Checkup on Health: Underage drinking's real dangers

Besides deaths, statistics show smaller brains, STDs, alcoholism

happy teens
To address increasing numbers of emergency department visits related to underage drinking, the Trauma Prevention and Outreach program at UC Davis co-founded the public-private Sacramento Regional Youth and Alcohol Coalition. 

By Dana Covington, RN, MSN

People may be aware that drinking can kill, but probably believe that it won’t happen to them — and certainly, not to their child. After all, plenty of people drink a lot and don’t die from it. But many people don’t consider the specific negative consequences of underage drinking.

About the author

Dana Covington is a 20-year UC Davis Medical Center emergency room nurse and a project manager for the UC Davis Trauma Prevention and Outreach program.

Teen alcohol use can have both acute and chronic ramifications. Problems can include acute poisoning and injuries — or death — caused by impairment, and also chronic brain, heart and liver diseases.

Alcohol is a drug like any other, and our body immediately goes to work trying to detoxify it. But when the liver can’t keep up, toxins start to build up, and we feel alcohol’s effects. At first, giddiness and disinhibition result, which are what many consider to be the pleasant, relaxing side effects of the drug. But underage drinkers are not looking for this effect. They are generally binge drinkers.

I'm reminded of a girl who almost died from alcohol poisoning. She was around 15 at the time and had skipped school with some of her friends. They went down to a local river to fish and drink some coconut-flavored rum. She said she finished a whole bottle in less than 30 minutes — and blacked out.

Frequency skyrocketing

The girl confirmed that for many teens, it's all about how much they can drink rather than about getting a buzz. While alcohol use is long-standing in our culture, underage binge drinking has skyrocketed over the last several years.

Parts of teen drinkers' brains can be up to 10 percent smaller than those of non-drinkers.

In the last four years, trauma centers in the Sacramento area have experienced an increase in emergency department visits related to underage drinking. UC Davis' Pediatric Trauma Center has seen a gradual but steady increase in the number of intoxicated 12- to 17-year-olds, from 69 in 2004 to 110 by 2007.

That's a nearly 60 percent increase.

UC Davis has also seen an increase in patients' average blood-alcohol concentration. In 2004 the average blood-alcohol level among 12- to 17-year-olds was 0.139 percent. It had increased to 0.164 percent by 2007. But some patients have had much higher levels — above .4 percent (the legal blood-alcohol limit for adults in California is 0.08 percent).

Unique consequences

There are real negative consequences from teen drinking:

  • The depressant effects of alcohol can cause slow breathing and heart irregularities, leading to coma and death.

  • In one common scenario during acute alcohol poisoning, the drunk person vomits in an instinctive attempt to rid the body of poison — but reflexes are too depressed to gag effectively and keep the airway clear. The person can choke to death on their vomit.

  • The chronic effects of alcohol use include permanent damage to the brain, heart and liver, causing conditions that can eventually be fatal. The brains of teens continue to grow and fine-tune themselves up to about 20 years of age. Drinking alcohol during these years can cause permanent brain damage. Parts of the brain of a teen drinker can be up to 10 percent smaller than those of non-drinkers, according to the American Medical Association..

  • Teens who start drinking before age 15 are four times more likely to become alcoholic than those that wait until they are 21..

  • The effects of alcohol on the brain depress inhibitions and reaction times. Teens that are already prone to risk-taking behaviors increase them even more with alcohol on board. Injuries from bad decision making increase with alcohol ingestion, such as injuries that result from getting into a car with a drinking driver, falling from balconies, roofs, and fences, and ngaging in unwanted or high-risk sex. For example, women who engage in binge drinking are five times more likely to contract the sexually transmitted disease gonorrhea than non-drinking women.

'Supervised drinking' popular, problematic

Currently there is a controversial trend of parents hosting parties with alcohol for their teens, thinking that they would rather their kids drink under their supervision than elsewhere. One can only assume that parents are unaware of the dangers of underage drinking. What parent would choose for their child to have a brain that is 10 percent smaller that their potential? What parent wants to increase, by five times, the chance of their daughter contracting gonorrhea? Also, a teen that drinks at a party and then sleeps it off for a few hours may still be drunk when they wake and drive home. 

In response to a dramatic increase in the number of underage patients who are under the influence, emergency departments in the Sacramento region, led by UC Davis Medical Center, will establish the first program in California to offer counseling aimed at curbing alcohol abuse to children, teens and their families while they're in the ER. Click here to read more.

It also, of course, gives their kids the wrong message about the appropriateness of getting drunk. Teenage drinking is not a right of passage. I can’t imagine a parent making these parental decisions for others by hosting a party that serves alcohol to underage drinkers. Many cities and counties in California have developed Social Host Ordinances that make providing a venue for underage drinking a civil or criminal offence.

Alcohol issues are complex, and extend beyond the family into the local communities. To address these challenges, the Trauma Prevention and Outreach program at UC Davis co-founded the broad based, public-private Sacramento Regional Youth and Alcohol Coalition. Through this collaboration we hope to raise awareness of the magnitude of the problem, and bring people to the table who have the power to address it with evidence-based solutions.