Help! I found my teen drinking

Anusha Sodhi is worried that her son Nishith, 15, may be drinking on the sly. Both she and her husband Rahul drink socially and stock liquor at home. She recently noticed that the stock seems to be going down. Moreover, Nishith's eyes are red and glazed at times, and she has noticed his hands trembling occasionally.
She has also observed changes in her son's behaviour over the past few months. His school grades have been slipping and he seems restless and preoccupied. Recently, when she saw him talking to a friend, he did not introduce her to him. Could he have gotten into the wrong group of friends? Could it be peer pressure that was behind his drinking? Anusha shares her concerns with Rahul. They are understandably worried and wondering how best to handle the situation.

The 'drug' most commonly used by teens the world over is alcohol. According to 2015 figures, quoted by the US-based National Institute for Alcohol Abuse and Alcoholism (NIAAA), by age 15, 33% of teens have had at least one drink, and by age 18, this figure rises to about 60%. The WHO (World Health Organization) Fact Sheet on Adolescent Health, 2015, says 14% of adolescent girls and 18% of adolescent boys, aged 13-15 years, in low and middle-income countries, have consumed alcohol.

CAUSES FOR TEEN DRINKING
Although teens drink less often than adults, when they do drink, they tend to drink more. Why is teen drinking such a problem these days? Here are some reasons:
Desire for novelty and risk taking: The brain undergoes major changes during the teen years. The level of dopamine (the reward chemical) dips. But, when the teen is involved in new and exciting experiences, there is a spike in the release of dopamine and the teen experiences a sense of 'high'. The teen brain is therefore wired to seek novel experiences and engage in risky behaviours. Curiosity about the forbidden, experimentation, and novelty- seeking risky behaviours, combined with peer pressure are all compelling reasons why teens may drink.

Peer pressure: The desire to fit in and belong to a group is a major factor driving teen drinking behaviour. A teen, who does not drink, may be dismissed by his peers as 'boring' and 'uncool'. Binge drinking, games like 'bottoms up', or doing shots (to determine who can drink the most, in the shortest interval) lead to heavy alcohol consumption by teens.

Parental attitude towards drinking: The environment at home and the parent's attitude towards drinking greatly impact a teen's attitude towards alcohol use. Let's look at what can happen when:
Parents are strict teetotalers: If parents are very strict and controlling, teens may rebel. Sometimes, parents may go to the extent of even restricting any talk or discussion on this subject at home. In such cases, when the teen experiences sudden freedom in college, they may lose his way and start abusing alcohol.
A parent may be an alcoholic: This is a situation of very grave concern that requires urgent intervention, especially if the parent is violent and abusive. Also, alcohol dependence (or alcohol use disorder) in a parent or close family member is a strong risk factor for teens to become alcoholic.
Parents drink socially: Here, children may see their parents drinking occasionally at home or at parties, conveying the unspoken message that drinking is acceptable. It is very important for such parents to talk to their children about the hazards of underage drinking.
Parents let their teens drink under their supervision: There is a belief that if a teen consumes alcohol under parental supervision, it can minimise harm, as he can then be taught 'responsible drinking' by parents. However, apart from the legal bar, research supports the view that a 'zero tolerance policy' is the preferred approach in curbing future alcohol abuse. It is also important to note that consuming even small amounts of alcohol, particularly in the teen years, has a huge impact on brain growth and development.

Influence of media: The media glamourises drinking and portrays it as 'cool' behaviour. Television shows and movies often show protagonists drinking. Additionally teens are regularly exposed to surrogate liquor advertisements, which slip through the law.

Alcohol is everywhere: Teen have easy access to alcohol - sometimes even in their own homes. Alcohol is often consumed as a part of many celebrations. Surprisingly, pubs permit even little children to enter the premises. Some teens get hefty allowances, which enable them to bend the law and buy liquor.

A way of coping: Some teens may drink to cope with stress, or because of depression, anxiety, or anger. While teens may drink to feel happy and get that 'high', what they may not know is that alcohol is actually a nervous system depressant that may increase the likelihood of them feeling low.

HAZARDS OF UNDERAGE DRINKING
Impact on brain: Apart from the negative effects on physical health, underage drinking impairs brain development. The brain undergoes a massive remodeling during the teen years. The prefrontal cortex, which manages cognition, impulse control and decision-making, is still developing during the teen years, and it is not fully developed till the person reaches 27 years. Teen drinking hampers this development, which could lead to cognitive and learning problems.

Impact on decision-making: Even though the teen may not exhibit physical signs of intoxication, his pre-frontal cortex, the decision-maker of the brain, may be affected. Hence, the teen may assume he is not drunk and that he can handle another glass of liquor. But, because his brain is affected, his judgment is impaired and his decision-making ability is compromised. So, teens under the influence of alcohol are less likely to recognize potential danger. They may engage in other risky behaviours, such as having unprotected sex, using drugs or acting violently. Teens who drink are more likely to become either perpetrators or victims of rape, assault, and robbery. Teen drinking can also lead to fatalities and injuries due to drunken driving.

