After speaking to tens of thousands of students over the last decade or so, it still never ceases to amaze me how much the young people of today want to look after each other. When I think back to my peer group in adolescence I am sure we were very similar—during the teenage years, your friends can become your second family, supporting you through this very difficult and emotional time. That said, I am increasingly impressed by the care, compassion and empathy that most of today’s kids exhibit.
I have already said that the vast majority of questions I get asked by school students focus on issues around personal safety and how to look after their friends. This chapter examines some of those questions.
I urge parents to read this section carefully and ask yourself how these questions relate to the information you have been giving your child. I assure you, you would be a very unusual parent if they even come close to matching up. In all my years of giving presentations I have yet to meet a parent who has provided information to their child on the topic I get asked about more frequently in schools than any other: ‘How do I look after a drunk friend?’
There are parents who will look at some of these questions and be concerned that by addressing them with their child they might be seen to be condoning their use of alcohol or tacitly encouraging risky behaviour.
Of course you don’t want to normalise risky behaviour, so how you present this sort of information is of paramount importance. To sit down with your child and give them instructions on how to look after a drunk friend does not provide a context, and could be dangerous. If, however, a conversation starts about alcohol and there is a discussion about responsible drinking, it would be entirely appropriate to provide information to your child about what to do should something go wrong.
Time and time again I have met young people who have lost friends simply because they did not know how to respond appropriately. Parents and teachers often say that ‘young people know more than we do’—absolute garbage! Sometimes kids think they know more than us, but usually all they really want is information that is going to be useful to them: some helpful tips that they regard as credible and that have some meaning in their lives. So much of what they are taught in schools has very little relevance to their day-to-day lives and, when it comes to alcohol and other drug information, spewing out the short- and long-term effects of using various drugs is neither interesting nor relevant to most young people.
I guarantee that if you use some of the questions in this chapter as conversation starters, and you are honest and open with your child during the ensuing discussion, at the very least, your credibility rating will go through the roof!
This is the information your child wants to know. It doesn’t matter whether they drink or don’t drink, whether they use drugs or don’t use drugs, if it is delivered in the right way, in the appropriate context, you will see your child take this information, absorb it, share it with others and use it in the future.
• How do you look after someone who has drunk too much?
Not too long ago I was asked to give a series of presentations to a private girls’ school. I was to talk to the year tens, elevens and twelves over the period of a day. I began with the youngest group and, after my talk, invited questions. By the time four or five questions had been asked I could see a pattern—they were all about how to look after someone who was drunk. I stopped the questions and asked the girls to indicate how many of them had recently had to look after a drunk friend. Within this group of fifteen-year-old girls, over 50 per cent put up their hands.
When the next two groups came through later in the day, I began my presentation by asking them the same question. Over 70 per cent of the year elevens and almost the entire year twelve group had at one time or another needed to look after an intoxicated friend.
When asked what they had actually done in these situations, there were a wide range of responses. When asked why they had responded in a particular way—had they been given some instruction or advice by someone, for example?—almost all of them said that they had been given no information, suggesting instead that their ‘maternal instincts had kicked in’.
My first dealing with Matt was when I received a phone call from him asking me to present to a group of his friends on the topic of ‘looking after your mates’.
Matt was fifteen at the time and had recently been witness to a life-threatening incident involving one of his friends and alcohol. A group of them had gone to a party and, although some of them had previously experimented with alcohol, they were all fairly naïve. One of Matt’s friends drank far too much and started to become very sick. He was vomiting and they were having a lot of trouble keeping him awake. None of the boys wanted to call for help for fear of getting into trouble with the police or, even worse, their parents. For almost two hours, Matt and two others nursed their drunken friend, praying that he would come around and be okay.
Luck was on Matt’s side that night and his friend survived, apparently no worse for wear. However, the evening had a tremendous impact on Matt. He could not believe that he had been put into that position without any information. He spoke to teachers at his school and asked why they hadn’t been given any lessons on how to look after someone who was drunk.
Unfortunately, Matt was met with brick walls at his school. He was given some very flippant answers, basically telling him that they shouldn’t have been drinking anyway and that it was not the school’s job to ‘babysit’ on the weekends.
Far from being discouraged, Matt called a number of people (me included) and set about putting together a ‘survival course’ for his peers. He involved the Ambulance Service, a local GP and a range of other people, asking them to provide information and skills to prepare young people to handle the risks associated with excessive drinking.
Matt is now in his early twenties and has gone from strength to strength. The course he created was adopted by his school and he remains actively involved in providing information to young people on a range of issues.
Matt is just one example of the amazing young people I have come in contact with over the years who are rarely acknowledged in our community. Not all young people have the same drive or passion as Matt, however all young people (I believe without exception) want to know how to look after themselves and their friends.
So how do you look after someone who has drunk too much? On pages 64-68 we discuss overdose situations and how to tell the difference between someone who is drunk and someone who is poisoned, but for now let’s look at someone who is drunk and can be looked after by friends.
There are a number of simple messages that all young people, whether they are drinkers or non-drinkers, should know when it comes to looking after friends who have had too much to drink:
• Stick with them and never leave them alone.
• Monitor them.
• Reassure them.
• Keep them comfortable.
• Keep them hydrated.
• If in doubt, call for help.
The most important message here is to make sure you stick with a drunk friend and never leave them alone. Years ago there was a government campaign called ‘How Will You Feel Tomorrow?’ that showed a young woman alone in a toilet cubicle, vomiting. Being alone in a cubicle vomiting is incredibly dangerous. If the person passes out and they’ve locked the door, how is help going to get in? Never, ever let someone go to the toilet, or anywhere else for that matter, to be sick alone.
