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You’re 18, Lets Have Another Drink

The ritual of ‘going to the clubs’ to drink (legally) on the day of your 18th birthday is eagerly anticipated by many young people as they arrange this rite of passage with their friends many weeks in advance. While there is no legal risk, there is increasing evidence that alcohol is significantly more dangerous to the 20-year-old brain than for a person 30 years and older. As practitioners, what can we say to parents who seek our advice about the risks or benefits to their children as they approach and pass this milestone?

What Does it Do on the Inside?

Science writer David Robson outlines the risks in a paper published for BBC Futures. The 18-year-old brain responds differently to alcohol as it is still undergoing a complex process of synaptic pruning and proliferation of axons, long distance connections creating more efficient neural networks that process information more quickly. This will not be complete for at least another 7 years and is not consistent across the brain. The first to mature is the limbic system which processes pleasure and reward while the prefrontal cortex, responsible for emotion regulation, decision making and self-control, lags. This creates the perfect conditions for a vicious cycle with more impulsive young people drinking more which increases thrill seeking and the risk of poorly regulated and ill-thought-out bad behaviour.

Excessive drinking affects the brain’s development with longitudinal studies showing that early drinking impairs the development of the neural networks which allow for rapid processing of information. In young people other parts of the brain can work harder to override the deficit but in time cognitive testing demonstrates poorer performance on these variables and less activation.

Mental Health Risks

Long term substance misuse is also correlated with earlier drinking especially for those whose families have a history of alcoholism. It has been suggested that the genes associated with a higher risk of alcoholism seem to be most influential during this phase of brain development and the longer a person abstains the less likely they are to be expressed.

Is Drinking Together as Family Protective?

Many people still ascribe to a romantic notion of the European model of drinking where even children are allowed a glass of wine in the context of a family meal. The belief is that this teaches young people to drink safely and with moderation and reduces binge drinking. Unfortunately, the evidence speaks differently with the earlier a child encounters alcohol the more likely they are to experience difficulties in the future. A review of 22 studies by Kaynak et al (2014) concludes ‘The weight of evidence from the studies reviewed here support the view that parental provision of alcohol and a place to consume alcohol is generally associated with increased adolescent alcohol use and, in some instances, increased heavy episodic drinking and higher rates of alcohol related problems. It appears that clear parental rules correlate with less drinking and fewer alcohol-related risky behaviours. This seems a small price to pay for protecting a child against potentially life long and devastating personal and relationship consequences.

Kaynak Ö, Winters KC, Cacciola J, Kirby KC, Arria AM. Providing alcohol for underage youth: what messages should we be sending parents? Journal of Studies on Alcohol and Drugs, 2014 Jul;75(4):590-605. doi: 10.15288/jsad.2014.75.590. PMID: 24988258; PMCID: PMC4108600.

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