By Melinda Beck
Parents teach their children how to swim, how to ride a bicycle and how to drive. Should they also teach their teenagers how to drink responsibly?
The volatile issue is seldom discussed at alcohol-awareness programs. But some parents do quietly allow their teens to have wine or beer at home occasionally, figuring that kids who drink in moderation with their family may be less likely to binge on their own.
Should parents introduce children to help them drink more responsibly or does early exposure lead to an increase in alcohol abuse later on? Kelsey Hubbard talks with WSJ's Health Columnist Melinda Beck about new government studies on the topic.
Many other parents argue that underage drinking of any kind is dangerous and illegal, and that parents who allow it are sending an irresponsible message that could set teens up for alcohol abuse in later years.
U.S. government surveys have started tracking where and how teenagers obtain alcohol—and that at least some of the time, parents are the suppliers.
Nearly 6% of 12- to 14-year-olds—some 700,000 middle-schoolers—drank alcohol in the past month. And nearly 45% of them got it free at home, including 16% who obtained it from a parent or guardian, according to a report released last month by the Substance Abuse and Mental Health Services Administration (SAMHSA). The survey doesn't report how much alcohol was involved or what the circumstances were.
"This report isn't designed to say, 'Bad parents!' It's designed to say, 'Here's an issue you should pay attention to,' " says Peter Delany, director of SAMHSA's Center for Behavioral Health Statistics and Quality. "When kids under age 15 start drinking and drinking heavily, they are about six times more likely to end up with alcohol problems."
Still, some parents think it's inevitable that teenagers will experiment with alcohol and worry that a message of abstinence doesn't stand a chance against a barrage of social pressures and media messages glamorizing drinking. By the time they turn 21, 86% of American youths have used alcohol, according to the 2009 National Survey on Drug Use and Health, and 50% are binge drinking, defined as having five or more drinks in a single session for men, and four or more for women.
If teens don't learn to drink responsibly at home, some parents fear they will learn on their own, in a club or private party, where there are few restraints.
Stanton Peele, a psychologist and author of books on addiction, also questions whether any kind of drinking before age 15 carries the same six-fold risk of alcohol problems. "There's a giant difference between a kid who gets totally wasted on some purloined booze in the woods with his friends, and someone who has wine at dinner with their parents or as part of a religious ceremony," he says.
Although the minimum drinking age is officially 21 in all 50 states, 31 states allow parents to furnish alcohol to minors, and 30 allow minors to drink for religious purposes.
Although the minimum drinking age is 21 in all 50 states, 31 states allow parents, guardians or spouses to furnish alcohol to minors. In seven of the 31 states, that's permissible only in a private residence.
Research on parents' role in underage drinking has been limited. A survey of 6,245 U.S. teens, published in the Journal of Adolescent Health in 2004, found that adults play a very important role in teen drinking—but in different ways. Teens who attended a party where alcohol was supplied by a parent were twice as likely to have engaged in binge drinking and twice as likely to be regular drinkers. But teens who drank along with their parents were only one-third as likely to binge and half as likely to be regular drinkers.
Many teens grow up drinking wine with their parents as an accompaniment to meals in wine-producing countries like Italy and France, where there is no minimum legal drinking age. But research is mixed on whether such teens are more or less likely to be problem drinkers.
A World Health Organization report found that 1-in-10 drinking occasions by 15- and 16-year-olds in southern European countries resulted in intoxication, compared with almost half in the U.S.
But the 2003 European School Survey Project on Alcohol and Drugs found that the proportion of 15- to 16-year-olds who binge drink is higher in France and Italy than in the U.S. Bingeing is even more prevalent in Denmark, Ireland, the U.K. and other northern European countries where drinking is usually done in bars rather than at home with meals.
U.S. government agencies and scores of alcohol-awareness groups say that no amount of underage drinking is permissible, and that no matter where it comes from, teens who drink alcohol are at extra risk of being involved in motor-vehicle crashes, homicides, suicides and accidents of all kinds, as well as unplanned sex, unplanned pregnancies and sexually transmitted diseases.
"Underage drinking is not safe, and it's not the case that somehow the risk is removed because the parents provided it," says Michael Hilton, acting deputy director for epidemiology and prevention research at the National Institute of Alcohol Abuse and Alcoholism.
Research also suggests that alcohol can do long-term harm to developing brains. In the late teens and early 20s, the brain is developing its adult shape, pruning away unused connections and forming permanent pathways, particularly in areas involved in planning, decision-making and impulse control.
Brain scans have shown that heavy drinking—20 drinks or more a month—in adolescents can create changes in the frontal cortex, the hippocampus and white matter, leading to decreased cognitive function, executive function, memory, attention and spatial skills, researchers at the University of California-San Diego wrote in the Journal of Clinical EEG and Neuroscience in 2009.
The researchers did not see such dramatic changes in adolescents who drank more moderately. But the report didn't determine a "safe" level of alcohol. Indeed, experts say more research is needed to understand what puts young people at risk for alcohol abuse in later years and what strategies are best to discourage it.
In the meantime, some parents remain stumped about what to say to their children about alcohol. Several studies have found that parents who are authoritative—communicating expectations with a give-and-take style with their children—are more effective at keeping them from alcohol abuse than those who are authoritarian, permissive or disengaged. What's often lost in the discussions is that many teens are not regular drinkers. In a national survey of 500,000 students starting college last summer, 70% of youths aged 12 to 20 haven't had a drink in the last month.
For his part, Dr. Delany says he's been very clear with his 14-year old son. "I think that using alcohol and drugs is not healthy. It's not just a matter of cognitive decision-making. His body is maturing."
He also suggests discussing upcoming situations with teenagers. "You can say, 'There may be a lot of people drinking. Have you thought about how you're going to handle that?' Then really listen to their answers."
Email HealthJournal@wsj.com, or write to Melinda Beck at HealthJournal@wsj.com