Alcohol use in children, and how parents can make a difference

Martin was 17 when he was first introduced to alcohol.

"As a young person, there's the world of alcohol. You go there as a way [to], I guess, get away from your problems," he says.

"It's a way to be social, it's a way people perceive to have fun, you see it as something to do with your mates and if you are not doing it then … you're different."

But for Martin, alcohol soon became a way to cope with his anxiety.

"I think it led to experiences that weren't necessarily the best for me," he says.

"The decisions you make while you are under the influence essentially can increase more of that anxiety in you as a young person."

In a culture where alcohol is prevalent, Martin says the pressure to drink can be overwhelming.

"I think just growing up in Australia in general, there's a lot of emphasis on drinking alcohol to be social," he says.

"At a stage of my life where I felt a bit shy or insecure, not confident in who I was, drinking alcohol was a way to cope with that social anxiety."

Add to that research that finds people living with an anxiety disorder are 2-3 times more likely to also have an alcohol use disorder, and it becomes all the more worrying.

Preventing problem drinking from the start

It's a familiar cause of angst for many parents — the concern that as their children grow up, they will encounter or face pressure to drink alcohol or try illicit drugs.

But while the pressure from media and peers is real, parents can make more of a difference than they think.

In fact, they are more influential than peers at this stage, according to Associate Professor Nicola Newton, the Director of Prevention Research at the University of Sydney's Matilda Centre.

"In fact, they are the number one influence over their adolescents' choices at this stage.

"Whilst it may appear and it may seem at the time that peers are the most important influence in your life, parents still have a critical role to play in their adolescents' health, behaviours and choices."

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Dr Newton says to reduce "uptake of substances", modelling good behaviour around alcohol is key — and that means parents need to have healthy habits themselves.

"If your kids are coming home from school and you are there having a glass of wine every night or a beer, that is not a good look," she says.

"Show them that there are other strategies for coping: go for a walk, use exercise as strategies to cope with everyday stressful life.

Dr Newton says it's also crucial not to supply alcohol to your children in the hope you can teach them good behaviour.

"There was a traditional view that perhaps giving your kid a sip of alcohol or a taste here and there, a glass of wine … that you might be protecting them from later harms," she says.

"But what the Australian research and also research in the US and Europe is starting to show, is that giving a kid any alcohol at all is increasing their chance of binge drinking, and it's actually then increasing their chance of seeking alcohol elsewhere."

Dr Newton says knowing where your child is and when they are going to be home as they get older is also important.

Even small amounts of alcohol can be harmful

It all begins in utero — women are told to avoid alcohol during pregnancy because there is no safe level of use.

Briana Lees, another researcher at the Matilda Centre, has found that even small amounts of alcohol exposure can lead to an unborn baby growing up to experiment with alcohol at a young age.

"We found that any level of alcohol use during pregnancy, so even low levels, having one or two standard drinks per occasion, was associated with a greater likelihood of that child experimenting with alcohol by the age of 10," she says .

"We also know from other studies that if kids are binge drinking at a young age, they are actually more likely to then go on to have an alcohol use disorder at some time in their life."

So why does even a small amount of alcohol while pregnant increase a child's risk of experimenting with alcohol ?

Researchers have their hypotheses, but more study is needed.

"One possibility is that the brain has been impacted," Ms Lees says.

"We know that out of all the organs in the body, the brain is most impacted by alcohol when the foetus is in the womb."

Ms Lees has also been studying emotional and behavioural problems in children exposed to alcohol in utero.

"Any level of drinking during pregnancy was associated with emotional and behavioural problems in the children," she says.

"These kids who were exposed even to one or two drinks per occasion, they showed higher levels of anxiety, of depression, they had more attention problems, were more likely to have a diagnosis of ADHD, and they were more impulsive and aggressive as well."

What role does the brain play in problem drinking?

Jennifer Debenham, another researcher at the Matilda Centre, says the factors which lead to problem drinking are complex.

"You can't look inside someone's brain and determine whether they are going to use drugs or not," she says.

"We really talk in terms of risk and probability, so there are other environmental and social factors at play as well."

But a recent review of previous studies has provided some insight into what part the brain might play in teens who abuse substances.

"There are limited neural predictors of single-time substance use [and] there are some neural associations with more frequent substance use," she says, pointing to white matter in the brain.

White matter is the cabling, or connectivity, of the brain. The frontal part of the brain is responsible for executive functions and impulse control, and the limbic system of the brain is involved in behavioural and emotional responses, like fight or flight. White matter is what connects them all.

"The connectivity of these tracks between the frontal part of the brain and the limbic system play a role in risk-taking," Ms Debenham explains.

Researchers are still trying to fully understand what causes reduced white matter integrity and delayed neurodevelopment, and what part the brain's neuroplasticity plays.

"This neuroplasticity offers both the opportunity to grow and to change and to repair, but also the risk to damage, and it does mean the brain is more vulnerable to damage. But exactly how long this damage may last is still unclear. The jury is still out on that one," Ms Debenham says.

Ms Debenham says studies are underway to learn more about what typical and atypical neurodevelopment in young people from age 10 and up looks like.

Anxiety and delaying the onset of drinking

While parents do have the biggest influence on their children when it comes to alcohol, Dr Newton points out peer influence is the number one reason children say that they start to use drugs.

"The more you can foster good communication and loving homes, [and try] to stop someone from participating in drug taking and alcohol taking early on, the better chance they are going to have — and the less mental health problems, the less severe substance use disorder problems they will develop," Dr Newton says.

For Martin, understanding why he was turning to alcohol helped him overcome his problem with it.

"The biggest help was seeing a psychologist. The psychologist really helped with addressing the underlying issues of my anxiety," he says.

"Also as a young person, being social, things like that, they taught me techniques that were really helpful in coping with my anxiety.

"I think also just having friends that were super supportive, that understood, and that we didn't necessarily have to drink all the time."

Indeed, teaching children ways to manage their anxiety from a young age is key.

Dr Lexine Stapinski, a clinical psychologist at the Matilda Centre, says anxiety often precedes the alcohol use, but it can turn into a vicious cycle.

"The problems will tend to exacerbate each other," she says.

"To give you an example, one really common type of anxiety that people might use alcohol for is social anxiety; feeling shy, feeling a lack of confidence to interact with others.

She recently helped design an online program called Inroads , which clinical trials have found helped reduce both anxiety and harmful alcohol use in young people.

Martin wants others to know that whether they are living with anxiety or feeling pressure to drink, there are other options.

"I'd say that there's a lot of services out there that are available to them. I'd say that it's really important that you find a good group of friends that are supportive of your decisions to not drink alcohol or to be able to support you while you are feeling anxious," he says.

"There's a lot of pressure as a young person to be social and to drink alcohol, but it's totally up to you and it's your decision."