Harms from drinking in adolescence

Government advice: safest option is for young people not to drink

New Zealand guidelines [5] are consistent with those in Canada [6], Australia [7], and the United Kingdom [8], and recommend that

Young people are best to delay alcohol consumption for as long as possible, particularly those under the age of 15 years. 
If drinking has begun, it should occur under guidance, and at low levels and frequency.

Alcohol harm

The harms from drinking are numerous - both short and long-term:

  • Being less likely to finish high school: the more alcohol-related harms a young student in New Zealand experiences, the less likely they are to finish high school [4]. We would all agree that this is not the future we want for our children.
  • Health risks: New Zealand adolescents who drink are at an increased risk of a later diagnosis of a sexually transmitted infection [5], major depression [6], and an increased risk of violent offending [7].
  • Suicide: In 2014, 510 New Zealanders committed suicide. Over one-third (34%) had alcohol in their system and a further 23% had a trace of alcohol in their system. Alcohol consumption has been clearly linked with youth suicide [8].
  • Irreversible impairment of brain functioning: The immature brain is particularly sensitive to alcohol use, especially those parts the brain responsible for learning and memory [9]. There is no safe or harmless level of drinking with regards to its effects on verbal learning and memory. Each drink further decreases a young person’s performance in relation to long-term cued and recalled memory, immediate recall, global verbal learning ability, short and long verbal recall, and overall word recognition discriminability. Female adolescent brains are particularly vulnerable to the damaging effects of alcohol [11].
  • Death: A significant proportion of deaths (24% in 2005-2007) in children and young people aged less than 16 years in New Zealand are attributable to their own alcohol use [12]. Of the 126 deaths in 15-19 year olds in New Zealand in 2014, the majority resulted from traffic accidents and self-harm. Alcohol use can often be a contributing factor to both of these causes of death.
  • Alcohol dependence: Many persons who are alcohol dependent developed their dependence or addiction in adolescence.
  • Injury and other harms: In 2012, New Zealand secondary school students reported the following harms attributable to their drinking: injury, doing things which could result in serious trouble, having unsafe sex, and having performance at school or work affected [13]. Students of Māori and Pacific ethnicity and/or living in socio-economic disadvantage were more likely to report a range of alcohol-related harms.

Alcohol affects adolescents differently

The effect of alcohol on adolescents is different to its effects on adults. This is because of a combination of factors relating to their metabolism and developing hormonal and neurotransmitter systems [1]. For example, social facilitation and the rewarding aspects of alcohol may be enhanced in response to low doses of alcohol among adolescents. Of particular concern for alcohol-related harm, adolescents are less sensitive to the motor impairment and sedative effects of alcohol.

As a result of these differing sensitivities and patterns of drinking, young drinkers experience disproportionately more harm from their drinking in comparison to older drinkers [2-3]. Those aged under 15 years are at particularly high risk, with the rates of harm remaining somewhat elevated among drinkers aged 15−17 years [4].


Effects on the brain

A significant and irreversible harm resulting from alcohol use in adolescence, even moderate use, is impairment of brain functioning. Areas of the brain, including the hippocampus and prefrontal cortex, which are not yet mature and are thought to be particularly sensitive to alcohol use, have been shown to be reduced in adolescents with alcohol use disorders [9,10,11,12,13]. Altered frontal lobe development is of significant import to academic success during adolescence given that this area of the brain is responsible for learning and memory abilities [14].

Recent research  [15] has found no safe or harmless level of drinking with regards to its effects on verbal learning and memory in adolescents. A linear dose-response relationship has been demonstrated, showing that with increasing levels of drinking, declines in performance are evident in relation to long-term cued and recalled memory, immediate recall, global verbal learning ability, short and long verbal recall, and overall word recognition discriminability. The consumption of three drinks versus four drinks among adolescents was found to be equally as deleterious on learning as four versus five drinks. It has also been shown that female adolescent brains are particularly vulnerable to the damaging effects of alcohol [16].


Death and other harms

Beyond the impact on brain development, a significant proportion of deaths (24% in 2005-2007) in children and young people aged less than 16 years in New Zealand are attributable to their own alcohol use. Motor vehicle accidents are by far the most prevalent cause of alcohol-related death [17].

In 2012, New Zealand secondary school students reported the following harms attributable to their drinking: injury, doing things which could result in serious trouble, having unsafe sex, and having performance at school or work affected [18]. Students of Māori and Pacific ethnicity and/or living in socio-economic disadvantage were more likely to report a range of alcohol-related harms.

Studies which have followed adolescents over time also show that heavy consumption of alcohol during adolescence is associated with subsequent alcohol use in later life [19]. New Zealand longitudinal studies have also found adolescent alcohol use to be significantly associated with an increased risk of a later diagnosis of a sexually transmitted infection [20] and major depression [21], and an increased risk of violent offending [22].


Harm from others’ drinking

Between 2003 and 2007, half of all alcohol-related traffic injuries in the 15-19 year age group in New Zealand were due to someone else’s drinking; the highest proportion in comparison to other age groups [23].

