Navigating conversations about underage drinking with teenagers

The "raising a teenager" phase brings its own unique set of obstacles and "firsts," including how to navigate their potential curiosities and behaviors around alcohol.

Summertime being a season of large group gatherings, music festivals and street fests means kids might be faced with more alcohol temptation. Lurie Children's Adolescent and Young Adult Medicine Physician and Substance Use & Prevention Program Medical Director Dr. Maria Rahmandar shares guidance on how families can effectively communicate with their child on this tough topic while knowing the potential consequences and prioritizing their safety.

"In the past two decades, alcohol use among high school students has overall decreased. And while it's reassuring to see that fewer teens are using alcohol over time, it's important to know that any use is still concerning at this age," Rahmandar said. "The good news is that while half of 12th graders in the U.S. report using alcohol in the past year, the other half of 12th graders have not. It can be helpful for teens to know that most of their peers are making the healthy decision not to drink alcohol."

As for why kids become curious about underage drinking - it comes down to a few factors. An unavoidable one is that the teenage years are typically spent developing independence and exploring new things, which may include drug or alcohol use for some kids. Other kids may start or end up continuing to drink alcohol to cope with mental health concerns or traumas they are experiencing in their lives.

If you know your teen is in the presence of alcohol more frequently or is getting curious about trying it, it's important that they understand the associated risks - both short- and long-term.

"Alcohol use can contribute to critical injuries and accidents, including motor vehicle accidents and drownings, which are two of the leading causes of death for 10-19-year-olds," Rahmandar said. "Other short-term risks include nondeadly injuries, poor decision-making, memory and coordination impairment while intoxicated and alcohol poisoning,"

Rahmandar notes that while alcohol use disorder won't develop the first time a person drinks, it has the potential to develop over time with repeated use, even in teenagers.

"It can also complicate mental health conditions and worsen underlying physical health conditions, like diabetes. Additionally, long-term alcohol use can lead to even more serious physical consequences, such as liver damage," she said.

The best way to approach this difficult topic with a child is to open lines of communication with them even before adolescence, and then keep talking over time.

"This will not be a one-and-done lecture, but you can talk and ask questions based on things you and your child are seeing in everyday life, such as commercials, upcoming parties, what they are learning in school, etc.," Rahmandar said. "Express your love and support for your child, while setting consistent rules and expectations around avoiding alcohol use."

In the event your teen comes home intoxicated one night, Rahmandar suggests waiting until the next day to have a discussion. Hashing it out that night will often be unproductive.

In this situation, she suggests parents and caregivers approach their teen with the intention to understand why they were drinking, how they feel about it and how they got home. In addition, it will be important and impactful to:

• Avoid shaming

• Reiterate the rules around drinking

• Set a plan for safe rides home

• Seek help if there are concerns about repeated underage drinking, developing alcohol use disorder or other concerns about the child's mental or physical health

Rahmandar also recommends small but meaningful actions to prioritize their safety as much as possible.

This might mean communicating with co-parents and friends' parents to make sure they are on the same page with avoiding alcohol use. Discuss the importance of staying hydrated (especially at hot outdoor events) and not mixing alcohol with other drugs, discuss safe ways to get home, and make sure the teen knows they can ask for a ride any time.

"It's also important to normalize not drinking alcohol in the first place," Rahmandar said. "Most teens are choosing not to drink, so talk with them about other ways to have fun that don't include drinking and prepare them with ways to say 'no' with confidence if they are offered alcohol."

Prepare them with ways to opt out of drinking alcohol in social settings, and the confidence to do so. Rahmandar says some teens like to use a simple "no, thanks," while others might share a reason such as "I don't drink because my family has had problems with alcohol," "I have to drive/work/wake up early," "it's gross," or whatever reason the teen wants to share with others.

• Find more information and support at Lurie Children's Substance Use & Prevention Program: luriechildrens.org/en/specialties-conditions/substance-use-prevention-program/.