Ask the Pediatrician: Just how dangerous is underage drinking?

With so many other issues affecting young people right now, teen alcohol use may not seem like that big of a deal. You might recall your own early experiences and figure that some drinking can be expected. But when we look at alcohol’s effect on a child’s developing brain, the risks become clearer.

It’s helpful to realize that the human brain continues to grow and develop until age 25. Frequent alcohol use can have a negative impact on regions of the brain that handle learning, memory and speech, as well as visual and spatial thinking.

Alcohol’s impact on the brain — not to mention its immediate effects on everyday functioning — may explain why kids who drink usually have serious difficulties in school. Young people who admit to binge drinking are four to six times more likely than nondrinkers to skip classes. High schoolers who drink regularly are five times more likely to drop out. Drinking is related to 40 percent of all academic problems in college — and 28 percent of kids who leave before getting their degrees cite problem drinking as one cause.

Because it changes the way people think and act, alcohol is also closely related to behaviors that can seriously harm your child or cause harm to others. Incidents of physical and sexual violence often involve young people who are under the influence of alcohol. Unintentional injury-related deaths, especially car accidents, frequently involve drunk drivers.

Young people who drink also face higher risks of depression and suicide.

Several factors might motivate kids and teens to drink, including peer pressure, stress, environment, family history, or bias and discrimination.

But there’s good news here. Kids care very much about what their parents think — and are much more open to talking about alcohol use than you might imagine. In fact, research shows that parents are the No. 1 reason kids decide not to drink. This is just one reason the American Academy of Pediatrics recommends you talk to your child early and often about underage drinking.

Here are suggestions for starting a meaningful and supportive conversation with your child:

Start talking about alcohol with your child when they are around 9 years old. This gives you the opportunity to help shape your child’s thoughts and actions around alcohol as they move toward adolescence.

Bring the subject up in a relaxed, nonjudgmental way. Avoid condemning all people who drink, which might confuse your child. Instead, ask what thoughts they have about alcohol. Do their friends talk about it? Do they have any feelings about the way adults around them use alcohol? Try to listen as much as you talk, especially with teens.

Find the right moments. Times when your child is present, engaged, and not rushed are best. Put your phone away and make sure the television is turned off.

Consider sharing your own stories. Kids appreciate honesty, especially when you’re talking about difficult subjects. Without overwhelming your child, you might touch on times when you saw alcohol hurt people. “My father used to get drunk a lot. It wasn’t good for his health and it definitely made things hard for him at work. I’m hoping I can help you avoid what happened to him.”

Normalize nonuse. Tell your teen often and repeatedly that it’s perfectly normal not to drink. You might acknowledge that, even though many kids do develop drinking problems, national studies show most teens stay away from alcohol during high school. In fact, the percentage of teens who don’t drink has been steadily rising for two decades.

Set clear expectations and guidelines based on age. Don’t be afraid to state that young children should not drink, period. As your child approaches junior high and high school, tell them you know they might feel pressured to try alcohol. Set clear limits and be prepared for pushback.

Offer to pick them up, no questions asked. If kids find themselves in a situation where they or others are drinking, they should call you immediately. Make sure they know you’ll give them a ride home anytime, day or night. Bring them home, give them time to recover, then discuss the issue with them when everyone feels calmer and more rested.

Be calm, loving and supportive and ask your pediatrician for support. Seek out specialized resources if you need them.

Make it safe for your child to tell you anything. Try not to overreact when your child tries alcohol. You don’t have to pretend you’re not disappointed, but staying away from shame and blame will signal that your child can trust you when things go wrong and they need you the most.

Don’t end the conversation when your child moves out or goes to college. Encourage them to come to you anytime they need perspective and support.

Dr. Wendy Hasson is the medical director for the Pediatric ICU at Randall Children’s Hospital in Portland, Oregon, and a Fellow of the American Academy of Pediatrics.