Virtually all teens hooked on drugs start with drinking. A 2014 review of research titled 'Adolescent Alcohol Use: Risks and Consequences', observed that alcohol use and other risky behaviours such as smoking, substance use, and engaging in promiscuous sexual activities, emerge in adolescence and tend to cluster together.

Impact on academics: The impact of teen drinking on academic and future career success is a big worry for many parents. A 2017 study from Norway published in Frontiers in Psychology found that alcohol and drug use was associated with school-related problems measured by low GPA (grade point average) and higher absenteeism.
According to reports, there is a significant increase in alcohol use between grades 7 and 12. In India too, incidents of children sneaking alcohol into school are not uncommon. Since alcohol reduces the ability to think clearly, impacts memory, and leads to absenteeism, underage drinking has a large impact on teens' academic performance. It also negatively affects achievement in sports and other artistic endeavours.

Long-term impact: Underage drinking increases the chances of addiction later in life. This is particularly worrisome. According to NIAAA, research shows that individuals who start drinking before the age of 15 are four times more likely to become alcohol dependent in adulthood than those who postpone drinking until age 21.

WARNING SIGNS
According to the US-based National Institute for Alcohol Abuse and Alcoholism (NIAAA), these are some of the signs that may indicate your teen may be consuming alcohol:

• Smelling alcohol on your teen's breath
• Slurring, trembling or coordination problems
• Finding alcohol in his possession
• Lying or stealing
• Changes in mood, including anger, irritability and being rebellious
• Academic or behavioural problems in school (including absenteeism)
• Changing groups of friends
• Low energy level
• Less interest in activities and being uncaring about one's appearance
• Problems concentrating and/or remembering

It is to be noted that some of these signs could be also attributed to the turbulent teen years. Not every teen who is moody or belligerent is drinking.

EXPERT TAKE
ParentCircle interacted with Dr Saurabh Mehrotra, psychiatrist and consultant at Medanta hospital in Gurugram. This is what he had to say:
Q. What are the factors that promote drinking among teens?
A. Easy access to liquor, the desire to experiment, peer pressure, and using alcohol to cope with stress and negative emotions, are at the forefront. Having a family member who drinks, and lack of education about alcohol and drug use are two other factors that may cause alcohol abuse. Positive expectations from drinking increase the chances of subsequent drinking. Parental drinking increases the chances of a child drinking. Media exposure (for instance, surrogate advertisements for liquor on television) is facilitatory.

Q. What is the influence of peer pressure on teen drinking?
A. Peer pressure is a key risk factor that initiates drinking. Having peers who drink, greatly increases the chances of a child drinking. For many it becomes necessary to drink to be accepted into a group. Besides, peers encourage experimentation and define a person as 'cool' or 'boring' based on his drinking. Lack of assertiveness and inability to refuse a drink in the face of peer pressure are also very relevant.

Q. Under what circumstances can teen drinking lead to addiction?
A. The chances of drinking becoming an addiction are higher if it starts in the teenage years, if it is a regular habit, if the home environment is dysfunctional (parental conflict/fights), chaotic, permissive, if there is abuse or neglect, and if there is poor parent-child communication. Lack of monitoring by parents, lack of parental understanding and support, harsh inconsistent discipline, childhood trauma, and severe stress on the child coupled with poor coping skills, are other risk factors for addiction. The risk becomes higher in teenagers who may be struggling with depression, anxiety disorders, and low self-esteem.

Q. When I comes to teen drinking, what message would you like to convey to Indian parents?
A. Parents have a very important role to play in preventing teenagers from becoming addicted to alcohol. The three M's are critical - Modelling, Mentoring, and Monitoring. My suggestions for parents:

• Avoid drinking in front of your children and do not have a permissive attitude towards alcohol use. Parents are the first teachers and children also learn from observation
• Get involved in your teen's life - studies, play, friends, and activities. This not only strengthens the parent-child bond, it also facilitates monitoring
• Display warmth and love towards your children. Ensure there is effective communication between you and your child
• Encourage your child to get involved in sports, hobbies, and family life
• Encourage independence, but set appropriate limits
• Finally, teach your child assertiveness skills, the ability to say no or refuse alcohol in the face of peer pressure. Your teen should realise that - being alcohol and drug-free is the true cool!

WHAT PARENTS CAN DO
Have open conversations: It is vital to have an open and trusting relationship with your child for any communication to be effective. Start having conversations with your child, even at a young age, about responsible drinking and why there is a minimum age limit for drinking. Social drinking is very common today especially among urban, middle class parents. Children observe their parents drinking at home and in social situations. So, it becomes all the more important for these parents to start having conversations with their children about being responsible even with social drinking. Have conversations with your child about the fact that you would like him to abstain from drinking before the legal age, and if he is exposed to drinks by peers at a party, how to handle himself, know his limits and have the courage to say NO.

