THERE CAN be few parents of teenagers who don’t worry about the possibility of drink or drugs derailing their youngster’s life. If there was a vaccination available against substance abuse for children entering adolescence, I suspect the uptake would be widespread.
But there is no instant way to protect a youngster who is growing up in this country among teenage peers who binge drink more than any of their European counterparts, following the lead of adults around them.
“Our approach to drinking in Ireland is not normal; we drink to get drunk,” says consultant child and adolescent psychiatrist Dr Bobby Smyth, who specialises in addiction. Every day, through his work at the Drug Treatment Centre Board’s offices on Pearse Street in Dublin and the Youth Drug and Alcohol Service in Tallaght, he sees the collateral damage of that culture among teenagers.
The youngsters he works with have problems with one or more of a range of substances, from alcohol and ecstasy to cocaine and heroin.
He worries that discussions about drugs tend to be dominated by heroin, despite the fact that it is one of the less commonly used drugs, particularly among under-18s – while the elephant in the room is alcohol.
“I was brought up in the late 1960s and the average age for people of my generation starting to drink was around 17 or 18. It is now 14-ish, so it has dropped by three or four years in a generation,” he points out.
HOW LOW is it going to have to go before we as a society take the issue of underage drinking seriously, he asks. “In another 30 years, if it continues dropping at its current rate, they will be drinking at 11.”
Smyth can’t understand why parents are not more angry with politicians who lack the will or vision to crack the stranglehold the drinks industry has on so many aspects of life in this country, and with other parents who turn a blind eye to what their teenagers are doing, or even condone it by providing 15 year olds with alcohol in the “safety” of their own home.
Parents are only deluding themselves if they take some comfort from the fact that their teenager is “only drinking” and not taking drugs. For a start, intoxication is intoxication is intoxication, says Smyth, and secondly, how do they know?
“There is nothing to distinguish between alcohol intoxication and intoxication with ecstasy, cocaine or cannabis by teenagers,” he says. “These drugs are often taken in combination with alcohol.”
Drunkenness is also undoubtedly the gateway to other drugs.
“In my experience, most kids who run into difficulty with drugs journey through a period of alcohol abuse and often times the two intermingle.”
He has started asking adolescents who are taking cocaine, were they drunk or sober the first time they did a line of coke. Usually the answer is they were drunk.
“We are trying to get hard data on it but my guess is with 80-90 per cent of people, the first time they do cocaine, they are drunk. It makes sense. The first time we do lots of crazy, stupid things that we regret subsequently, drink is involved.”
QUIETLY SPOKEN and immaculately dressed, Smyth’s calmness and control is the polar opposite to the chaos caused by drink in the lives of his young patients. Both as a professional and a parent himself, with two step teenagers and two younger children, his attitude to underage drinking has hardened the more he has learned about it.
He advocates no alcohol for under-18s. “The longer kids avoid alcohol, the better for them” – both mentally and physically. It can cause irreversible damage to a still developing brain, not to mention the liver.
“We know the younger the person starts drinking, the more likely they are to develop a dependency on alcohol in later life, the more likely they are to develop a drug problem.”
They are also much more likely to take part in risky behaviour and suffer accidental injuries.
In addition to his clinical work and lecturing on addiction in Trinity College, Smyth also regularly gives talks to parents. At the outset, he likes to remind them what is happening during adolescence.
“At age 10 kids are entirely reliant on parents or adults to meet all their basic needs. By 20 they are pretty much capable of dealing with any problem life might throw at them.”
The whole point of adolescence is to pick up the skills needed for an independent life. The last thing that’s needed at this stage is the “crutch” of some chemical substance.
The biggest single thing parents can do, Smyth says, is to try to delay drinking in teenagers, particularly delay any movement towards drunkenness.
But we all know that is not as simple as it sounds.
How do you build a child’s defences against drink and drugs?
Trying to maintain a positive relationship with your child from a young age is crucial. Parents should have an interest in their son or daughter’s life: how they spend their time; who they spend their time with; what their interests and hobbies are.
“It is a bit late to develop an interest in those things when you begin to get worried at the age of 14, 15 or 16 that things are beginning to take a turn for the worse,” Smyth comments.
“Then they are going to see it as you are just being intrusive,” he says.
The Search Institute in the US has drawn up a list of 40 “developmental assets” which adolescents need to thrive. The more they have of these, the less likely they are to engage in high-risk behaviour such as alcohol abuse.
“If kids grow up in an environment where they have 25 of those 40, they tend to do very well,” says Smyth. “They tend to avoid a lot of negative outcomes in life, whether it is depression, self-harm, drug abuse or criminality.”
It is worth looking up the list on the website on www.search-institute.org and seeing how many of those assets parents are directly responsible for, such as family support, good communication, setting boundaries and helping them succeed at school, as well as indirectly as adult members of the community.
Smyth stresses the importance of teenagers having a confiding relationship with at least one of their parents, or another adult “with whom they can think through stuff that may be causing conflict with their parents”.
WHAT HOPE do parents have in the face of so many social and commercial pro-alcohol messages?
You can’t control a teenager’s behaviour but you can influence it, he stresses. Parents need to decide what they deem to be acceptable for their son or daughter in terms of their behaviour around alcohol or drug use.
There should be rules and expectations which are clearly communicated, with a consequence for the failure to meet those standards.
