By Dr. Amy Glaser

As parents we are constantly faced with the challenge of modifying our children’s behaviors. Whether it is the toddler throwing a temper tantrum in a grocery store, an older sib grabbing a coveted toy from his playmate, or a student taking hours to do a short homework assignment, our aim is to prevent physical harm, incorporate some lesson that will be taken into future situations, make the child feel stronger not belittled,  and hopefully, not alienate oneself as a dominating figure but instead remain emotionally connected.

With teens and alcohol during their years at home we can monitor parties at home, speak with other parents, maintain curfews, and most importantly, share our views on alcohol and our feeling for their welfare. We hope that we make ourselves understood so that the message will become ingrained for when their daily whereabouts are out of our reach.

Here are some facts that might help your children consider their behavior in context of what is known about neurocognitive development. They’re good kids. They want to have fun. They don’t want to make irrevocable mistakes.

As teens move from dependence to independence and self-definition there are physical changes within that are in flux. The portions of the brain that express emotions and seek gratification mature more rapidly than the parts of the brain responsible for planning and regulating behavior. Thus the impulsivity of the adolescent period has a biologic basis. . Through advanced imagery studies, we now know that the frontal lobe, the area of the brain that has inhibitory and planning functions, is still developing into the mid twenties as various synapses/neurons are eliminated or pruned.   And these changes are determined both by genetics and by interactions with the environment.

Much of the knowledge about the brain and human behavior is derived from laboratory studies of animals. These studies of both rats and humans show that the developing brain responds differently than the adult to alcohol. Alcohol has been shown to impair memory, cause more brain damage and cause cognitive impairment to a greater extent in adolescents than in adults, both in rats and humans.

Conversely drinking causes less sedation and motor impairment  in adolescents than in mature brains. Thus a teen with an  equivalent alcohol exposure to an adult is more likely to be awake and mobile and thus ready for more “action.” This exposure during adolescence to alcohol affects not only that moment in time but can also alter the way the person will respond to alcohol later in life.

Studies in rats who have “Chronic intermittent alcohol exposure” (ie  binge drinking) are more likely to  have withdrawal seizures on stopping drinking. Extrapolated to humans the belief of investigators is that repeated exposure to alcohol during adolescence could lead to loner lasting deficits in learning and memory.

Now to college campuses. A recent national study following student from early adolescence through their mid 20’s found that compared with their peers who never attended college, current college students were less likely to have been binge drinkers prior to their college years but more likely to binge drink once they entered college. Binge drinking behaviors were greatest in those with a genetic risk factor and in environments in which drinking behaviors were promoted. Heavy drinking among college students is not a unique to US college students but is reported to be a problem in Europe, South America and New Zealand as well, with higher risk attributed to males, , higher economic status and family education and excessive alcohol use by family and peers. The perceived norm on college campuses is the belief that “everyone is doing it”. But in fact the truth is that students feel that other students drink much more than they actually do and that their administrations are more lenient towards drinking than they really are.

This last sentence may be the most important beginning on campuses to change behavior. Social norm campaigns on campuses to communicate the true rate of alcohol use coupled with  community crackdown on alcohol availability and the advertising the availability of help, particularly peer supported for those with alcohol problems have shown to be effective on some campuses. Colleges must work hard to create an image of the “ new cool” other than the frat house. And knowledge is a powerful thing. In junior high and high school bio and health classes can add brain development to their curriculum. Students have all heard the term” binge drinking” the episode intake of alcohol to raise the blood alcohol level to .08. But fewer have heard of “ alcohol poisoning” where the intake is toxic to the point where mental confusion lead to coma, vomiting irregular breathing , temperature deregulation and even death. Yes Alcohol can kill.

OTBKB is thrilled to feature The Doctor is In, a regular weekly column by Amy Glaser. Born in Brooklyn, Dr. Amy Glaser of Slope Pediatrics received her undergraduate degree from Smith College, her medical degree from Mount Sinai School of Medicine and completed her pediatric residency at Montefiore Hospital. She started in Park Slope 25 years ago with a special interest in teens, after completing a fellowship program in Adolescent Medicine at Mount Sinai. She has brought her expertise in that area into the community during her career at the Door, El Puente, Elmhurst Adolescent Center and Barnard. Dr. Glaser has been named by NY Magazine as a “top pediatrician” and as one of the “Best Doctors in America”. She recently started a part-time practice for ages 13-22 called “Adolescents Only.”