Educate your child about drinking hazards: Some children may not know the extent of harm caused by underage drinking. Discuss with your child the impact of drinking on their growing brain. Let your child know how the damage caused by alcohol on the teen brain is significantly more than the damage inflicted on an adult brain. Explain that it is scientifically proven that when a person starts drinking during his teen years or earlier, the chances of developing dependency and addiction are much higher. Discuss how drinking alcohol and getting drunk makes a person lose control of his physical, mental and decision-making ability and this can lead to harmful consequences. Talk about situations in the family and among friends on how alcohol has negatively affected their lives.

Model responsible drinking: Your child follows not your talk, but your behaviour. So, if your child sees you binge drinking, getting drunk, behaving in an aggressive or violent manner, or driving while under the influence of alcohol, there is a high probability he will follow your lead. When it comes to alcohol use, model the behaviour you want your child to follow.

If you catch your teen drinking: It is a source of anxiety for most parents if they discover their teenager has been drinking. But a lot can be done to ensure the situation does not get out of hand. Here are some tips on how to deal with the situation if you happen to find out your teen has been experimenting with alcohol use:

• Don't react in anger or panic: Calm down before you sit him down for a talk. Do not immediately initiate punitive action
• Find out the root cause: Ask how much and how often he has been drinking. It is also important that you understand the reason behind the drinking. Is it peer pressure, a way to cope with stress, natural curiosity, or poor emotional regulation? Is it a case of serious drinking that may lead to addiction? Find out if there is something bothering your teen. Get to the root cause before you try to solve anything. If you feel you will not able to deal with the matter effectively, get help from a mental health professional
• Do not blame or shame him: Be understanding (but firm) rather than judgmental. If you catch your child drinking, do not shame her or make her feel like a criminal
• Convey your expectations: Research shows that teens are less likely to drink if parents communicate clearly that they don't want them drinking. State clearly and firmly to your child that you want him to abstain from drinking
• Engage with your teen to find a solution: When both of you are in a better mood, work together to find a way for your teen to resist the temptation and stay away from consuming alcohol. Ensure your teen knows you will always be there for her and she can call you at any time if she runs into trouble. Discuss limits and privileges she may have to give up should she be caught drinking again, such as staying out late and sleepovers with friends. Be firm and consistent in enforcing limits and consequences
• Help him deal with peer pressure: Get to know his friends. Guide him on how he could resist a friend who pressurises him to try a drink - on how he can politely refuse. Maybe, he can put the blame on you - that you will be angry and he will have to face unnecessary consequences (even if it may not be true!). Make your child understand the importance of choosing friends wisely
• Monitor closely: When your teen goes out, make sure you know who your teen is with, where they are going, and what they are doing. Make sure there is adult supervision at parties your child attends to make sure there is no alcohol being served. Stay connected with the parents of your teen's friends and the school counsellor
• Don't ignore the problem: Don't underestimate the problem and think it's just a passing stage of development. Don't hesitate to approach a de-addiction centre or a therapist with experience in treating teens with drug or alcohol problems, if the problem persists

We all need to come together as a community to prevent alcohol abuse among teens. Government can step in to make alcohol more expensive and to strictly enforce rules regarding the minimum age of drinking. Be aware that in India the minimum age for drinking varies between 18 and 25 depending on the state. Schools too can get involved to educate students about the dangers of substance abuse.
However, it is parents who are the biggest influencers. Children whose parents are actively involved in their lives are less likely to drink alcohol. When your teen feels close to you and trusts you, she is less likely to drink or engage in harmful, risky behaviours. So, show your teen unconditional love, and assure her you are always there for her whenever she needs you.

In a nutshell

• Teen drinking is one of the biggest challenges facing parents today
• There are several reasons why teens drink - curiosity and novelty, peer pressure, parental attitudes, media influence, and easy access to alcohol
• The hazards of underage drinking, especially the impact on the brain, should be conveyed strongly to children
• If you find your teen drinking, there are several strategies you could adopt, the most important one being have open conversations with your teen about responsible behaviour and staying away from alcohol

What you could do right away

• Find ways to celebrate and relax without alcohol
• Emphasise the importance of honesty and integrity to prevent drinking in stealth
• Have a casual talk with your pre-teen about substance abuse. Ask him open-ended questions like - 'I wonder why kids are so drawn to alcohol' or 'How do you feel when you see drunk people behave so out of control?' Ensure it doesn't become a lecture

About the author:
Written by Aruna Raghuram on 2 October 2019.
Raghuram is a journalist and has worked with various newspapers, writing and editing, for two decades. She has also worked for six years with a consumer rights NGO. At the time of writing this article, she was a consultant with ParentCircle.

About the expert:
Reviewed by Meghna Singhal, PhD on 7 November 2019.
Dr. Singhal is a clinical psychologist and currently heads the Content Solutions Zone at ParentCircle. She has a doctorate degree from NIMHANS (Bangalore) and holds a post-doctorate in parenting from the University of Queensland (Australia).

Join our Circles to share, discuss, and learn from fellow parents and experts!

Looking for expert tips and interesting articles on parenting? Subscribe now to our magazine. Connect with us on Facebook | Twitter | Instagram | YouTube