Monitor your friend carefully. The line between being drunk and being poisoned can be fine. If they are already unwell and drank more alcohol in the past hour or so, there is every likelihood that they could become worse.
When you are unwell after drinking it can be very frightening. Adding to the discomfort is the fear that their parents may discover what they have been up to or that the police may become involved. Friends being close, reassuring them that everything will be okay, is important.
If they are feeling sick there is every likelihood that they may be feverish. Their temperature may rise and often they will want to take off surplus clothing and footwear. Putting a cold compress (or even a cold water bottle) on the back of the person’s neck can make them feel much more comfortable. Make sure that there is also something warm to wrap around them just in case they start to get cold—particularly true in situations where young people have gathered in parks or country areas to drink.
Hydration is a difficult one. If they are not being sick, make sure that your friend replaces lost fluids. That is, if they have been urinating a lot, they need to drink water. It is also important to make sure that someone is hydrated if they are vomiting, but if you give them water to drink during that time, it is highly likely that they will simply vomit it back up relatively quickly. A piece of advice that I give young people is to soak a T-shirt or cloth in cold water and then have the person vomiting suck on that between bouts. That way they are rehydrating and also making their mouth feel a little more pleasant, but not gulping down water that is likely to make them vomit more.
If in doubt, don’t hesitate to call for medical assistance. It’s hard to be too specific here as it’s not always easy to say what constitutes a ‘medical emergency’. Young people need to know that they won’t get in trouble for calling an ambulance. Even if the ambulance arrives and the situation has resolved itself, it’s better to be safe than sorry. They also need to know that as a general rule, the police will not attend a medical emergency involving alcohol or other drugs unless another crime, such as violence, has taken place.
Dialling 000 can be a daunting experience when you first do it. I still remember my first time—I got the number wrong and called 911 (which will not get you connected to emergency services in Australia although some mobile phones sold in Australia will redirect such calls to 000)!
Running through making a 000 call with your teenager can be useful, just in case.
Justine lived in a country area and was out with her best friend Katy. Both were fifteen years old. They were at a party with a group of older boys and felt completely out of their depth. Most of the people were older and for the first time the girls were drinking straight spirits, not pre-mixed drinks.
Katy became unwell quite early and it was obvious that the boys they had arrived with were now completely uninterested in them both. When Katy lost consciousness and began to vomit without waking up, Justine knew it was a medical emergency and tried to get help.
The older girls at the party told Justine that Katy would be okay and to let her ‘sleep it off’. Knowing the danger, Justine called 000. The operator asked, ‘Which service do you require?’, the standard first question for the 000 line. Justine, who was already scared and confused, had no idea what the operator meant and when the follow-up question asked whether she wanted ‘police, fire or ambulance’, she completely freaked out and hung up.
Fortunately, Justine finally worked up the courage to redial 000 and request an ambulance.
It’s all well and good to tell our children to call 000, but they also need to know what happens next. (And they need to know that you support them in their decision to make this type of call.)
When you call 000 the operator will ask whether you need the police, fire or ambulance service. Depending on whether you use a mobile, fixed line, voice-over-internet-protocol (VoIP) service or a payphone, you may also be asked to provide details of the state and town you are calling from. The operator will then connect you to the emergency service organisation you have requested.
If you are calling from a landline, your location details will automatically appear on the operator’s screen and will be passed on to the emergency service you request. However, you may still be asked by the operator (or the emergency service) to confirm your location.
However, we know that most young people will be using a mobile phone. Unfortunately, in these cases the operator will not be able to pinpoint the location. Mobile phone users should provide the operator with as much information as they can about the location of the emergency, including the state or territory and the town or suburb. This simple step will ensure that the emergency call is connected to the appropriate state or territory emergency service organisation.
It will be useful for you to discuss with your child the sort of questions the ambulance operator may ask them. These will most probably include the following:
• What is the exact address of the emergency? (The operator will ask for the suburb name and nearest cross street.)
• What is the phone number you are calling from? (This information is important in case the operations centre needs to call back to obtain further information.)
• What is the problem? Tell me exactly what happened.
• How old is the patient?
• Is s/he conscious?
• Is s/he breathing?
Once these questions have been answered an ambulance is sent.
The person calling needs to remain calm, and not hang up until the operator has obtained all of the required information. There may be some additional questions asked or instructions given, depending on the situation.
One important message that we do not emphasise enough to our children is that they need to know the address of where they are partying. If something goes wrong, the 000 operator will need a location—if you don’t know the street address this will prove difficult. This is a particular problem in country areas, where young people often hold parties in hard-to-reach places and at almost non-existent addresses. One really useful tip is to get your child into the habit of taking the address of the party they are attending on a slip of paper just in case. Start this early and you’re unlikely to meet as much resistance.
It is also important to let your teenagers know that 112 is the international standard emergency number which can only be dialled on mobile phones. You can dial 112 anywhere in the world with mobile coverage and it will automatically default to that country’s emergency number.
For those people who are deaf, or who have a hearing or speech impairment, there is also a text-based Emergency Call Service number—106. This service operates using a teletypewriter (TTY) but does not accept voice calls or SMS messages.
Many parents can remember a time in their past when they had a little bit too much to drink and found themselves doubled up and vomiting. It’s not a particularly pleasant experience and most people only ever do it once—they never want to go back there.
