Alcohol & drug useDrinking alcohol among adolescents is a major concern in many countries. It can reduce self-control and increase risky behaviours, such as unsafe sex or dangerous driving. It is an underlying cause of injuries (including those due to road traffic accidents), violence and premature deaths. It can also lead to health problems in later life and affects life expectancy. Worldwide, more than a quarter of all people aged 15-19 years are current drinkers, amounting to 155 million adolescents. Prevalence of heavy episodic drinking among adolescents aged 15–19 years was 13.6% in 2016, with males most at risk.
Why do some adolescents drink alcohol :
Risk-Taking—Teenage brain continues to grow & develop till the age of 25 years , hence risk taking ability is high as the frontal cortex has not matured ( seat of control ). This lengthy developmental period may help explain some of the behavior which is characteristic of adolescence—such as their propensity to seek out new and potentially dangerous situations. For some teens, thrill-seeking might include experimenting with alcohol. Impulsivity is high and engaging in risky behaviour without considering potential outcome of decision
Expectancies—expectancy influences drinking patterns from childhood through adolescence and into young adulthood. Beliefs about alcohol are established very early in life, even before the child begins elementary school. Before age 9, children generally view alcohol negatively and see drinking as bad, with adverse effects. By about age 13, however, their expectancies shift, becoming more positive. Adolescents who drink the most also place the greatest emphasis on the positive and arousing effects of alcohol.
Sensitivity and Tolerance to Alcohol—Differences between the adult brain and the brain of the maturing adolescent also may help to explain why many young drinkers are able to consume much larger amounts of alcohol than adults before experiencing the negative consequences of drinking, such as drowsiness, lack of coordination, and withdrawal/hangover effects. This unusual tolerance may help to explain the high rates of binge drinking among young adults.
Personality Characteristics and Psychiatric Comorbidity—Children who begin to drink at a very early age (before age 12) often share similar personality characteristics that may make them more likely to start drinking. Young people who are disruptive, hyperactive, and aggressive—often referred to as having conduct problems or being antisocial—as well as those who are depressed, withdrawn, or anxious, may be at greatest risk for alcohol problems .Other behavior problems associated with alcohol use include rebelliousness ,difficulty avoiding harm or harmful situations
Hereditary Factors—may be directly linked to genetics. Children of alcoholics (COAs) are between 4 and 10 times more likely to become alcoholics themselves than are children who have no close relatives with alcoholism
Environmental Aspects—genetic factors appear to have more influence on adolescent drinking behavior in late adolescence than in mid-adolescence.
Environmental factors, such as the influence of parents and peers, also play a role in alcohol use
WHAT ARE THE HEALTH RISKS?
Whatever it is that leads adolescents to begin drinking, once they start they face a number of potential health risks..
Brain Effects—adolescent brains are still maturing, and the study of alcohol’s effects becomes even more complex. continue to show long-lasting impairment from alcohol as they age .It’s simply not known how alcohol will affect the long-term memory and learning skills of people who began drinking heavily as adolescents.
Liver Effects—Elevated liver enzymes, indicating some degree of liver damage, have been found in some adolescents who drink alcohol .Young drinkers who are overweight or obese showed elevated liver enzymes even with only moderate levels of drinking
Growth and Endocrine Effects—Drinking alcohol during this period of rapid growth and development (i.e., prior to or during puberty) may upset the critical hormonal balance necessary for normal development of organs, muscles, and bones.
Cannabis is the most widely used psychoactive drug among young people with about 4.7% of people aged 15–16 years using it at least once in 2018. Alcohol and drug use in children and adolescents is associated with neurocognitive alterations which can lead to behavioural, emotional, social and academic problems in later life.
Prevention of alcohol and drug use are important areas of public health actions and may include population-based strategies and interventions, activities in school, community, family and on the individual level. Setting a minimum age for buying and consuming alcohol and eliminate marketing and advertising to minors are among the key strategies for reducing drinking among adolescents.
Adolescent Treatment Interventions—Complex interventions have been developed and tested in adolescents referred for treatment of alcohol and other drug disorders. Many of these patients are likely to have more than one substance use disorder (e.g., alcohol and marijuana) and to have other psychiatric disorders as well (e.g., depression, anxiety, or conduct disorder). Brief interventions are, as a rule, delivered to adolescents in general medical settings (e.g., primary care clinics, emergency rooms) or in school-based settings. These settings offer an excellent opportunity for intervening with adolescents to address their drinking before they progress to serious alcohol use disorders and to prevent the development of alcohol-related problems