By: Jennifer Greene
Introduction
Risk
-taking is defined as engaging in behaviors that may have harmful consequences,
but simultaneously provide an outcome that can also be perceived as positive (R. Beyth-Marom & B. Fischoff, 1997). Teen consumption of
alcohol is considered a risk-taking behavior because it can results on feelings
of elation, but at the same time it results in damage to the brain with long
lasting consequences. The potential long-term consequences of engaging in the
most adolescent risk-taking behaviors
include, but are not limited to, alcohol abuse, substance abuse, cancers
associated with tobacco use, unwanted pregnancies, sexually transmitted infections
(STIs) and serious criminal activity (J. M. Sales, & C.E. Irwin,Jr., 2009) .
Latest
Neuroscience Findings
Substance abuse has been linked to
poorer cognitive development, spatial, learning, inhibitory, and memory
function (Professor Jonathan D. Chick Professor P. De Witte Dr Lorenzo Leggio,
2012).
Adolescence is a fragile and critical unique stage in neurodevelopment where
illicit narcotics and alcohol are common place. The use of drugs and alcohol
literally change the amount of white matter quality in the brain, along with
the brain structure (L.M. Squeglia, J. Jacobs, S.F. Tapert PhD., 2013). The article goes on to discuss the changes in
neurocognition, brain structure and brain function with teens who engage in
alcohol or substance abuse with relations to neuromaturational processes. As
Social Workers we need to understand the effects of drug and alcohol usage,
especially during the teenage years of 12-18 when the brain is going through
dramatic changes. Understanding the volume increase of usage on adolescent neurocognition
is the first critical step. During this stage in life adolescent usage begins
to increase. Epidemiological studies have shown that “past month alcohol use
increases from 17% to 45% between 8th and 12th grade, and
illicit drug use prevalence expands from 8% to 22%. Lifetime rates indicate
that 73% of youth have used alcohol and 48% have used illicit drugs by their
senior year of high school. In the past year, 23% of youth meet diagnostic
criteria for a substance use disorder (alcohol or drug abuse or dependence) by
age 20” (L.M. Squeglia, J. Jacobs, S.F. Tapert PhD., 2013).
During the teenage years, peer group
identity and peer pressure impact adolescent behaviors and how his or her brain
functions during this time period. Transformations that are occurring in the
prefrontal regions and limbic systems may be a contributing factor to increased
risk taking behavior in adolescence, that alter neuromaturation and
neurochemical changes to cognitive, emotional, and behavioral changes. These changes affect the
amount of drugs and alcohol an individual may consume in a given period of
time. (Cheryl Anne Boyce, PhD., Karen Sirocco, PhD., 2011)
Literature for Neurobiological
Underpinnings
Alcohol
affects many aspects of a developing adolescent brain, including the cerebral
cortex, central nervous system, frontal lobes, hippocampus, cerebellum,
hypothalamus and medulla (Substance Abuse and Mental Health
Service Administrations, 5). Alcohol literally alters the structure and
function of the adolescent brain that is still in its developmental stages
until the mid-twenties. Among alcohols effects on brain function, is memory.
According to a study conducted by the National Institute on Alcohol Abuse and
Alcoholism, researchers discovered that adolescents that engage in drinking
revamp the structure of their pre-frontal cortex that is thought to be
responsible for memory. By revamping the pre-frontal cortex adolescents are
changing voluntary motor behaviors, impulse control, rule learning, spatial
learning, planning, long-term memory and decision making functions of the brain
(Susanne Hiller-Sturmhöfel, Ph.D., and H. Scott Swartzwelder, Ph.D.,
2005).
Memory is also affected in terms of being able to recall names, dates phone
numbers or events. This inability to recall certain memories has been linked by
researchers to be similar to those who have damage done to the hippocampus
region of the brain. By disrupting the normal functioning of the hippocampus,
adolescents who engage in alcohol, even 1-2 drinks, affect the brain’s
long-term memory potential (Susanne Hiller-Sturmhöfel, Ph.D., and H. Scott Swartzwelder, Ph.D.,
2005).