Although many young people talk about wanting to get ‘drunk’ or ‘wasted’ when they go out with their friends, I have yet to speak to one who intentionally set out to make themselves sick.
Vomiting is an experience that almost all people, young and old, abhor. Yet every weekend, thousands of Australians drink to the point of throwing up. For some young people vomiting is perceived as just an unavoidable part of the ‘alcohol experience’—a negative part, but a part nevertheless. Unfortunately, many are unaware that vomiting can be life-threatening.
Felicity was fifteen years old, and she and her best friend Thalia had gone out one Saturday night as they had many times before. As always, alcohol played a big part in the evening and both girls became quite drunk. Thalia began to feel extremely sick and told her friend that she was going to go outside to vomit. Felicity, being a good friend, went with her to the front garden of the party and sat with her. Holding her hair behind her head, patting her on her back and regularly providing her with sips of water, Felicity did what any friend would do.
This went on for some time. In fact it went on for so long that Thalia became quite embarrassed and urged her friend to go back inside and join the party. At first Felicity refused, but finally Thalia convinced her. She was feeling better, she told her friend, she just needed a bit of air and then she would follow her in. Felicity was still unsure but she did want to go back to the party, so she went inside. What could go wrong? Her friend was sitting on the front lawn of a house in the suburbs, it was well lit and there were lots of people around.
Unfortunately, Thalia was still severely affected by alcohol and, not long after she was left alone, she passed out on the lawn. She landed awkwardly, her chin hitting her chest, and then vomited. Within seconds the vomit had blocked her airway and she had choked to death.
Alcohol is a powerful depressant and can cause death directly by ‘turning off’ the brain areas that control consciousness, respiration and heart rate, resulting in unconsciousness, coma and then death.
In many cases, drinking too much alcohol will make you sick and you will stop drinking. There are many old wives’ tales about why someone vomits after drinking, but the real reason is quite simple—you’ve been poisoned. Your brain actually has specialised poison-control cells that detect when you have had too much alcohol and send a signal to your stomach to vomit. Vomiting is an attempt to get rid of any unabsorbed alcohol. If you can prevent any alcohol that’s still in the stomach from being absorbed into the bloodstream, it may prevent further poisoning and, in the process, save your life.
Many young people try to encourage their friends to vomit in an attempt to sober them up. They may do this in a number of ways, including urging the person to stick their fingers down their throat, making them eat and making them drink copious amounts of water. Of course, vomiting is going to have no effect on the sobriety of the young person—all it will do is empty the contents of their stomach, possibly making them feel less nauseous. However, it may be useful in preventing further alcohol from being absorbed and therefore reducing the risk of further poisoning. If someone feels as though they want to vomit they should never be discouraged from doing so.
Force-feeding someone or making them drink huge quantities of water is potentially dangerous, yet these are ways of ‘looking after’ friends that many kids try. Young people need to be aware that vomiting can be life-threatening. If someone is vomiting, or looks as though they may start, stick with them—never leave them, not even for a few seconds. It can take just seconds for someone to choke on their own vomit. Most of the time, you can look after someone who is vomiting just by being there and monitoring the person. However, there are times when you will need to call for help. Some of the warning signs to look out for include:
• vomiting for longer than 24 hours
• blood or bile in the vomit
• severe abdominal pain
• headache and stiff neck
• signs of dehydration, such as dark yellow urine or crying without tears.
Many young people have seen blood in a friend’s vomit and become concerned. This is usually caused by prolonged and vigorous retching which leads to a tear in the small blood vessels of the throat or the oesophagus. It can usually be seen as small red streaks. Occasionally, bleeding can be caused when the person vomiting bites their tongue or the inside of their mouth. Although these are minor injuries and unlikely to cause significant problems, it is difficult to know for sure that these are the causes for the blood without a medical evaluation. It is always better to err on the side of caution and seek medical assistance immediately if you see blood in the vomit.
• How can you help someone sober up?
The mythology that exists around this question is quite astounding. This book is full of stories about young people finding themselves or their friends in trouble after trying to accelerate the sobering-up process, but the fact is, the only thing that will help sober anyone up is time.
The two most popular sobering-up methods are drinking a strong cup of coffee and putting someone under a cold shower. Neither of these is effective and one of them has proven to be extremely dangerous. If you think about the logistics of taking a drunk person (who is likely to have little coordination and be unable to stand properly) into a bathroom (one of the most dangerous rooms in the house—hard floors, sharp edges and, possibly, a sheet of glass), the hazards become all too clear.
Hillary was a year ten girl. She and her friends were pretty heavy drinkers and were having a big Saturday night at a classmate’s party. They decided to play shot games. After skolling a large number of drinks the world began to spin and Hillary remembers little else about the evening. According to the other partygoers, Hillary started to lose consciousness and, although her two friends were drunk as well, they swung into action, deciding to put her under a cold shower to sober her up a little.
They took the unconscious girl into the bathroom and turned the shower on. The shower was over a bath so they had to lift Hillary into the bath to get her under the water. The girls struggled to hold onto their friend, but Hillary fell backwards, straight through the glass shower screen. The glass shattered and slashed her back and arms.
When Hillary came to the next morning she found herself in hospital. She still has the scars from that night but feels no anger towards her two friends. She admits she would have done the same thing if she had been in their situation. She just wishes someone had told her that it was a potentially dangerous thing to do and that, most importantly, it doesn’t work!
