Sensible teenage drinking Dr Stephen Newell

1. Sensible teenage drinkingDr Stephen Newell

2. Social importance Humans like bitter flavours Fermentation was known in antiquity Wine has been made from grapes for six millennia Beer has been made since the 8th century BC In history, cleaner to drink than water Used in celebrations and social functions Part of everyday life for many people

3. Importance in agriculture, e.g. In 2002 France produced 7.6 million metric tonnes of grapes Barley / hops important crops Viticulture and brewing are huge industries with fascinating histories and academic interest

4. Economic importance, e.g. In the UK, tax on alcoholic drinks raises £7 billion per annum Tourism to wine-producing areas There are about pubs in UK 60 000

5. But there are also negative elements to alcohol…

6. Alcohol use • Substance use and associated disorders are common • Alcohol is one of the most commonly misused substances • The majority of people in Western societies are current or past users of at least one psychoactive drug

7. Percentage of U.S. Population (aged 12 and over) who have ever used drugs of abuse National Household Survey on Drug Abuse, 1998

8. Influences on alcohol & substance use • Biological • Psychological • Developmental • Family & social influences

9. Biological influences on substance use • Alcohol and drug use have genetic influences • “Novelty seeking” temperament • There are genetic predictors of response, metabolism, risk of later dependence • Familial factors relating to medical consequences of alcohol use

10. Family & social factors Families develop patterns of alcohol use which are modelled and passed on to future generations Should parents allow teenagers to have some alcohol at home to learn about its effects? Cultural & religious influences Peer group influences

11. Alcohol units • 1 unit = 1 small glass of wine = ½ pint of beer = 1 measure of spirits • Weekly “allowance” 21-28 for men, 14-21 for women • These are guides – may be too much for some small females

12. Teenage drinking • 1998 in UK the ONS general household survey showed 50% of men age 16-24 had drunk more than 4 units per day in the week before the survey • Corresponding figure for women was 40%

13. Health benefits of moderate alcohol use • 1-2 units of alcohol per day has a protective effect on the heart – less heart attacks • Reduced incidence of gallstones • Reduced incidence of macular degeneration (eye disease)

14. Appropriate and sensible use of alcohol? or Inappropriate and unsafe use? What is being modelled at home?

15. Domestic violence Child abuse Impaired family relationships Financial consequences Male 35, 3 children, 5 bottles of Malibu p.w. @ £11, 40 cigs/day @ £9, so spending £118 p.w. or £6136 p.a. On long term sick certification. Possible consequences of inappropriate alcohol usage on the family

16. Domestic violence • Approximately 80% of spouse to spouse violence is alcohol related • Physical abuse of children involves 20-30% of parents who are heavy drinkers • The child abusing parent is often under the influence of alcohol when the incident occurs

17. Effects on the family • Inappropriate alcohol use can have a highly disruptive effect on family rituals - • “Uncle Fred ruins every Christmas dinner by becoming drunk”

18. Effects on children of alcohol abuse in the family • Conduct and academic problems • Emotional difficulties • The effects of whatever has promoted the alcohol abuse e.g. family difficulties

19. Medical consequences of alcohol

20. Epidemiology • Alcohol misuse costs the NHS up to £3 billion per year on hospital services • Alcohol abuse causes 22 000 deaths per year • 150 000 hospital admissions p.a. for alcohol-related accidents & illnesses • Alcoholics who continue drinking shorten their lifespan by 15 years

21. Effects of alcohol • Acute effects • Chronic heavy use • Withdrawal

22. Acute Effects 1 • Brain & nervous system disinhibition sedation accidents hangover • Gastrointestinal nausea / vomiting gastritis bleeding hepatitis

23. Acute Effects 2 • Respiratory suppression choking on vomit overdose

24. Acute Effects 3 • Reproductive system disinhibition erectile dysfunction unplanned pregnancy • Legal drunk & disorderly vagrancy vandalism fights / assault drink driving – 1 in 20 RTAs involve driving over the legal limit

25. Effects of Chronic Heavy Drinking • Brain and nervous system • Neuropathies • Cerebellar degeneration • Wernicke-Korsakoff’s syndrome • Dementia

26. Effects of chronic heavy drinking • Gastrointestinal • Gastritis / ulcers • Liver damage / cirrhosis • Pancreas • Cardiovascular (heart & blood vessels) • Hypertension (high blood pressure) • Cardiomyopathy • Stroke

27. Effects of chronic heavy drinking • Reproductive fertility problems erectile dysfunction foetal alcohol syndrome

28. Foetal alcohol syndrome • Growth retardation • Facial dysmorphism • Learning difficulties and other neurological problems

29. Effects of chronic heavy drinking • Hematological (blood) • Musculoskeletal (muscles and bones) • Endocrine (glands) • Dermatological (skin)

30. Withdrawal effects • Withdrawal effects are generally the opposite of intoxication • Alcohol detoxification (treatment)

31. Alcohol-Drug interactions • Illicit drugs (e.g. cocaine, heroin) • Prescription drugs(e.g. benzodiazepines, metronidazole) • Over-the-counter drugs

32. Summary • Alcohol can be medically hazardous acutely, with chronic high levels of use, and in withdrawal • Every major organ system can be affected • There is the possibility of damage and a risk of death associated with alcohol use

33. So what advice to teenagers? • Parents need to set a good example • Stress the importance of not drinking and driving • Explain that alcohol can have a stronger effect on young people - who have immature livers, etc • Explain that too much alcohol can cause more than just a bad headache the next day – e.g. where you wake up, unprotected sex • Help them understand the meaning of drinking sensible amounts of alcohol – e.g. by using units • When they are out with friends encourage them to look after each other

34. Advice and downloadable informationwww.portman-group.org.ukwhose tag line is “Promoting responsible drinking”

35. A few words about drugs…..

36. Marijuana • Motor vehicle accidents • Motivation / concentration difficulties • Smoking damage • Immune impairment

37. Stimulants (Cocaine, Amphetamine, Ecstacy) • Cardiovascular • Neurological • Injection risks

38. Opioids • Overdose • Injection risks • Gastrointestinal • Musculoskeletal

39. Other Drugs • Phencyclidine (PCP) • Inhalants

40. Summary • Drugs of abuse are physically hazardous • There are many possible medical consequences of use • Specific drugs affect major organ systems differently • There is the risk of damage and mortality associated with these drugs