“For most kids just the fact that they know mum or dad is upset with them or worried about them or angry with them, is enough to cause them to step back from their behaviour and prevent it becoming too out of control. It doesn’t mean it will stop though,” he says.
“I think a lot of parents I see have given up, they have decided they have no influence any more: ‘I’ve no control, there’s no rules. He comes and goes whenever he wants and I can’t control him’” – he has heard that from parents of teenagers as young as 13.
“Just because a teenager does stay out late, which is against the rules, it doesn’t mean that the rule should just be abandoned. There should be some sort of consequence for deviation, the consequence doesn’t have to be big but it is marking it.” You are making it very clear that you are not happy with the behaviour.
He also says it is important to explain why you think it crosses the line of acceptable behaviour, such as it is unhealthy and dangerous. It holds more weight with teenagers if you do have a reason, even if they don’t agree with you.
Our parents’ or grandparents’ generation had it easy because it was just a “sin”, he says.
“That doesn’t wash anymore; we can’t just use the Catholic Church to parent our children by proxy. I think a lot of parents struggle with that because they haven’t been parented that way themselves.”
Smyth encourages teenagers to learn to socialise, have fun and meet the opposite sex – while sober. He tells them: “If as an adult you want to change those experiences through a bit of intoxication, so be it, but it shouldn’t be your strategy, when socialising, to get drunk.”
What do you look out for in a teenager who may be using drink and drugs?
The average age of starting to drink is 14. “From the age of 13 you have got to be vigilant that alcohol is going to be creeping into their behaviour,” he suggests. Early signs include: the chewing of mints and gum; alcohol or money disappearing from home; your child staying out for long periods.
“Talking to teenagers, they will always tell me that they can get away with it,” Smyth reports. “The way they drink, they get drunk quite quickly and sober up quite quickly.
“If they are aware that you might swing by at some stage, the way you always have since they were eight or 10, just to check in on them, they will be less inclined to use those opportunities of four or five hours out on a Saturday to start drinking.”
Running into problems with alcohol and drugs can happen within months, he warns. But what went on before in their lives can dictate the outcome.
SMYTH PAYS a lot of attention to his teenage patients’ “journey through childhood”. Two teenagers may be displaying the same behaviour, but their personal history will indicate whether they have just temporarily taken a wrong turning, or are in danger of travelling in the wrong direction for life.
“The more normal, healthy and adaptive that [childhood] is, the more evidence of resilience and coping skills they show during childhood, the more optimistic I am that they are actually going to get through this current situation.
“I worry more about the teenagers who, when you track back to how they were at primary school, at home with mum and dad, with friends, as an eight year old and a four year old and a two year old and you see that they have actually struggled throughout.”
Will letting them drink the odd glass or two of wine at home in their mid-teens help to encourage more restrained drinking habits?
No, he believes this just adds momentum to the behaviour. “The kids who drink at home are the ones who drink outside of home as well. Very often what it is doing is legitimising behaviour that was previously underground.”
Another issue is that teenagers are well aware it is not legal to drink under 18, although this does not apply to private homes. However it is illegal to supply somebodys elses underage child with alcohol in your home without parental permission.
“You are telling them the law is a bit of an ass if you allow them to drink any significant amounts. And if you are saying to them the law is an ass on alcohol, maybe it is a bit of an ass around coke or cannabis or whatever?”
He quickly counters the argument about the example of Mediterranean countries, where patterns of alcohol consumption are healthier and youngsters drink at the family table.
“Kids in Mediterranean countries don’t grow up to have a reasonable relationship to alcohol because they were introduced to it so early. They grow up to have a reasonable relationship with alcohol because of those cultures – whether you’re 13 or 30, it is not acceptable to get drunk.”
Whereas, “we are probably the last country in the world where you should be giving kids drink, when our whole culture and approach to drunkenness is really so tolerant”.
Smyth believes more parents need to get angry with other parents who are deeply tolerant of drinking. He recalls the fury of one father at a talk he was giving in a south Dublin school where a particular family was hosting a party to celebrate the Junior Cert results, at which drink was to be provided.
“This father’s son wanted to go and he was saying ‘I don’t want to stop him, it is a big night out, I want my son to celebrate’. But he was angry with this other parent who clearly had bought into the idea that a bunch of 15 year olds could not possibly celebrate one of the happiest nights of their life without getting twisted.”
IS IT all right for parents to drink at home in front of children?
Children should learn it is something adults do and they may choose to do it, or not, as an adult. Again you explain why it is not a good idea for them to drink at this stage of their lives.
“If you are wandering around the house twisted, certainly you are losing your moral authority,” Smyth adds. But he wouldn’t get hung up about a few glasses, showing a restrained use of alcohol.
If a teenager drinks before they are 15 they are:
- Four times more likely to develop alcohol dependency than those who wait until they are 21
- Seven times more likely to be in a car crash because of drinking
- Eleven times more likely to suffer unintentional injuries after drinking
Dr Bobby Smyth will speak on Preventing Drug and Alcohol Problems in Teenagers – What Parents Can Do in the UCD Robing Room, O’Reilly Hall on Wednesday, September 9th, 6.30-8pm, in one of a series of talks for parents next week being organised by the Lucena Foundation in conjunction with the Royal College of Psychiatrists UK Faculty Meeting in UCD.Admission is free but places must be booked by e-mailing Marie.mccourt@sjog.ie or tel 01-4923596/4999349
