Last partial update: October 2019 - Please read disclaimer before proceeding
Alcohol use and abuse in general
This section relates to alcohol issues concerning young people. A more comprehensive coverage of alcohol use and abuse, including information about harm caused by alcohol and treatment, is available in the separate section on alcohol abuse in adults.
Alcohol and the young
Alcohol use, both responsible and harmful, is an integral part of Australian culture and it is responsible for a large amount of illness in our society. As about 80 per cent of adults consume alcohol, learning how to consume it without harm is important for every young adult who decides to use this drug. It is therefore unfortunate that adolescents get very confusing messages about its use from the adult community. This is because:
- Many adults do not consider alcohol as a ‘drug’ or feel that it is less harmful than illicit drugs. This is of course not true; alcohol causes more harm than any drug other than cigarettes. It is not surprising then to find that many young people, despite being under the legal age to consume alcohol, are frequently provided with alcohol by their parents / other adults and that many parents are not particularly worried about their teenagers consuming alcohol. Some adults when supervising underage adolescents tolerate / accept alcohol consumption; sometimes to relatively high levels. This is unfortunate as medical research has shown that the younger a person is when starting alcohol consumption, the more likely he or she is to have problems with its use.
- Many adults / parents set a poor example regarding alcohol use. Prominent media and sports personalities are often culprits.
- Australians traditionally celebrate success and achievement with alcohol. This positive association enhances the image of alcohol use.
- Alcohol use in Australia is encouraged in young people, especially teenagers, by sophisticated marketing. This includes:
- the development of sweet fruit soft-drink-like alcohol products ('Alcopops') that appeal directly to this age group (especially girls). People can now buy bottles of raspberry flavoured full-strength vodka and flavoured sweet drink mixtures in plastic sacs to which vodka can just be added. (Such products make it very difficult for teenagers to know how much alcohol they are consuming, especially if they have already consumed some alcohol.)
- the labeling and marketing of these products to attract young drinkers.
- the use of national sporting teams etc in alcohol promotion
Some reasons why alcohol is becoming an increasing problem for young people.
1. Their adolescent period, the period that they are free to overindulge in alcohoi, is lengthening for two reasons. Firstly, they are starting to consume alcohol at a younger age and secondly, many are adopting adult responsibilities (i.e. leaving home, getting a job) at a later age. They are experiencing an 'extended adolescence'.
2. Young people have more money to spend on alcohol. This is partly because the commumity is generally more affluent than in times past and partly because delaying staring families and purchasing homes means that more money is available to spend on alcohol.
3. Another is that there are less restrictions on young people today. Few have the restrictions imposed by religious affiliation that were more common in times past and parents are generally less authoritarian than in times past.
4. Greater influence of the alcohol industry. There are far more outlets / venues providing alcohol and they are open for much longer. Also, as mentioned above, the alcohol industry has been very active in promoting alcohol use in young people; even though the adults resposible for such marketing are very likely to have children that will also suffer the consequences. (This includes significantly increasing the alcohol content of mixed drinks by as much as 50% over the past 15 years) and combining alcohol with caffeine. (See later comments.)
5. The social position and earning power of young women as changed. This has led to them adopting the drinking habits more like those of young men, with drinking being a defining part of their culture.
How big is the alcohol problem in teenagers and young adults?
All the above has led to a large increase in overall alcohol use and harmful alcohol use in the 14 to 18 year age group, with 10 to 20 per cent of females and almost 30 per cent of males in this age group consuming alcohol in a harmful manner at least once a month. Altogether, about 66 per cent of adolescent alcohol use poses a short-term risk of harm, with both males and females being heavily involved.
Adolescents who start consuming alcohol before the age of 13 are of great concern as they are significantly more likely to experience alcohol related problems both in adolescence and later life. Such problems include dropping out of school, unemployment and social isolation. The use of alcohol (and cigarettes) in the young also increases their risk of using illicit substances.
Adolescents often use more than one drug at a time when consuming alcohol e.g. cannabis and alcohol or alcohol and caffeine.
Self-harm and suicide in young people are also increased with alcohol use.