Alcohol
does not just affect memory though. The Cerebellum, otherwise known as the
motor coordination powerhouse of our brain, is also affected. The inability to
walk a straight line, drive a vehicle, or perform simple tasks such as touching
your nose when your eyes are closed, are all affects that alcohol has on motor
coordination, which is the primary function of the cerebellum (Chambers, R.A.; Taylor, J.R.; and Potenza, M.N.,
2000).
Diverse
Populations
Alcoholism
can affect anyone from any background. It plays no favorites to skin color, gender,
sexual orientation, socio-economic background, your level of education or
religion. It affects people from all walks of life at all ages.
Results
from a national 2013 survey showed 39.5% that youth between the ages of 12-17
were drinking at least one to two alcoholic drinks per week. Nine percent of 8th
graders, 23.5 percent of 10th graders, and 37.4 percent of 12th graders
reported past-month use of alcohol and binge use by seniors was at a staggering
19.4 percent Although men had between the ages of 12-17 were at a higher rate
of trying alcohol at least one in their adolescent years, 51.7% compared to the
female counterpart at 47.5%, current use of alcohol showed even number between
the two genders at 11.2% for men and 11.7 % for females (Rockville, MD: Substance Abuse and Mental Health Services
Administration, 2014).
Race
and ethnicity showed the same consistent patterns among our youth within this
same study. Despite race or ethnicity, youth between the ages of 12-17 had
rates of current alcohol use between 8.2%-12.9percent. The only slight difference this study showed
with regards to race and ethnicity were that Hispanics and Caucasians at the
higher end of the spectrum for alcohol usage between 10.2-12.9%, which was a
decline from previous years.
Regarding
geographical area and alcohol use, the numbers appear pretty consistent from
region to region. Those that resided in the South had the lowest percentage of
teenage drinkers at around 48.2%, followed closely by the West who came in at
50.7%, and then the Midwest rose to 55.7%, followed lastly by the Northeast at
58.0%. Showing no matter your geographical location the results were consistent
with youth between the ages of 12-17 that currently used alcohol of some type (Rockville, MD: Substance Abuse and Mental Health
Services Administration, 2014).
In
a research study done by The University of Missouri, those that defined their
sexual orientation as exclusively heterosexual or exclusively homosexual drank
at the same rate. Those that defined themselves as bisexual or mostly
homosexual or mostly heterosexual drank at an increased rate and frequency than
those that claimed exclusivity to one sexual identity. The University of Missouri research team
speculated that “these differences might be due to the fact that individuals
who do not define themselves as exclusively heterosexual or homosexual feel a
stigma from both groups” (University of Missouri Research Team, 2015). In another study on sexual identity and
alcohol use among adolescents found that lesbian and bisexual females reported
more binge drinking than their heterosexual and gay/bisexual make peers, but
results were unclear due to a sample that failed to document the sexual
identity of participants in the same way as the other samples taken. (Shaaron Scales Rostosky, Fred Danner and Ellen D.B. Riggle,
2008)
Several
factors influence the likelihood of adolescent alcohol use, but regardless of
skin color, gender, sexual orientation, socio-economic background, your level
of education or religion what does remain the same are the adverse neurocognitive
effects that can be avoided by abstaining from alcohol.
At
the same time there has been much debate about what the legal drinking age
should be. The National Minimum Drinking Age Act of 1984 required all states to
raise their minimum purchase and public possession of alcohol age to 21, but
teens can still have legal access to alcohol under the following circumstances:
- · An established religious purpose, when accompanied by a parent, spouse or legal guardian age 21 or older
- · Medical purposes when prescribed or administered by a licensed physician, pharmacist, dentist, nurse, hospital or medical institution
- · In private clubs or establishments
- · In the course of lawful employment by a duly licensed manufacturer, wholesaler or retailer. (United States Supreme Court, 1986)
Furthermore,
there is much debate around lowering the minimum drinking age to eighteen years
of age. The average drinking age in most countries is 15.9 years of age from a
global perspective. The majority of countries have a set drinking age at 18,
but there are fifty countries that have a drinking age younger than eighteen
and twelve countries that have a drinking age higher than eighteen. We also
have nineteen countries that have no set drinking age at all (David J. Hanson, 2015)!
