Do you let your children drink alcohol?

My children recently asked about drinking alcohol with dinner. They told me that two of their friends were allowed to drink beer or wine with dinner. I asked around and discovered the permissive home regarding alcohol is very common in our community.

For our kids who have been soaked in education about drinking and drug use they were shocked. “Don’t their parents know that alcohol is dangerous?” Was followed by, “alcohol is just yeast-pee, who would want to drink that?” They had lots of questions and that got me to looking into the matter.

Recently, an excellent article was published in the Wall Street Journal, written by Melinda Beck.[i] She explored the issue of responsibility and asked whether when drinking is permitted at home the kids go on to develop alcoholism. As interesting as the article was the comments section on the WSJ website.

The range of responses varied from “Americans are Puritans” to “Alcohol causes brain damage and nobody should drink it.” I gleaned from the heat of the discussion and the relative absence of light that that there is controversy.

First of all, we are talking about a highly charged topic: child rearing. There is obviously no single best way to do it. Families make up their own rules so long as the resulting policy does not hurt the child or the society at large people tend to favor a hands-off approach.

In this case the issue does concern child welfare and since drug and alcohol addiction is in large part a societal problem I think it reasonable to debate as a public policy issue.

How do you make an alcoholic?

Marc Schuckit and colleagues conducted one of the best studies on the genetics of alcohol addiction. We have to be careful here as alcoholism is not limited to alcohol consumption but for this discussion we’ll limit the scope to the link between alcohol consumption and the future development of alcohol abuse or dependency.

Dr. Schuckit[ii] found when he looked at the children of fathers with alcohol problems versus children of fathers without an alcohol problem about 40% of the correlation was explained on the basis of genetic inheritance. The study has limitations but the important takeaway message is that behavior and specifically, timing of alcohol exposure to the developing brain is probably important.

It is not as simple as exposure=alcoholic. If that were the case then most people would be a wreck. It is also not as simple as alcohol + loving parents ≠ alcoholic. Worse some would argue there is no risk-free choice. If we make alcohol the forbidden fruit the defiant teenagers will naturally sneak drink versus casa bacchanalia and the head start to wanton self-destruction.

Most kids drink before college

According to SAMSHA (Substance Abuse and Mental Health Administration) most kids (86%) have had alcohol before age 21 despite every state having that set as the minimum age for alcohol consumption. In the same data set it is revealed that half of college students have at least 5 drinks in a setting at least once a month. That’s called binge drinking.

In SAMSHA’s Behavioral Health Statistics section they report kids who start drinking heavily before age 15 are six times more likely to develop an alcohol problem in adult life. I think that if a 15 year-old is drinking heavily then s/he already has an alcohol problem. If the baseline prevalence of alcohol abuse is 10-20% nationally then a six-fold increase means that heavy drinking at age 15 is diagnostic of a problem later in life (without treatment).

Can’t fight this enemy

But what about a little wine here and there? The problem is twofold. First, brain development is not complete before at least the mid-twenties.

Specifically the developmental process of myelination (the insulation covering on the nerve cells) is not complete before age 25. That means connections between neurons are still being formed. The most significant area of brain development is the frontal cortex. This is the principal location of the judgment area. No surprise that teens that consume alcohol have an increased rate of pregnancy, car crashes, suicide and dropping out of school. There is a direct correlation between alcohol consumption and years of life lost in teenage populations.

The second problem is much more subtle and more important. No matter how good the communication level between parents and their children the alcohol gets in the way. The point of drinking is to alter the function of the brain. When the child drinks the heart-felt words of caution from the caring parent are dissolved in the alcohol. All of the best-laid plans to “be careful” or to “know your limit” are also subject to change once the young person starts drinking.

The trouble is sorting out which kids are safe to drink alcohol from the ones that are not. So far we don’t know how to do this in advance. I think the permissive alcohol strategies by the parents are an attempt to reduce the risk to their children[iii]. Maybe they think they can educate away the risk by providing a safer environment than by letting them experiment with their friends.

Unfortunately it seems that exposure itself is the triggering agent for the progression to abuse. Or maybe it is not unfortunate. Human beings for survival do not require alcohol. I think the national policy of protecting our children from alcohol is sound if difficult to implement. The bright side of the SAMSHA data is that only 6% (that’s still 700,000 kids) drank alcohol. I believe we can get this down lower.

Many parents assume that the kids are going to try alcohol and drugs anyway. Statistically it is hard to argue with them. There is a tipping point, however, the other way. I believe the greatest determinant in underage drinking is parental expectations. My advice is to tell your kids that other families may have different ideas about drinking but that you expect them to not drink alcohol until they are of legal age.

At least that’s what I said to my kids.


[i] http://online.wsj.com/article/SB10001424052748703386704576186380879004132.html

 

[ii] Schuckit, M. A. (2000), Genetics of the Risk for Alcoholism. The American Journal on Addictions, 9: 103–112.

[iii] Growing Up in a Permissive Household: What Deters At-Risk Adolescents From Heavy Drinking? Journal of Studies on Alcohol and Drugs. Volume 69, 2008 > Issue 4: July 2008

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Category: Current Events, Drugs, Neuroscience

About the Author: Dr. Jason Giles is certified by the American Board of Addiction Medicine and the American Board of Anesthesiology. He is a physician specializing in the treatment of drug, alcohol, and behavioral addictions. He is the founder of Haywire.


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