Drinking a strong cup of coffee to battle alcohol’s effects is another popular ‘remedy’. The theory behind it is that strong coffee will contain a high dose of caffeine, the stimulant properties of which will counteract the alcohol’s depressant effect. To a point this may have some limited effect, particularly if you haven’t drunk that much, but most likely all that will happen is that for a short time you will be a more wide awake and alert drunk. You will not sober up!
In recent years a number of new ‘cures’ have emerged. One that is of great concern is the practice of giving someone water to help them sober up. You may think that this sounds fairly sensible, since it is ensuring that the person is well hydrated, and I would agree with you if that is what these young people were doing. Unfortunately it is not. Rather, they are ‘force-feeding’ their drunk friends water, some of them even using a funnel to pour the water down their friends’ throats. The logic they give for this is that drinking water ‘dilutes the alcohol’. Now, I’m not too sure where these guys think the alcohol goes when we drink it, but we’ve got to start telling our children that our bodies are not cordial bottles! It’s not like the alcohol is sitting at the bottom of our stomachs and then we pour water over the top at the end of the night. When someone is drunk, one part of the body has been well and truly affected—the brain. No amount of water you drink at the end of the night is going to sober you up.
I need to reiterate that a small amount of water is not going to be harmful, but the reports from some young people about the amount of water they are giving to their friends are deeply disturbing. The reason we should worry about this is a condition known as water intoxication.
Water intoxication (also known as water poisoning or internal drowning) can be fatal, and is caused by the normal balance of electrolytes in the body being pushed outside safe limits by too much water. Most water intoxication-related deaths have resulted either from water-drinking contests (in which individuals attempt to drink huge amounts in a very short time), after taking ecstasy, or after long bouts of hard exercise. Tragically, it would seem that some young people could be putting their friends at risk of this condition due to the large amounts of water they are using to try to sober them up.
It is imperative that you talk to your child, whether they drink or not, about alcohol and its effects. It is also important that you make them aware that there is no way to help someone sober up apart from time, and that many of the so-called remedies will do more harm than good.
• I think a friend of mine might be using drugs. What should I do?
Sometimes young people approach me because they are concerned about a friend who they believe may be experimenting with illicit drugs. On other occasions I have come in contact with teenagers who are extremely worried about a friend who they think is a regular drug user. These are difficult situations to manage as the young people are often very distressed, having been concerned about their friend for some time and not knowing where to turn for help.
Erin, a year ten student, approached me after a talk I had given at her school. She was obviously upset and found it difficult to share her story. It was obvious that she was also extremely concerned about any teachers overhearing.
She travelled by bus to school and had a travelling companion, a year eleven boy, who she was obviously fond of. A few months before she had observed her friend purchasing something she believed to be cannabis from another boy on the bus. She had not said anything to anyone since that time but had seen another couple of transactions occurring since.
Sobbing, Erin expressed her concerns for her friend. What would happen to him if he got busted? What would his parents say? Would he go to jail? She was also racked with guilt because she had not said anything and the dealing was still occurring on the bus, right in view of some very young students. Could her inaction lead to problems for other students?
This had obviously been playing on her mind for some time and my presentation had brought it all to the surface. Fortunately I was able to convince her to talk to a school counsellor and the school responded to the claims.
Some young people face extremely complex problems with no parental assistance simply because their parents are unaware that there is an issue. Giving your child the opportunity to raise these issues in a non-confrontational and non-judgmental environment is important.
The concerns young people describe usually involve their friend doing one or more of the following:
• giving up activities he or she used to participate in, particularly things they used to do together
• taking risks, including sexual risks
• appearing to be experiencing a range of mental health problems, including depression, paranoia or suicidal thoughts
• constantly talking about drugs and drug use and appearing to become entrenched in the drug culture
• associating with a new group of friends who are known drug users
• getting in trouble with the law and not seeming to care about the consequences.
Coping with these types of situations can be a terrible burden for a young person. The most important thing to do at this point is to support them as much as possible. It can take a great deal of courage for a teenager to even broach this subject with an adult. As I’ve indicated, often they have lived with this problem for some time, and they need to feel that they have done the right thing in coming forward and that the trust they have put in you is not going to be broken. Some of the questions that may be going around their heads could include the following:
• What if I get my friend into trouble?
• What if I lose my friend over this?
• What if I don’t do anything and something awful happens?
Most young people are afraid to discuss serious issues with their friends because they fear being rejected and losing their friendship. It is never going to be easy to tell a friend that you believe they have a problem. It is vital that we let the teenager know that they are doing the right thing coming to you and that friendship is all about doing whatever is best for the other person. If they aren’t going to discuss the problem with their friend, the chances are that no one will. If their friend is getting into trouble with drugs, the next person who speaks to them about the topic could be a police officer or an emergency department worker. Intervening in an appropriate way could prevent problems in the future.
So once you have reassured the young person that they have done the right thing in coming forward, and you have supported them in that decision, what information can you give them?
First, it is important for them to know that they can make a difference. Sometimes, simply expressing their concern about a friend’s drug use can make the friend examine their behaviour more closely and, as a result, make changes. However, whether or not the friend acts on the advice and accepts the offer of friendship is completely the friend’s decision and responsibility. As the old saying goes, you can lead a horse to water but you can’t make it drink—you can only do your best, and that needs to be made very clear to the young person at the outset.
It is important that any intervention is well thought out and planned. Before acting, the teenager needs to gather as much information as they can about the topic and find out where help is available should their friend need it. Making sure you have the phone number of the alcohol and other drug helpline in your state or territory can be extremely useful. A list of these can be found on my website (www.darta.net.au). Visiting the local community health centre and picking up some brochures regarding services in the local area can also be of assistance. This information is not necessarily going to be given to the drug-using friend when they first raise the issue, but it is vital that they have it on hand if ever a crisis situation occurs.
