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Reality Check – Underage Drinking in America

The parents of “John” waited to speak with me after my recent presentation at a private, independent school in New England. They appeared anxious, even scared, sharing their son’s response to admonishment over his alcohol use: “Everyone … really, everyone, does it!”

But in high school, as in life, things are not always what they appear to be.

Even long-held beliefs, such as the Titanic’s sinking because of an iceberg, have been questioned, so why not youth alcohol use?

In fact, good news can be found in the 2016 Monitoring the Future Survey: High School and Youth Trends. It states, “Alcohol use and binge drinking continued to decline among all grades [studied] and for nearly all time period measures.”

  • Past-year use of alcohol was reported by 17.6 percent, 38.3 percent, and 55.6 percent of 8th, 10th, and 12th graders respectively, compared to 26.9 percent, 49.8 percent, and 63.5 percent in 2011.
  • Daily alcohol use decreased significantly among 12th graders to 1.3 percent, and binge drinking (consuming five or more drinks sometime in the past 2 weeks) declined among 8th graders to 3.4 percent.
  • The percentage of high school students who reported ever using alcohol dropped by as much as 60 percent compared to peak years.
  • Among 8th graders, 22.8 percent reported ever trying alcohol, a 60 percent drop from a peak of 55.8 percent in 1994.
  • Among 10th graders, lifetime use fell by 40 percent from 72.0 percent in 1997 to 43.4 percent in 2016.
  • Among 12th graders, there was a significant 25 percent drop in lifetime alcohol use from 81.7 percent in 1997 to the current 61.2 percent.

Don’t get me wrong. The fact that almost a third of 8th graders and more than half of 12th graders report the illicit use of alcohol is, um, problematic. (More on that later.)

So, why John’s assertion to the contrary? According to social norming theory, misperceptions of the behavior of peers (in this case teens using alcohol) make it more likely that other youth will follow suit. Thus, it follows that “campaigns” to correct the record may be effective in convincing young people that there exists a credible – robust – peer group that is socializing without breaking the law – let alone the trust of their parents and other caring adults in their lives.

After all, if 61.2 percent of high school seniors are drinking, that means 38.8 are not!

As I stated in my 2014 Psychology Today column “Cool Kids,” “While some may pine to be this, that or the other thing, it’s really that desire to be like everyone else that drives the social juggernaut of adolescence. But behind the façade of the stereotypical cliques crowding the high school hallways are much more nuanced notions of what it means to be cool, or at least popular. There are also longer-term ramifications of teenage social status that may be missed or simply misunderstood by adults and young people alike.”

What might those long-term outcomes be? According to research from the University of Virginia, “cool kids” are just as likely to be bullied as other kids and may be more likely to engage in risky behavior, such as underage drinking. It also presciently points out that these young risk-takers may actually accelerate their behaviors in order to maintain their status in the peer group and suffer ongoing consequences in their adult lives.

Similarly, Mitch Prinstein at the University of North Carolina Chapel Hill, who studies peer influence and adolescent health risk behaviors, disputes the “cool kid” estimates, pointing to the fact that peer perception is the number-one predictor of drug use, delinquency and unsafe sex.

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Of his research, Prinstein offers, “We started by asking adolescents in a typical public high school to tell us all about the different groups in their school. If you’ve ever seen The Breakfast Club, you know exactly what I mean. We found out which kids were the Jocks, the Populars, the Brains, and the Burnouts. Then we asked all of these kids to tell us how much they really did engage in a wide variety of risky behaviors. When we asked teenagers how much the[y] though[t] the Jocks and Populars drank alcohol, smoked pot, or had sex, their estimations were sky high. But it was all a misperception. Jocks actually had no more sex than the Brains. And their substance use wasn’t that much different either. Why does that matter? Because when we followed these kids over the next two years, we learned that the more teens thought that the Populars used substances the most likely they were to increase their own substance use over time.”

What’s the concern?

The Centers for Disease Control and Prevention (CDC) states, “Alcohol is the most commonly used and abused drug among youth in the United States.”

  • Excessive drinking is responsible for more than 4,300 deaths among underage youth each year.
  • Although drinking by persons under the age of 21 is illegal, people aged 12 to 20 years drink 11% of all alcohol consumed in the United States. More than 90% of this alcohol is consumed in the form of binge drinks.
  • On average, underage drinkers consume more drinks per drinking occasion than adult drinkers.
  • In 2010, there were approximately 189,000 emergency rooms visits by persons under age 21 for injuries and other conditions linked to alcohol.

The CDC goes on to cite possible consequences for youth choosing to use alcohol, saying that “they are more likely to experience” the following.

  • School problems, such as higher absence and poor or failing grades.
  • Social problems, such as fighting and lack of participation in youth activities.
  • Legal problems, such as arrest for driving or physically hurting someone while drunk.
  • Physical problems, such as hangovers or illnesses.
  • Unwanted, unplanned, and unprotected sexual activity.
  • Disruption of normal growth and sexual development.
  • Physical and sexual assault.
  • Higher risk for suicide and homicide.
  • Alcohol-related car crashes and other unintentional injuries, such as burns, falls, and drowning.
  • Memory problems.
  • Abuse of other drugs.
  • Changes in brain development that may have lifelong effects.
  • Death from alcohol poisoning.

So, what options do parents like John’s have (other than correcting incorrect “norms”)?

1. Set clear expectations.

2. Enforce consequences.

3. Have a “bailout” plan.

On the third point, last month Jeremy Hon wrote of a compelling case in point of what he refers to as the “X Plan” in an articled titled “Dad Lets Son Stay at a Sleepover, That Night He Gets a Text With Just One Letter.”

It’s worth a read, and a reality check.

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