Why is underage drinking targeted when studies suggest it is in decline?
Every April since 1987, the National Council on Alcoholism and Drug Dependence has sponsored Alcohol Awareness Month. The aims of the annual event are to increase public awareness and understanding, reduce stigma and to encourage local communities to focus on alcoholism and alcohol-related issues.
The National Council on Alcoholism and Drug Dependence (NCADD) also selects a different theme each year for their campaign to focus on. As such, this year, Alcohol Awareness Month is tackling the issue of underage drinking.
Alcohol Awareness Month is supported by the alcohol industry, whose brewers regularly announce new policies and programs aimed at diminishing harms associated with drinking. Recently, these have included working with taxi firms to provide discounted cab fares for drinkers in an effort to reduce drunk driving.
However, when it comes to underage drinking, statistics can be wielded to present very different perspectives on the issue.
For instance, The Beer Institute - the body formed in 1986 to represent the beer industry before Congress - while at pains to show support for Alcohol Awareness Month in a media announcement, puts a relatively positive spin on statistical changes regarding underage drinking.
'Record low levels' of underage drinking reported in NSDUH
The Beer Institute quotes the federal government's National Survey on Drug Use and Health (NSDUH), which they claim shows "record low levels" of underage drinking among adolescents. Records for this particular survey, however, only began in 2002, so it may still be premature to see what long-term patterns are.
Nevertheless, the reported falls do sound encouraging. In 12- to 17-year-olds, past-month drinking was shown to be down by 27%, binge drinking to have declined by 33% and heavy drinking to have been nearly halved, at 48%.
In 12- to 17-year-olds, past-month drinking was shown to be down by 27%, binge drinking to have declined by 33% and heavy drinking to have been nearly halved, at 48%.
"Monitoring the Future" is another government survey quoted in the news release, reporting 8th, 10th and 12th graders' drug and alcohol use. The results suggest that alcohol use and binge drinking in these groups continued long-term declines in 2013 - also reaching their lowest points in the history of that study.
In 2013, an annual survey from the University of California Los Angeles also proclaimed record lows. In this case, it was in the number of hours college freshmen spent "partying" in a typical week.
The number of freshmen who devoted 6 or more hours a week to this traditional form of college-age recreation is said to be down 65% from 1987, when this question was first put to Los Angeles students. The same survey also reported a 53% fall in the number of college freshmen who reported drinking beer in 2013 - down from a peak of 73.7% in 1982.
Medical News Today spoke to Chris Thorne, The Beer Institute's vice president of communications, about the figures quoted in their news release.
"Judging by the statistics," he replied, "today's kids are listening. But we will remain diligent in working with educators, parents, retailers and law enforcement to eliminate underage drinking."
"According to recent research," Thorne continued, "parents, by far, have the most influence on teens' drinking decisions. Brewers and beer importers, along with many government and non-profit organizations, support parents through numerous programs that teach them how to talk with their children about alcohol and responsibility."
These statistics sound pretty good. But if the numbers are looking up, why is the NCADD choosing to make a big deal out of underage drinking in 2014?
More statistics from the NSDUH and NIAAA
The 2012 NSDUH reports that 9.3 million 12- to 20-year-olds reported drinking alcohol in the past month. Of these, 5.9 million were binge drinkers and 1.7 million were heavy drinkers.
As with all things, there are two sides to every story. A fact from the 2012 NSDUH, which The Beer Institute declined to report, is that adolescents use alcohol more frequently than they do all other illicit drugs combined.
Other sobering statistics from the same survey - omitted from the beer industry's news release - include that 9.3 million minors between the ages of 12 and 20 years old reported drinking alcohol in the past month. Of these, 5.9 million were binge drinkers and 1.7 million were heavy drinkers.
The 2012 survey goes on. Of drinkers between the ages of 12 and 17, approximately 889,000 youths needed treatment for an alcohol use problem. However, treatment was only forthcoming for around 76,000 of these youths.
That approximately 813,000 children were unable to access the treatment they need does not only represent a high rate of missed opportunities. Outcomes for underage drinking can be fatal. According to a 2006 report from the National Institute on Alcohol Abuse and Alcoholism (NIAAA):
"Each year, approximately 5,000 young people under the age of 21 die as a result of underage drinking; this includes about 1,900 deaths from motor vehicle crashes, 1,600 as a result of homicides, 300 from suicide, as well as hundreds from other injuries such as falls, burns, and drowning."
The report also states that in 2003, the average age of first use of alcohol was 14, compared with 17.5 in 1965 - a statistic that emphatically challenges The Beer Institute's insinuated cultural shift toward a more responsible drinking culture.
That first drink may not just represent a harmless coming-of-age ritual. The NIAAA claim that people who first drank before the age of 15 are four times more likely to later meet the criteria for alcohol dependence at some point in their lives.
In fact, the NIAAA research shows that the younger people are when they start to drink, the more likely they are to engage in risky behaviors that may harm themselves or others. These include "using other drugs such as marijuana and cocaine, having sex with six or more partners and earning grades that are mostly Ds and Fs in school."
What are the health outcomes for underage drinkers?
While the burden on society caused by underage drinking is much reported, what sometimes seems less clear are the adverse health consequences specifically caused by underage drinking.
A 2013 study found that those who binge drink during their college years may face a raised risk of heart disease.
In contrast to the plummeting rates of campus drinking referred to earlier in this feature, the author of the 2013 study, Shane A. Phillips, associate professor and associate head of physical therapy at the University of Illinois at Chicago, says that:
"Regular binge drinking is one of the most serious public health problems confronting our college campuses, and drinking on college campuses has become more pervasive and destructive."
In his college-aged subjects, Prof. Phillips found vascular changes similar to those caused by a lifetime of heavy drinking in the participants who reported binge drinking six times a month.
"Discoveries and advances in many different areas of medical science have cautioned against the notion that youth protects against the adverse effects of bad lifestyle behaviors or choices," warns the study's co-author Prof. Mariann Piano, head of the department of biobehavioral health science at the University of Illinois
Those who binge drink during their college years may face a raised risk of heart disease.
Medical News Today asked Prof. Phillips if he thought that a renewed emphasis on the health risks of underage binge drinking to the individual - rather than on societal harms - may improve the effectiveness of alcohol awareness campaigns.
"Although anecdotal to our study," he replied, "we find that young people are surprised to find they drink alcohol as much as they do when you review their medical records."
"In addition, showing an individual scientific data that demonstrates the relationship between binge drinking and negative health outcomes can be an important component of any health behavior change," he said.
But what about those statistics quoted by The Beer Institute? The NSDUH showed that binge drinking is down 33% in 12- to 17-year-olds, and the University of California's survey suggested that beer drinking is down 53% overall among college freshmen.
Prof. Phillips urges readers to look again at the NSDUH data.
"In this national report, the results of the binge alcohol use among adults 18-25 were very different," he said, pointing out that this group showed only a small 4% reduction in past-month binge drinking in men and a 1.5% increase in women.
"It's important to point out that The Beer Institute survey was limited to freshmen," he continues, "and did not dissociate binge drinking per se, but percentage of freshmen who drank beer in the past year - a window to their past and not their college years overall."
"Taken together," he concludes, "it doesn't appear that binge drinking is a dying trend."
Written by David McNamee
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