Here are some approaches to assist a young person when they speak to their friend. Talk these through with your teenager if they ask for your help and try to work out what would be best in their particular situation.
• Before any attempt is made to have a discussion with your friend, prepare a list of issues or incidents that have occurred that have led to this point. Make these as specific as possible and make sure you focus on how their drug-using behaviour has affected you, not other people. For example: When you were stoned you became very paranoid and accused me of things that weren’t true. You said them in front of other people. That hurt my feelings.
• Make sure you get the timing right. Having a discussion with a friend about their drug use when they are intoxicated is not going to be particularly productive, so social situations such as parties are not the ideal time for these types of conversations. Choose a time when your friend is most likely to accept the information. For example, the message is much more likely to have an impact after something bad has happened, so keep an eye out for an opportunity to raise the issue.
• Have your conversation somewhere where you can talk without fear of being overheard or interrupted. Public places such as schools and coffee shops can be difficult because the number of people around may make the friend feel self-conscious. A discussion in a bedroom or somewhere else quiet is more likely to be effective.
• No matter how bad the situation is, ensure that you include some type of positive message in the discussion. This will remind your friend that the conversation comes from a place of care and concern rather than criticism and judgment. You are a wonderful person and I care about you very much, but your drug use is changing you and that upsets me.
• Rather than talk about how bad their behaviour is and how it is affecting other people, restrict your comments to what you feel and what you have experienced of your friend’s behaviour. Try hard to avoid generalisations like ‘Everyone is really worried about you’, as this will only lead to your friend becoming defensive and demanding to know who ‘everyone’ is. I’m really worried about you and I don’t want anything bad to happen to you.
• Be sure to distinguish between the person and the behaviour. Emphasise the fact that you still care about your friend but when they have been using a drug their behaviour changes, and that is what is causing the problem—remove the drug and the person will return. You are one of my best friends but when you smoke dope you change and are no fun to be with. When you are stoned you become boring.
• Although it can be extremely difficult, don’t accuse or argue. There is every possibility that your friend may get angry and react in a negative way. They may even lash out and bring up things they don’t like about you. This should be no surprise and you should be prepared for such a reaction. You need to remain calm and stay focused on what you are trying to do by expressing your concerns as honestly and clearly as possible. I understand there are things that I do that may upset you, but for now I am very concerned about what is happening to you. Maybe we can talk about my faults later. I am worried about your drug use and what is happening to our friendship.
There is no way of knowing how the friend will react to this type of conversation and it will be important for the young person to have a sounding board to discuss what happened.
Helping a friend with a drug issue is hard work and can be a very difficult experience for all concerned. Your teenager may feel it is their responsibility to get their friend to stop using drugs and that they are being a bad friend if they don’t succeed in their endeavours. They might also be very frightened that if their friend continues to use there may be tragic consequences. This is definitely my experience in schools where teenagers have been exposed to information about the consequences of drug use and then worry themselves sick about a friend who they think may be using. In these cases it is very important for the teenagers to know that they are not responsible for their friend’s drug use. They need to be reminded that ultimately it is up to the individual to make decisions that will affect their life and no one else can do that for them.
It may sound harsh, but the reality is that as hard as you may try to get someone to stop using drugs or seek professional help, sometimes it just isn’t going to happen—no matter what you do. If this is a situation that your child finds him or herself in, then you need to do the following:
• Make sure your child gets some additional support from either a responsible adult or a trained professional. As much as their friend may need help, it is important to remember that your teenager has also been through a tough experience and may need help in this situation.
• Convince your child to limit the amount of time they spend with the friend. If the friend is continuing to use drugs, they are also putting others at risk of a range of harms, particularly the legal consequences associated with illicit drugs.
It is important to make sure that the adolescent who is concerned for their friend is supported as much as possible. You need to be sure that they do not place themselves in a dangerous situation in the future, whether it be physical, psychological or legal danger.
If they have taken the huge step of opening up to you, make sure that you acknowledge the trust that they obviously have in you. As far as possible, avoid betraying that trust. However, there will always be cases, particularly when you discover that a young person is at risk, where you will have no alternative but to tell others what you have learnt. The important thing to remember here is that if the adolescent has got to the point of telling someone about their fears, they have usually got to a point where they have realised that there is no turning back, and that this is a crisis situation.
• One of my friends drinks far too much. What can I do?
Drinking alcohol is very much a part of many teenagers’ lives and how they learn to socialise and become young adults. Unfortunately, some of these young people will drink to excess and get themselves into trouble. When this happens to an individual on a regular basis it is not unusual for their friends to become concerned about their mate’s health and wellbeing. The problem is that most of these young people have no idea where to go for help and advice.
Young people can worry about their friend’s drinking for a variety of reasons. Some of the disturbing situations that young people have described to me have involved friends exhibiting one or more of the following behaviours:
• becoming aggressive and violent after drinking
• avoiding their friends in order to go and get drunk
• planning drinking in advance, hiding alcohol from their friends or drinking alone
• having ‘blackouts’—that is, forgetting parts of the night while drinking and, while drunk, behaving in ways that are not in character
• despite having been hospitalised due to their drinking, not changing their behaviour after the experience
• having one of a range of social problems, including abuse of some sort, and drinking to escape or cope with these issues
• drinking and driving.
