From the editors – adolescent drinking – Editorial

The stages of life follow a predictable course from infancy to old age. But an individual’s life at any given stage is shaped by bioligical influences and experiences in ways that are not yet fully understood. What biological influences and experiences might contribute, for example, to adolescent drinking? This special focus issue of Alcohol Health & Research World, “Alcohol and Youth,” examines not only adolescent drinking itself, but explores what might happen during childhood and adolescence to contribute to alcohol use later in life. In one sense, therefore, this issue is about alcohol and youth. In another sense this issue is about alcohol use throughout the life cycle.

Alcohol use among youth and its impact on later drinking behavior are addressed in Dr. Michael Windle’s lead article. Dr. Windle presents results of a recent national survey of adolescent drinking behavior that reveal the prevalence among youth of alcohol use both alone and in combination with other drugs. In addition, he examines the relationship between a young person’s age at the time of first alcohol use and the development of heavy drinking over time.

Survey reveal the prevalence of problem alcohol use that already exists. Should we attempt to predict alcohol problems before they actually begin? Drs. James R. Wilson and Lawson Crowe discuss what genetic research has contributed to making such prediction possible, and present some of the ethical dilemmas involved in early identification of youth at risk.

Genetic research is one of many lines of inquiry into the causes of alcohol problems later in life. To understand some of the influences that environment and experience have on eventual alcohol problems, Drs. Robert A. Zucker and Hiram E. Fitzgerald take a developmental perspective. They examine the stage of early childhood and ask, “What types of early experiences might put a child at risk for alcohol problems as an adolescent and later as an adult?”

A child’s early experiences may provide one explanation for later alcohol problems. But, as Drs. Robert O. Pihl and Jordan B. Peterson explain, childhood psychiatric disorders–particularly childhood conduct disorder–may increase the risk for developing alcohol problems in adulthood as well.

Conduct disorder is one of a number of psychiatric disorders that can occur in childhood. Drs. Jeannette L. Johnson, Kenneth J. Sher, and Jon E. Rolf consider that children of alcoholics are more susceptible to alcoholism and psychopathologies such as conduct disorder, anxiety, and depression than children of nonalcoholics. These authors examine the genetic and developmental processes that may influence this susceptibility.

The above-mentioned articles describe what research has revealed about the ways in which genetics, experiences, and underlying psychopathology may put a child at risk for later alcohol problems. But, as Drs. Baruch Fischhoff and Marilyn Jacobs Quadrel explain, drinking also depends on the decision to drink. These authors explain how decision theory can be applied to reveal factors involved in adolescents’ decision making with regard to alcohol use.

Once an adolescent begins to drink, how might alcohol affect his or her health over time? Ms. Amelia M. Arria and Drs. Ralph E. Tarter and David H. Van Thiel review what is now known about the medical consequences of adolescent alcohol abuse, and suggest areas in need of further research.

Sexually transmitted deseases are common medical problems among adolescents, according to Drs. Barbara C. Leigh and Diane M. Morrison. During a time when HIV infection and AIDS are a number one public health concern, the authors underscore that an understanding of the possible connections between alcohol and sexual risk-taking behavior is vital for prevention.

Adolescents and adults who experience problems with alcohol need help–not only with the medical consequences of drinking, but with their problem drinking itself and problems in other areas of functioning. Drs. Ralph E. Tarter and Andrea M. Hegedus explain that a brief, efficient, and informative screening instrument, such as the Drug Use Screening Inventory, is needed for comprehensive screening and assessment, leading to accurate diagnosis and effective treatment.

Because adolescence may be a stage during which alcohol use is only one problem in a constellation of problems, Dr. Thomas F. Babor and colleagues explain that treatment should be a complex process involving many people coordinating specialized services to meet individual patient needs. The authors cite their experiences with the Youth Evaluation Services program, describing the rationale and procedures used to design the program, and to guide client assessment, treatment planning, and case management.

A consideration of alcohol use among youth is incomplete without a consideration of efforts aimed at preventing such use. Dr. Lewis D. Eigen and Ms. Joan W. Quinlan describe the campaign, “Put on the Brakes: Take a Look at College Drinking!,” launched by the Officer for Substance Abuse Prevention in the spring of 1991. This campaign is designed to raise college students’ awareness of the serious consequences of drinking, to prevent drinking problems before they begin.

Adolescent drinking is not only a national, but also an international, concern. Our International Perspective department describes the International Project on Adolescent Drinking, a study being conducted jointly by the National Institute on Alcohol Abuse and Alcoholism and the Finnish Foundation for Alcohol Studies. As this article notes, the goal of the project is to determine the development, nature, and extent of alcohol use among adolescents in a variety of cultures.

Finally, in our Epidemiologic Bulletin for this issue, Dr. Bridget F. Grant and coauthors present detailed prevalence and population estimates of alcohol abuse and dependence for the United States for 1988, using the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised (DSM-III-R).

Youth is a time of promise, of potential, that can be developed and realized through all the stages of adulthood. But, as this issue of Alcohol Health & Research World explains, not every child or adolescent will relize this potential. Young people, like the adults they become, develop alcohol problems–and other problems–for a multitude of reasons that researchers continue to investigate. The challenge for alcohol research is to fill the gaps that still exist in our knowledge as to the causes and consequences of, as well as treatments for, these problems. We hope that this issue of Alcohol Health & Research World will help to point the way.

COPYRIGHT 1991 U.S. Government Printing Office

COPYRIGHT 2004 Gale Group

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