Risk Factors to Watch For
"The traditional thinking is that risk factors for alcohol abuse show up in adolescence," says Robert A. Zucker, Ph.D., director of the Addiction Research Center at the University of Michigan,
who has led studies designed to identify kids at risk for alcohol and other substance abuse. "But, actually, they can show up earlier — in children 9 or younger, even in preschoolers."
Chad Dignan of Eden Prairie, MN, got drunk for the first time when he was 9, at a party thrown by one of his older sisters while their parents were away. A thin boy with sandy hair, Chad wandered
into the living room and started drinking beer. He also tried his first cigarette and puffed some marijuana. Soon after, he began nipping the leftovers from his father's martinis, then stealing
from vodka bottles that his father stored in the garage. His parents' marriage was troubled, and his dad was a problem drinker, sometimes verbally abusive when he was under the influence.
"Drinking was an escape from all my problems," explains Chad, now 19 and clean for more than three years.
Kids at risk for early drinking may have a parent who is an alcoholic or a problem drinker. That was the case with Chad and Brooke, whose fathers drank heavily, and with Mary, whose mother is an
alcoholic in recovery. But having an alcoholic parent doesn't guarantee that a kid will drink — and not having an alcoholic parent doesn't guarantee that a kid won't. "Yes, we see problems
in kids who are children of alcoholics," says Vivian B. Faden, Ph.D., deputy director of the Division of Epidemiology and Prevention Research at the NIAAA."But we have a huge problem going on
with lots of other kids too. Some who fall off the cliff are kids you never would have expected, kids who always followed the rules and have had minimal previous involvement with drinking. They
can end up making poor decisions."
Other Risk Factors
Children at risk for early drinking may also:
- Have a close friend or sibling who uses alcohol and/or other drugs
- Tend to hold in anger or negative feelings instead of expressing themselves — or, at the other extreme, fly off the handle too easily
- Be socially awkward
- Have poor impulse control
- Engage in risk-taking behavior
- Have parents who don't keep track of their whereabouts or behavior
- Have experienced trauma, such as a parental divorce
- Receive harsh or inconsistent discipline from parents
- Have experienced childhood abuse
- Be aggressive or hard to control
- Do poorly in school
Zucker points out that not every child with these traits and behaviors will become a drinker, nor will every young drinker exhibit them. But knowing about risk factors can help alert parents,
teachers, and counselors to potential problems so they can be prevented by timely intervention.
Chad was 11 when his parents announced they were divorcing. After that, he says, his drinking and drug use accelerated. "I tried it all: crystal meth, LSD, cocaine, ecstasy. And I never stopped
drinking." In fact, he graduated to binge drinking — consuming more than five drinks in a sitting. According to a 2005 national survey at the University of Michigan, 10.5 percent of all
eighth-graders and 28 percent of high school seniors had engaged in binge-drinking in the previous two-week period. "When I was bingeing, I felt cool and popular," Chad says.
When he was 14, Chad discovered hotel parties: An older kid, at least 18, would rent a room. "We'd all show up, get high, and drink a lot," says Chad. "No parents were there, so we could trash
the hotel room. I would always tell my parents I was going to some smart kid's house, a kid who was doing well in school." Chad's parents didn't ask many questions, something his mother,
Reneé Dignan, now admits was a big mistake. "I didn't want to believe there was a problem," she says.
Things got worse. Always an athlete, Chad began to get high on cocaine, pot, and alcohol before football and ice hockey games. He played football drunk, hurt his knee, and required surgery. While
on acid, he set fire to his school. For many kids, as with Chad, early drinking leads to early abuse of other drugs. More than 66 percent of kids who are heavy drinkers also use illicit drugs,
compared with 5.5 percent of nondrinkers, according to a CASA report.
Why Treatment Is Tough
After her frightening bout with alcohol poisoning, Mary Brennan told her father she thought she needed help. But he was unable to grasp the seriousness of her problem. "I think he was in
denial," says Mary. "He said, 'You're only 15. There's no way that it's already out of hand. It can't be that bad.'" He sent her to an outpatient treatment center in their suburban town. "It was
hard to take the program seriously," Mary recalls. "The people who ran it were amazing, but they were only with us a few hours a day. After a while, I realized that half the kids in there were
lying about their drinking, about wanting to quit. I started drinking again too." For two years after her unsuccessful trip to rehab, Mary led a double life. To her dad and her counselors, she was
"in recovery." To her friends, she was a party animal who still drank every day. Brooke and Chad also bounced out of their first outpatient rehab programs and continued drinking.
