Alcoholism in Adolescents The EdWeb Gateway

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       Alcohol dependence represents a significant public health problem among

adolescents. Teen drinking is associated with a range of health and social problems,

including poor school performance, crime, and injury and death due to automobile and

other accidents. The causes of this problem may be due to sociological, psychological,

biological, and family factors. Despite laws restricting minors from purchasing alcohol,

drinking begins in early adolescence and is virtually universal by the time teens finish

high school.

       As a current student I can personally vouch for the existence of adolescent

alcoholism. The College at Florham campus is considered one of the least party schools

in the nation and yet I witness serious binge drinking and alcohol abuse starting at the age

of 18 (or 17 if a freshmen student is young). The goal on a Tuesday night is to get drunk

and get drunk fast. Furthermore, I’ve personally witnessed handles of Dewar’s Scotch

finished in one night. I’ve witnessed boys drinking the night away because they got into

a fight with their girlfriend; and I’ve witnessed groups of people getting drunk simply to

ease stress. These are the actions of older adolescents, but I also have close relationships

with many high school students. Their weekends are composed of finding a person of

age or with a fake ID to buy alcohol and get drunk. Connecting my own personal

experiences to this research made me realize how much of a “real” problem adolescent

alcoholism is.

       According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA),

alcohol is the number one drug of choice among children and adolescents. They estimate

that about 4.6 million teenagers, ages 14 to 17 experience serious alcoholic related
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problems. Forty percent of those who start drinking before the age of 15 meet criteria for

alcohol dependence at some point in their lives. Research indicates that the human brain

continues to develop into a person's early 20’s and exposure of the developing brain to

alcohol at any young age up to his or her mid-20’s may have long-lasting effects on

intellectual capabilities and may increase the likelihood of alcohol addiction


       For most people who drink, alcohol is a pleasant accompaniment to social

activities. Moderate alcohol use—up to two drinks per day for men and one drink per

day for women and older people—is not harmful for most adults. The consequences of

alcohol misuse are serious, and in many cases, life threatening. Alcoholism, also known

as “alcohol dependence,” is a disease that includes four symptoms, 1. Craving: A strong

need or compulsion to drink, 2. Loss of control: The inability to limit one’s drinking on

any given occasion, 3. Physical dependence: Withdrawal symptoms, such as nausea,

sweating, shakiness, and anxiety occur when alcohol use is stopped after a period of

heavy drinking, and 4. Tolerance: The need to drink greater amounts of alcohol in order

to “get high” (

       Many people wonder why some individuals can drink alcohol without any

problems but others cannot. One important reason has to do with genetics. Scientists

have found that having an alcoholic family member makes it more likely that if you

choose to drink your chances of becoming an alcoholic are very high. Genes, however,

are not the whole story. In fact, scientists and researchers also believe that certain factors

in a person’s environment influence whether or not a person is at risk for alcoholism. A

person’s risk for developing alcoholism can increase based on the person’s environment,
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including where and how he or she lives, family, friends, culture, peer pressure, and even

how easy it is to get alcohol.

       A great deal of research has been conducted on the factors that contribute to

making an adolescent susceptible to becoming dependent on alcohol. Sociological and

psychological factors are two significant effects on alcoholism use and abuse in

adolescents. In our text, Gullotta, Adams, and Markstorm (2000) examine some

psychological factors of teen alcoholism. The results of a longitudinal study that

followed several hundred male children over 30 years proposes that those who become

alcohol dependent are “extroverted and worried over their masculinity and were

rebellious as children” (Gullotta et al., 2000). Other research has shown that alcoholic

dependent individuals are depressed failures seeking to escape the problems of living.

Some psychologists speculate that alcohol dependence is a subtle form of suicidal


       Alcohol dependent adolescents are found to be less religious than their peers, are

more likely to use other illicit drugs, and are influenced more by their peers than by their

families. According to our text, it is estimated that more than half of teens with drinking

problems have a co-occurring emotional disorder. Some may be using alcohol to numb

their emotional sufferings associated with their disorders like depression and some use

alcohol to numb their pain even if they are not suffering from any disorder (Gullotta et al.,

2000). Irvin and Maag further explain psychological pressure that come along with

adolescence because adolescence is a time of enormous physical, emotional, social, and

psychological transition. Adolescents face a series of important decisions involving
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family and peer relationships, sexual expression, vocational/educational development,

and experimenting with drugs and alcohol. “Perhaps as a consequence of these

developmental transitions, the number of stressful life events is arguably at its maximum

during adolescence. Attaining a stable sense of self requires adolescents to successfully

navigate these transitions. This task—depending on one's personality structure and

dynamics—is more difficult for some adolescents whose ability to cope with stress,

anxiety, and interpersonal relationships is compromised” (Irvin & Maag, 2005). As a

result, they are at greater risk for developing a variety of mental health problems and

turning to alcohol and other substances for support.

