1. Dear Dr. H.: How Does Teenage Drinking affect the family unit?

This is a complicated question. 

Actually, parents and teenagers are often both ignorant of the effects of teenage drinking. Teenagers, filled with the optimism of youth, feel that chemical dependency (or other negative effects of teenage use) won't happen to them. They view themselves as experimenters imbued with some sort of magical immunity. "I can handle using," they tell each other. At the same time, parents may have no idea of the drug pressures their children face. Parents confronted with the ignorance factor also confront self-doubt. "Would we have caught it sooner if we'd been better informed?" parents ask each other. This is followed by the gut-wrenching question, "Have we been good parents?" Although both questions are logical, the answers don't matter. Worrying about ignorance doesn't change what happened. 

The ignorance factor is usually long-term and twofold. First, parents are ignorant about a child's experimentation with drugs. Second, parents are ignorant about today's drugs and their effects. Unfortunately, parental ignorance is more common than rare. Often, parents are the last people to learn that their child is using alcohol or other drugs. This is because parents have been fooled. Their child has worked hard to maintain normal behavior, getting decent and sometimes outstanding grades, and participating in a variety of school activities. Home behavior focuses on not arousing parental suspicion. 

A child using alcohol or drugs creates a ripple effect in the community. Peer group members, in the middle of the ripple, know that your child is using. Perhaps the youngsters are even using together. Children tell concurrent stories, matching times, places and incidents to mask alcohol or drug use. As parents, you are not at the center and have no idea what is going on. 

Strangers, on the outer edge of the ripple, are often parents of peer group children. These parents now that your child is using, they might not know that their child is using, and face a terrible dilemma. Should they call you to report what seemed like suspicious behavior, based upon fragmentary evidence? Not to say anything is the choice usually made. Usually by this time cracks begin to occur in the adolescent's wall of defe3nses. Grades began falling, increasing car accidents occur, items at home of other family members seem to be misplaced and not to be found, arguments arise easily out of nothing, and a disproportionate amount of time is spent on that individual child much to the displeasure and discomfort of other family members. When a family member becomes dysfunctional due to chemical dependency or other reasons, then the other members of the family much shift into new behaviors. 

Often parents feel constantly tired. So much energy is being spent on "that" child; they have little left for themselves or anyone else. Some parents may feel a resurgence of guilt. Working mothers, in particular, may feel guilty about setting career goals. Parents may feel guilty about spending time together and enjoying themselves. Finishing dinner in a well-known restaurant, a wife commented to her husband, " I feel guilty about having fun." At least she could identify her feelings. Some parents are unable to do even that.

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2. Dear Dr. H.: Why is using alcohol [or other drugs] so much worse for kids than for adults?

The teenage years are the time in which valuable learning about oneself and the world is generally taking place. Meeting challenges, overcoming frustrating, and tolerating anxiety play an important role in the learning process. This is also a time for young people to develop socially acceptable behavior. This is also a time to meet people and work at building relationships. Teaching children how to ask questions about others and to be good listeners is one of our tasks as adults. Letting adolescents know that many social situations can be awkward at first and are not initially easy for most people is also important. Adolescents must be allowed to learn that it is okay to feel awkward at times. We all do! If we point out to them that some people turn to alcohol and drugs to get them through awkward social moments and they don't get to practice these skills, learning them ask an adult is even more difficult. Users and their parents both should be concerned about the potential dangers of inhibiting or blocking out these important elements of growing up. Also the younger someone starts to use alcohol and drugs, the more likely he or she is to develop problems associated with such use. Youth can develop a harmful dependence on alcohol much more quickly than adults due to their heightened sensitivity to intoxication. The adolescent is four to five times more likely to become an alcoholic when he begins consuming alcohol at age fourteen than at twenty-one. Young people who use alcohol and drugs are also more likely to be victims or perpetrators of violence, engage in unplanned and unprotected sex, experience school failure, or be seriously injured from driving or engaging in other risky behavior while impaired. Many young people are killed this way every year. Young people who use tobacco are more likely than others to drink heavily later or use illicit drugs. Nearly 40 percent of the young people in adult correction facilities reported drinking before committing the crime that landed them there. We cannot say with certainly whether or not any of these young people had problems before they began using alcohol/drugs., but in either case it is important to deal with them without the presence of alcohol/drugs.

