Millions of American teen-agers have a problem with alcohol. If your son or daughter is among them, help is available
By Stanley L. Englebardt
The arrive at the emergency room of Massachusetts General Hospital regularly, youngsters, 9 to 19, with hallucinations, blackouts, tremors, injuries from falls, fights and car crashes, and suicide attempts. "Just a whiff sometimes," says one physician there, "and you know the cause is alcohol."
At a time when the media are full of stories about cocaine, this country’s adolescents are in the midst of an even more pervasive drug epidemic-alcohol. A 1983 Weekly Reader survey of children 9 to 12 showed that almost half reported peer pressure to drink. Other studies confirm that children now use alcohol at earlier ages than ever before. Last year a Parent Resource Institute for Drug Education (PRIDE) study of 6155 seventh graders reported that 43 percent were already experimenting with beer and wine and 23 percent with hard liquor. According to the National Council on Alcoholism Inc., 3.3 million drinking teen-agers from 14 to 17-nearly 1 in 5-are already showing signs of developing serious alcohol-related problems. One result: almost 10,000 young people die each year in accidents linked directly to imbibing.
But aren’t a few beers on Saturday night more desirable than smoking marijuana or snorting cocaine? "Not if you view the results from where I sit," says Dr. Harold Rockaway, a psychiatrist and chief of the St. Joseph Hospital Alcohol Rehabilitation program in Houston. "The adolescent alcoholics we’re dealing with are sick. They’re school dropouts. They’re often in trouble with the law. And they can’t stop without help." Alcohol, he stresses, can be more physically destructive than the "hardest" of illicit drugs.
Fortunately, there are many ways of treating and preventing adolescent alcohol use. "Many adults think that adolescents don’t need or want their intervention, but nothing could be further from the truth," says Dr. Marie Armentano of Massachusetts General’s alcohol clinic and an instructor in psychiatry at Harvard Medical School. The raucous behavior of intoxicated youngsters is a cry for help.
Deadly Firsts. Why do young people start drinking? Researchers at the National Institute on Alcohol Abuse and Alcoholism attribute it to peer pressure, a belief that drinking is adult, the example set by relatives and family friends, and the easy availability of alcohol. One way or another, adolescents get the message that drinking is okay.
If there is a family history of alcoholism-parent, sibling, grandparent, uncle, aunt-the chances of problem drinking are considerably greater. In one survey of adopted children, the biological sons of alcoholics were over three times more likely to be alcoholic than were the sons of nonalcoholics-even though there was no exposure to the alcoholic biological parents after adoption. Another study concluded that having an alcoholic parent is one of the most important factors in an adolescent’s early use of liquor.
What’s the first step if signs point to alcohol abuse? "Try to determine the degree of drinking," says Dr. Armentano. There is a difference between "abuse" and "Alcoholism." Abuse-the most prevalent problem among adolescents-is characterized by frequent drinking that leads to other problems: the junior-high student who starts fighting or staying out all night; the youngster who becomes reclusive, cutting off family and friends; the good student who fails courses.
An adolescent alcoholic, by contrast, may have any or all of these problems with one thing more: a physical dependency on alcohol. Several years ago, a group of recovering adolescent alcoholics appeared on the Merv Griffin television show to describe their experiences. A baby-faced 17-year-old told of his first drunk at age 5 after sneaking champagne at a family New Year’s Eve Party. This started him on secret drinking-which wasn’t discovered until he was a 10-year-old altar boy. At that time he polished off several bottles of sacramental wine and threw up during a communion service. It took four more years of uncontrolled drinking before he landed in Alcoholics Anonymous.
Another teen-ager said she started sharing older boys’ booze to be part of the crowd. By age 15 she was a quart-a-day drinker, feeding her habit by bartering sexual favors. One day, after she wretched bile and blood for six hours, emergency-clinic doctors diagnosed cirrhosis of the liver-giving her one year to live if she didn’t stop drinking. That same day she joined AA and has been "clean" since.
