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Rita Kay Cydulka, MD, MS Emergency Physician talks about the dangers of underage drinking from the standpoint of a physician.

I have been an emergency department physician for 30 years and a mom for 27. No matter how long you have practiced medicine, nothing ever prepares you for a death or injury in your own social circle, especially when it is alcohol-related and preventable.

I often jog through Lakeview Cemetery in Cleveland, Ohio. As frequently as I am there, I still gasp each time I come across Will’s grave. I always stop to say “hi”. My reaction is similar each time I visit. I feel both overwhelming joy and sadness as I think of Will, who died at age 19 as a result of a car crash while driving drunk.

I watched Will grow up. He was a family friend who protected my daughter at ice hockey and was learning culinary arts. Will’s sudden departure from this world was met with disbelief and lots of tears. I remember the looks on his parents’ faces at the church. I remember his funeral mass and I remember the priest’s message.  He spoke about Will’s wonderfulness but he also spoke of Will’s alcoholism- his underage drinking, his binges, his efforts to stop and his inability to control his drinking.  I know his message hit home with many in the chapel.

It’s easy to pretend that Will was unique in his drinking. He wasn’t. Excessive drinking among teens and college students (and even adults) happens a lot and can be deadly. As a parent and an emergency physician, I know this all too well. In my home state of Ohio, 16% of high school students in 2013 and 20% of adults in 2011 admitted to binge drinking within the previous month (Centers for Disease Control and Prevention (CDC). 1991-2013 High School Youth Risk Behavior Survey Data. Available at http://nccd.cdc.gov/youthonline/. Accessed on July 1, 2014; Centers for Disease Control and Prevention. Prevention Status Reports 2013: Excessive Alcohol Use— Ohio. Atlanta, GA: US Department of Health and Human Services; 2014.  Available at http://www.cdc.gov/psr/alcohol/2013/OH-alcohol.pdf .)  Thirty-four percent of traffic fatalities in Ohio were alcohol-impaired driving fatalities in 2012 (US Department of Transportation National Highway Traffic Safety Administration. Traffic Safety Facts 2012 Data Alcohol-Impaired Driving, December 2013; DOT HS 811 870 Available at http://www-nrd.nhtsa.dot.gov/Pubs/811870.pdf  Accessed on August 13, 2014.)  I dread discussing death and organ donation with the family of a patient when I should be discussing the miracle of the life-saving care provided.

It’s important for parents and kids to understand that underage drinking is not a rite of passage. It’s not something everyone is doing. In fact, consumption rates nationally and among those under the legal drinking age showed marked decreases in 2013 reaching historic low levels as measured by past month consumption and binge drinking. (2013 Monitoring the Future Survey)

Reported incidents of binge drinking (having five or more drinks in a row in the past 30 days) also declined among 10th and 12th graders. Additionally in 2013, students reported an increase in their disapproval of binge drinking among peers further indicating a shift in underage drinking behaviors and attitudes. (2013 Monitoring the Future Survey)

In the summer, accounts of alcohol-impaired driving and underage drinking typically increase among teens. It’s important to know what you can do to stop underage drinking. Talk to your loved ones - your kids, friends and family members — about the dangers of underage drinking, binge drinking and drunk driving. According to the 2013 Monitoring the Future Study, too many young people report they are binge drinking (22 percent of high school seniors and 35 percent of college students). Inform them that teen brains are still developing and that alcohol hinders the brain’s growth and development. Let them know that children who start drinking as teens have four times the risk of developing alcohol dependence as adults.

Discuss responsible drinking. Remind your kids that it’s illegal to drink alcohol under the age of 21. Even though peer influence and fitting in is a priority with teens, research shows parents are the greatest influence on your teen’s decisions regarding underage drinking. Discussions about alcohol and drugs are not easy and are often uncomfortable.  Remember to listen carefully and respectfully to your teen’s opinions and be prepared to respond in a constructive way when s/he expresses an opinion with which you disagree.

Actions speak louder than words. If you drink alcohol, model responsible drinking behaviors – know how alcohol affects your blood alcohol concentration level, drink moderately, don’t drive drunk and do not allow houseguests who drink too much to drive themselves home. Do not allow underage drinking in your home or allow your children to go to homes or parties where underage drinking is allowed. Call your children’s friends’ parents when they are hosting a party. I was often surprised when – as the meanest mom in the world according to my then- teenagers - I called the parents of my children’s friends to find that they were chaperoning a house party with alcohol and felt that their presence in the house was enough to ensure everyone’s safety. Set limits and be consistent. Establish and enforce consequences for breaking the “no underage drinking” rule. Talk to them about thoughtful decision-making.

As an emergency physician, I routinely screen my patients for signs of problematic drinking, talk to those with unhealthy drinking habits about their choices and provide them with available local resources to help them develop a healthier lifestyle. Many of my patients land in the emergency department as either a direct or indirect result of alcohol misuse.

If you suspect your child has a problem with alcohol, please talk to your physician, clergy or a trusted friend who has dealt with similar issues. If you’re uncomfortable doing so, search for online resources such as those produced by The Foundation to Advance Alcohol Responsibility at www.responsibility.org.

I spoke with Will’s mom and shared this piece with her before submitting it to make sure that she approved of my message. She said, “If you can help one person with this and prevent a tragedy like Will’s for another family, I’ll be happy. Thank you for thinking of Will and keeping his memory alive.”

So, as you enjoy summer and especially as you prepare for your kids to return to school, find a time to talk with your children about alcohol. Be patient. Don’t hurry. The first step is starting the conversation.

Rita Kay Cydulka, MD, MS; Emergency Physician

*The views and opinions expressed in this blog are solely those of the author and do not necessarily reflect the views of The Foundation for Advancing Alcohol Responsibility or any Foundation for Advancing Alcohol Responsibility member.*