July 2015 Bulletin

Talking With Adolescents and Their Parents About Underage Drinking: A Q&A With Dr. Leslie Walker

Leslie Walker bulletin

Dr. Leslie Walker, division chief of Adolescent Medicine at Seattle Children’s and professor and vice chair of faculty affairs in the Department of Pediatrics at the University of Washington School of Medicine, addresses questions about talking to kids about underage drinking.

Thank you to Dr. Wendy Sue Swanson, a pediatrician at The Everett Clinic in Mill Creek, a member of Seattle Children’s medical staff and executive director of Digital Health, and author of the Seattle Mama Doc blog, for submitting these questions.

How serious a problem is underage drinking?

Alcohol consumption is the greatest world health issue. It is the greatest predictor of world illness and death, and contributes to significant costs worldwide. In the United States, and Washington state more specifically, 75% of kids have tried alcohol by the time they graduate from high school. Research shows that kids who consume alcohol before they graduate high school are more likely to have a drinking problem as a young adult.

What are typical risk factors for teens regarding alcohol use and abuse during childhood and early adulthood?

Parents have the strongest impact on a child’s potential to drink, both with their words and their actions. It’s important that children understand their parents do not want them to drink. Research shows that if a teen thinks their parents condone alcohol consumption, they are three times more likely to consume alcohol before graduating high school.

Additionally, kids model their parents’ drinking habits. If a parent needs a drink at the end of each work day to “unwind,” their children will believe they need a drink to relax. If a parent is an alcoholic and still drinking, their children are also more likely to drink at younger ages.

A recent study published by the American Academy of Pediatrics reported that exposure to alcohol use in films was associated with earlier drinking in teens and risky behavior. How can parents counter this influence?

There are many factors that influence an adolescent’s risk of underage drinking, including the media. Unfortunately, alcohol is so woven into our society, and it’s impossible to avoid the marketing around us. Even when parents have conversations with their children about alcohol references in the media, that subliminal messaging will still affect teens. I think it’s best that, as much as possible, parents limit their kids’ exposure to media that celebrate drinking.

How do those risk factors translate into lifelong risk of alcohol abuse and co-morbid health problems?

Alcoholism is a pediatric disease. It starts in childhood and develops into lifelong addictions. Like drug use, alcohol consumption as a teen or child causes irreversible changes to the brain, depleting hormones in the brain that support mental health and causing depression. A Harvard 75-year study reported that over a lifetime, the No. 1 deterrent of happiness was alcohol use.

Adolescents and young adults with alcohol dependence or abuse have a hard time getting up in the morning, completing school, keeping jobs and maintaining healthy relationships. Still, alcoholism is 100% preventable.

Can parents reduce their child’s chance of developing alcoholism by exposing them in a safe way at a younger age?

There is no such thing as safe drinking for adolescents or teens. When you introduce a mind-altering drug like alcohol to a developing brain in any way, the child is much more likely to become addicted than an adult.

We know that in Europe, where the drinking age is younger, the population has a much greater problem with alcohol-related morbidity.

A recent study published by the Center of Alcohol Studies reported that children whose parents let them sip alcoholic drinks before their teen years consumed more alcohol in high school, as opposed to the common notion that sips may decrease use by demystifying it.

The fact is, teens don’t want to be like their parents, so if the parents offer their kids sips of alcohol, the child will only want to take it further by consuming much more alcohol. Additionally, kids don’t drink for taste – they drink to get drunk and to change how they feel. And if they are predisposed to addiction, the earlier they start to ingest alcohol, the earlier their brain will be primed for addiction.

What data-proven strategies can pediatricians share with parents to discourage underage drinking?

Set clear guidelines that underage drinking is never acceptable, and if you see it happening, address it directly. Do not minimize the issue. Additionally, know your family history and address any alcohol problems in your home.

Parents can also reduce their teen’s access by “childproofing” the home. Just as we protect young children from sharp corners and electrical sockets, it’s important to make sure teens can’t access alcohol in your home.

Finally, it’s important that parents stay connected to their community. Talk to other parents, especially the parents of your kids’ friends, about their views on alcohol use. You’ll have a better chance of preventing underage drinking by working together.

How can parents balance the behaviors they model for their children while allowing themselves to drink alcohol around their children?