Teenagers who regularly consume alcohol are more likely to develop chronic alcohol use disorders, especially if they consume it in a risky manner, and unfortunately the length of time that adolescents are being exposed to a culture that includes risky alcohol use is increasing. (This period commonly stretches from the start of alcohol use, which is occurring at an increasingly early age, to the time when adolescents take on adult responsibilities i.e. become adults, which many adolescents / young people are delaying.) Thus, it is not surprising to find that there is an increasing incidence of long term alcohol problems in young adults. (The prevalence is estimated at 11 per cent of Australians aged between 18 and 34 years.)
A fifth of young people aged 16 to 24 years drink to intoxication most times they drink, and 42 per cent of drinkers report memory loss after drinking. Further, between 20 per cent and 40 per cent of young people report exposure to / involvement in alcohol-related violence, and around 30 per cent report alcohol-related sexual risk taking.
The fact that 52 per cent of alcohol-related serious road accidents occur in the 15 to 24 year age group (and 75 per cent in the 15 to 34 year age group) is a potent reminder of the consequences of problem alcohol use in young people. In the ten years from 1993 to 2002 about 500 teenagers died as a direct effect of alcohol use, mostly related to motor vehicle deaths.
However, the news is not all bad. Initiatives such as the 'Good Sports' program, in which sporting clubs reduce their promotion of alcohol, is proving a success both in terms of reducing alcohol consumption and in attracting new club members from people who were previously 'put off' by the club's 'alcohol culture'.
For more information, see their web site; www.goodsports.com.au
When should teenagers start to drink?
As stated above, an early onset of alcohol consumption has been shown to increase the likelihood of harmful use. All medical experts agree that alcohol should not be consumed before the age of 16. Above this age it is recommended that parents try to delay their child’s alcohol use as long as possible, with most medical authorities recommending avoiding use until after 18 years of age. Laws regarding the supply of alcohol vary from state to state but generally it is illegal to supply people under the age of 18 years with alcohol in a public place. In some states the same restriction applies to supplying alcohol on private property.
Some European cultures have a tradition of allowing younger children to consume small amounts of alcohol with their main meal. The problem with adopting this practice in Australia is that our culture has a very different attitude to the use and promotion of alcohol which means that these young Australian children who consume alcohol are more likely to have issues with alcohol that their counterparts overseas. Thus, early use in Australia is more likely to lead to harmful later use than it would in countries that generally have a more responsible attitude to adult alcohol use. (In some countries an adult would regard it as an insult for a someone to get intoxicated whilst in their company socially.)
Source – Adapted from Australian Institiute of Health and Welfare: Mathers 1999. |
Advice regarding steps parents and other adults can take to reduce underage alcohol consumption
Parents need to play a very active role in reducing the exposure of their teenage children to alcohol, both by looking after their teenagers well and by reducing the promotion of alcohol to teenagers. Here are some suggestions about how these aims can be achieved.
- Educate your children regarding alcohol: Information regarding alcohol use and the harm that it causes can be found in the section on alcohol use by adults on this web site. Remember that education re alcohol should be a continuing process, not a one-off lecture.
- Reinforce messages delivered at school: For the parents of young people, drug avoidance / harm minimization strategies taught in schools need to be reinforced at home. This should include problem solving skills, self-care and safety skills, assertiveness training, and peer support skills. Parents need to provide information about maximum safe intake and discuss safer drinking strategies, such as avoiding loading drinks and drinking with food. Other issues relating to risk reduction include contraception and the importance of condoms to avoid sexually transmitted diseases and strategies to avoid driving with someone who has been drinking. It is also a good time for parents to bring up the subject of other drug use and the dangers of mixing alcohol with other drugs, such as cannabis or caffeine.
- Make and keep rules for teenagers regarding alcohol consumption: This includes decisions about when to allow teenagers to start drinking at home and rules regarding consumption away from home.
- Provide a good example: Responsible use of alcohol by parents and other care-givers is one of the best learning experiences a child can receive. This especially includes refraining from binge drinking and drinking to avoid problems.