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Living with an adult parent who has an alcohol problem is a highly stressful and upsetting situation. Those who struggle with this issue (and there are many) seem to have the most success when they reach out to others. Refusing to "keep the family secret" and talking to and drawing support from others ca help you make the best decision for you in dealing with your mother. Support groups such as ALANON (for family members of the alcoholic), ALATEEN (for teenage children of an alcoholic parent), and ACOA (for adult children of alcoholics) can be a great resource. In addition, I would advise that you consider securing the aid of a mental health professional who has experience conducting interventions. An intervention is a "caring" confrontation of the alcoholic by a group comprised of the alcoholic’s family members, friends, co-workers, etc. who are concerned about the alcoholic’s welfare. Consider contacting your health insurance company or your local mental health center for a referral to a therapist who has had experience with this successful therapeutic technique. Good luck.

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4. Dear Dr. H.: Does alcohol make people violent? My boyfriend sometimes gets more angry with me when he’s drunk and I get scared of what he might do.

My best guess is that the part of your boyfriend’s brain (and anybody’s brain who drinks alcohol) that keeps him from doing things he normally would not do, i.e. get angry, yell and/or become aggressive is "numbed out" when he is drinking. Unfortunately, some people who use alcohol become more unpredictable and intimidating when intoxicated. Your question seems to suggest that this may be an ongoing problem and if this is the case, I would strongly advise that you discuss your concerns with your school counselor (if you are a student) or a mental health professional. Good luck.

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5. Dear Dr. H.: Being drunk is the only time I can relax and be myself. I can never feel that good when I’m sober. How can you tell someone is an alcoholic? Am I a bad person?

Emotionally healthy people recognize that feeling good is related to what they think and do. They become aware of the fact that they themselves are responsible for thinking productive thoughts and taking productive action. To paraphrase Abraham Lincoln, we are just about as happy as we are going to let ourselves be, and this takes responsible living of lives every day.

Chemically dependent people learn hot to feel better by using alcohol or other mood-altering chemicals. When feeling good is achieved using alcohol or other mood altering chemicals, our emotional growth stops. We are in a sense emotionally paralyzed.

As we discontinue seeking to think or act more responsibly to feel better, our dependency on the use of alcohol and other drugs to achieve this state of well-being results in an the development of "tolerance" to these substances. As a person learns to tolerate the mood-altering chemicals, it takes more the achieve the same effect. As a result, people begin using more frequently. Heavy and frequent use of alcohol and other drugs leads to dependence. People who are dependent get uncomfortable when they stop using. This discomfort is caused by a combination of physical, psychological and social factors.

Physically, withdrawal from alcohol and other drugs create symptoms of agitation and discomfort. Psychologically withdrawal creates anxiety. The drug on which the chemically dependent person relies on in order to cope with stress is no longer available for soothing them. Socially, withdrawal feels uncomfortable. A chemically dependent person’s entire social network has been organized around their progressive alcohol and drug use. And, when use stops, social pressure is put on the person to use again.

The National Institute of Alcoholism and Alcohol Abuse recently defined alcohol abuse in these terms: "Alcohol abuse involves persistent patterns of heavy alcohol intake associated with health consequences and/or impairment of social functioning. In contrast, we can also define alcoholism as a pre-occupation with acquiring alcohol, compulsive use of alcohol in spite of adverse consequences, and a pattern of relapse to alcohol use in spite of those consequences.

Underlying these three criteria for alcoholism (alcohol addiction) is the alcoholic’s loss of control; an alcoholic cannot control his or her drinking while drinking. As a result, addictive use of alcohol inevitably leads to adverse consequences. This loss of control over alcohol once established, exists for the alcoholic’s lifetime and destructively affects his or her life. The effects include: disturbances in interpersonal relationships and employment, as well as a steady and sure decline in physical and mental health. For the alcoholic, the only means of control is abstinence.

Recovery from the disease of alcoholism rests not on the alcoholic’s futile attempt to control his or her drinking, but on the alcoholic’s decision to begin a new life based on abstinence.

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6. Dear Dr. H.: A lot of my friends are getting me to try hard-core drugs with my drinking. I have been having trouble concentrating in school. Is that why?

When substances such as alcohol and other drugs are combined the individual effects of the drugs are disproportionately multiplied. No longer does one plus one equal two. One plus one equals four or six or eight depending on the substances. This is known as the synergistic process.

With the increased impact on our body’s ability to metabolize the enhanced effects of the drugs, our return to drug free status requires more time and stress on our organs and systems is increased. Also, once a chemical enters our system, we lose the ability to make choices as productively as when sober. The chemical takes control and dictates our behavior. We are compelled to do things against our values. Loss of control can be defined as ongoing use of a drug despite harmful consequences. Not being able to perform our function as a student, due to having trouble concentrating is heading in that direction. Perhaps it’s better to find new friends.

