Saturday, October 30, 2010

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

6 comments:

  1. I suspect that this is an ever increasing problem in the India, what with more money, more freedom, more peer pressure and poor connections between the parents and the progeny (who have just sufficient quality time to spend in terms of quantifying the time spent)...
    Well, I hope more than the experimenting adolescent, it is their parents who act responsible too...

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  2. I think talking to your kids about alcohol / drugs and peer pressure should begin early. Funny that India has reached this level when the west is realising the implications of underage drinking and thanks to organisations like MADD etc.. have policies and regulations in place.

    Doesn't help that parties in India now begin at 9.00 pm and go on till 3.00 am

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  3. Thanks Sanjiv
    Responsibility rests at many levels. Society sends out conflicting signals, adolescents exploit these, and parents have different thresholds as to when to intervene. The CRAFFT provides an evidence based indication of the need for intervention - whether social, parental or individual.

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  4. Kids also learn by modelling and the first models are us - the parents :) Regulations have brought counsellors into many schools in India, including those in Pune.

    Supervision and regulations help reduce the incidence but some adolescents will still require treatment by a psychiatrist for alcoholism.

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  5. Hi,
    I have been teaching teenagers for almost three decades now and I feel that the change in the social panorama has far reaching influences on the behavioural patterns of the youth.I am surrounded by kids who are from very affluent families, these children are really blessed (or are they?)because they live in the lap of luxury, have no clear goal in life, they have all the time in the world,unlimted access to money and no parental sanctions to speak of!!!That leaves these young adults seeking some meaning in a life that revolves around endless vodka shots till wee hours of morning.The parents have accepted this as the norm and their permissive and indulging approach has become a fertile ground to breed a young generation that is addicted to alcohol and permissive lifestyle.I wonder who is to blame- the parent or the child??

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  6. Mitu what you describe could occur in any social strata, just the surroundings would differ. I've found peer pressure is a major contributor.

    More than who to blame - what can be done?
    Its been shown repeatedly that children including teenagers will respond to someone whom they can respect and who cares for them. If its not the parents it may be a coach or a teacher. Lifeskills training at the school could be another area for preventive action.

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