drugs. 

If you or someone you know is struggling with addiction, please consult a physician for evaluation. Recovery is possible, and there is no better time to ask for help than now.

For more information on addiction, visit http://psychiatry.org/addiction. 

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Binge Drinking: What you should know before your next tailgate party

By Heidi Huang, Medical Student
Reviewed by Claudia L. Reardon, M.D.

Have you ever been in a situation where one alcoholic drink led to another and before you knew it, you had one too many drinks?

Whether it’s at college parties, summer cookouts, or tailgating at sports events, millions of Americans have experienced what it is like to binge drink and some do so regularly. Recent studies show that 1 in 6 Americans binge drink at least 4 times a month with an average of 8 drinks each time they binge drink.

Have you ever wondered if this is harmful and what to do to prevent drinking too much? Here are some commonly asked questions about binge drinking.

What is the definition of binge drinking?

Binge drinking is drinking 5 or more alcoholic drinks for men and 4 or more drinks for women in one sitting.

What are the consequences?

• There are over fifty different injuries and diseases associated with heavy alcohol use and binge drinking. Some of these include car accidents, violence, arrests, unintended pregnancies, sexually transmitted diseases, depression, and suicide.
• Heavy alcohol use causes 80,000 deaths in the U.S. each year, and binge drinking accounts for more than half of these deaths.
• Binge drinking increases your chances of developing a full-blown alcohol addiction.

Why do people binge drink?

• Some people may not be aware of the safe limits for drinking.
• People often feel social pressure from friends and peers to drink. For example, while tailgating at a football game or attending college social events, you may feel pressure to binge drink because everyone else is drinking a lot, and people are offering you too much to drink.
• Most binge drinkers are not alcoholics and are able to go many days without having a drink. Because of this, they may feel their alcohol use is not a problem and may not be aware of the serious consequences of binge drinking.
• BUT binge drinking may be part of an alcohol addiction problem.

 What are some strategies to avoid binge drinking?

1. Stay within safe limits: For men, this means no more than 4 drinks in one day and no more than 14 in a week. For women, this means no more than 3 drinks in one day and no more than 7 in a week.
2. Keep track of the number of drinks you have: Take mental note or write it down. One drink is the same as 12 ounces of beer or 5 ounces of table wine or 1.5 ounces of liquor.
3. Pace yourself: Try to have less than 1 drink per hour.
4. Alternate with non-alcoholic beverages such as water or soda.
5. Avoid drinking contests and drinking games.
6. Find someone who you can trust and who can offer some support to help limit the amount you drink.
7. Know that it is perfectly acceptable to politely refuse a drink when you have had enough.

When to get help from a health professional?

It can be difficult to tell when binge drinking will become or is already part of a more serious alcohol addiction such as alcohol abuse or alcohol dependence. If you are unsure about your alcohol use pattern or want to reduce your drinking, you should talk to your doctor or other health professional for more information and guidance to cut down. In the meantime, try some of these tips at your next get-together or sports event.

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Caring for the Mental Health of Your College Student

By Roberto A. Blanco, M.D.

A recently released national survey on the state of mental health for entering college students revealed that this year's freshmen class has the highest stress levels in the history of the 25 year survey.  There are several reasons.  According to study authors, students face increased competitiveness and demands in high school as well as more financial challenges due to today's economy.

Although it's an exciting time, your child's transition to college can be a difficult one - especially if he or she suffers from a mental illness.  Here are some things that you and your prospective college student should be thinking about prior to choosing a university and heading off to school:

1.    What can I do to ease the college transition? 

Some schools offer an orientation program over the summer to help students become comfortable with the campus and surroundings, learn organizational and study skills and socialize with fellow freshmen.  

Apart from these organized programs, it is important that, as a parent, you work on transition issues and independence.  Make sure that your child has all materials needed for school including an organizer and a computer.  If your child is getting psychiatric treatment, teach your son or daughter the importance of their medicines, therapy and attending their appointments regularly.  If they haven’t yet been self-administering their medications, before going to college, it is important that they learn and start taking their medicines without supervision.

If you have serious concerns about how your child will do with the college transition, you may want to consider schools close to home.  Depending on the amount of concern, it may be best to choose a school which would allow your child to drive home for the weekend if needed.

2.   What’s the quality of the college's mental health program?

Some colleges and universities do not have mental health services available through the school.  If they don’t, you need to understand how a student can go about getting help.  If the school is not in a major city, you need to make sure that there are enough providers close by so that your child can get the services that he or she needs in a timely manner.

Some universities have therapists but no psychiatric providers on staff.  Others offer both counseling and psychiatric services but put a cap on the number of appointments at the university mental health center prior to referring students out to the community.  All of this information should be provided by each individual school.  And you should know all of this information prior to committing to a particular school, especially if your child is likely to use mental health services.

3.    What is the educational environment of the university?

Some universities are known to be high-pressure, unforgiving environments.  This could be due to the rigor, expectations or challenges of courses.  Sometimes, this can be eased by a strong academic support team or advising system.  Often, peers can make the university culture overly competitive in unhealthy ways.  Some places are notorious for students stealing other students’ lecture materials and notes or not helping out when needed.  If your child is particularly sensitive to stress, it may be best to go to a school where the environment is more collegial and supportive.

Other schools are notorious for having easy access to drugs or alcohol on campus.  While drugs and alcohol are available at most schools, they are easier to get at some schools which are located in major cities or areas of high accessibility.  If your child has a history of drug or alcohol abuse, you should be extra considerate of these location factors.

4.    Will the financing of this school put my child in overwhelming debt?

While a good college education is one of the most important investments, your child should not mortgage his or her future by creating large amounts of unnecessary debt.  In addition, universities with higher tuition may necessitate your child working during school to avoid excessive debt.  This can also add stress.  If schools are relatively equivalent in meeting your child’s long-term career goals, choose the college which will put your child in a better financial position after he or she graduates.

Of course, after your children go to college, you will want to monitor how they are doing intermittently.  Particularly stressful times are usually at the beginning of school, around exam time (midterms and finals) and anytime a romantic relationship ends.  Checking in around these times may be the most beneficial.  If it turns out that they need more help than some parental TLC, make sure that they see a professional.

I hope that these suggestions have been helpful.  Feel free to leave comments or questions for further discussion.

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Won’t they do other drugs?

By R. Scott Benson, M.D.

This is a question I get every time I talk with a family about medication treatment for their child with attention deficit hyperactivity disorder (ADHD). And the best answer has been “some will, some won’t”.

But at the APA meeting in New Orleans there was a report from the research group at the Mass General in Boston. They have been able to suggest answers to a lot of question about the outcome of children with ADHD. There is a higher rate of substance use problems in adolescents and adults who have a diagnosis of ADHD. But in this 10 year follow-up of children they asked “What are the predictors?”

Their data confirmed that a diagnosis of ADHD was associated with an increased incidence of drug and alcohol problems. But the finding of severe conduct problems in these children was even more highly associated with future substance use problems.

The take home message for me is that medication alone will not be sufficient to address the severe problems that many children with ADHD present. Parent training, especially for those with severely disruptive behaviors, is a necessary, integral part of their treatment.