Underage drinking: what's the big picture?

Like most GPs today, I have a bit of a 'portfolio career'. Along with my commitments in my practice (I still work for about 35 hours a week in the same practice I joined as a partner 26 years ago) I write - obviously - for Patient.info and comment on medical news stories in the media. But I also work as a medical advisor for the charity Drinkaware. I first became involved with them several years ago, as part of a drive to target young people and the particular dangers alcohol poses for them.

This week, my media and alcohol worlds coincided with the launch of a new survey about drinking patterns among young people aged 11-14. The survey that caused all the furore found that:

- Half of parents of under-14s let them drink at home

- For one in 12 under-14s, this is at least a monthly occurrence

- One in nine parents lets their five to seven-year-olds drink alcohol at least occasionally

- 34% of parents with children aged under 14 use alcohol as a bribe, to help prevent them rebelling

- A quarter of parents of under-14s who let their children drink see nothing wrong with it

- One in seven parents have seen their child have an accident while under the influence of alcohol in the home

- One in five parents allows minors who aren't family members to drink alcohol in their home.

Sky News, Channel 5, BBC Breakfast, 5 regional radio stations all asked me for comment, and I found myself poring through national statistics to see if the worrying results of this survey were reflected elsewhere.

I knew exactly what the counter arguments to my medical advice would be. Many parents I speak to believe that 'continental drinking' - introducing young people to alcohol (such as watered-down wine) with meals in a family environment - takes the mystique out of alcohol. If they drink when they're supervised, goes the argument, they'll be less likely to drink with their friends and more likely to avoid trouble if they do.

That may be the case in some countries, but countries like Britain and the USA have very different drinking patterns to continental Europe. In the UK, drinking is regarded as a social event in itself, rather than as part of a meal, which is much more common than in other countries. In a major UK survey in 2010, half of teenage pupils had been drunk in the previous four weeks, and almost two thirds of these had deliberately planned to get drunk (2).

This carries risks of accidents, injuries, becoming a victim of assault or having unprotected sex. It's estimated that in the USA there are about 188,000 emergency room attendances every year due to alcohol among under-21s (1). In the UK, figures for under-16s are hard to come by, but alcohol-related hospital admissions among young people aged 15-24 have been rising steeply since 2002. (2)

The link between alcohol and mental health problems is well proven, and being a teenager is tough at the best of times - as recent headlines about worrying levels of depression among young people remind us. (3) Also, there is good evidence that adolescent brains are still developing, which means that alcohol may have a far greater impact on concentration, academic achievement and long-term job prospects than they would for an adult.

It's not all doom and gloom. The biggest survey of household lifestyle habits (Smoking, Drinking and Drug Use Among Young People in England report) tells a slightly different story from this survey. In the UK, the proportion of under-16s who have ever drunk alcohol has been going down for 13 years, and today that figure is 38% - similar to the US figure of 35%. (4)

But alcohol, as the survey suggests, causes mishaps of varying degrees of severity, and having parental supervision may reduce problems, but doesn't always stop them. Two in five teenagers who drunk unsupervised experienced alcohol-related harm, compared with one in 12 of the group who have always had adult supervision. (5) They're also more likely to take risks - and get caught. A Home Office report in 2004 found that 10- 17-year-olds who drank at least weekly made up 14% of the population being surveyed, but carried out 37% of the crimes. (2)

The Chief Medical Officer recommends that young people should have an alcohol-free childhood, at least until the age of 16. Parents I speak to often don't know how to broach the subject - but broach it they must if their youngster's friends aren't going to get there first. It may not feel like it, but the evidence is that young people pay far more attention to their parents than they let on. If that's you, you have three days to go until GCSE results come out - how do you want your teenager to celebrate?


1) National Institute on Alcohol Abuse and Alcoholism (NIAAA). Underage drinking: Why do adolescents drink, what are the risks, and how can underage drinking be prevented? Alcohol Alert, No. 67. Rockville, MD: NIAAA, January 2006. 

2) Institute of Alcohol Studies underage drinking factsheet

3) http://www.nuffieldfoundation.org/time-trends-adolescent-well-being

4) National Survey on Drug and Alcohol Use (NSDUH) 2014 

5) Drinkaware report: http://bit.ly/2bwd2Vd 

Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Egton Medical Information Systems Limited has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.