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7. Dear Dr. H.:  Can you list 5 reasons why people still drink and drive?

In my experience working with DUI offenders, I have heard many reasons why people chose to drive despite being impaired by alcohol. Here are the 5 most cited reasons for drinking and driving:

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8. Dear Dr. H.: My boyfriend and I were at a party and he was drinking and started to flirt with other girls - what should I do about it?

This is a tough one. Unfortunately, I would need more information about your relationship with your boyfriend as well as information about your boyfriend’s drinking pattern to offer any specific suggestions. Still, I don’t want to leave you without any advice. So… Assertively (but not aggressively!) telling your boyfriend (when he is sober!!) our feelings about his behavior is the place to start. If you feel as if this approach isn’t working, think about seeking professional counseling to address the issue. Good Luck!

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9. Dear Dr. H.:  When you get busted for DUI, what are those classes supposed to do for you? How do they cure you?

The purpose of the classes is to prevent the DUI offender from getting a second DUI. Most of the time, the classes just reinforce the changes people make after the DUI regarding separating drinking and driving. Unfortunately, the educational classes are not a cure. But, research has revealed that participation in educational classes after a first DUI significantly reduces the offender’s risk of a second DUI.

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10. Dear Dr. H.:  How can I get my boyfriend to stop drinking so much? When we go out, he always drinks too much. He never gets mean, but I wish he wouldn’t get drunk. What can I say or do?

Thank you for the question. You are in a very difficult situation that requires support from others. I would advise you to try attending an Al-Anon meeting. Al-Anon is a support group for people who have a significant other who misuses alcohol. The group may be of great help to you because all the members can relate to your situation and give you support and specific practical advice about your situation. Good Luck!

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11. Dear Dr. H.: How many teen deaths occur in one day due to Drinking and Driving?

PS. My sister was killed at the age of 6 by a Drunk Driver. I was also injured.

First, my sympathies to you and your family. Your loss is a difficult one.Drinking and driving greatly increases the risk of being involved in a car crash, and it is further complicated for teens, because they are generally short on experience with both drinking alcohol and driving a car.

More than 2,300 youths aged 15 - 20 died in alcohol-related crashes in 1996 - that’s 33.6 % of all traffic fatalities for this age group, and it means 6 to 7 deaths per day due to alcohol-related crashes.

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12.  Dear Dr. H.: How widespread is the problem of underage drunk driving in our nation?

A survey focussing on alcohol-related problems experienced by high school seniors and drop outs revealed that within the preceding year, approximately 80 % reported getting “drunk,” binge drinking (defined as 5 or more drinks in one episode) or drinking and driving. More than half said that drinking had caused them to feel sick, miss school or work, get arrested or be involved in an auto accident.

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13.  Dear Dr. H.: I hear so much about binge drinking these days. Most kids probably drink more in college than later in life when they have lots of responsibilities, right? So what’s the big deal? Does it mean we all have a drinking problem?

In 1997, 15 % , 25 %, and 31 % of eighth, tenth and twelfth graders respectively, reported binge drinking.Although alcohol is a legal drug used by many adults without negative consequences, it holds unique dangers for underage drinkers. The younger you begin drinking, the greater your chances are of developing a clinically-defined alcohol disorder.

Researchers at the National Institute on Alcohol Abuse and Alcoholism (NIAAA) found that people who begin drinking before age fifteen are four times more likely to become alcohol dependent and twice as likely to abuse alcohol as people who start drinking at age twenty-one.

Underage drinking can impair physical and psychological development as well as learning. Underage drinking correlates with increases in other types of high-risk behavior, including unsafe sexual practices. Alcohol use among adolescents has also been closely linked to increased risk for suicide, with a ratio as high as 3:1, compared to non-drinkers in this age group.

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14.  Dear Dr. H.: What do you consider to be “normal” experimentation with alcohol and/or drugs - what age and amounts?

If boys and girls can reach adulthood without using illegal drugs, alcohol or tobacco, they will probably never develop a chemical dependency problem. Children must be nurtured and protected from alcohol and drug use as well as othr forms of risky behavior to ensure that they grow up as healthy and productive members of society.

The negative social consequences fostered by alcohol/drug-related crime and violence mirror the tragedy that substance abuse wreaks on individuals.

For adult, non-alcoholic women, one to two drinks per day is the suggested limit.

For adult, non-alcoholic men, two to three drinks per day is the suggested limit.