The
drinking age debate seems to be centered around that at the age of eighteen you
are considered an adult. You can be tried under the court of law as an adult.
You can enlist in any branch of the military and give your life. You can
legally wed, live on your own without consent from a parent or guardian, yet
you cannot drink or buy alcohol legally. Choose Responsibly is a public debate
forum that has a platform set up to discuss the best way the public feels we
can reduce the number victims of alcohol abuse. The organization has opted for
alcohol education course curriculum to be implemented and taught with a home
and school partnership. Choose Responsibility believes “Parents across the country should
be allowed and encouraged to provide their own children (and not their
children's friends) with alcohol in the context of teaching and modeling
responsible decisions about alcohol and its use” (Prof. David J. Hanson, 2015).
Social
Work Implications
What
can Social Workers do to help combat teen drinking? As social workers it is
important for us to understand the developmental stages of each client we might
come into contact with. We do not only need to listen to their stories and what
is troubling them, but we need to understand the underlying causes that might
be at play. Knowing the effects that alcohol usage has on the developing brain
is just one way we can begin to collect our data to develop a treatment plan
that is tailored fit for each client. Knowing what neurocognitive effects are
at play, in addition to any psychiatric disorders when assessing a client will
help when assessing the relationships between alcohol consumption and brain functioning
(Chambers, R.A.; Taylor, J.R.; and Potenza, M.N., 2000). We also need to be aware of current trends,
data, and debates that surround hot button topics such as with underage
drinking.
Teens that are engaging in
risk-taking situations, such as underage drinking, place themselves in
danger. It has been found by researchers
that the risk-taking behavior teens demonstrate follow them into adulthood (Park,
Mulye, Adams, Brindis, & Irwin, 2006). The potential long-term implications are
crucial for teens to understand. From the biopsychosocial perspective social
workers need to be ready and able to discuss biological, psychological and
social aspects of psychology with their clients. When you leave one of these
areas out of your treatment you do the client an injustice by not meeting all
their needs for true healing. For example if you have a client that is drinking
alcohol because he/she is depressed (psychological), they might also begin to
berate themselves (psychological). He or she might begin to distance themselves
from their peers and family (social). Once this occurs they may begin to
neglect their general hygiene (biological) since they spend their day alone,
depressed, berating themselves with no one who seems to care around. If you
only address one or two of these issues but do not address them all, you have
failed your client. If you treat them all you can rest knowing you have served
your client with comprehensive care (Jessica M. Sales and Charles E. Irwin Jr., 2013).
Conclusion
Adolescents
have been consuming alcohol for decades and for almost as long parents have
been trying to limit the amount of alcohol youth consume. In pre-Revolutionary
America, young apprentices were handed buckets of ale. In the 1890's, at the
age of 15, the writer Jack London regularly drank grown sailors under the table
(BUTLER, 2006). It was not until recently that major
concerns and debates began erupting over the long lasting neurological effects
alcohol might have on an adolescent’s brain. Since then several studies have
been conducted to determine exactly how alcohol affects our developing brain.
What researchers have found is how delicate the adolescent brain is and how
easy it is to demolish causing cellular damage to the frontal lobes and
hippocampus. Alcohol use by teens
affects their lives on numerous platforms. From poor test scores, to impaired
cognition and motor skills there is no denying the horrific effects that one
drink can have on a developing brain. Despite
this knowledge, debates rage on around what the legal drinking age should be
and how to best combat the growing epidemic of underage drinking that is
prevalent in the United States. So far, success has not consistent.
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