Given the high prevalence of binge drinking among adolescents, parents and pediatricians should talk to children about the dangers of alcohol use from the age of 9 years. This is according to a clinical report from the American Academy of Pediatrics.
Co-authored by Dr. Lorena Siqueira, clinical professor of pediatrics at Florida International University and member of the American Academy of Pediatrics (AAP) Committee of Substance Abuse, the report is published in the journal Pediatrics.
Alcohol use among children and adolescents has become a major concern in the US. According to the AAP report, around 21% of adolescents have had at least one sip of alcohol before the age of 13, with almost 80% having done so by 12th grade.
In addition, the report notes that around 36-50% of high school students drink alcohol, with 28-60% reporting binge drinking. Of these, almost two-thirds report binge drinking on at least one occasion in the past 30 days.
The National Institute on Alcohol Abuse and Alcoholism (NIAAA) define binge drinking as a “pattern of drinking that brings blood alcohol concentration (BAC) levels to 0.08 g/dL,” which normally occurs after the consumption of four alcoholic beverages within 2 hours for women and five or more drinks within 2 hours for men.
However, Dr. Siqueira and colleagues note that because children and teenagers typically weigh less than adults, it is likely to take less alcohol to reach unsafe BAC levels.
Three or more alcoholic beverages in 2 hours is considered binge drinking among girls aged 9-17 and boys aged 9-13, according to the report authors. For boys aged 14-15, four or more drinks in 2 hours is defined as binge drinking, rising to five or more drinks in 2 hours for boys aged 16-17.
“Given their lack of experience with alcohol and smaller bodies, children and adolescents can have serious consequences – including death – with their first episode of binge drinking,” says Dr. Siqueira.
“Studies have indicated that continued alcohol use during this growth period can interfere with important aspects of brain development that can lead to cognitive impairment, alcohol-induced brain damage and substance use disorders later in life,” she adds.
What is more, Dr. Siqueira points out that adolescents who engage in binge drinking are more likely to engage in risky behaviors – such as drunk driving – and have higher rates of suicide.
“As with most high-risk behaviors, early prevention proves to be more effective than later intervention,” she notes. As such, the report authors say both pediatricians and parents should be aware of the dangers alcohol use can pose to children and teenagers and recommend that they communicate these risks to children from the age of 9 years.
Explaining the reasons for their recommendation, the authors say:
“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 report suggests pediatricians should inform parents about the key role they play in their child’s alcohol use, pointing to a 2013 study that found parental communication about alcohol use before children went to college reduced the likelihood of heavy drinking in adolescence by 20 times.
In addition, the authors say pediatricians should assess all adolescents for alcohol use using “structured screening instruments.”
They recommend the use of a screening tool created by the AAP and NIAAA consisting of two questions that vary by age group. For children aged 9-11, for example, the tool would ask: “Do you have any friends who drank beer, wine, or any drink containing alcohol in the past year?” and “How about you – have you ever had more than a few sips of beer, wine, or any drink containing alcohol?”
“This very brief screen can detect risk early, is empirically based, and is a good predictor of current and future negative consequences of alcohol use,” say the authors.
While adolescent drinking remains a key concern in the US, a report from the Substance Abuse and Mental Health Services Administration (SAMHSA) released in June found the rate of alcohol use among youths aged 12-20 drinking has reduced significantly over the past decade, falling from 28.8% in 2002 to 22.7% in 2013.