- Condemn the excessive drinking that high-profile sports and media personalities often indulge in: Discussion of such behaviour with the family and refraining from supporting clubs that do not appropriately discipline such players etc helps set the standards parents expect from their children. This should especially be the case when the alcohol misuse has resulted in sexual misconduct and / or violence. Talking about how family members would feel if the abused woman or injured person had been a family member is a good way to make the point.
- Do not purchase alcohol for under-age drinkers. While it is difficult to prevent adolescents under the age of 18 from gaining access to all alcohol, giving in to pressure from adolescents by buying it for them sends completely the wrong message. If parents can not show responsibility by sticking to their principles, how can they expect their children to do so. Even worse is providing alcohol for other people’s children, either by providing alcohol at parties where under-age drinkers are likely to be present or by purchasing alcoholic drinks for one's own under-age child who then shares them with their friends. Such behaviour shows complete disregard for the rights of other parents who choose not to supply their children with alcohol. It is also important that the patents of underage teenagers do not allow their older siblings to purchase alcohol for them.
Drug and alcohol expert Paul Dillon, when commenting on a father who supplied alcohol for his son’s party for 16-year olds (in his book Teenagers, alcohol and drugs) states:
‘I am sure the father had the best of intentions. According to him he had tried to keep the party as safe as possible. But what was the most powerful message he sent his son about alcohol that night? It was; ‘to celebrate you need alcohol.’ Is that really the message you want to send your child when you introduce them to the drug that we know contributes to more young people dying than any other.’
Mr Dillon also states that by providing alcohol to minors adults are ‘telling them to ignore the law – alcohol is an illegal drug for those under the age of eighteen’. On the often stated parental belief that if teenagers are going to drink anyway it is safer for them to do it at home he says ‘… I challenge any parent hosting a party where alcohol is being served to underage teenagers to prove that they are providing a ‘safe environment.’
- Discuss alcohol with the parents of children’s friends: If parents as a group can come to a mutual agreement regarding the supply of alcohol to their under-age children, this will send a clear message to their children about what is right and wrong with regard to alcohol use. And keeping in touch with parents is a great way of keeping up with what is going on in a child’s life outside home.
- Ensure that children are well supervised when alcohol may be available: It is important to check that parties etc that teenagers attend are supervised by responsible adults and to make sure that a responsible adult drops them off and pick them up.
- Encourage governments to better regulate the alcohol industry by:
- Help reduce alcohol marketing to young people. Parents should do what they can to persuade the governments of this country to start controlling the free-for-all attitude towards marketing alcohol to young people that the liquor industry has adopted. The proliferation of alcoholic beverages that have been created for and marketed to young people (especially the fruity sweet products, the so-called ‘alcopops’, targeted especially at females) in Australia shows that the alcohol industry has treated with contempt the responsibilities that go with privilege of being allowed self-regulation with respect to the marketing of their products. (I just can not understand how adults can promote behaviours that are just as likely to affect their own children. Do these people think that their own children will be immune to the effects of alcohol or are the extra profits / bonuses they make worth it.) It is time for governments to start representing the interests of the Australian people with regard to this issue, not the Australian liquor industry, and it is parents who have to tell them to do it.
- Legislating for the compulsory labelling of alcoholic drinks with recommendations regarding safe levels of consumption: Many young people are unaware of what is the ‘safe’ level of consumption of each different alcohol product. This would rectify this situation.
- Standardising and reducing the alcohol content in 'alcopops' / pre-mixed drinks: Ensuring that each serving of alcohol (i.e. a can or a small bottle) contained no more than 10g of alcohol (one standard drink) would allow teenagers to better regulate how much alcohol they are consuming. At present servings can contain close to double this amount of alcohol.
- Prevent the mixing of alcohol and caffeine in alcohol products: Many 'alcopops' contain caffeine (found in the additive 'guanara') as well as alcohol. This mixture increases the risk of aggressive behaviour.
- Encourage governments to make alcohol distribution less harmful: Helpful initiatives would include increased money spent on public awareness campaigns, review self-regulation of alcohol marketing, and more responsible serving of alcohol by licensed premises.