It’s just a fact of life that for the most part young people would never consider talking to their parents about this issue. Teenagers are well aware that Mum and Dad are likely to frown upon their drinking behaviour and reason that if they raise the issue of a friend having a problem with alcohol it could open a whole can of worms. There is also the risk that you may contact the friend’s parents, which raises many issues around trust.
Unfortunately, young people don’t seem to feel comfortable approaching any other adults about this sensitive issue either. Research shows that there are very few sources of help and information that teenagers would be willing to utilise. There are a few that they are likely to believe (i.e. they think they will have accurate information), and these include doctors or telephone helplines, but unfortunately they tend not to access them. Instead, they rely on their friends, and this can be dangerous. When it comes to the complex issue of alcohol it can even have life-threatening consequences.
Year eleven students Leslie and Sian approached me after I had given a presentation that dealt with alcohol poisoning. They told me that during my talk they and their group of friends had been thinking about one of their peers who had only recently joined their circle. Veronica was a year younger than the rest of them and did not have the drinking experience that the others had. This had resulted in some pretty nasty experiences for the group of friends, but Leslie, who had introduced Veronica to the others, felt particularly responsible for the young girl.
It appeared to the girls that Veronica had an extremely low tolerance to alcohol. It seemed to take only a very small amount of alcohol to get her drunk. After only two or three drinks she was ‘pretty out of it’ and Leslie and Sian were very concerned that she seemed to be trying to keep up with the rest of the group in order to fit in, and not pacing herself as she should considering her limited experience.
An incident only a fortnight before had brought the situation to a crisis point. The group of friends was at a party and lots of alcohol was being consumed. Veronica had drunk three bottles of pre-mixed spirits very quickly and became violently ill. Her friends had responded with care and concern as they usually did, though they were all getting a bit tired of looking after the young girl every Saturday night. They sat with her and tried to talk her through her drunken stupor, but this was not like the other nights—Veronica was not just feeling sick, she began to lose consciousness.
Mistakenly believing her to be falling asleep, Leslie and the rest of the group put their friend to bed. Laying her carefully on her side, they placed a bucket on the floor, in case of emergency. It wasn’t too long before the bucket became necessary. However, Veronica rolled over and vomited all over the bed and did not wake up.
Vomiting without waking up is a sign of possible alcohol poisoning. It is a life-threatening situation and is an important warning sign that you should call for medical assistance immediately. When I spoke about this to the group, Leslie and Sian became even more concerned about Veronica than they were before and that is why they decided to talk to me.
They wanted to know how they could approach their friend about this problem without making her feel uncomfortable. Apparently Veronica had a range of other problems to deal with, including some unpleasant family issues, and Leslie felt that if they did not deal with this in a sensitive manner it could result in their friend feeling even more alone than she already did. They did not want to lose their friend—when she was sober she was a great girl—but her drinking behaviour was becoming increasingly dangerous and was putting them all at risk. How could they handle this very complex issue with sensitivity but still get a very important message across to their friend?
Leslie and Sian were very distressed when they spoke to me. They had been extremely worried about their friend’s welfare for some time, but now that they realised she could have died, the need to respond in some way became much more urgent.
The most important thing to do in these cases is, first, to make sure that the young person who is raising the issue is supported in some way. It’s all well and good to try to provide information to give to the person with the alcohol problem, but often the concerned young person needs just as much support. Often they have been burdened by their concern over their friend’s alcohol use for some time. They haven’t shared their worries with anybody and it has become a bigger and bigger problem over time.
After they have aired their concerns, reassure them that they were right to do so. Make sure you ask them how they are feeling after they have shared the information—check that they are okay about what they have said and that they do not feel guilty about possibly betraying their friend’s trust. Do they feel better now? Are they relieved that they have got it all off their chest? In my experience, the sense of relief that many of these teenagers feel after they have expressed their concerns is unbelievable. Often just sharing the problem with a responsible adult removes a huge burden from a teenager who is concerned about a friend.
Here are just a few examples of some of the issues that young people are coping with. Some of these are extreme cases while others are not at all unusual. For each of these, the young person who shared their story had had to deal with the problem for some time before sharing it with a responsible adult who they felt could assist them in some way. As I’m sure you’ll agree, it must have been a tremendous burden for such a young person to shoulder.
Shauna was extremely concerned about one of her friends, Joelle. Joelle was a big drinker and when she became very drunk she would become depressed and would cut herself. This started a few months ago and had recently been getting worse. Shauna wanted to know how to approach her friend and also how to deal with her self-harm issues. What should she do?
Mike and his best mate Brad were both in year eleven. Mike had been worried about his friend’s drinking for some time. They had been drinking together for a couple of years but it seemed to Mike that Brad’s drinking was getting completely out of control. It was not unusual for Brad to drink at least a bottle of bourbon on a Saturday night, and lately he was drinking just as much on a Friday evening. Some weekends he was even drinking on Sunday afternoon.
What had really freaked Mike out, however, was the discovery that Brad now drank during the week. He had found this out by accident after visiting his friend one evening after school and walking in on him gulping down a glass of bourbon. Brad laughed it off and said that he was having a drink to calm him down after a big day, but his mate became really worried. Isn’t that what alcoholics do? The young man did not know where to go next. Who should he talk to and how could he deal with this problem without jeopardising a friendship he really valued?
Ella had been going out with Neil for six months and the relationship was going really well, apart from when he was drunk. Ella lived in a small country town and most of the parties that she attended with Neil were at properties outside town. Before they went they would usually negotiate some basic rules about how they would get home, with the usual decision being that they would stay overnight on the property.
