Calling the situation a challenge to “our national conscience,” Secretary of Health and Human Services Richard S. Schweiker last week announced a new federal initiative aimed at curbing alcohol abuse by young people.
Mr. Schweiker launched the effort--a supplement to existing programs--in response to the large number of motor-vehicle deaths among young people that can be linked to alcohol. He also cited the unacceptably high rate of alcohol misuse among young people.
But experts on alcohol and its effects agree that traffic-fatality statistics are only the most visible part of a problem with many dimensions. Despite considerable research on alcohol, there are still many unanswered questions about teen-age drinking and many public misperceptions of the nature of the problem.
Anecdotal evidence, at least, suggests that more teen-agers are drinking in school.
“It is a major problem in the schools, and it is becoming a more obvious problem, " said Patricia O’Gorman, a psychologist, author, and consultant, and former head of the federal alcohol-prevention and education program.
School officials may not be able to produce statistics that document a rise in student drinking in the schools, she said, but “administrators and teachers are saying, ‘We’re noticing more.”’
In response, some school districts--such as Boston--are setting up alcohol programs for students and staff. Others, such as Philadelphia, have had alcohol programs for years.
Virtually all states require that students be taught something about alcohol, but the specific requirements vary.
Research and Education Programs
The new federal effort will supplement the research and public-education programs now sponsored by the U.S. Department of Health and Human Services (hhs). It will include nine regional conferences for school personnel and parents, as well as other conferences on alcohol programs for young people. The government is encouraging private industry to support these programs.
Also, Secretary Schweiker is urging government agencies and private organizations to cooperate on research on teen-age alcohol use.
Next spring, he will convene a “Secretarial Conference” on a “growing youth movement” called Students Against Driving Drunk.
According to recent studies, 87 percent of all high-school students have used alcohol at least once. About 15 percent are considered “problem drinkers,” according to the National Council on Alcoholism (nca).
In 1981, about 10,000 people under the age of 25 died in alcohol-related crashes, according to the National Highway Traffic Safety Administration, which compiles reports from state police.
Concern about the problem is vital in preventing teen-age alcohol abuse, alcohol educators say. But it is equally important that school officials and parents understand the nature of the problem--what researchers do and do not know about the way teen-agers drink, their reasons for drinking, the effects of alcohol use, and the most effective education and intervention strategies.
“The problem very often gets misrepresented in the press,” said Susan Maloney of hhs’s office of disease prevention and health promotion. “Teen-age alcoholism is not the [major] problem.”
Rather, she said, teen-agers drink in situations that are likely to get them into trouble. But patterns of drinking among teen-agers are very different from adult drinking patterns. Teen-agers favor periodic bouts of heavy drinking, rather than constant alcohol use. Teen-agers drink illegally, and in out-of-the-way public places, like parks and parking lots. They seek privacy, so they drink in cars. They are less skilled at modifying their behavior in response to alcohol’s effects; they get rowdy, they wreck cars, they cause trouble.
A careful reading of the statistics, Ms. O’Gorman said, shows that an increasing number of teen-agers approve of and indulge in “binge drinking” of this sort. Although the amount that high-school students report drinking has remained stable in recent years, Ms. O’Gorman said, their patterns of use are changing. Before, students who reported having five beers per week would generally have one each night, perhaps in combination with marijuana.
Now, she said, the students are likely to drink all five beers on one occasion. In short, she said, “what we find is that intoxication is on the increase.”
“All these factors contribute to what we are now terming ‘the teen-age alcohol problem,”’ Ms. Maloney said. They are factors related to alcohol use, but they are very different from alcoholism.
Nevertheless, there are teen-age alcoholics--young people who cannot control their drinking, but who may not have been drinking long enough to exhibit the physiological changes that characterize adult alcohol abusers, according to Joanne Yurman, director of prevention and education programs for the nca
Teen-agers and younger adolescents drink for many reasons, some of which are more complex than “peer pressure,” according to researchers. They may drink in reaction to a difficult home life or in response to the social cues that confront them constantly.
Peer pressure, of course, does play a role in teen-age alcohol use, researchers say. But they suggest that a child’s basic attitudes toward alcohol are formed much earlier and by forces other than their friends.
Early drinking patterns are established between the ages of 12 and 15, Ms. O’Gorman said. “Kids learn first from their families and second from their peers. Peers rarely create the response.” By the time a teen-ager is 15, he or she will have a pattern of alcohol use that will probably be maintained for at least two years, she added.
Society’s ambivalent attitude toward alcohol makes it difficult for teen-agers to know how to react to alcohol, Ms. Yurman said. Parents may tell them that drinking is bad, then drink themselves. On television, glamorous and successful people drink. In one hourlong episode of the now-defunct series Mannix, for example, the cast was shown drinking 235 times, Ms. O’Gorman said. “That sends a very powerful message,” she said.
Teen-age drinking is “a social problem far greater than we realize because we permit kids to drink,” said Daniel P. Falco, director of the student and employee assistance program for the School District of Philadelphia.
