Like all parents, I have a long list of prayers for my daughter's safety. One of the biggies is that she'll make it through high school without killing herself or someone else because she's driving drunk. Science now says I should worry not just about car wrecks but whether drinking at a time when her brain is forming its adult connections will make her sick, sad, and lonely for the rest of her life.
Drinking is part of teenage life—a part that can range from having one beer at a party every now and then to becoming wasted enough to pass out every Saturday night. Decades of prevention efforts and parental harangues haven't changed that picture much, despite increased recognition that teen drinking is a major cause of traffic deaths.
But in the past few years, scientists have started to really understand how teenagers' brains change as they turn into adults. The brain-development people are now working with the alcohol-abuse folks to figure out what role alcohol plays in this critical phase. "We needed to do something different, to get more traction to deal with the problem," says Vivian Faden, a deputy director at the National Institute on Alcohol Abuse and Alcoholism. It's no small question. About 11 million teenagers drink alcohol, and the majority of those, more than 7 million, are considered binge drinkers. And they're starting young, according to the federal Monitoring the Future study:
• Nearly half of 14-year-olds say they've had a whole drink, not just a sip or a taste.
• Twenty percent of eighth graders and 42 percent of 10th graders say they've been drunk.
• Eleven percent of eighth graders and 21 percent of 10th graders say they've had more than five drinks in one session within the past two weeks.
Faden has helped lead a four-year effort to merge what we know about children's development and about drinking; the results were published in this month's Pediatrics. The authors' conclusion, greatly simplified: Teenagers drink because their brains are changing, a process that makes them more likely to take risks, at the same time that the faculties for weighing those risks aren't fully developed. And drinking changes their brains. Those changes can persist into adulthood, affecting health, career, and family relationships.
"We have a much greater knowledge than we ever did before on what some of the negative consequences of drinking are at this age level," says Michael Windle, Rollins professor and chair of behavioral sciences at Emory University in Atlanta. Twenty-two years ago, he started studying a group of 15-year-olds, charting the effects of their drinking and other behaviors as teens on their lives as adults. Those people are now in their mid-30s. The findings so far:
• Teenagers who drink heavily are 4.5 times as likely as other teenagers to have serious problems with alcohol when they become adults.
• Those who drank as teenagers were much less likely to finish college, earn less money as adults, and are less satisfied with their jobs.
• Adults who drank as teenagers are more likely to have mental-health disorders, such as depression.
• Heavy teen drinkers have more problems forming and maintaining close relationships as adults.
What these data don't tell us is whether those kids were already predisposed to have problems or whether drinking helped cause the trouble. Why is it that some teens can binge drink and end up OK, while others become seriously messed up? Why can some teenagers experiment with alcohol without becoming dependent as adults? It's becoming increasingly clear that boys and girls deal with alcohol quite differently and that there are differences among racial and ethnic groups, too. In the long term, this could mean that alcohol prevention and treatment will be customized to a person's specific genetic and cultural makeup. Short term, the scientists hope to come up with better screening and prevention tools. Clearly, the ones we have now aren't working so great.
"For a while, there was denial that there really were these high rates of problems," says Windle. Now, he says, parents recognize that drinking and driving poses a risk. But he doesn't know if parents are willing to accept that adding alcohol to a growing brain causes other serious risks that are not so immediate but could cripple their children for life. "We really haven't attended to this."
• A parent guide on how to talk to kids about alcohol, published by the National Institute on Alcohol Abuse and Alcoholism
• A guide on underage drinking, from the surgeon general's office