Transcript Sensible teenage drinking Dr Stephen Newell

Sensible teenage drinking
Dr Stephen Newell
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Social importance
Humans like bitter flavours
Fermentation was known in antiquity
Wine has been made from grapes for six
millennia
Beer has been made since the 8th century BC
In history, cleaner to drink than water
Used in celebrations and social functions
Part of everyday life for many people
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Importance in agriculture, e.g.
In 2002 France produced 7.6
million metric tonnes of grapes
Barley / hops important crops
Viticulture and brewing are huge
industries with fascinating
histories and academic interest
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Economic importance, e.g.
In the UK, tax on alcoholic drinks
raises £7 billion per annum
Tourism to wine-producing areas
There are about 60 000 pubs in UK
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But there are also negative
elements to alcohol…
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Alcohol use
• Substance use and associated disorders
are common
– Alcohol is one of the most commonly misused
substances
– The majority of people in Western societies are
current or past users of at least one
psychoactive drug
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Percentage of U.S. Population (aged 12 and
over) who have ever used drugs of abuse
70
60
50
40
30
20
10
0
Tobacco
Heroin
THC
Cocaine
Alcohol
National Household Survey on Drug Abuse, 1998
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Influences on alcohol &
substance use
• Biological
• Psychological
• Developmental
• Family & social influences
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Biological influences on
substance use
• Alcohol and drug use have genetic
influences
– “Novelty seeking” temperament
– There are genetic predictors of response,
metabolism, risk of later dependence
– Familial factors relating to medical
consequences of alcohol use
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Family & social factors
Families develop patterns of alcohol use
which are modelled and passed on to
future generations
Should parents allow teenagers to have
some alcohol at home to learn about its
effects?
Cultural & religious influences
Peer group influences
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Alcohol units
• 1 unit = 1 small glass of wine
= ½ pint of beer = 1 measure
of spirits
• Weekly “allowance”
21-28 for men, 14-21 for
women
• These are guides – may be too
much for some small females
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Teenage drinking
• 1998 in UK the ONS general
household survey showed
50% of men age 16-24 had
drunk more than 4 units per
day in the week before the
survey
• Corresponding figure for
women was 40%
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Health benefits of moderate
alcohol use
• 1-2 units of alcohol per day has a
protective effect on the heart –
less heart attacks
• Reduced incidence of gallstones
• Reduced incidence of macular
degeneration (eye disease)
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What is being modelled at home?
• Appropriate and sensible use of
alcohol?
• or
• Inappropriate and unsafe use?
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Possible consequences of
inappropriate alcohol usage on
the family
Domestic violence
Child abuse
Impaired family relationships
Financial consequences
Male 35, 3 children, 5 bottles of Malibu
p.w. @ £11, 40 cigs/day @ £9, so
spending £118 p.w. or £6136 p.a. On
long term sick certification.
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Domestic violence
Approximately 80% of spouse to spouse
violence is alcohol related
Physical abuse of children involves 2030% of parents who are heavy drinkers
The child abusing parent is often under
the influence of alcohol when the
incident occurs
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Effects on the family
Inappropriate alcohol use can have a
highly disruptive effect on family rituals “Uncle Fred ruins every Christmas
dinner by becoming drunk”
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Effects on children of alcohol
abuse in the family
• Conduct and academic problems
• Emotional difficulties
• The effects of whatever has promoted
the alcohol abuse e.g. family difficulties
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Medical consequences
of alcohol
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Epidemiology
• Alcohol misuse costs the NHS
up to £3 billion per year on
hospital services
• Alcohol abuse causes 22 000
deaths per year
• 150 000 hospital admissions p.a.
for alcohol-related accidents &
illnesses
• Alcoholics who continue drinking
shorten their lifespan by 15 years
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Effects of alcohol
• Acute effects
• Chronic heavy use
• Withdrawal
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Acute Effects 1
• Brain & nervous system
disinhibition
sedation
accidents
hangover
• Gastrointestinal
nausea / vomiting
gastritis
bleeding
hepatitis
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Acute Effects 2
• Respiratory
suppression
choking on vomit
overdose
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Acute Effects 3
• Reproductive system
disinhibition
erectile dysfunction
unplanned pregnancy
• Legal
drunk & disorderly
vagrancy
vandalism
fights / assault
drink driving – 1 in 20 RTAs
involve driving over
the legal limit
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Effects of Chronic Heavy
Drinking
• Brain and nervous
system
– Neuropathies
– Cerebellar
degeneration
– Wernicke-Korsakoff’s
syndrome
– Dementia
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Effects of chronic heavy
drinking
• Gastrointestinal
– Gastritis / ulcers
– Liver damage / cirrhosis
– Pancreas
• Cardiovascular (heart & blood vessels)
– Hypertension (high blood pressure)
– Cardiomyopathy
– Stroke
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Effects of chronic heavy
drinking
• Reproductive
fertility problems
erectile dysfunction
foetal alcohol syndrome
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Foetal alcohol syndrome
• Growth retardation
• Facial dysmorphism
• Learning difficulties and other
neurological problems
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Effects of chronic heavy
drinking
• Hematological (blood)
• Musculoskeletal (muscles and bones)
• Endocrine (glands)
• Dermatological (skin)
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Withdrawal effects
• Withdrawal effects are generally
the opposite of intoxication
• Alcohol detoxification (treatment)
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Alcohol-Drug interactions
• Illicit drugs
(e.g. cocaine, heroin)
• Prescription drugs
(e.g. benzodiazepines, metronidazole)
• Over-the-counter drugs
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Summary
• Alcohol can be medically hazardous acutely,
with chronic high levels of use, and in
withdrawal
• Every major organ system can be affected
• There is the possibility of damage and a risk
of death associated with alcohol use
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So what advice to teenagers?
• Parents need to set a good example
• Stress the importance of not drinking and driving
• Explain that alcohol can have a stronger effect on
young people - who have immature livers, etc
• Explain that too much alcohol can cause more than
just a bad headache the next day – e.g. where you
wake up, unprotected sex
• Help them understand the meaning of drinking
sensible amounts of alcohol – e.g. by using units
• When they are out with friends encourage them to
look after each other
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Advice and downloadable information
www.portman-group.org.uk
whose tag line is
“Promoting responsible drinking”
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A few words about drugs…..
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Marijuana
• Motor vehicle accidents
• Motivation / concentration
difficulties
• Smoking damage
• Immune impairment
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Stimulants
(Cocaine, Amphetamine, Ecstacy)
• Cardiovascular
• Neurological
• Injection risks
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Opioids
• Overdose
• Injection risks
• Gastrointestinal
• Musculoskeletal
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Other Drugs
• Phencyclidine
(PCP)
• Inhalants
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Summary
• Drugs of abuse are physically hazardous
• There are many possible medical
consequences of use
• Specific drugs affect major organ systems
differently
• There is the risk of damage and mortality
associated with these drugs
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