Often, however, this was not what ended up happening. Once Neil had been drinking for a while, his personality changed and he became very aggressive. Even though they had planned to stay at the property, halfway through the night he usually changed his mind and would decide to drive back to town, demanding that Ella go with him.
Ella did not want to get into a car with her drunken boyfriend. She was frightened for his safety as well as her own, but Neil was a scary character when he was drunk and she did not feel that she could argue with him. She had driven back to town with him many times but was becoming more and more concerned about this dangerous behaviour.
When she tried to raise this with Neil when he was sober, however, he had no recollection of his aggressive behaviour. He could not remember how he had got home and refused to discuss the issue with Ella. She wanted some strategies for dealing with a boyfriend who obviously had a drinking problem. The worst thing was that he was not only putting his own life at risk—he was also jeopardising Ella’s.
Sometimes it’s not just their friends that young people worry about. A relative’s alcohol use, particularly a parent’s, can be just as concerning for teenagers.
Peta, a year twelve student, believed that her mother was an alcoholic. She did not approach me for advice or information—she simply wanted to share her story because she was concerned that even though I warned about some of the short-term harms associated with alcohol, I failed to mention the possibility of long-term dependence.
Her mother had had a problem with alcohol for as long as she could remember, although she believed that it had got worse since her parents’ divorce. Just some of the incidents that she shared with me were as follows: the nights that she had to put her mother to bed after she had become too drunk to make it to the bedroom; the many times that her mother had either driven her to or from school intoxicated; and the evening Peta had to take her mother to the emergency department of the local hospital after a drunken fall had resulted in a broken arm.
Peta was definitely street-smart. She had had to grow up very quickly and, as a result, she had a very mature attitude towards alcohol. She rarely drank, and when she did it was usually only a very small amount. She had seen the ‘ugly’ side of alcohol and it had had an enormous impact on her life. She wanted more young people to know that this was a very real consequence when alcohol was abused.
It is vital that parents communicate with their children about the role that alcohol plays in their lives. Although there are cases where there are indeed great problems, there are many other times when unnecessary distress could easily be prevented simply by talking.
Daniel, a year ten student from an inner-city school, spoke to me about someone he knew who drank every evening—a couple of glasses of alcohol—and how worried he was about what this might be doing to the person’s health.
By the way Daniel was talking I was convinced he was speaking about one of his peers, another year ten student. Daily drinking by a school-based young person is highly problematic and I began to give some advice to Daniel about how to intervene. But his response to my advice made it clear that the person he was worried about was not a friend. It suddenly dawned on me that he was talking about his father.
When he finally confirmed that it was indeed his father Daniel was talking about, it immediately became a very different story. His father was coming home from work and having a couple of glasses of wine. There was no evidence of excessive alcohol consumption and Daniel admitted that there were many nights when his father drank nothing at all. Did he ever see his dad drunk? I asked him. He shook his head. From the information I was given it sounded as though there was no significant alcohol problem. Daniel appeared to be worried about nothing—the only real problem was that the family never spoke about alcohol and how it was used in their home.
Alcohol is not going to go away. It is such a huge part of what defines us as Australians that it may be quite challenging for many of us to acknowledge that it can cause major problems in people’s lives.
Positive conversations with your children about alcohol and the role it plays in your family will help your sons and daughters to develop a healthier attitude towards this popular drug. As a parent it is vital that you discuss that some adults experience problems with their drinking. Too often, the fact that alcohol is a significant community issue is ignored in favour of highlighting the youth alcohol problem. Sharing any useful strategies that you may have developed in helping friends and family members in this area could assist your child to deal with friends they believe are exhibiting similar problems.
• If I call an ambulance because a friend gets into trouble, will the police become involved?
One of the most important messages we must get across to young people is the need to call for medical assistance should someone they know get into trouble. What ‘get into trouble’ actually means can be interpreted in many ways. If someone loses consciousness and can’t be woken up it is clearly a medical emergency, but I usually tell young people that if they’re unsure, if something doesn’t feel right, it is appropriate to call for help.
One of the major barriers to young people calling for help is the fear that there may be police involvement—that is, if they call an ambulance, the police will automatically become involved. It’s always interesting to break this fear down with school students. On first glance it would appear that it has something to do with a fear of the police and that they could get into trouble with the law. When you scratch the surface, though, you quickly discover that it has far more to do with their parents finding out that they have done the ‘wrong thing’. I’m not saying that these young people aren’t worried about getting into trouble with the law—they are! It’s just that for many teenagers, getting into trouble with the law usually means that you let your parents down, and most young people don’t want that.
When answering whether police would respond to an ambulance call, you have to be very careful because there is no clear-cut response. There are always examples that will challenge what the rules are meant to be.
Sixteen-year-old Tran attended one of my education sessions at his school. During the session I had been asked whether the police became involved if a young person called an ambulance to a person who was drunk or who had taken illegal drugs, and I had told them that this was typically not the case. In the small group session after the presentation, Tran wanted to share his story as he felt that it contradicted the information I had given.
A few weeks before, Tran and a group of friends had gone out for a big night. Instead of going to a party, the group of friends decided to meet in a local park—a regular hangout for young people in his area on a Saturday night. They had all been drinking for some time when it became obvious that one of the boys was in trouble. He had lost consciousness and, no matter what any of them did, they were unable to rouse him. After some discussion they decided to call an ambulance. Within a few minutes it had arrived and the officers had swung into action.