It’s unreasonable to tell the whole country to stop drinking until their kids reach age 21. Alcohol is incorporated into too much of American society.

However, it is important to understand that exposure to drinking and drug use in the home and/or tolerance for underage drinking is the most powerful determinate of adolescent and childhood alcohol and drug dependence. No matter what the situation is at home, it is still beneficial to have clear and strict rules about not allowing underage drinking or use of marijuana or other illegal drugs.

Coming in August: New Seattle Children’s South Clinic

South Clinic external rendering

Our newest regional clinic, Seattle Children’s South Clinic, will open its doors to patients and families on Aug. 18, 2015. The clinic, located on Enchanted Parkway South in Federal Way, will offer more than 15 specialties – and evening and weekend urgent care – near home for families in communities south of Seattle.

The existing Seattle Children’s clinic in Federal Way will close permanently at the end of the day Wednesday, Aug. 12; no clinic appointments will be available in Federal Way on Aug. 13, 14 or 17.

Families who schedule appointments at Seattle Children’s South will receive information about the new location in their appointment reminder letters.

Come see our beautiful, new, 32,000-square-foot clinic!

Join us for a referring provider meet-and-greet on Thursday, Aug. 6, from 6 to 8 p.m. Visit with Dr. Mark Del Beccaro, Seattle Children’s chief medical officer; Dr. Ruth McDonald, pediatrician-in-chief; and other Seattle Children’s providers who will be practicing at Seattle Children’s South.

Enjoy drinks and appetizers, tour the clinic and catch up with colleagues. RSVP by email or phone to Laurel Hopkins, manager of Physician Liaisons, at 206-987-5031.

Your patients, families and neighbors are invited to a health fair at Seattle Children’s South on Sept. 12. This free, fun, hands-on event for kids and parents gives everyone a chance to learn about health and safety and see our new clinic.

Learn more about Seattle Children’s South Clinic.

Grand Rounds for July 2015 (CME Credit Available)

Upcoming Grand Rounds

  • July 2: Firearm Violence in the U.S.: Lessons for Clinicians
  • July 9: Building Healthcare Capacity in Low-Resource Countries
  • July 16: Genetic Therapies for Genetic Disease: Gene Therapy in Pediatrics
  • July 23: Mosaicism, a New Frontier in Pediatric Genetics: How Many Mutations Are We Missing by Only Testing Our Patient's Blood?
  • July 30: Aerodigestive Program: A New Resource
  • Aug. 6: Insatiable: Understanding Prader-Willi Syndrome, a Unique Phenotype of Obesity
  • Aug. 13: Comparative Effectiveness Research: Attitudes About Risk and Consent for Research on Common Medical Practices
  • Aug. 20: Managing Transition of Childhood Disease to Adulthood: CHD and Beyond
  • Aug. 27: Managing Transitioning Adolescents with Chronic Disease to Adult Care: What Works
  • Sept. 3: Drop Your Assumptions and Pick Up the Evidence: Strategies to Address Vaccine Hesitancy
  • See all upcoming grand rounds.

Watch Past Grand Rounds Online

  • Evolving Scope of Fetal Cardiology
  • Ambulatory Blood Pressure Monitoring in the Evaluation of Childhood Hypertension
  • Advances in Pediatric Stroke: Mechanisms and Management
  • Department of Pediatrics: New Frontiers for Translational Research
  • The Learning Health System: Translating Research into the Standard of Care
  • See all online grand rounds.

For Provider Grand Rounds information, visit our website.

New Medical Staff and Allied Health Professionals, July 2015

Medical Staff

  • Emily Bronec, MD, Bainbridge Pediatrics, PLLC, Pediatrics
  • Kathleen Kieran, MD, Seattle Children’s, Urology
  • Rachel Umoren, MB ChB, MS, University of Washington, Neonatology
  • Elizabeth Watkins, MD, Seattle Children’s, Emergency Medicine

Allied Health Professionals

  • Julie Aldrich, ARNP, Seattle Children’s, Urology
  • Catherine Horner, ARNP, Seattle Children’s, Cardiology
  • Michelle Sakoda, ARNP, Seattle Children’s, Emergency Medicine
  • Amy Sherrod, ARNP, Seattle Children’s, Hematology-Oncology