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Alcohol: The Most Popular Choice

Alcohol is by far the most widely used psychoactive drug in the United States. Yet while the possession, use or sale of other drugs is against the law, alcohol is legal for those aged twenty-one or older.

“We have a double standard in this country,” observes Dr. Peter Rogers, a pediatrician and specialist in addiction medicine at Children’s Hospital in Columbus, Ohio. “Parents will say, ‘My kid may be drinking, but at least he’s not doing drugs.’ ”

An adolescent may employ similar logic to gain permission to drink alcohol. “C’mon, Dad, the three of us are just gonna split a six-pack while watching the playoffs at Andy’s house. How come you and your friends get to do it and we can’t? Besides, it’s not like I’m smoking weed or shooting up heroin. It’s just beer.”

In discussing alcohol use with a teenager, address the glaring contradictions in our societal views about drinking. Your candor will be appreciated. Here is an example of what you might say:

“It does seem hypocritical, doesn’t it, that we say it’s okay for adults to drink but not to smoke marijuana. Maybe nobody should use alcohol at all, but it’s such a part of our culture that I don’t see us going back to the days of Prohibition anytime soon.

“Until you turn twenty-one, our rule on alcohol is simple: You are not to drink, if for no other reason than it is against the law. Once you’re of legal age, then it will be your decision whether or not to use alcohol. Illicit drugs, you are never to take; I don’t care how old you are.”

What Every Parent and Teen Should Know About Alcohol

Adolescents who drink usually start with beer, wine or flavored malt alcohol, a sweet-tasting blend of alcohol and carbonated fruit juice, which many youngsters tend to guzzle like soda pop. Although many teenagers mistakenly believe that these drinks are “safer” than hard liquor, it’s the amount of alcohol you drink, not what you drink, that matters. Fact is, a twelve-ounce can of beer and a four-ounce glass of wine each has the same amount of alcohol as a shot of eighty-proof whiskey, and flavored malk alcohol drinks have the same amount of alcohol as many beers. Proof is twice the percentage of ethanol, the active ingredient in alcohol. Thus an eighty-proof drink contains 40 percent alcohol.

There is no generalization we can make about how much alcohol it takes to get drunk. Everyone is different in his or her ability to metabolize alcohol, and women metabolize it less efficiently than men. However, we do have a legal definition of drunkenness—the blood alcohol content, or BAC, in each state has been established for drivers and the means to assess BAC, which can be done through a Breathalyzer test, which measures the weight of alcohol in a volume of breath, or a blood test. BAC is expressed as a percentage.

The legal limit varies from one state to another, ranging from .05 to .09 (grams per 210 liters of breath or 100 milliliters of blood). 

Signs of Alcohol Use

  • Slurred speech
  • Impaired judgment and motor skills
  • Poor coordination
  • Confusion
  • Tremors
  • Drowsiness
  • Agitation
  • Combative behavior
  • Nausea and vomiting
  • Depression
  • Weight gain
  • Possession of a false id card
  • Smell of alcohol on breath

Possible Long-Term Effects

  • Blackouts and memory loss
  • Vitamin deficiencies
  • Malnutrition
  • Suppression of the immune system, which leaves a person open to infectious diseases such as pneumonia and tuberculosis
  • Hormonal deficiencies, sexual dysfunction, infertility
  • Inflammation of the pancreas (pancreatitis)
  • Alcoholic hepatitis
  • Alcoholic cirrhosis
  • Cardiovascular disease and stroke
  • Alcohol-withdrawal delirium, or delirium tremens, which can range in intensity from mild irritability and sleeplessness, to frightening hallucinations and delusions While the most serious physical effects of excessive drinking typically take many years to develop, alcohol abuse can exact a terrible toll on adolescents’ lives.

Car crashes are just the most obvious of the adverse consequences of getting drunk. Statistics from the National Council on Alcoholism and Drug Dependence implicate alcohol use in about half of all sexual assaults involving adolescents and college students, including date rape. A frighteningly high proportion of teens—one in six—admit to having experienced alcohol-induced blackouts, where they could not recall the events of the previous evening.

Sexually active teens who overindulge are also less likely to protect themselves against pregnancy and sexually transmitted diseases, for the simple reason that they’re too besotted to take the necessary precautions before having intercourse. The fact that heavy drinking wears down the immune system adds to their risk of contracting a sexually transmitted infection.

A point to impress upon boys and girls: It isn’t just confirmed alcoholics who suffer the more harrowing repercussions of alcohol abuse. A single episode of reckless drinking can end in tragedy, as when a boy slides behind the steering wheel of a car while under the influence, or when an intoxicated young woman accepts a bar acquaintance’s offer to continue partying back at his apartment.

Last Updated
Adapted from Caring for Your Teenager (Copyright © 2003 American Academy of Pediatrics)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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