       Our text also examines some sociological factors of teenage alcoholism. There

are many “healthy” purposes of drinking such as, occasionally wanting to escape

responsibilities, celebrating a special event, or simply drinking from the desire to have a

pleasant sensation. Less healthy reasons for turning to alcohol include the desire to avoid

the emotional pain of growing up, to encourage sexual activity, or to compensate for

feelings of inadequacy (Gullota et al., 2000). Furthermore, society strongly advocates

drinking and underage drinking. When one turns on a reality television show the people

are always getting drunk at one point or another; advertising campaigns of alcohol

involve good looking men and women who are laughing, partying, and having a great

time; and MTV has endless amounts of shows and music that give light to drinking

heavily. For example, J-Kwon’s song Tipsy, which was played on MTV a lot when it

first became popular, begins by saying “Teen drinking is very bad. Yeah but I got a fake

ID though.” The song then proceeds to talk about them getting “wasted” and doing all

kinds of sexual activity. Furthermore, MTV’s reality shows such as The Real World and
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Road Rules have underage participants, and a large amount of the footage shows these

underage people having a great time while they are binge drinking and getting extremely

intoxicated. Socially, teens are faced with the everyday pressures of growing up, while at

the same time watching these examples of the “positive” effects of underage drinking.

Therefore, no matter how cliché, underage drinking then becomes the “cool” thing to do

and as a result, some become dependent on it.

       Hussong and Hicks (2003) from the Journal of Abnormal Psychology bring up an

interesting point. Most past studies generally interpret relations between negative effects

and adolescent alcohol use in terms of the self-medication hypothesis, where adolescents

use alcohol as a means of alleviating negative or stressful emotional experiences. More

recent work suggests that positive affect may also be important in predicting factors of

adolescent alcohol. “Some adolescents in more positive relationships with substance-

using peers may experience the shared use of substances as a means of fostering a closer

sense of camaraderie, more positive affect, and reduced negative affect” (Hussong &

Hicks, 2003). In other words, shared substance use among friends may strengthen the

relationship bond and result in greater security and positive affect. Such strong

friendship bonds have typically been interpreted as a sign of social competence and

healthy adjustment. “Close friends may come to replace family among troubled

teenagers who become more involved in deviant behavior as a way of developing social

attachments and a feeling of acceptance from others” (Hussong & Hicks, 2003). Of

course, this does not justify the use and abuse of alcohol or other illegal substances, but it

gives another side to the sociological view.
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       Gullota, Adams, and Markstorm (2000) also explain some family effects on

adolescent alcoholism. They initially stress upon the fact that individual, community,

and other factors can negate even the best of families, but research shows that certain

aspects of family life contribute to adolescent alcoholism. One perspective that G. M.

Barnes discussed in his classic paper suggests that “problem drinking is a manifestation

of incomplete, inadequate socialization within the family” (Gullota et al., 2000). Two

studies our text discusses support this conclusion. The first study draws from a 30 year

longitudinal study of 133 White, middle-class subjects and their parents. It concluded

that the ones who abused alcohol were rejected by their mothers, their families

experienced conflict over childrearing practices, or they exercised inconsistent or

restrictive discipline. The second study is based on a sample of 2,048 Ontario school

children. The children who experienced alcohol misuse experienced a lack of parental

affection, concern, or involvement in their lives. In general, an alcohol dependent

adolescent’s family contains characteristics of poor parental control over the adolescent

and a distant relationship between the teen and his or her parents. Some find that these

“dysfunctional” families not only condone, but also encourage their child to drink.

       Furthermore, whether they realize it or not, adolescents use their parents and other

adult family members as role-models. Research has show that parents’ current use or

abuse of alcohol, or the admission to their teen of their past experiences with it are

contributing factors to their own child using or abusing alcohol (or any drug for that

matter) (Gullota et al., 2000). In Ullman and Orenstein’s (1994) article in the magazine,

Adolescence, they discover that family patterns associated with the transmission of

alcoholism from one generation to another are also those patterns which enhance
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emulation of the alcoholic. Under such conditions, offspring are likely to develop a

strong, internalized motivation to drink. The parental model shows adolescents how

alcohol can provide a solution for the feelings of powerlessness (Ullman & Orenstein,


         Another discussed factor in adolescent alcohol use in our text is a biological

connection. In many studies, at least one parent of an alcohol dependent adolescent was

also alcoholic dependent at some time. A widely debated issue is whether or not there is

a genetic predisposition to dependency. A one “alcoholic gene” has not been found, but

there are many studies that support the fact that there is some biological connection. This

is illustrated through a study Bohman conducted. He found that adopted sons with

alcoholic biological fathers were three times more likely to become alcoholic as were

adopted sons of nonalcoholic fathers (Gullota, et al., 2000).

