First you take a drink, then the drink takes a drink, then the drink takes you. —F. SCOTT FITZGERALD
People talk a lot about drinking in moderation. No one at parties I go to drinks in moderation. They drink to get drunk. —RYAN (DAVIS, CALIFORNIA)
ONE
It’s used to celebrate success and drown failure. It’s used at frat blowouts and fancy dinner parties. It’s everywhere.
In fact, alcohol use is so common that lots of teens don’t even think of it as a drug, but it is. It has as much power—or more—to be misused, to create addiction, and to ruin lives as some other, less prevalent drugs. Just because it’s legal at age twenty-one doesn’t mean it’s harmless.
Sometimes people use alcohol because they’re feeling depressed without understanding that the drug is a depressant—that is, after an initial buzz, it can make them far more depressed. Also, alcohol can lead to reckless behavior because of its impact on various brain centers.
Even moderate use can make people sloppy and stupid. As a high school senior in San Francisco said, “I went to a party a little while ago. Usually, I’d get drunk like everyone else, but this time I was the only one who didn’t. It was the first time I realized how stupid drunk people are. It got gross when they started throwing up and passing out.”
Excessive alcohol use has immediate effects that increase the risk of many harmful health conditions. These are most often the result of binge drinking. Over time, excessive alcohol use can lead to the development of chronic diseases and other serious problems.
Injuries:
Motor vehicle crashes
Falls
Drownings
Burns
Violence:
Homicide
Suicide
Sexual assault
Intimate partner violence
Alcohol Poisoning
Reproductive Health:
Risky sexual behaviors
Unintended pregnancy
Sexually transmitted diseases, including HIV
Miscarriage
Stillbirth
Fetal alcohol spectrum disorders (FASDs)
Chronic Diseases:
High blood pressure
Heart disease
Stroke
Liver disease
Digestive problems
Cancers:
Breast
Mouth and throat
Liver
Colon
Learning and Memory Problems:
Dementia
Poor school performance
Mental Health:
Depression
Anxiety
Alcohol Dependence
Most adults who drink do so occasionally. A martini. A couple of beers. Wine with dinner. And for many adults, drinking is mostly harmless.
But even light drinking can cause problems in people’s lives. Alcohol use can contribute to physical violence and sexual assault as well as suicide.
Many accidents, including fatal ones, occur after people drink moderately, having had just one or more drinks. Body size and metabolism rates determine the impact of alcohol on an individual’s blood alcohol content (BAC)—see the figure below. Every day, about thirty people die in drunk-driving accidents—more than one every hour. Kids who started drinking young are seven times more likely to die in alcohol-related crashes. Almost 40,000 people die each year in car accidents. Overall, alcohol kills more than 88,000 people a year.
BINGE
is even more dramatic—much more dramatic—when you binge drink, which is defined as having four alcoholic drinks for women and five alcoholic drinks for men within two hours. Binge drinking is prevalent—and often deadly—among teenagers. About 90 percent of the alcohol consumed by those under the age of twenty-one comes in the form of binge drinks.
In some places, bingeing has become a perverse rite of passage. Kids have died at parties at which they drink twenty-one shots to celebrate their twenty-first birthdays. Many teenagers drink to get drunk. Some boys told us they were looking forward to the weekend when they were “going for blackout.” It’s probably not a surprise to hear that that kind of drinking is particularly dangerous and can be deadly.
Bingeing, sometimes combined with other drugs, is also related to what’s been described as an epidemic of sexual assault. Being drunk is never an excuse for sexual assault; any sex without consent is rape. And consent from someone who’s drunk or high isn’t consent.
Lisa’s Story
I lived in a small town. All through high school I worked hard to keep up my GPA. I didn’t drink or do drugs. I was getting ready for college. But in my senior year, I went to a party. I still don’t know what happened exactly. I do know I had a beer. Then something must’ve been slipped into it. I’m not sure what happened, but it wasn’t good. When I came to, I was outside in the backyard. I’d been molested. I don’t know who did it.
I went home. At first I didn’t tell my parents—I was pretending that it wasn’t a big deal. Then when I did tell them, they said that the best thing to do was forget it happened. I tried, but I couldn’t help thinking about it, especially at night. I couldn’t sleep. So, I began drinking a lot. Beer, shots. And partying more and more. It was my way of dealing with what happened. Or not dealing with it. I started taking pills someone gave me. I was that kid. The one I never wanted to be and couldn’t imagine being.
I began thinking about killing myself—I looked up suicide on the Internet. I got more and more depressed, wasn’t keeping up in school, was sick a lot. A teacher finally called my parents, who brought me to see a therapist. The doctor said I was suffering trauma from the assault. I’m still in therapy. Sometimes it’s the last thing I want to do, but I’m doing better. I have a boyfriend. My grades are up again and I got into college. I’m not drinking or taking drugs at all. You hear about things like that happening to other people, and we never think it could happen to us, but now I know it can. I just want girls to know. To be careful.
