Adolescence, a period of transition that is a risk factor for excessive drinking

Adolescence is the period of transition from childhood through puberty to adulthood. It is generally acknowledged to be a very awkward time.

Adolescence is often defined by physical and biological changes, but there is more to it than that. Significant social changes also occur as people pass from childhood, i.e. requiring supervision, to adulthood, i.e. responsible for their own behaviour.

Increasingly, researchers are coming to agree that individual characteristics and social demands, as opposed to simply age, are what define adolescence. Given that periods of transition and upheaval are strongly associated with excessive drinking, adolescence itself is a risk factor for excessive drinking.

It therefore comes as no surprise that this is the time when most young people have their first experience with alcohol.

How the adolescent brain develops

The brain exemplifies the changes and transitions of adolescence. Contrary to what neurologists and psychiatrists believed for so long, the brain of an adolescent is not yet fully developed. In fact, just like the body, it goes through a major transformation during this particular period.

During the pre-teen and teenage years, the brain is “reconfigured” and the areas responsible for emotions undergo particular modification. The emotional intensity of adolescence, which some adults recall with nostalgia, is one phenomenon that can be explained by neurochemical developments in the brain. Last to mature is the frontal lobe*, which is involved in planning, strategizing, organization, concentration and attention.

*The frontal lobe and the prefontal cortex.

The brain’s slower pace of development may cause excessive drinking

The adolescent brain may be slow to develop, but children are reaching puberty earlier and earlier. This remarkable contradiction is identified as a risk factor in alcohol abuse among young people.

This puts adolescents doubly at risk for alcohol abuse: their capacity to think properly and make good judgements is still developing, and they are thrill seekers. That makes them awkward.

Why adolescents drink

Adults and adolescents have different reasons—individual, social and environmental—for drinking too much.

Drinking to deal with a problem is a marginal but disturbing phenomenon

A minority of adolescents drink out of boredom, to forget their daily concerns or because of family, school or relationship problems.

When they drink for such reasons, it’s cause for concern. If friends notice such risky behaviour, it is important to take action.

Like adults, most adolescents drink socially

The vast majority of adolescents drink for social reasons. The principal factors motivating young people to drink are socializing with friends, having fun and giving in to peer pressure.

What’s different about them, however, is that they tend to do their socializing in settings known to promote excessive drinking.

Among younger pre-teens (12 and under), the motivators are different. The girls tend to start drinking because they feel sad or lonely and turn to alcohol because they want to feel better and forget their problems. Boys drink more out of a desire to belong to a group and in response to behavioural problems. Curiosity is another reason why pre-teens try alcohol.

Problems associated with excessive drinking

There are few studies on adolescents’ biological sensitivity to alcohol, given the ethical issues related to administering alcohol to underage subjects for research purposes. Nonetheless, a number of animal studies reveal that the adolescent brain— particularly the hippocampus, which is the area of the brain responsible for memory—is more sensitive to the effects of alcohol than the adult brain.

The tremendous plasticity of the adolescent brain, and the fact that it undergoes so many changes during puberty increasesthe risk that young people will damage their brains more than adults who drink the same amount of alcohol.

It has also been found that early excessive drinking causes people to make more risky decisions and that this does not diminish over time.

Adolescent hormones are in a delicate balance

Adolescence is associated with pronounced hormonal changes and an increase in the production of sex hormones. This, in turn, stimulates the production of growth hormones, which are essential to human development. These changes are complex and relatively synchronized, which makes drinking during this time particularly likely to disturb the hormonal balance necessary for the development of organs, muscles, bones and the reproductive system.

It is ironic that the adolescent brain, which is more vulnerable to the neurotoxic effects of alcohol than the adult brain, is actually less sensitive to the sedative and motor effects of alcohol. Consequently, adolescents—whose brains are more likely to suffer short and long-term damage from excessive drinking—are more likely than adults to drink greater quantities, since it takes longer for them to feel the immediate effects.

Excessive drinking can cause physical dysfunction

Clearly, prolonged excessive drinking causes a number of health problems. And while alcohol may cause fewer problems among young people than among adults, the truth is that when adolescents gets drunk, even just once, they are at risk for serious physical dysfunction, which they ignore all too often.

Excessive drinking can obviously lead to nausea, vomiting and fainting, but it can also cause gastrointestinal bleeding, cardiac arrhythmia, a cerebrovascular accident (CVA, or stroke) and respiratory depression that can lead to coma and death.

Incidents and accidents

Young people report all kinds of social problems associated with their drinking, since they get drunk frequently and take a lot of risks.

Risky sexual behaviour

One work group has reviewed a number of studies on the effects of alcohol on teenage sexual relations. Briefly, drinking is associated with lack of condom use in first and subsequent sexual encounters, the risk of sexual activity at a younger age, unprotected sex and unplanned pregnancy, and increased risk of sexually transmitted disease (STD).

While this is not necessarily a causal relationship, the authors note that the association is strong enough to allow the conclusion that alcohol probably contributes to poor judgement with regard to sexual behaviour.

Link between alcohol and violence

Young drinkers are more involved in violent altercations, as both assailants and victims. As with adults, alcohol makes some young people more inclined to be aggressive.

However, this connection is probably not due solely to alcohol’s pharmacological properties, but rather to the interaction of biological, psychosocial, situational and cultural factors. Several studies show that the link between alcohol and violence varies greatly, depending on the drinking circumstances and social values regarding the use of violence.

Young people who drink must remain vigilant because alcohol probably facilitates the expression of violence among those who are predisposed to it.