Alcohol abuse and alcoholism, known collectively as alcohol use disorders or AUD, are potential consequences of excessive consumption of beer, wine, malt liquor, distilled liquor or a variety of other alcoholic beverages, often requiring professional treatment. For a variety of reasons, the vast majority of the scientific studies used to establish the definitions for alcohol use disorders were performed on adult population groups. According to a study review published in 2010 in Pediatrics,the adult standards for both alcohol abuse and alcohol dependence differ significantly from appropriate standards for teenagers.
Adult Alcohol Abuse Standards
Alcohol abuse is the generally accepted term for any pattern of alcohol consumption that seriously disrupts the life of an affected individual. Types of disruptions caused by such an abusive pattern of alcohol use include an inability to meet home-, school- or work-related obligations, intoxicated driving, recurring family arguments regarding alcohol intake, and involvement in alcohol-related arrests or legal proceedings. Unlike alcoholics, alcohol abusers don’t have a physical dependence on alcohol use. However, they may participate frequently in clearly harmful drinking behaviors like binge drinking, a pattern of heavy consumption that gets a drinker legally intoxicated within a two-hour time period. Alcoholism is a severe type of alcohol abuse. Alcoholics have developed a physical and perhaps emotional reliance on alcohol. Reactions in the body that indicate dependence include the development of a tolerance to alcohol’s mind-altering effects and symptoms of withdrawal when alcohol use stops or decreases abruptly. Additional signs of alcoholism include persistent cravings for alcohol, a reorientation of one’s daily routine toward alcohol use and recovery from alcohol’s effects, abandonment of life responsibilities as a result of alcohol use, a repeated failure to control alcohol intake, and a related failure to successfully stop drinking.
Teen Alcohol Abuse Standards
The standard definitions for alcohol abuse and alcoholism come from research conducted on adult drinkers. In many respects, these definitions also apply to teen drinkers. However, according to the study review published in 2010 in Pediatrics, certain key differences exist between adults and teens. One such difference arises in the application of the accepted definition for binge drinking. Typically, an adult male consumes five or more drinks during a two-hour binge in order to meet legal standards for alcohol intoxication (a blood alcohol content of 0.08 g/dL). The average adult female consumes four or more drinks to reach legal drunkenness during the same period of time. However, most teen drinkers get drunk in a two-hour period on considerably less alcohol. Teenage girls (and all preteen drinkers) can reach legal drunkenness with as little as three drinks; teen boys age 14 or 15 can get legally drunk in two hours on as little as four drinks. Only older teen boys typically need to drink as much alcohol as adults to meet current standards for binge drinking. Other important differences appear in standard definitions for alcoholism. For example, teenagers who engage in drinking patterns that would likely lead to alcoholism in adults may simply not have drinking histories that are long enough to produce adolescent alcoholism. Heavy teen drinkers who stop or abruptly reduce their alcohol intake also don’t typically go through alcohol withdrawal. In addition, because of certain biological factors involved in adolescent growth and development, researchers experience considerable difficulty when trying to apply standards for alcohol tolerance to teenagers.
Detecting Alcohol Problems in Teens
In light of their findings, the authors of the Pediatrics review make several recommendations regarding the application of alcohol abuse and alcoholism standards to teenagers. In regard to binge drinking, they recommend using age-specific definitions that accurately reflect the intoxication and abuse risks for teenage girls and younger teenage boys. On broader questions related to both alcohol abuse and alcoholism, they point to the usefulness of a concept called “alcohol misuse.” Essentially, this concept applies to any pattern of alcohol use that is currently causing personal, social or family harm, or has a strong likelihood of causing such harm at a later point in time. If this concept replaced adult-centered definitions for alcohol abuse and alcoholism, it could greatly improve the ability to detect serious alcohol-related problems in teenagers, whether or not those problems meet current standards for abuse or dependence.