Alcohol Use and Abuse: A Pediatric Concern

Since the beginning of recorded history, people have consumed alcoholic beverages for purposes of religious ceremony, celebration, medicinal therapy, pleasure, and recreation. Problem drinking in all age groups has also been recognized and reported for thousands of years.1 Research continues to evaluate the wide range of alcohol use—from its hazardous use in pregnancy to its possible beneficial use for adult physical or psychological health. There is debate as to whether youths should postpone the use of alcohol until the legal drinking age or be encouraged to develop safe, responsible drinking patterns through progressive, controlled exposure in family or religious settings. The debate is complex because although alcohol is a legal drug, its purchase, possession, and use by minors are illegal. Further confusion exists because of negative adult attitudes and poor adult role modeling regarding alcohol use that are observed by our youth. Although pediatricians witness the consequences of alcohol use in their patients and families, physician training about substance abuse is deficient,2 and efforts to improve physician knowledge are clearly indicated. ALCOHOL USE AND ABUSE AMONG YOUTH The annual "Monitoring The Future Study" of alcohol and drug use by American students has shown consistently that alcohol is the drug most often used and abused by children and adolescents.3 In 1992, 88% of American high school seniors had tried alcohol at least once, compared with 82% of 10th graders and 69% of 8th graders. With regard to recent use of alcohol, 51% of 12th graders, 40% of 10th graders, and 26% of 8th graders had at least one drink in the previous month.