Thankfully, the Federal Government in 2008 seems to at last be taking this issue seriously and is introducing some of the above measures but more needs to be done.
Getting adolescents home safely
Going out with friends, especially to parties, can expose adolescents to risky situations. With about 30 per cent of males and females between the ages of 14 and 19 drinking at least once a week, often at harmful levels, getting home safely is a major issue.
A mutual agreement between parents and their adolescent children including the following should ensure a safe return home when things get out of hand; as they occasionally will.
Parents should:
- agree to pick up their child at any time from any place. This will mean that when parents know their child is out, one parent needs to refrain from alcohol so that he or she is able to drive.
- agree not to be critical of any behaviour that leads to the call at te time. (Not consuming alcohol will help this.)
- agree to sort out any issues arising from inappropriate behaviour at a later date in a calm manner; not when doing the pick up or on arrival home.
- agree to give any friends a lift home if they require it.
Adolescent should:
- agree to call a prent for assistance regardless of the time, place or reason.
- agree not to drive when intoxicated by alcohol or after using any other drugs or if tired.
- agree not to be driven by anyone similarly affected or who they feel is an inadequate driver
- agree not to get into an over-crowded car and always wear a seat belt.
For parents who are having a party at their home and want to do so safely, the ‘Safe Party Tips’ distributed by the NSW police is a great source of information. Also see 'Hosting a Teenage Party' by the Drug and Alcohol Foundation.
Drink spiking and date rape
About 3000 drink spiking incidents were reported in Australia in 2002/3 but it is thought that far more episodes occur and go unreported. Most victims are younger women, with about half the cases occurring in women under 24 years of age. About 25 per cent of cases involve sexual assault.
While a range of drugs is involved, the practice of putting extra alcohol in drinks is responsible in the vast majority of cases; at least two thirds. Other drugs used include GHB (gammahydroxybutrrate, more commonly called ‘fantasy’) and benzodiazepines.
A young person’s drink is more likely to be spiked by someone they know than a complete stranger
It is a commonly held belief that drink spiking is mostly done by strangers. Unfortunately this is not the case and drink spiking is actually more likely to be done by someone the person knows. In this situation it is also likely to be done in private and not in a public bar or nightclub; another commonly held belief.
Thus people need to be careful in all situations and be careful whom they trust, especially relatively new acquaintances.
Practices that can help avoid harm from this problem include the following.
- A person should only consume drinks that he or she purchased (and watched being poured) or drinks that come in a sealed can or bottle that he or she has opened.
- Do not leave drinks unattended.
- Drink through a straw when drinking from a bottle
- Never accept drinks from strangers.
- Do not taste somebody else’s drink.
- Do not consume a drink if it tastes funny. Most drugs do have a taste. For example, GHB can taste salty or chemical-like. Likewise, feeling anything gritty in the drink may indicate an added substance is present and the person should stop consuming it immediately.
- Drink in a safe place where help is available if required.
- Avoid binge drinking / getting drunk as this makes the person an easier target. (Sober people are less likely to be targeted by ‘drink spikers’.)
- Refraining from using cannabis with alcohol also reduces the risk. (Multiple drug use is always a dangerous practice.)
- Drink with well-known friend / friends that can be relied on and try to always have a designated sober person / driver when going out.
- Anyone feeling dizzy, nauseated or disinhibited after consuming alcohol should seek help urgently.
- Help a friend if they feel their drink may have been spiked by:
- Staying with them
- Reporting the suspected crime to the police. (This action may also be helping future victims!!)
Alcopops – The most common alcoholic drink consumed by teenage girls
Alcopops are pre-mixed, spirit-based drinks, also called alcoholic sodas or alcoholic soft drinks. They are typically based on 'white' spirits such as vodka and white rum which have a blander flavour than dark spirits such as bourbon. They usually contain high levels of sweeteners, colouring and flavouring, and in appearance and taste they resemble soft drinks more than traditional alcoholic drinks. Alcopops are available in a wide range of flavours including lemon, passionfruit, raspberry and blueberry. They are a distinct category of the ‘ready-to-drink’ or RTD segment of the alcohol market. In their packaging, branding and marketing, alcopops appear to be designed to appeal to a younger age group than traditional alcoholic drinks, such as beer and bottled wine. Alcopops are most popular among the 12 to17 year-old age group (i.e. under-age drinkers) and younger women. A high level of consumption of these products by very young girls (12 to 14 years of age) is particularly concerning.
