When is teen alcohol drinking problem drinking?

The legal age for obtaining an alcohol permit (yes, that's a prerequisite for alcohol consumption in Maharashtra) is 25 years. However, a recent survey of teenagers in major Indian cities including Pune would have us believe that 45% of Class XII students consume alcohol five to six times a month.

Adolescence is characterised by experimentation

The maturing adolescent brain with its new tool of abstract reasoning seeks to explore the environment and reach its own conclusions regarding the world. Experimenting with socially acceptable intoxicants is just another facet of this behaviour. So, whether legal or otherwise, some of Pune's teens will continue to consume alcohol.

When does alcohol drinking become problem drinking? Is it to do with the frequency? If 5-6 times a month is excessive would 2-3 times be alright? Is it OK to drink alcohol in groups but not OK to drink when alone? When would it be time to seek help?

How would a teenager know the experiment has gone out of control?

The CRAFFT was designed to answer this question. It is a brief screening test for adolescent alcohol and other drug use. CRAFFT is an acronym of key words in six questions. Our staff nurse gets teenagers to answer it in the waiting room. 
(Knight JR; Sherritt L; Shrier LA//Harris SK//Chang G. Validity of the CRAFFT substance abuse screening test among adolescent clinic patients. Archives of Pediatrics & Adolescent 156(6) 607-614, 2002.)

The CRAFFT questions

• C - Have you ever ridden in a CAR driven by someone (including yourself) who was "high" or had been using alcohol or drugs?
• R - Do you ever use alcohol or drugs to RELAX, feel better about yourself, or fit in?
• A - Do you ever use alcohol/drugs while you are by yourself, ALONE?
• F - Do your family or FRIENDS ever tell you that you should cut down on your drinking or drug use?
• F - Do you ever FORGET things you did while using alcohol or drugs?
• T - Have you gotten into TROUBLE while you were using alcohol or drugs?

2 or more YES answers suggests a 94% chance of significant alcohol related problems