Sensible teenage drinking Dr Stephen Newell

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Sensible teenage drinkingDr Stephen Newell
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Social importance
Humans like bitter flavours Fermentation was
known in antiquity Wine has been made from grapes
for six millennia Beer has been made since the
8th century BC In history, cleaner to drink than
water Used in celebrations and social
functions Part of everyday life for many people
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Importance in agriculture, e.g.
In 2002 France produced 7.6 million metric tonnes
of grapes Barley / hops important
crops Viticulture and brewing are huge industries
with fascinating histories and academic interest
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Economic importance, e.g.
In the UK, tax on alcoholic drinks raises 7
billion per annum Tourism to wine-producing
areas There are about pubs in UK
60 000
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But there are also negative elements to alcohol
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Alcohol use

• Substance use and associated disorders are common
• Alcohol is one of the most commonly misused
  substances
• The majority of people in Western societies are
  current or past users of at least one
  psychoactive drug

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Percentage of U.S. Population (aged 12 and over)
who have ever used drugs of abuse
National Household Survey on Drug Abuse, 1998

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Influences on alcohol substance use

• Biological
• Psychological
• Developmental
• Family social influences

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Biological influences on substance use

• Alcohol and drug use have genetic influences
• Novelty seeking temperament
• There are genetic predictors of response,
  metabolism, risk of later dependence
• Familial factors relating to medical consequences
  of alcohol use
  
• 
  
  

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Family social factors

• Families develop patterns of alcohol use which
  are modelled and passed on to future generations
• Should parents allow teenagers to have some
  alcohol at home to learn about its effects?
• Cultural religious influences
• Peer group influences

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Alcohol units

• 1 unit 1 small glass of wine
• ½ pint of beer 1 measure of spirits
• Weekly allowance
• 21-28 for men, 14-21 for women
• These are guides may be too much for some small
  females

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Teenage drinking

• 1998 in UK the ONS general household survey
  showed 50 of men age 16-24 had drunk more than 4
  units per day in the week before the survey
• Corresponding figure for women was 40

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Health benefits of moderate alcohol use

• 1-2 units of alcohol per day has a protective
  effect on the heart less heart attacks
• Reduced incidence of gallstones
• Reduced incidence of macular degeneration (eye
  disease)

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What is being modelled at home?

• Appropriate and sensible use of alcohol?
• or
• Inappropriate and unsafe use?

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Possible consequences of inappropriate alcohol
usage on the family

• Domestic violence
• Child abuse
• Impaired family relationships
• Financial consequences
• Male 35, 3 children, 5 bottles of Malibu p.w.
  _at_ 11, 40 cigs/day _at_ 9, so spending 118 p.w.
  or 6136 p.a. On long term sick certification.

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Domestic violence

• Approximately 80 of spouse to spouse violence is
  alcohol related
• Physical abuse of children involves 20-30 of
  parents who are heavy drinkers
• The child abusing parent is often under the
  influence of alcohol when the incident occurs

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Effects on the family

• Inappropriate alcohol use can have a highly
  disruptive effect on family rituals -
• Uncle Fred ruins every Christmas dinner by
  becoming drunk

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Effects on children of alcohol abuse in the family

• Conduct and academic problems
• Emotional difficulties
• The effects of whatever has promoted
• the alcohol abuse e.g. family difficulties

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Medical consequences of alcohol
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Epidemiology

• Alcohol misuse costs the NHS
• up to 3 billion per year on
• hospital services
• Alcohol abuse causes 22 000
• deaths per year
• 150 000 hospital admissions p.a.
• for alcohol-related accidents
• illnesses
• Alcoholics who continue drinking
• shorten their lifespan by 15 years

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Effects of alcohol

• Acute effects
• Chronic heavy use
• Withdrawal

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Acute Effects 1

• Brain nervous system
• disinhibition
• sedation
• accidents
• hangover
• Gastrointestinal
• nausea / vomiting
• gastritis
• bleeding
• hepatitis

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Acute Effects 2

• Respiratory
• suppression
• choking on vomit
• overdose

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Acute Effects 3

• Reproductive system
• disinhibition
• erectile dysfunction
• unplanned pregnancy
• Legal
• drunk disorderly
• vagrancy
• vandalism
• fights / assault
• drink driving 1 in 20 RTAs
• involve driving over
• the legal limit

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Effects of Chronic Heavy Drinking

• Brain and nervous system
• Neuropathies
• Cerebellar degeneration
• Wernicke-Korsakoffs syndrome
• Dementia

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Effects of chronic heavy drinking

• Gastrointestinal
• Gastritis / ulcers
• Liver damage / cirrhosis
• Pancreas
• Cardiovascular (heart blood vessels)
• Hypertension (high blood pressure)
• Cardiomyopathy
• Stroke

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Effects of chronic heavy drinking

• Reproductive
• fertility problems
• erectile dysfunction
• foetal alcohol syndrome

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Foetal alcohol syndrome

• Growth retardation
• Facial dysmorphism
• Learning difficulties and other neurological
  problems

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Effects of chronic heavy drinking

• Hematological (blood)
• Musculoskeletal (muscles and bones)
• Endocrine (glands)
• Dermatological (skin)

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Withdrawal effects

• Withdrawal effects are generally the opposite of
  intoxication
• Alcohol detoxification (treatment)

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Alcohol-Drug interactions

• Illicit drugs (e.g. cocaine, heroin)
• Prescription drugs(e.g. benzodiazepines,
  metronidazole)
• Over-the-counter drugs

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Summary

• Alcohol can be medically hazardous acutely, with
  chronic high levels of use, and in withdrawal
• Every major organ system can be affected
• There is the possibility of damage and a risk of
  death associated with alcohol use

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So what advice to teenagers?

• Parents need to set a good example
• Stress the importance of not drinking and driving
• Explain that alcohol can have a stronger effect
  on young people - who have immature livers, etc
• Explain that too much alcohol can cause more than
  just a bad headache the next day e.g. where you
  wake up, unprotected sex
• Help them understand the meaning of drinking
  sensible amounts of alcohol e.g. by using units
• When they are out with friends encourage them to
  look after each other

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Advice and downloadable informationwww.portman-g
roup.org.ukwhose tag line is Promoting
responsible drinking
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A few words about drugs..
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Marijuana

• Motor vehicle accidents
• Motivation / concentration
• difficulties
• Smoking damage
• Immune impairment

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Stimulants (Cocaine, Amphetamine, Ecstacy)

• Cardiovascular
• Neurological
• Injection risks

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Opioids

• Overdose
• Injection risks
• Gastrointestinal
• Musculoskeletal

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Other Drugs

• Phencyclidine
• (PCP)
• Inhalants

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Summary

• Drugs of abuse are physically hazardous
• There are many possible medical consequences of
  use
• Specific drugs affect major organ systems
  differently
• There is the risk of damage and mortality
  associated with these drugs