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15.  Dear Dr. H.: I am tired of my father's alcoholic behavior every time he drinks. Sometimes he gets abusive and very temperamental. What kind of AA meetings are there for the victims of the alcoholic?

I’m sorry to hear about the pain your father’s alcohol misuse has caused you. Thankfully there are support groups for family members who are negatively impacted by their loved one’s addiction. ALANON (www.al-anon.org to find a meeting near you) is a support group comprised of family members empowering themselves as they deal with the addicted person(s) in their lives. Adult Children of Alcoholics (A.C.O.A.) (http://www.adultchildern.org or call (310) 534-1815 messages only) groups are made up of adults who grew up in a "dysfunctional" household as a result of substance abuse in their family. Both of these support groups have proven to be highly effective in helping their members to learn to develop healthy and happy relationships despite having to endure being raised in a dysfunctional family.

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 16.  Dear Dr. H.:  Hello Doc! I was asked by a friend of mine to give ten reasons why teenagers want to drink at early ages and why can't they drink at 18 instead of 21 ??Dear Dr. H.:  Hello Doc! I was asked by a friend of mine to give ten reasons why teenagers want to drink at early ages and why can't they drink at 18 instead of 21 ??

I’m no David Letterman, but here are my top 10 reasons why teenagers drink at an early age:

In response to the second part of your question, my best guess is that society has made the assumption that the majority of teenagers would benefit from the three additional years (18-21) by learning to be more mature and responsible in their use of alcohol.

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17.  Dear Dr. H.: Why is drunk driving not considered such a large crime?

Based on the way you phrased your question, I sense some impatience and dissatisfaction with the current legal consequences for a DUI offense. Let me assure you that the legal and societal trends have been to dramatically increase the penalties for the DUI offender over the past few years. My best guess is that drunk driving will be considered an even "larger crime" in the years to come.

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18.  Dear Dr. H.: I gave up drinking for a while because I thought maybe I drank too much. Now my friends say I’m no fun at parties. What’s the happy middle ground? How often is ok for a college student?

This is an excellent question. In my opinion, the "happy middle ground" is different from one person to the next, and also, it may vary during one’s lifetime. For some people who have a drinking problem, one drink is too many. For others, two to three drinks a couple of times a week doesn’t cause them any problems with work, school, family or friends. The American Medical Association defines "moderate drinking" as:

For Men:	no more than 12 drinks per week,
	no more than 4 drinks at one time,
	3-4 days without drinking per week.

For Women:	no more than 9 drinks per week,
	no more than 3 drinks at one time,
	3-4 days without drinking per week.

I hope this definition is of some help to you. As I suggested earlier, most people’s alcohol use varies over their lifetime. Based on my professional experience, many non-problematic adult alcohol users drank most heavily in their late teens and early twenties. Still, if a college student has questions/concerns about their alcohol use, he or she should consider contacting their school counseling center or local health department for more information.

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19.  Dear Dr. H.: Do you believe that the legal age of drinking should be raised? Do you think lowering it to 18 again would really change anything for the worse?

21 is a reasonable age in the United States – it jibes with other legal privileges in our country. There is a proven scientific connection between early drinking and the development of the disease of alcoholism. The earlier you begin to drink, the greater the likelihood. To me, that’s a powerful reason not to lower the legal drinking age. Better to spend those "almost adult" years developing a strategy and the means to follow through for a productive, healthy lifestyle. At this stage of life, young people are learning coping strategies, stress management and problem solving skills, and fine tuning their ability to make wise and thoughtful decisions.

Drinking alcohol reduces judgment and perception and diminishes your ability to accurately assess risk. Impaired judgment can lead to sexually transmitted diseases (including HIV/AIDS), auto accidents and/or injuries. You may also face risks like an inability to control your drinking, rapid increases in tolerance levels, blackouts and memory loss, poor nutrition, damage to the heart and central nervous system, interference or damage to personal relationships, sexual impotence and/or damage to reproductive ability.

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20.  Dear Dr. H.: I have heard that insurance companies are trying to stop covering treatment for alcoholism, saying it isn’t a "medical condition." What’s up with that – I thought alcoholism was a disease?

Alcoholism is a chronic, relapsing disease such as diabetes and hypertension. Look at these stats: More than 70% of people who currently use illicit drugs put themselves at risk of developing an addiction. Of the estimated $165 billion spent each year related to alcoholism and substance abuse in 1990, more than $60 billion is attributed to crime, criminal justice costs and property damage.