         In an article from the Alcohol Research and Health journal, Clark, Vanyukov, and

Cornelius (2002) explain how some research has shown that childhood antisocial

behaviors are a central element in the developmental pathway leading to adolescent

alcohol abuse or dependence. “Theories and empirical observations indicate that

childhood antisocial behaviors increase the risk for alcohol use disorders (AUD’s). In its

most severe forms, childhood antisocial behavior can lead to diagnoses of conduct

disorder (CD) or oppositional defiant disorder (ODD). Particularly for children meeting

the criteria for CD, childhood antisocial behaviors predict early initiation of alcohol use,

adolescent alcohol-related problems, and the onset of AUD's” (Clark et al., 2002).

Although extensive evidence has established that genetic factors are a major influence in

the development of AUD’s, researchers have not yet been able to identify the
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mechanisms leading to the development of AUD’s and the specific genes involved. One

candidate that has been implicated in AUD’s is a brain signaling system called the

dopamine neurotransmitter system. Individual differences in this system are likely to

influence the extent to which a person experiences alcohol's effects as pleasant, and

therefore wants to consume more alcohol (i.e. the extent to which a person experiences

drinking as positively reinforcing). Variations in the level of reinforcement obviously

can influence a person's risk for alcohol and other drug use disorders (Clark et al., 2002).

       With every substance abuse problem comes an intervention plan. For nearly all

dependent teens, kicking the habit begins with detoxification. The primary goal of

detoxification is to provide the medical care that is necessary to alleviate the physical

discomforts that accompany withdrawal. The second most important aspect of

intervention is to assist the dependent teen in finding the most suitable treatment program

to help prevent the recurrence of substance dependence. Some forms of alcohol

intervention include self-help groups, therapy, prevention, and pharmaceutical help.

       Dooren (2005) from the Wall Street Journal describes one form of alcoholism

intervention. A once a month, “injectable” medication has been shown to significantly

reduce heavy drinking among alcoholics, according to a study that has been published in

the Journal of the American Medical Association. The drug, which is being developed by

Alkermes Inc. in Cambridge, Mass., is a long-acting formulation of naltrexone, a little-

used drug approved to treat alcohol dependence. The company filed an application with

the Food and Drug Administration on April 1 to approve the drug, which would be

known under the brand name Vivitrex. Currently, naltrexone must be taken daily, which
                                                             Alcoholism in Adolescents    9

researchers say is a difficult regimen for alcoholics. They wrote that the once-monthly

Vivitrex has the “potential to improve intervention strategies for alcohol dependence.”

“Overall, the study showed that the number of “heavy drinking” days was cut by 25%, a

drop they deemed “significant” among those using the highest dose of the drug” (Dooren,

2005). Unfortunately, the medication is not a large part of alcohol treatment programs,

partly because patients don not consistently take it; and because there's been little

marketing of the drugs to clinicians. Most programs use talk therapy, addiction

counseling, and self-help groups like Alcoholics Anonymous.

       Alcoholics Anonymous (AA) and other programs operate under the belief that a

recovering alcoholic is “in the best position to understand and help the individual

struggling with an alcohol or a drug problem” (Gullota et al., 2000). Self-help groups

such as AA rely upon ex-addicts (not professionals) to provide help to the dependent

community. They all demand abstinence from the substance, and through weekly

meetings, group members attempt to support one another in their goal of abstinence. It

helps the dependent individual to cope with their own individual addiction if they have

people in their position around them and supporting them. If temptation becomes too

great for a member, the programs intervene with a “buddy system” where members are

matched to other members to provide extra support for one another outside the meetings.

The success of such self-help groups is hard to conclude, however the ideal of “neighbors

helping neighbors” is effective from the public’s point of view (Gullota et al., 2000).