There are currently about 400 alcopop products available in Australia.
Alcopops may seem like soft drinks but they are anything but soft. In fact, many alcopops contain about 5% alcohol, which is a higher alcohol concentration than most full strength beers, and some are even stronger; up to 8% or 9% alcohol. Thus, one can or bottle may well contain up to two standard drinks (i.e. 20g of alcohol). Even more worrying is that caffeine is also being added to these high alcohol-content drinks, often by adding guarana which has a relatively high caffeine content.
Popular brands of alcopops sponsor youth events such as dance parties at ‘schoolies week’, where large numbers of underage people are present. Other marketing techniques used by alcopop manufacturers include dedicated websites promoting their products, an environment in which there is no way to restrict their messages to people over 18 years of age.
The alcopop market has developed over the past ten years largely without scrutiny by governments or public health authorities and the impact that these products may be having on youth ‘high risk’ drinking has not been the subject of any major research studies. Other alcoholic products, such as alcoholic flavoured milks, alcoholic icy poles and alcoholic jellies, have been banned from sale in Australia on the basis that they are likely to appeal to children and young people and could be confused with similar non-alcoholic products. However, alcopops, which resemble soft drinks in their appearance, packaging and taste, have been allowed to be freely promoted.
There are no specific policies or guidelines for the marketing of these products to young people and little is spent on alcohol interventions aimed at adolescents. It is estimated that state governments in Australia receive well over $100 million in revenue from the sale of alcoholic beverages to underage drinker. Thankfully it looks like a reasonable amount of this money is going to find its way into an underage drinking / binge drinking prevention campaign in the near future.
A letter to a local member of parliament highlighting concerns regarding this issue would be a help.
Parenting to prevent adolescent alcohol abuse
The child and adolescent health section of this website provides general information regarding the parenting that can help prevent alcohol use becoming a problem.
Drinking alcohol in the presence of children
As well as avoiding hazardous and excessive drinking, it is important to adjust drinking habits according to the occasion, especially when children are present. Adults should not drink at all if they are in charge of the safety of young children (especially if swimming is at all likely). They should also moderate their drinking if they will be interacting with children or teenagers. Young people can tell when adults have drunk too much and will appreciate their company less. Drinking habits are often learnt at home and parent’s drinking habits should act as a good model for their children. If children wish to start drinking when they are old enough, allowing them to drink responsibly at home is an excellent way to learn responsible drinking habits.
Advice regarding reducing harm from alcohol consumption in the young
Eventually most teenagers will decide to consume alcohol. Young people can make a special effort to reduce harm from alcohol by adopting the following behaviours. The diagram relating harm from alcohol consumption and age provided earlier in this section indicates why this is such an important health issue for young people.
- Avoid loading doses of alcohol: ‘Loading doses’ refers to the rapid intake of alcohol, usually at the beginning of a drinking session. Drinking cocktails is a good example. Such drinking causes loss of control, changes in personality and increases the likelihood of indulging in risk taking behaviours, such as drinking and driving.
- Make the first drink a large non-alcoholic drink
- Drink with food and use non-alcoholic drinks to slow down alcohol consumption: Drinking with food will slow down alcohol absorption and this helps reduce peak blood alcohol levels. Drinking non-alcoholic drinks also helps. A good plan is to have a non-alcopholic drink between each alcoholic drink.
- Restrict number of drinks per drinking session: In a short drinking session (four hours or less), drinking five standard drinks (50g) or more (binge drinking) is hazardous as it increases risk-taking behaviours, such as being driven by a person under the influence of alcohol or sexual practices that may lead to later regretted sexual behaviour, unplanned pregnancies and increased exposure to sexually transmitted diseases. At high intakes, alcohol may lead to acute physical problems such as fitting, loss of consciousness and even death.
