Saturday, 5 April 2014

A 16 year old and a bottle of bourbon

This week I met Neil, a 16 year old young man who had become concerned about his drinking behaviour after listening to my presentation. When he approached me I could tell that he was quite uncomfortable and through the whole conversation that we had he was constantly biting his nails, running his fingers through his hair nervously and obviously very anxious. What had disturbed him were my comments about spirits and the sheer amount of alcohol a young person was consuming when they shared a bottle of vodka between three or four of them (i.e., 21-22 standard drinks - the equivalent of 21 glasses of beer), and the impact that this could have on the developing liver.
I'm simplifying the conversation, but essentially this is what Neil said to me:
"Do you build a tolerance to alcohol and if you do, what does that actually mean to your health? If you are able to drink a whole lot more than you used to and not get any of the 'drunk' effects, does that mean your liver and the rest of your body are also not getting negative effects? When I drink I usually drink at least a bottle of bourbon to myself and I have no outward negative effects and I have to drink that much to get any effect at all. I was drinking less than that a couple of years ago but now that is the norm. I've never thought it was a problem because I don't get sick and usually I'm the one in my group of friends who is 'sober' enough to look after anyone should they get into trouble. Now I'm beginning to worry that maybe I am doing some damage!"

Let me start by saying that there are so many things wrong with this conversation it is unbelievable! When I asked him how often he was drinking a full bottle of spirits to himself he replied that it was usually fortnightly! Neil had been doing this for the past 12 months at least and had actually started drinking alcohol regularly at around 13 years of age. He was such a nice guy and to see that something in my presentation had triggered something and was causing him such obvious distress was heart-wrenching. He asked me whether I thought he had an 'alcohol problem' and I had to be honest and tell him that I believed he had to take a serious look at his patterns of drinking and make changes quickly. The only good news was that Neil was not drinking during the week, although he had recently started to drink a couple of times over the weekend, rather than just on a Saturday night as he had done in the past.

Is this 'normal' teenage behaviour? Absolutely not! If we look at the data that we have on school-based 'current drinkers' (those that drank in the previous week), the numbers have fallen quite sharply since 1984. However, there are a core group of these who drink more than four drinks when they drink and the number of young people in this group has remained fairly consistent over time. This group is our greatest worry and when I meet a young man like Neil I realize that it is this group that we are failing badly when it comes to providing them appropriate education.

Admittedly some of the young people who have similar drinking patterns to that of Neil have a range of social problems and one of the major reasons they are drinking that much is to 'block out' bad feelings, i.e., they're using to cope. Simply providing them information about the risks associated with heavy drinking is most probably not going to make a great deal of difference. In those cases, often the best we can do is to provide them with ways to look after themselves and their friends should something go wrong. However, there are also many young people who simply have no idea what damage they're causing to themselves and have an extremely skewed view of what is 'normal'.

I truly believe we need to do a dramatic overhaul of what we're doing in alcohol education in schools. Firstly, we need to start earlier, providing lessons in primary schools that challenge the positive messages around alcohol that young people are bombarded with through advertising, product placement and sport sponsorship. In secondary schools we need to look carefully at how many lessons are dedicated to alcohol education (usually very few and to be honest, becoming fewer in recent years as schools get asked to deal with more and more social issues) and then start to use what we do have in a more careful, strategic way. The promotion of positive norms is vital (i.e., letting young people know that it is not the norm to start drinking at Year 8, 9 or 10), we also need to continue to challenge the alcohol messages they receive and encourage critical thinking in this area and most importantly, provide information to them that is useful, credible and age appropriate. I've got to say, some of the material that we provide is just plain useless and of no real relevance to many students.

Spirit education is a must. When I give any information on vodka (as that is the drink of choice for many) you literally can see jaws dropping around the room - many young people simply have no idea what they are doing to themselves when they consume large amounts of these products! Shouldn't we be telling them about the potential dangers before they start drinking them?

Do I believe that this will solve all our problems and simply giving them information will result in them choosing not to drink? Of course not, but young people certainly deserve to have all the information we can give them so that they can at least make an informed choice. Drinking a bottle of bourbon is potentially life threatening, whether you're a teenager or an adult. If it doesn't kill you as a result of alcohol poisoning, the possibility of major damage to the liver and the rest of your body over time is very real! 

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