Addressing adolescent alcohol use in South Africa

Excessive alcohol consumption constitutes a significant public health problem for South Africans. Alcohol use by South African (SA) adolescents is characterised mainly by binge/heavy episodic drinking. Levels of binge drinking have been high, but relatively stable, among males since 2002, while there has been a significant increase in binge drinking by females since then. Binge drinking is a major risk factor for a range of alcohol-related harms in SA, including traffic-related accidents and deaths, interpersonal violence, fetal alcohol spectrum disorder (FASD), crime, sexual risk behaviour, HIV, tuberculosis and the resultant burden of all of these on the economy. Clinicians may play a key role in addressing adolescent alcohol use and alcohol-related harm. Such a role may involve screening, brief interventions and referrals to treatment. There are several assessment, screening and diagnostic tools to detect alcohol use and misuse, specifically among adolescents. Furthermore, various pharmacological and psychological approaches are available to treat adolescent alcohol problems. Special issues to consider when dealing with alcohol use problems among adolescents in SA include recognising the risk factors, and acknowledging and addressing the harms associated with alcohol use (including sexual risk behaviour and FASD) and the possible existence of comorbid mental health problems.