- Keep count of drink alcohol intake; The best way to do this is to consume alcoholic drinks that only contain one standard drink's worth of alcohol (10g). It is also important not to refill unfinished drinks as this makes it difficult to count the number of standard drinks consumed.
- Avoid drinking in hazardous situations: Young people should avoid drinking when driving, when pregnant, while operating vehicles, boats or machinery, when swimming and when in charge of children.
- Avoid mixing alcohol with other drugs such as cannabis
- Alcohol should be reduced or avoided in those with mental illness: Alcohol may exacerbate anxiety, depression and increase the risk of suicide.
- Alcohol should be reduced in those who experience adverse changes in behaviour with its consumption: Such changes include aggression and inappropriate loss of inhibitions that may cause public drunkenness, violent behaviour at home and in the general community, relationship problems, inappropriate attitudes to work, and later regretted sexual activity.
- Avoid drinking large amounts of water or eating large quantities of food such as bread after consuming alcohol. Such practices increase the risk of vomiting and choking, which can be fatal.
Further information
Self-help resources
SayWhen - SayWhen provides information and resources to help patients make decisions about their drinking, http://mapi.betterhealth.vic.gov.au/saywhen
Hello Sunday Morning - Hello Sunday Morning encourages people to commit to a period without drinking and to share their experiences on the website, https://www.hellosundaymorning.org
OnTrack Alcohol - OnTrack Alcohol provides an online self-help program to help people cut back on their drinking, https://www.ontrack.org.au/web/ontrack/programs/alcohol
Counselling Online - Counselling Online provides confidential online counselling to people with alcohol and drug concerns who might be unable to attend treatment, might be reluctant to access face-to-face counselling or who may find online counselling more suitable for them, www.counsellingonline.org.au
Alcohol and Drug Information Service in your state.
This service will provide information and/or advice regarding problems. They can also refer you to health professionals that can help you personally regarding alcohol and other drug problems.
ACT Ph 6205 4545; NSW Ph 9361 8000 or 1800 422 599: NT 8981 8030 or 1800422 599; Qld Ph 3236 2414 or 1800 177 833; SA Ph 1300 131 340; Tas 1800 811 994; Vic Ph 9416 1818 or 1800 136 385; WA Ph 9442 5000 or 1800 198 024) Check directory assistance if these numbers have changed.
Australian Drug Information Network www.adin.com.au
Information about alcohol, tobacco and other drugs.
Australian Drug Foundation
www.adf.org.au
Another good general site regarding drug use; easy to access information about most types of drugs.
Family Drug Support 24 hour hotline www.fds.org.au
Ph 1300 368 186 (throughout Australia)
National Health and Medical research Council National Guidelines on Responsible Drinking https://www.nhmrc.gov.au/health-topics/alcohol-guidelines
Brief Intervention: the Drink-less package (University of Sydney) http://sydney.edu.au/medicine/addiction/drinkless/index.php
This site the very helpful and commonly used alcohol reduction program ‘Drink-less’. It can be downloaded free or orders can be taken from the site.
Information for doctors
Specialist advice for doctors regarding drug and alcohol problems (24 hour service)
NSW: Drug and Alcohol Specialist Advisory Service: Ph: 1800 023 687 or (02) 9361 8006
Vic, Tas, NT: Drug and Alcohol Specialist Advisory Service. Ph: 1800 812 804 or (03) 9416 1818
ACT: Alcohol and Drug Program. Ph: (02) 6205 4545
WA: Dept of Health Clinical Advisory Service. Ph 1800 688 847 or (08) 9442 5042
Qld: Alcohol and Drug Information Service. Ph: (07) 3636 7098 or (07) 363607599
NSW Detoxification Clinical Practice Guidelines (for doctors): A Practical Guide to Managing Withdrawal from Psychoactive Substances
www.health.nsw.gov.au/public-health/dph/publications/pdf/detoxification_clinicalpractice_guidelines.pdf