Treat underage drinking as a serious public health problem

April 21, 2006|By PIERRE N. VIGILANCE

Sneakers and jeans, vodka, electronics and models, beer, car and movie reviews, cognac, tobacco, rum, more models, more vodka ... cover article. This is the order of things in a number of popular magazines that carry the latest buzz-worthy items designed to appeal to young people.

It should come as no surprise that alcohol is high on the list, as the combination of sound marketing research and seemingly innocuous advertising has maintained alcohol as a staple in our social diets.

Underage drinking is not just a problem for young people, parents, law enforcement and proponents of sound public health practices. It is a problem for the general public, and one that we need to actively discuss so that the dangerous outcomes that result from the practice can be prevented.

We all have a role to play in public health, from curbing tobacco and alcohol use to abating the spread of infections. As part of our collective mission to stop underage drinking, we should be armed with the facts.

A 2002 National Institute on Alcohol Abuse and Alcoholism study showed that 1,700 college students ages 18 to 24 died as a result of hazardous drinking, 80 percent of them from car crashes. Additionally, because of underage drinking, 500,000 college students suffered unintentional injuries.

Alcohol consumed in excess remains the substance most frequently associated with physical and sexual assaults, overdose deaths and unprotected sex. The early abuse of alcohol also has mental health ramifications because it may be used to cope with stress and is highly correlated with suicide.

While surveys show that alcohol is the substance of choice for the majority of college students who admit to drug or alcohol use, this is not a problem confined to young people in college.

In Maryland, most underage drinkers begin drinking when they are 13 to 16 years old, nearly 70 percent of high school seniors had tried some form of alcohol, and half of all high school seniors surveyed admitted to binge drinking (consuming five or more alcoholic beverages in a single sitting), according to a 2004 Maryland Adolescent Survey.

In one study, 33 percent of high school students admitted to binge drinking, but in the same study, only 3 percent of parents believed that their children engaged in this practice.

Moreover, underage drinking is associated with community problems, such as public disturbances, and academic and professional consequences, such as poor performance and low productivity, making it a broader public health problem.

Lack of awareness and denial are significant obstacles to effective communication that must be confronted if we are to make any progress on addressing this problem. The failure of some entertainment establishments to effectively enforce the legal drinking age is evidence of irresponsibility on both sides of the bar. Easy access to alcohol, clever alcohol advertisements, low-priced drink specials, drinking games and parents who allow their homes to be used for parties at which underage drinking takes place all foster an environment that promotes the idea that "a good time" cannot be had without alcoholic beverages.

Coalitions of individuals affected by alcohol abuse work with law enforcement, local business and community groups to prevent the many issues that this problem presents. Some help parents deal with the realities of losing a child to a drunken driver, while others teach parents how to communicate effectively with their children about the dangers of drinking alcohol.

Accepting the truth about the dangers our young people may be facing as a consequence of their alcohol use and collaborating to create changes in public perceptions of the appropriateness of underage drinking must both be at the core of any efforts to address this critical public health issue.

Dr. Pierre N. Vigilance is director of the Baltimore County Department of Health. His e-mail is

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