The unconscious boy was taken by the ambulance to the local hospital with one of the group accompanying him. The rest of the boys were left in the park, all feeling a little shell-shocked by what had just happened. Minutes later, a police car pulled up. Two officers approached the group and gave cautions to two of them for possession of alcohol by minors.
Had the police been called to the park by the ambulance officers, and did they just wait until the ambulance had left to pounce on them? Tran wanted to know.
After discussion with a number of police officers around the country about this story and others like it, all I can say is that it’s important for us to let our young people know that there are no hard and fast rules when it comes to this issue. Most importantly, though, it is vital that young people are aware that when a call is put out for an ambulance, that is exactly what you get. You will call 000 and be asked by the 000 operator what service you require. If you request an ambulance you will be put through to the ambulance operator, who will ask for the relevant details regarding the incident and location. When the call gets put out, it is put out on the ambulance radio lines, completely different lines to that which police listen to. As a result, the police are unaware that the call even exists.
There are some occasions, however, particularly in regional centres, when an ambulance is not able to get to the incident fast enough (usually because they are dealing with another emergency) and, as a result, the police are sent to the scene. At these times the police are not there to lecture or get people into trouble, they are simply there to ensure that the person in trouble is kept safe until the ambulance arrives.
So what could have happened in the story Tran told above? One explanation I have been given by police is that sometimes, when an ambulance has been called out to a party or to a gathering of young people (such as in a park), a neighbour or some other interested member of the public will call the police to report it. Once the police have been called, they have no choice but to attend the incident. Another possibility could be that the ambulance officers were sufficiently concerned about the remaining young men in the park that they put a call in to police.
So what message should you give your child in response to this question? It needs to be remembered that there are no guarantees here, but essentially it is highly unlikely that the police will attend an ambulance call unless there is another crime committed—for example, a fight breaks out or weapons are observed by ambulance staff. It is important to remember that even if the police do attend, they are not there to harass the person who is unwell, or their friends.
It is up to you as parents to ensure that your children feel confident enough in their relationship with you that they do not fear the possibility of police involvement. I’ve said it before and I’ll say it again: every time your child leaves the house they need to know that they can call you for your help, any time of the day or night, no matter what they have done. This unconditional commitment to your child will help erase any barriers to them asking for help for themselves or their friends.
• Would the hospital call my parents if I was hospitalised after drinking too much?
This is a very similar question to the previous one, but much more difficult to answer. Over the years I’ve had the question asked in a number of different ways, including:
• If I take a friend to hospital will my parents be called?
• Would I need to give my full name to the hospital if I took a friend to hospital after they have drunk too much?
• Would my parents be charged for my time in hospital?
• Can I give a fake name if I get taken to hospital? What happens to me if I get caught using a false name?
And the list goes on and on. As you can see, they are all versions of the same concern: What if my parents discover that I have been drinking?
I’m sure I should say here that if you have a good and honest relationship with your child and you maintain open lines of communication they will not have these concerns, but in reality there’s always going to be a certain degree of shame associated with getting into trouble with the police or being hospitalised after drinking too much or taking other drugs. There are going to be very few young people who feel confident enough in themselves, let alone in their relationship with their parents, to feel okay about being hospitalised after a big night out. If they can avoid being discovered, they’re going to feel much better about it.
I’ve discussed this question with emergency departments across the country, and I have to say that this is an incredibly complex area and there are no simple answers. Hospitals are hesitant to give too many details because there is always a tabloid newspaper or current affairs show ready to attack them either for being irresponsible by not calling parents if their child has been admitted or putting young people at risk by making the call. They really can’t win no matter what they do!
The one thing that seems fairly clear is that if the young person is under sixteen years of age, the hospital has no choice. In those cases, they must contact the parent. When it comes to those aged sixteen or seventeen, however, the rules appear to be a little more fluid. Hospital staff stress that decisions are made on a case-by-case basis, and in my experience the response is very much dependent on the staff who are on duty at the time. One of the emergency department workers I spoke to told me a story that highlights why different staff may respond in a particular way when a young person is brought in after drinking too much.
Narelle, the mother of two teenage sons, was a senior nurse in the emergency department of a busy inner-city hospital. One Saturday night a young man was wheeled into the department by ambulance officers. He was having difficulty breathing and was on a respirator. A friend was accompanying him, and he also appeared to be quite intoxicated.
The young man had lost control of his bodily functions. As well as being drenched in vomit, he had wet himself and it smelt as if he had emptied his bowels. He was a total mess and was obviously going to be with the staff for some time.
Details were taken from the friend and, after finding out that the patient was sixteen years old, staff had to decide whether to call his parents or not. It was then that Narelle noticed the T-shirt that the boy was wearing. She had bought exactly the same one for her eldest son for his birthday. It was then that she made the decision to call the parents. This boy could have been her son and, if it was her, she would have wanted to be there with him.
Although there were such varied responses from hospital staff I spoke to as to their procedures and protocols in this area, one thing remained constant—they wanted young people to feel that they could call an ambulance without fear.
Regardless of whether parents are called or not, we need to ensure that our children continue to seek medical assistance should something go wrong. The only way this is going to happen is if we make it really easy for them to do so by making sure that any barrier to them making the call to an ambulance is reduced whenever possible.
When you have a conversation around calling an ambulance and hospitalisation, let your child know that if they are going to call for help they have your complete support in doing so. You hope that they will never have to do it but, if they do, tell them that after they have made the call to the ambulance, you expect them to make a second call to you to inform them about the emergency. You want to be there with them, to support them through this scary time. It’s a big thing to call 000—adults find it confronting, it must be terrifying for a teenager!