Start with a free account for 3 free CME credits. Already a subscriber? Sign in.

Alcohol Use in Teens

Diane Tanaka MD and Solomon Behar, MD
00:00
29:47

No me gusta!

The flash player was unable to start. If you have a flash blocker then try unblocking the flash content - it should be visible below.

Sol and Diane Tanaka, Associate Professor of Clinical Pediatrics at CHLA, discuss alcohol use in teens.

  • Alcohol remains the number one substance that adolescents use, misuse, abuse and become dependent upon.  It is accessible and relatively cheap.

    • Even though the rates are still relatively high (one out of three adolescents is currently using alcohol), the overall trend is decreasing.

  • Like adults, adolescents may use alcohol as a social lubricant.  Additional reasons for use may include: curiosity - this may be because of parental use, peer-group use and/or the media.

  • Alcohol use in teens is associated with a number of risky behaviors: risky sexual encounters, drinking and driving, drinking and water safety

  • The AAP recommends the first screening for alcohol use between 9 and 11 years of age.  At this age, the caregiver is usually in the room and this can be beneficial to assess the caregiver’s views on alcohol.

    • Encourage parents to share their own perspectives as clear boundaries around alcohol expectations can curb alcohol abuse in adolescents

    • It is also important to assess the friends or peer groups attitude to alcohol; studies show that drinking with two or more friends leads to drinking more than even planned in the beginning

    • A few questions to ask pre-teens, “are any of your friends using alcohol?” and “what about yourself?” or “have you ever tried more than a sip of alcohol?”

    • For the older teens, asking the questions without the caregiver present is very important.  These questions should also focus on individual and friend use of alcohol.

  • The CRAFFT is an evidence based alcohol use screening tool for adolescents (can also be used for other drug screening in this age group).

    • C: car (have you ridden in car while using alcohol or the driver is using alcohol?)

    • R: relax (do you use alcohol to relax?)

    • A: alone (do you use alcohol alone to manage your feelings?)

    • F: forget (do you forget things you did while using alcohol?)

    • F: friends (have your friends/family told you you need to cut back?)

    • T : trouble/tolerance (have you gotten in trouble while using alcohol?)

  • The line between curiosity and a problem is tricky but hinges on a) the quantity of use and b) reason for use and/or c) comes at the expense of other activities

  • The risk of alcohol use disorder increases in an adolescent a) who has a family history of alcohol abuse and b) started drinking at a younger age (especially under 14 years old)

    • Young people who drink alcohol are more likely to use other substances, mostly for the same reasons they started using alcohol

  • The main intervention for alcohol abuse in teenagers is therapy with a substance abuse therapist

    • If these therapists or programs are not available, one has to get creative and see the patient more often and use motivational interviewing skills

  • Medications are not commonly used for alcohol abuse in teens in and of itself.  However, if there is a comorbidity of depression and/or anxiety, that should be managed appropriately with medication if needed.

  • The AAP has a nice resource for this topic. 

To join the conversation, you need to subscribe.

Sign up today for full access to all episodes and to join the conversation.

To download files, you need to subscribe.

Sign up today for full access to all episodes.
Hippo Peds RAP July 2021 Written Summary 170 KB - PDF

To earn CME for this chapter, you need to subscribe.

Sign up today for full access to all episodes and earn CME.

0.25 Free AMA PRA Category 1 Credits™ certified by Hippo Education or 0.25 Free AAP credits certified by AAP (2021)

  1. Complete Quiz
  2. Complete Evaluation
  3. Print Certificate

3.25 AMA PRA Category 1 Credits™ certified by Hippo Education or 3.25 AAP credits certified by AAP (2021)

  1. Complete Quiz
  2. Complete Evaluation
  3. Print Certificate