Nine out of 10 teens who get treatment for alcohol abuse will relapse at least once, according to Judi Hanson, program director of Sobriety High West Academy in Edina, MN, a charter school for
teens with substance-abuse problems. Emerging research suggests that part of the reason may be changes in brain development caused by early alcohol abuse: Very young drinkers may prime themselves
to seek out alcohol even if it makes them sick, according to a 2006 animal study.
Jaime Diaz-Granados, M.D., chairman of the psychology and neuroscience department at Baylor University, exposed adolescent mice to alcohol. Then, when the mice grew up, he and his team offered
them alcohol again. "We found that if we first exposed animals to alcohol as adolescents, they would seek it out as adults, even though it then made them sick," he says. A different group of mice
got its first illness-inducing exposure to alcohol in adulthood. When these mice were offered alcohol a second time, they refused it. "This relates to children," Dr. Diaz-Granados explains.
"Early drinking can alter normal brain development, leaving the adult more vulnerable to drinking problems."
Getting Through at Last
Many kids who abuse alcohol don't get effective treatment — or any treatment at all. Of the 3.7 million kids ages 12 to 17 who met the criteria for alcohol-abuse disorder (and/or
received some treatment for it) in 2004, only 232,000, or less than one-tenth, were treated in a specialty facility, reports the NIAAA. And rehab programs for young people often consist of
short-term outpatient treatment, mainly because that's what health insurance companies are most likely to pay for. But that form of treatment works better for adults than for kids, who need more
support and structure. In 2004, the Steering Committee of the NIAAA's Initiative on Underage Drinking Research launched a long-term research program to help professionals better understand how to
prevent and treat adolescent alcohol abuse. Treating teen and preteen drinking is a big job, says Carol Loveland-Cherry, Ph.D., a professor at the University of Michigan School of Nursing who has
studied alcohol use among young school-age children. "It requires work at multiple levels — with the adolescent, the school, the family, and the community." This kind of "whole person"
approach is labor-intensive, and thus often expensive. For example, residential programs — often the most effective treatment for teen drinkers who haven't been helped by outpatient programs
— involve a regimented daily schedule: breakfast, school, lunch, art classes or recreational therapy, individual therapy sessions, chores, dinner, then a 12-step meeting that can last up to
two hours. Such programs often aren't covered by insurance.
The whole-person approach is what finally worked for Mary Brennan, Brooke B., and Chad Dignan. When Mary was 17, she again asked her father for help. This time, he faced the fact that his
daughter was an alcoholic, researched addiction programs, and flew with her to California, where she entered Echo Malibu, a treatment center that admits only six teens at a time. "It was, 'I'm
doing this or I'm not going to survive,'" Mary says. "I was hanging out with drug dealers, always looking over my shoulder."
In 2003, 20-year-old Brooke, emaciated at 85 pounds, called home and begged her mother to check her into the Betty Ford Center in Rancho Mirage, CA. Brooke responded well, she says, to the strict
structure of the treatment program. And because she'd always been shy, she found comfort in the recovery community. "Knowing that there are other people like me gave me strength," Brooke says. "I
learned that I'm not crazy, I'm just alcoholic." Sober since rehab, she works at an insurance company.
After he set the fire, Chad Dignan faced a police officer in the principal's office who gave him a choice: juvenile detention or rehab. A counselor at the outpatient treatment center Chad
attended suggested he enroll at Sobriety High West Academy in nearby Edina, one of five Sobriety High campuses in the Minneapolis/St. Paul area. His mother was reluctant to transfer him from an
affluent school district with lots of extracurricular programs and sports, but Chad insisted. "He kept saying if he went back to his old school, he would go back to using," says Reneé
Dignan. She knew things were different at Sobriety High when Chad threw a Halloween party not long after starting there. Some of his former, drug-using friends showed up — and his new
classmates surrounded the uninvited guests and escorted them out. "Sobriety High was a lifeline," says Reneé, who now serves on the school's board, as does Chad, a community college
Mary found enough peace and individual counseling at Echo Malibu to begin working through the rage and pain she had felt when her mother left their family. "At Echo, I had to accept that my mom
may never be the way I want her to be," says Mary, who's now a freshman at a Christian university in Southern California. "My dad and I started to create a great relationship. And every day I get
up and make a conscious decision not to drink."
Signs that your child may be drinking
He or she has a new friend who makes you uneasy, or a friend you've never met; adopts a "nothing matters" attitude; withdraws emotionally, becoming depressed, anxious, or secretive; is having
trouble at school. If you see any of these signs and suspect a serious problem, take a whiff of your kid's soft drink or sports drink bottles. Filling empty bottles with alcohol is a common tactic
of underage drinkers. And don't forget the most obvious tip-offs: You smell alcohol on your child's breath or find bottles or cans in her backpack or closet.