Alcohol also plays a role in more than a third of teenage deaths involving accidents, homicide, or suicide. “The problem,” says the psychiatrist Dr. James D. Flack, associate medical director of the Menninger Clinic, “is that a beer or two can appear to relieve depression for a little while, but by the time you have your eighth beer you feel suicidal, angry, or out of control and more depressed.”
In fact, alcohol is used disproportionately by people who are already depressed. Teens who’ve had an episode of major depression are twice as likely as those who aren’t depressed to start drinking alcohol.
There’s also ample evidence that heavy drinking has a negative impact on many other aspects of kids’ lives. One study showed teenagers who began binge drinking performed more poorly on intellectual tests as they got older. Researchers looked at brain scans of some of the teens and found that heavy drinkers had damaged an area of the brain vital for learning, which continues to develop into middle age. This means the damage done during teenage years could limit a drinker’s intellectual growth well into adulthood.
BREAKING IT
—a form of alcohol—reaches the brain and all the organs of the body within ninety seconds. Ten percent of the ethanol is eliminated (through sweat, breathing, etc.), and the liver begins working to metabolize the rest; alcohol is toxic, and the body tries to get rid of it as quickly as possible. On average, the liver metabolizes half an ounce of ethanol in an hour. When there’s more alcohol in the body than the liver can break down, the concentration of alcohol in the bloodstream increases, which makes people feel buzzed/high.
Alcohol decreases the normal functioning of the brain, particularly in areas of the brain involved in memory formation, decision-making, and impulse control. By preventing a chemical called glutamate from doing its work, ethanol slows reaction times, impairs memory, dampens motor skills, and can cause slurred speech, nausea, emotional volatility, loss of coordination, and visual distortions.
The effects of alcohol vary according to the individual’s gender, body size, amount of body fat, amount of alcohol consumed, family history, and other factors. That is, all people aren’t created equal when it comes to the process by which our bodies metabolize alcohol. Women absorb and metabolize alcohol differently from men; they’re more vulnerable to smaller amounts.
Kids often think that compared to other drugs—especially some hard drugs—alcohol is safer. But alcohol damages more neurotransmitter systems than many drugs. If you become addicted, withdrawal can be lethal, triggering seizures and even heart attacks. And the earlier someone begins drinking, the more likely he or she will abuse alcohol and become addicted.
Some people think it takes decades for alcohol to damage the brain, but at the University of California, San Diego, researchers looked at twelve- to fourteen-year-olds’ brains before they used any alcohol or drugs and then followed them as they began drinking. The researchers scanned the brains of those who became binge drinkers and compared them to the brains of kids who drank moderately. They also tested their thinking and memory. The results were dramatically different, with a much greater damage done to the brains of the heavy drinkers.
Cerebral Cortex: This is the main area involved in thinking, decision-making, emotions, and the five senses. Alcohol’s effects on this area can impair your ability to think clearly and lower your inhibitions. Alcohol may make you act impulsively or make you angry or sad for no reason. Your senses may be affected, such as blurring your vision. Long-term alcohol abuse can permanently damage this region.
Cerebellum: This part of this brain is important for coordinating your daily movements, such as walking and grabbing objects. Alcohol can slow your reflexes, cause you to lose your balance or make your hands shake.
Hippocampus: Your memory is controlled by the hippocampus. Drinking a lot of alcohol at one time can cause you to black out, or forget a period of time. Long-term alcohol abuse can permanently damage the hippocampus, making it difficult for a person to learn.
Hypothalamus: Many body processes, such as heart rate and the feeling of hunger or thirst, are controlled here. Alcohol can slow your heart rate and may make you hungrier and thirstier.
Central Nervous System: Alcohol slows down this system, which is made up of the brain, spinal cord, and nerves, making you think, speak, and move more slowly.
Medulla: Involuntary processes, such as breathing and maintaining body temperature, are controlled here. Drinking a lot of alcohol at one time can shut down the medulla, leading to a coma.
Elsewhere in the body, alcohol is especially toxic in the liver, kidney, and nervous system, though it affects every organ. Alcohol slows breathing and heart rate, sometimes to the point of coma—even death. Alcohol is potentially dangerous for anyone, but’s it’s extremely dangerous for a person who’s pregnant; it can damage a developing fetus.
As with all drugs, it’s important to remember that some people are more likely to become addicted than others. If alcoholism runs in the family, if you experience high stress, traumatic events, learning disabilities, or psychological problems like depression, your chances of developing the disease of alcoholism are higher. However, anyone can become addicted.
Ten to fifteen percent of people who try alcohol will become addicted. And as with every drug or dangerous endeavor, no one really believes the risk is to them. But it will always start with that first step—that first drink.
