Combating underage drinking with the 6Gs

Key Points

Alcohol kills more children and adolescents each year in the US than all other drugs combined. Some 5,000 young people are killed in this country annually due to car crashes involving a drunk driver, accidents or acts of violence while intoxicated, or alcohol poisoning. Among 15-24 year-olds, alcohol remains a leading factor in cases of death.

This article proposes a new and time-saving approach to guide pediatricians as they formulate office-based strategies aimed at the prevention and assessment of alcohol use, and education of patients and families about its dangers.

Studies of adolescent brains that have been repeatedly under the influence of alcohol show changes in myelination and synapse formation.² The disruption of these processes appears to be associated with delayed acquisition of cognitive skills, and the resultant risky decisions that are strongly influenced by peers and emotions. Recent research suggests that children and adolescents may have a lower level of response to alcohol, and thus require higher blood levels to become intoxicated. Furthermore, they may experience fewer side effects (hangover, loss of equilibrium, sedation, nausea), and thus be more likely to drink heavily.³

Children at risk

Family function/dysfunction creates additional risk factors for underage drinking. One out of four children grows up in a home with an alcoholic. The vast majority of these kids have adverse childhood experiences such as observing abuse, neglect, or witnessing domestic violence in the home.⁷ Such experiences have a strong influence on a young person's health, and directly impact the likelihood of teen pregnancy, smoking, alcohol and drug abuse, and risky sexual behavior. Indeed, there is a direct relationship between these adverse childhood experiences and the later likelihood of heart and lung disease, mental illness, suicide, and sexually transmitted diseases. Poverty, low educational status, latchkey time, and lack of family time are also drivers for underage drinking.⁸