There, school officials have operated a drug and alcohol student-assistance program for 10 years. The students who seek help, Mr. Falco said, come from all social and economic brackets and races.
The students who end up in the counselors’ office, however, often have one thing in common: “I think that it’s generally a very poor self image. You look at a kid who drinks, he hates himself. He’s not making it with his girl, he’s not doing well in school,” Mr. Falco said.
Children from troubled homes are also more likely to turn to alcohol, several researchers said. In particular, the children of alcoholic parents are far more likely to become alcoholics themselves. They drink “to show themselves and the world that they’re not like their parents,” Ms. O’Gorman said.
Dramatic Evidence
Motor-vehicle accidents are the most dramatic evidence of the problems that alcohol can cause, but there are other ill effects as well, according to researchers.
Drinking in school creates disciplinary, educational, and social problems for both students and teachers. One view is that “any time there’s drinking in and around the school, there’s a problem, because the students are thinking about drinking, not about their schoolwork,” said Ms. Yurman.
Those who work with students concur that alcohol abuse hurts a student’s schoolwork. “I think you’ll find that when a youngster has a drinking problem, his work will suffer,” said Mr. Falco of Philadelphia. “If he’s really an alcoholic, that will take precedence. He becomes a loner because there’s only one thing in his life that has meaning.”
Although there are still many uncertainties about the long-range ef-fects of alcohol on young people, one study has shown that teen-agers, especially boys, who drink heavily are more likely to become alcoholics later in life. Few studies have been done on the subject, however, and many researchers say that they simply do not know whether that is so.
“They drink a lot and they have problems,” said Ms. Yurman of the nca “That may mean they’re setting themselves up for alcoholism later.”
But at least one immediate effect that could have serious implications for education has emerged in recent years. In a series of studies conducted on college students, Elizabeth S. Parker, a research psychologist with the National Institute on Alcohol Abuse and Alcoholism, has found that consuming relatively small amounts of alcohol leads to a loss of memory.
“The ability to acquire new information is significantly impaired,” she said. If after drinking enough alcohol to raise his blood-alcohol level to .04--well below the intoxication level--a student is asked to study or report on something, “you’ll see a very significant drop in what they remember.”
The memory loss increases in proportion to the level of alcohol in the blood, Ms. Parker said. Consuming a large amount of alcohol in a short period of time--as many teen-age drinkers do--would lead to greater memory loss, the research suggests.
Since she has not studied any high\school-age populations, Ms. Parker said that she does not know whether her findings apply also to that age group. She said, however, that the findings “could be particularly important for [high-school] students, who are at the formative stage and whose brains are still developing.”
“Time spent under the influence of alcohol is not going to be the same as time spent sober,” she said.
In another study of college students that could have implications for high-school students, Ms. Parker found that the ability to form abstractions and synthesize new information was inversely related to the amount that the subjects reported drinking at one time. Those who drank a lot when they drank performed worse on tests of these tasks.
Those who work in the field say they believe that schools can make a great difference in teen-agers’ use and abuse of alcohol.
Classes to help students learn about the potential problems posed by alcohol help; so do “peer-counseling” projects, in which students work with other students.
“Education is helpful because it allows the peer group to identify members who are having problems,” Ms. O’Gorman said.
Boston’s alcohol-education program will be designed to help both staff members (the district employs 8,000 people) and students, according to Rosemarie Rosen, deputy superintendent for finance and administration for the Boston Public Schools.
District officials are not creating the program in response to a crisis, Ms. Rosen said, but because they believe there is enough alcohol abuse among students and staff to warrant action.
For students, Ms. Rosen said, the program will take an approach that differs from the “horror stories” sometimes employed to discourage youths from drinking.
Telling students that they will end up in the gutter if they drink, she said, “doesn’t jibe with the glamor that kids see.” Most of the adults they know drink. So the curriculum will emphasize “drinking as a social fact of life,” Ms. Rosen said. Its intent will be “not to encourage them, but to recognize that it’s part of life.”
In Boston and elsewhere, school officials enlist the aid of the entire staff. Boston administrators have found that custodians and school nurses play key roles in discovering evidence of students’ drinking. Custodians may find empty bottles in trash cans and report their findings to administrators. Nurses may pick up physical symptoms that a teacher would miss, said John Diggins, senior advisor for pupil services in Boston.
In Philadelphia, such a system has proved extremely successful, Mr. Falco said. Most of the referrals come from students, he added. “Kids help other kids. They trust them more.”
Teachers and administrators may notice clues that a student has, or is developing, an alcohol problem, Ms. Yurman said.
“If a student who has been acting one way suddenly begins acting different,” that may be a sign. He or she may begin hanging around with a different group of friends, become less careful about personal appearance, or begin behaving erratically. The punctual student who begins being late or the good student who begins performing poorly may be having alcohol problems, Ms. Yurman said.
The signs may be more obvious--alcohol on the breath, for example, is a sure sign, she added.