       In today’s rapid advance in technology, intervention has even made it to the

Internet. Stofle (2004) from the Behavioral Health Management magazine discusses the

topic of online treatment. “Online treatment uses three distinct modes: e-mail interaction,
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real-time chat-room therapy, and Internet” (Stofle, 2004). Among them, e-mail therapy

seems to be the most frequently used mode. Online treatment obviously does not work

for all dependents. For example, clients who are medically compromised and those in

need of detoxification services obviously need to be treated in person (and often need an

inpatient level of care); clients who require monitoring also will need to see someone face

to face; clients who are quite resistant to the treatment process might be inappropriate for

active treatment online; and clients who are severely mentally disabled in addition to

their drug and/or alcohol problems might not be ideal candidates for online addiction

treatment, depending upon their level of stability. For some clients, active treatment over

the Internet might be what they need to achieve lasting sobriety. A number of private

practitioners currently provide online addiction treatment services using either e-mail or

chat as the treatment medium. The accredited online chemical dependency treatment

program eGetgoing (www. is one example of an online treatment

program. It uses audio and video over the Internet to provide group treatment for U.S.

clients. Additionally, it has links to inpatient treatment agencies across the country to

which clients needing that level of care can be referred. Online treatment also aids in

relapse prevention. An online provider using either e-mail or chat can easily reinforce

the tools for recovery obtained in treatment. Written text provides a permanent copy of

concepts and information needed by the addicted person to prevent relapse. “Text can be

viewed as a personalized handout focusing on the issues and concepts that apply to the

particular client. Written text, while at times harsh, can be honest and direct, which can

be quite helpful for the alcoholic/addict in both active treatment and relapse prevention”

(Stofle, 2004).
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       Psychotherapy is another form of intervention that seems very promising in

treating adolescent alcohol dependency. Psychotherapy is individual counseling that can

take place in a hospital ward, methadone clinic, youth service agency, or in a physician’s

office. Therapy is focused on discussing the abuser’s problems and making attempts to

resolve them. Our text explains that while cognitive behavioral approaches are promising

for adolescents, it alone is not successful. Therapy must be done in conjunction with

other treatment methods. Furthermore, psychotherapy often fails to help the substance

dependent individual because the approaches sometimes do nothing to change the system

from which the individual has come and has been a factor in his or her addiction. For

adolescents, this system is usually the family. Therefore, another important intervention

program is family therapy. Therapists help family members solve their problems and

achieve more positive and constructive ways of relation to one another. They encourage

families to examine their own behaviors and the ways in which they contribute to the use

of illegal substances by one of its members. Again, however, this program is not fool-

proof. In many cases, adolescents abuse alcohol or drugs to serve “useful” functions to

their family like keeping their parents from getting a divorce. Therefore, if disrupting

this “balance” is too threatening to the family system, the family will resist the

intervention and preserve more common and comfortable ways of behaving.

       Prevention is actually very important in the intervention of alcoholism amongst

teens. It is extremely important that much focus is placed upon preventing alcoholism

rather than just treating it because when treating it that means it’s already too late. Not

too late in the sense that there is no turning back, but too late meaning that the adolescent

has already experienced all the attributes of addiction. Many states require junior high
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school students to take at last one course in drug and alcohol education. Programs are

combined with factual information with social skills training as an effort to provide

adolescents with the ability to reject any drug use. However, Gullota stresses that

preventing drug and alcohol abuse can not be accomplished with education alone.

According to an article from the FBI Law Enforcement Bulletin prevention should consist

of three things: provide lifestyle education, reduce stress, and encourage early detection.

Individuals unaware of the effects of alcohol risk the development of alcohol-related

problems. Although the use of such knowledge likely can be affected by values and

beliefs, experts argue that the presence of such knowledge and education reduces the

likelihood of alcohol abuse. “Contrary to common belief, lectures on alcoholism remain

one of the least effective methods of educational prevention. Providing information

about how to identify and explore lifestyle factors that support alcohol abuse proves more

beneficial” (Violanti, 1999).

       Minimizing stress can help to prevent alcohol abuse as well. Research has shown

that people who experience high stress remain more at risk for alcohol abuse (Violanti,

1999). Finally, early detection is key in the prevention of alcoholism according to

Violanti (1999). Some common signals of alcohol abuse may be increased absenteeism,

a change in personality, or possibly memory lapses such as forgetting important days,

events, assignments, etc. Detecting these early signs of alcohol abuse can limit its

devastating effects and illustrates another factor in prevention. “A significant difficulty

for those individuals abusing alcohol remains their reluctance to admit the problem;

therefore, it becomes necessary for others to intervene” (Violanti, 1999).
                                                         Alcoholism in Adolescents     13

         Adolescent alcoholism is a major problem in our society today. Teen drinking is

very common at a very young age, and many are unable to control themselves. Thus,

resulting in an addiction. There are many researched factors of why and how adolescents

become dependent on alcohol such as, psychological, sociological, family, and biological

factors. Extensive research has been done in each of these areas and significant

correlations between each factor and teen alcoholism have been found and documented.

Fortunately, there are many intervention and prevention programs out there that are

constantly improving and growing to help our teens put down the bottle and kick the


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