The 3 A’s: April, Alcohol, Awareness

April 5, 2013
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By Teresa Liccardi, M.D.

April has been designated as national alcohol awareness month. This month has been chosen because of a very troubling fact. According to the National Highway and Traffic Safety Administration, one-third of all alcohol related fatalities in those less than 21 years of age occur during April, May and June. In 2001, more than 2,950 children under the age of 21 died in known alcohol-related fatalities; of this 1,021 died between April, May and June. A decade later the statistics have not changed.

Despite this sobering fact, we as a nation still have a difficult time controlling dangerous drinking behavior in our youth.

My purpose by writing this article is not to condemn or blame anyone for his or her views on teenage drinking. Rather, just as the month is named, I hope to help stimulate a renewed awareness of the evidence-based facts of underage drinking.

Ongoing research and statistics demonstrate that the large volume of alcohol being consumed by youth under 21 years of age has severe short- and long-term health consequences. Beyond motor vehicle crashes, accidents, suicides, physical and sexual assault, and acute poisoning, evidence demonstrates that underage drinking is associated with long-term and probably permanent harmful alterations of the brains of youth, which are still developing through age 24.

Alcohol is the most readily available and abused drug by youths under the age of 21. Nearly one-third of youths start drinking before the age of 13. The highest prevalence of alcohol dependence in the U.S. occurs in adolescents between the ages of 18-20.

Of the total amount of alcohol consumed in the U.S., 11 percent is consumed by youths aged 12-20 years old. More than 90 percent of this consumption by youths occurs as binge drinking.

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The National Institute on Alcohol Abuse and Alcoholism defines binge drinking as a pattern of drinking that brings a person’s blood alcohol concentration (BAC) to 0.08 grams percent or above. This typically happens when men consume five or more drinks, and when women consume four or more drinks, in about two hours.

The CDC Morbidity and Mortality Weekly Report Oct. 8, 2010 states that the prevalence of teenage alcohol use was 41.8 percent and of this current use, 60.9 percent reported “current use” was defined as binge drinking. On average, youths aged 12-20 drink less often than adults, but when they do consume alcohol they do so in larger quantities and more rapidly.

It is a natural reaction for youth to drink more and rapidly when presented with alcohol. From a developmental framework, youth are more impulsive and have a greater propensity for risk-taking behaviors. Alco­hol causes disinhibition and euphoria, enhancing the impulsive and risk-taking behaviors of youth.

Binge drinkers are 14 times more likely to report alcohol- related driving than non-binge drinkers.

Binge drinking has far-reaching effects both for our economy and the health of our nation. Excessive drinking and binge drinking cost the United States $223.5 billion in 2006. The U.S. Surgeon General’s Call to Action to Prevent and Reduce Underage Drinking discusses how underage binge drinking leads to academic failure, illicit drug use, increased tobacco use, increased risk of physical and sexual assault, increased risky sexual behavior leading to unwanted pregnancy, sexually transmitted diseases including HIV, alcohol-related injuries, suicides, increased risk for heavy drinking later in life with associated cardiovascular and liver disease, increased risk of certain cancers (oral and liver), pancreatitis, hemorrhagic stroke, secondhand harm of bystanders such as in motor vehicle crashes, and alterations in the structure and function of the developing brain that continues to mature into the mid-20s.

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Alcohol poisoning, characterized by severe disorientation, reduced respirations, seizures, vomiting, unconsciousness and death, is a severe sequela of binge drinking.. There are more than 900 known deaths related to alcohol poisoning in teenagers every year. There are many more admitted to hospitals for alcohol poisoning every week.

The overwhelming literature regarding the detrimental effects of underage drinking and especially binge drinking, leaves us grappling with our desires to see our children grow into socially, well-rounded individuals enjoying their youth without being victims to the ravages of binge drinking. Know­ledge and awareness of the facts about underage binge drinking is the first step to helping our youth and ourselves make informed decisions with regard to alcohol. I also believe we must want to understand our own behaviors with alcohol. As our children’s role models, their lives depend on our knowledge and awareness.


More information on the topic of underage binge drinking is available at fact-sheets/binge-drinking.htm.


Dr. Teresa Liccardi, who is board certified in internal medicine and nephrology, maintains a clinic for hypertension and chronic kidney disease at the Parker Family Health Center in Red Bank.

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