Working Treatments. "Teen-age alcoholics aren’t weighed down by all the emotional baggage’ carried by adult drinkers," says Dr. Rockaway. As a result, they are more amenable to psychiatric treatment and usually recover faster. In the St. Joseph’s Hospital program, the first few weeks of in-patient treatment establish certain truisms: the youngsters are hooked on an addictive drug; they are not alone in this addiction; they can function without alcohol. The program includes AA members who speak the same language and provide examples of alcoholics who have their habit under control. Most of these teen-agers make it back home and to school within four weeks.
For about 25 percent of teen-agers referred to the Massachusetts General alcohol clinic, the cause turns out to be depression, an emotional disorder that afflicts over nine million Americans and is grossly underdiagnosed in adolescents. A teen-ager who can’t live up to his parents’ expectations may use alcohol to cope with the pressure; setbacks such as parents’ divorce or failing grades may send an adolescent into a tailspin. A regimen of anti-depressant medication- "which often is enough to stop the drinking, when the drinking is a symptom rather than the primary problem," says Dr. Armentano-plus one-on-one psychotherapy can be effective. In the majority of cases, though, the most effective intervention is in group setting. This can mean school alcohol-education classes, clinic-based groups, or self-help organizations such as AA, which are increasingly being used by adolescents.
Early Intervention. "Although treatment of alcohol abuse and alcoholism is effective," says Ellen R. Morehouse, head of the White Plains, N.Y., Student Assistance Services (SAS), "it often comes too late to prevent irreparable damage." A teen-age drunk at the wheel of a car becomes a lethal weapon; a daily drinker may be on the way to liver disease. Hence one SAS goal is to prevent alcohol use among youngsters who haven’t started drinking-as well as to provide support for the children of alcohol parents and to counsel adolescents already using alcohol. Early in the school year, prevention sessions are designed to help newcomers adjust, while high-school-senior groups focus on alternatives to alcohol as a means of relieving stress.
How do you get kids to attend such sessions? "There’s nothing mandatory about the program," explains Morehouse, "except for students caught using alcohol or other drugs on school grounds." Nevertheless, local publicity and presentations by student-assistance counselors attract up to 4000 students a year.
"Occasionally," says Morehouse, "we come across a true alcoholic." The youngsters with serious problems are usually referred to outside agencies for more comprehensive treatment. The rest are evaluated and slotted into an appropriate group or individual counseling sessions.
A survey of nearly 3000 students who participated in the SAS program in 1982-83 showed a significant drop both in school absenteeism and in the number of students using alcohol and other drugs. The survey also showed an effectiveness in preventing students from becoming involved. This program is now also used by other schools in New York and in 16 additional states.
Recognizing a Killer. Not every adolescent who needs help is willing to confide in adults. So in the Boston suburbs, an organization called CASPAR (Cambridge and Somerville Program for Alcohol Rehabilitation) has developed the Alcohol Education Program (AEP), with after-school sessions in a facility that looks like a private residence. Teen-age peer leaders are used, and group members are paid $2 an hour to attend. A bribe? "Maybe," says a CASPAR counselor, "but the results are worth it."
The program’s first thrust is in grades two to six, where specially trained teachers conduct 45-minute classes once a week for ten weeks. "Although our primary objective is to reach children of alcoholic families," explains Ruth B. Davis, AEP director, "the presence of youngsters whose parents are not alcoholic removes any onus." This way, large numbers of children receive basic alcohol-prevention education at a time when it has maximum impact.
A second thrust involves youngsters in grades 7 to 12. To get around their reluctance to deal with adults, 12 high-school students from a cross section of backgrounds are selected each year for extensive training as peer leaders. About half come from alcoholic families; the rest have at least observed negative alcohol use. The result is stronger rapport between the leader and group members.
AEP’s third target is children from alcoholic families. The program helps these children understand why a parent drinks, why they are not at fault for the parent’s habit, and how the child can avoid the same trap.
Not long ago, a parent summoned to the emergency room of a Connecticut hospital was told that his 16-year-old son had been injured in a drunk-driving accident. The parent heaved a sigh of relief. "Well," he said, "at least he wasn’t using drugs." But, clearly, alcohol can no longer be considered as the lesser of two evils. Instead, we must recognize liquor for what it is: a potentially addictive substance responsible for 10,000 teen-age deaths each year, as well as thousands more lives wrecked in other ways.
Source: Reader’s Digest, November 1986