75% of alcoholics are employed. Most employer-provided health care plans already discriminate against claims for substance abuse treatment by requiring a greater patient burden than other diseases – the employee pays more out of pocket for deductibles or co-payments while being entitled to fewer number of visits or days of coverage. Commonly, there are also lifetime limits regarding total dollar expenditure. For example, a medical plan that has a lifetime expenditure cap of $1,000,000 might only allow between $5,000 and $25,000 in lifetime costs for substance abuse treatment. Parity for such treatments should only increase the average premium by 0.02%, an affordable increase to ensure fair policies.

Money spent on prevention and/or treatment will help effect positive changes like these:

Lives saved, fewer highway deaths, reductions in crimes like theft and robbery and illegal drug trafficking. There would be reduced use of coverage for other medical illnesses (side effects of the disease of alcoholism or substance abuse), reduced employee absenteeism and increased employee productivity. As a matter of fact, a study conducted by the California Drug and Alcohol Treatment Assessment (CALDATA) shows that treatment actually saves taxpayers approximately $7 for every $1 spent over the course of one year.

Insurance companies may want to reduce or eliminate coverage of alcoholism and substance abuse. But clearly, we can’t afford to let that happen.

(Other refs: "The Costs and Effects of Parity for Mental Health and Substance Abuse Insurance Benefits," conducted by Mathematical Policy Research, Inc., March 1998.)

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21.  Dear Dr. H: There’s a kid in our gang who ALWAYS, ALWAYS gets so wasted we have to take care of her. I know she doesn’t have the greatest home situation, but we are tired of cleaning up after her, and bailing her out of trouble. Short of blowing her off for good, is there anything we can do to get her to lighten up?

Not too much, if she doesn’t want to do something to help herself. You might try suggesting a self help group like AA. Encourage her to start with an introductory open meeting – one anyone is welcome to attend. One of you could even volunteer to go with her the first time.

People who abuse alcohol or drugs don’t live in isolation. As her situation gets worse, she may try to place blame or guilt on others – some of her friends might benefit from support programs like Al-anon, a program for friends, spouses, family members, even employers who are affected by her behavior. Al-anon can help you understand the ways in which alcohol and drugs play a role in their lives. Even if she won’t get help right now, you might learn something from a program like Al-anon.

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22.  Dear Dr. H.: A friend told me I should look into A.C.O.A. meetings because I lived with my alcoholic father until I was 12 years old when my mother divorced him. What are these meetings for and how do I find one close to home?

Signed, A.C.O.A. Hunter

Dear Hunter: Adult Children of Alcoholics (A.C.O.A.) meetings are designed to provide free group support for adults who grew up in families where someone (typically a parent) was a substance abuser. Like Alcoholics Anonymous, these meetings are anonymous and confiential. Groups usually meet once a week for about an hour. You can participate, or just sit and listen. The best way to find a meeting near you is to look uo ACOA in your local phone book - when you call, tell them where you live and they'll tell you when and where. I recommend that you attend a couple of different meetings to find the right "fit" for you. Happy Hunting!

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23. Dear Dr H.: I just got a DUI and I have to attend some type of classes as part of my sentence. What's the deal with these classes?

Signed, Reluctant Student

Dear Student: They are probably called Alcohol Education classes and they are designed to help you to separate drinking and driving. Many people change their drinking and driving behavior after their DUI. The classes are set up to reinforce these changes and to help you to not get another DUI. How many classes you must take depends on a number of factors, but don't worry, the judge and the court will spell it all out for you.

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24. Dear Dr. H.: I heard that taking a cold shower, drinking lots of water and boogying on the dance floor will sober you up. Is that true?

Signed, Wanna be Sober

Dear Sober Wannabe: If you take the steps above, you will be a clean, bladder-busting tired person - but still drunk. The only thing that gets alcohol out of your system is time.

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25. Dear Dr. H.: Let's get real, Doc. Everybody drinks and drives! When my buddies and I go out, a DUI is the last thing we're thinking about. If I try to avoid drinking and driving, I get a bunch of grief from my friends - like I can't handle myself. Any ideas?

Signed, Pressured Peer

Dear Pressured: You are right, many people do drink and drive. I can appreciate your dilemma - you want to be safe, but you don't want to be hassled by your friends every time you go out. Here are a few tips that might help:

1. Tell your friends that you heard the police are cracking down on drunk drivers more now (that's the truth!) and you can't afford a DUI.

2. Tell them about this web site and about all you've learned about the penalties and fines related to DUI.

3. If they keep bugging you, you might want to ask yourself why you'd want to keep hanging out with people who won't respect your decisions. Good Luck!

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