Children are also affected by the drinking of others. In a New Zealand study examining the prevalence of alcohol-related harm to others, 17% percent of respondents with children in the household indicated the children were negatively affected by the drinking of someone else in the last 12 months. Eleven percent of those with children living in the household indicated that the child had been yelled at or verbally abused because of someone else’s drinking. Seven percent of respondents with children in the household reported that children had witnessed serious violence in the home because of someone else’s drinking [24]. 

REFERENCES 

  1. Spear LP. Adolescents and alcohol: Acute sensitivities, enhanced intake, and later consequences. Neurotoxicol. Teratol. 1// 2014;41:51-59.
  2. Ministry of Health. Alcohol use in New Zealand: Key results of the 2007/08 New Zealand Alcohol and Drug Use Survey. Wellington; New Zealand: Ministry of Health;2009.
  3. National Health and Medical Research Council. Australian guidelines to reduce health Risks from Drinking Alcohol. Canberra: Commonwealth of Australia; 2009.
  4. Ibid.
  5. Health Promotion Agency. Low-risk alcohol drinking advice. n.d.; http://alcohol.org.nz/help-advice/advice-on-alcohol/low-risk-alcohol-drinking-advice.
  6. Butt P, Beirness D, Gliksman L, Paradis C, Stockwell T. Alcohol and health in Canada: A summary of evidence and guidelines for low risk drinking. Ottawa, ON: Canadian Centre on Substance Abuse;2011.
  7. National Health and Medical Research Council. Australian guidelines to reduce health risks from drinking alcohol. Canberra: Commonwealth of Australia; 2009.
  8. Donaldson L. Guidance on the consumption of alcohol by children and young people. London, United Kingdom: Department of Health;2009.         
  9. Bellis MD, Narasimhan A, Thatcher DL, Keshavan MS, Soloff P, Clark DB. Prefrontal cortex, thalamus, and cerebellar volumes in adolescents and young adults with adolescent‐onset alcohol use disorders and comorbid mental disorders. Alcoholism: Clinical and Experimental Research. 2005; 29(9):1590-1600.
  10. Nagel BJ, Schweinsburg AD, Phan V, Tapert SF. Reduced hippocampal volume among adolescents with alcohol use disorders without psychiatric comorbidity. Psychiatry Research: Neuroimaging. 2005;139(3):181-190.
  11. Johnson CA, Xiao L, Palmer P, et al. Affective decision-making deficits, linked to a dysfunctional ventromedial prefrontal cortex, revealed in 10th grade Chinese adolescent binge drinkers. Neuropsychologia. 2008; 46(2):714-726.
  12. Tapert SF, Schweinsburg AD, Barlett VC, et al. Blood oxygen level dependent response and spatial working memory in adolescents with alcohol use disorders. Alcoholism: Clinical and Experimental Research. 2004;28(10):1577-1586.
  13. Schweinsburg AD, McQueeny T, Nagel BJ, Eyler LT, Tapert SF. A preliminary study of functional magnetic resonance imaging response during verbal encoding among adolescent binge drinkers. Alcohol. Feb 2010;44(1):111-117.
  14. Ibid
  15. Nguyen‐Louie TT, Tracas A, Squeglia LM, Matt GE, Eberson‐Shumate S, Tapert SF. Learning and Memory in Adolescent Moderate, Binge, and Extreme‐Binge Drinkers. Alcoholism: clinical and experimental research. 2016;40(9):1895-1904.
  16. Squeglia LM, Sorg SF, Schweinsburg AD, Wetherill RR, Pulido C, Tapert SF. Binge drinking differentially affects adolescent male and female brain morphometry. Psychopharmacology (Berl.). 2012;220(3):529-539.
  17. Child and Youth Mortality Review Committee, Te Ròpù Arotake Auau Mate o te Hunga Tamariki, Taiohi. Special report: The involvement of alcohol consumption in the deaths of children and young people in New Zealand during the years 2005-2007. Wellington: Child and Youth Mortality Review Committee;2009.
  18. Clark TC, Fleming T, Bullen P, et al. Youth’12 prevalence tables: The health and wellbeing of New Zealand secondary school students in 2012. Auckland, New Zealand. The University of Auckland;2013.
  19. McCambridge J, McAlaney J, Rowe R. Adult consequences of late adolescent alcohol consumption: a systematic review of cohort studies. PLoS Med. 2011;8(2):e1000413.
  20. Boden JM, Fergusson DM, Horwood LJ. Alcohol and STI risk: evidence from a New Zealand longitudinal birth cohort. Drug Alcohol Depend. Jan 15 2011;113(2-3):200-206.
  21. Fergusson DM, Boden JM, Horwood LJ. Tests of causal links between alcohol abuse or dependence and major depression. Arch. Gen. Psychiatry. Mar 2009;66(3):260-266.
  22. Wells JE, Horwood LJ, Fergusson DM. Drinking patterns in mid-adolescence and psychosocial outcomes in late adolescence and early adulthood. Addiction. 2004;99(12):1529-1541.
  23. Connor J, Casswell S. The burden of road trauma due to other people's drinking. Accid. Anal. Prev. Sep 2009;41(5):1099-1103.
  24. Casswell S, You RQ, Huckle T. Alcohol's harm to others: reduced wellbeing and health status for those with heavy drinkers in their lives. Addiction. 2011;106(6):1087-1094.