Question

Natalie Shelton is a 17-year-old who is in the Woodburn Juvenile Detention Center. She was brought to the police station around 10 p.m. and was held overnight for her third driving under the influence offense and for driving without a license. Her blood alcohol level was twice the legal limit. She was in the car alone and seemed to be in a great deal of emotional distress when the officer stopped her. Authorities placed a call to her mother, who was unable to come to the station at that time because she was home alone with a younger child. The family has been under a great deal of stress, as Natalie’s father committed suicide 4 months ago. Natalie was taken to the Juvenile Detention Center overnight, and her mother will meet her there in the morning.

The Youth Risk Behavior Survey conducted by the Centers for Disease Control and Prevention in 2013 found that 66.2% of all ninth to twelfth graders had taken at least one drink of alcohol; 34.9% currently drink; and 20.8% reported having had at least five drinks in a row. Although this number has not significantly increased over the past several years, it still continues to be a public health concern in the United States.

1. What are some of the issues that concern you about Natalie?
2. What are some resources that might be available to Natalie and her family?
3. Based on the statistics related to underage alcohol use, what are some possible prevention strategies that could be implemented?

Answer 1

Issues of concern about Natalie are:

· Drinking underage that is at the age of 17 years

· Binge drinking

· Driving under influence of alcohol

· Repeated offender- this is third offence

· Increased stress in life from recent death of the father that further increases risk of indulging in harmful practices like alcohol and drug addiction

· Mother is alone and has to take care of younger sibling of Natalie, which further leaves her alone to deal with stressors of life.

· Increased risk for physical and sexual assault, injuries, accident. This can result in adolescent pregnancy (studies have shown pelvis continues to grow till age of 20 years) which will further result in her dropout from school, risk of complications during pregnancy, anaemia, preeclampsia, depression, low birth weight

· Increases the risk of alcohol problems later in life- Research shows that people who start drinking before the age of 15 are 4 times more likely to meet the criteria for alcohol dependence at some point in their live

· Interferes with brain development. Researches have pointed out that the part of the brain responsible for making decisions and controlling impulses, called the prefrontal cortex, does not fully develop until people are in their mid-20s.

The Substance Use Resources for Adolescents and Young Adults and their families:

Adolescents, young adults and their families looking for additional information, including online resources, support groups, peer networks, helplines, treatment locators, and advocacy opportunities.

Online resources

These resources help those struggling with substance use by providing in-depth information on various substances and concurrent disorders, heir effects, withdrawal, as well as steps to seek help, recognizing peer pressure and how to resist it, life-stories, videos and expert interviews.

Substance use resource institutes like

· National Council on Alcohol and Drug Dependence ( informational website provides support to those who need assistance confronting the diseases of alcoholism and drug dependence),

· National Institute of Alcohol Abuse and Alcoholism (NIAAA supports and conducts research on the impact of alcohol use on human health and wellbeing. They provide resources directed toward young people to evaluate your drinking and tools to stay in control),

· NIDA for Teens: (NIDA provides a wealth of knowledge and resources including easy-to-read guides about various drugs through videos, blog posts and drug facts),

· Substance Abuse and Mental Health Services Administrations: (SAMHSA works to reduce the impact of substance abuse and mental illness on America’s communities, including through a series of workbooks for teens and substance use.)

Treatment service locators

· Behavioural Health Treatment Services Locator: Find treatment facilities for substance abuse/addiction and/or mental health problems.

· Buprenorphine Treatment Physician Locator: Find physicians authorized to treat opioid dependency with buprenorphine by state.

· National Council on Alcoholism and Drug Dependence:  Find your nearest affiliate who will provide professional guidance and support.

· Sober Nation Treatment Locator: An extensive directory of recovery centres

· Substance Abuse Treatment Facility Locator for locating programs run by state

Support groups

· Al-Anon Family for Teens: A group for problem drinkers who can find understanding and support through group meetings, podcasts, and other resources.

· Alcohol Anonymous: The AA website can help young people find AA meetings near them and has brochures directed at young people.

· Narcotics Anonymous: The NA website can help young people find NA meetings near them and has resources including brochures for young addicts.

· National Alcohol and Substance Abuse Information Center

· Smart Recovery: SMART Recovery is a leading self-empowering addiction recovery support group. The website provides resources for teens and youth support programs, meeting locations, and an online community.

Helplines

· Crisis Call Center:

· Crisis Text Line

· Lifeline Crisis Chat

· National Suicide Prevention Lifeline

· SAMHSA’s Helpline

Prevention strategies that could be implemented

Preventing underage drinking is a complex challenge. Any successful approach must consider many factors, including:

· Genetics

· Personality

· Rate of maturation and development

· Level of risk

· Social factors

· Environmental factors

Several strategies are:

Environmental interventions

This approach helps in preventing alcoholism by making alcohol harder to get—for example, by raising the price of alcohol, ban on sell of alcohol to people below 21 years of age, and keeping the minimum drinking age at 21. Enacting zero-tolerance laws that outlaw driving after any amount of drinking for people under 21 also can help prevent problems.

Individual-level interventions

This approach seeks to change the way young people think about alcohol, so they are better able to resist pressures to drink.

School-based interventions

These are programs that provide students with the knowledge, skills, motivation, and opportunities they need to remain alcohol free.

Family-based interventions

These are efforts to empower parents to set and enforce clear rules against drinking, as well as improve communication between children and parents about alcohol.

Role of parents and teachers:

Parents and teachers can play a big role in shaping young people’s attitudes toward drinking. Parents in particular can have either a positive or negative influence.

Parents can help their children avoid alcohol problems by:

1. Strong, regular and open communication with them. Talking about the dangers of drinking, setting reasonable limits and guidelines that convey them that you care while establishing safe boundaries for acceptable and non-acceptable behaviour

2. Drinking responsibly, if parents or teachers choose to drink, as children learn or imitate parents.

3. Serve as positive role models in general by showing positive behaviours, healthy habits, and emotional health.

4. Not making alcohol available in home

5. Get involved in child’s life, know their friends Observe them interacting with his or her friends. Supervise all parties to make sure there is no alcohol

6. Having regular conversations about life in general and ‘alone time’ with each child

7. Try to stay calm and work with your teen to solve problems, make changes, and promote cooperation when in conflict with children.

8. Consistent, daily encouragement helps teens in building confidence, creativity, and passion for new activities.

9. Family fun time

10. Connecting with other parents about sending clear messages about the importance of not drinking alcohol

11. Encouraging kids to participate in healthy and fun activities that do not involve alcohol

Research shows that children whose parents are actively involved in their lives are less likely to drink alcohol. On the other hand, research shows that a child with a parent who binge drinks is much more likely to binge drink than a child whose parents do not binge drink.