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When Is It Time to Seek Alcohol Treatment for Adolescents?

Written by Evolve's Behavioral Health Content Team​:

Alyson Orcena, LMFT • Melissa Vallas, MD • Shikha Verma, MD • Ellen Bloch, LCSW • Lianne Tendler, LMFT • Megan Johnston, LMFT

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Alcohol is the most abused substance among teens in the U.S.

Most parents understand their teenager is likely to experiment with alcohol at some point during adolescence. That goes for all teens, and most parents understand their teen is not immune. From students who do everything by the book to students who love to rebel for the sake of rebelling, the chances are they’ll have a drink – probably more than once – at a party, get together, or on a random Tuesday afternoon when someone pulls out a flask and offers a sip just this once.

Some teens do try alcohol just that one time. Others go a step further, but not too far. They reserve it for special occasions: homecoming, prom, that one big epic all-grades party, or end-of-the-year Schools Out! Events. And still, others start out with experimentation, progress to drinking on weekends, and over time end up drinking almost every day – and some end up drinking every day.

This article is for the parents of teens in those last two categories: teens who drink almost every day or drink every day and develop what’s known as an alcohol use disorder (AUD). When alcohol use reaches this level, parents begin to wonder if they can find specialized alcohol treatment for adolescents.

The answer is yes: there are many teen rehab centers that specialize in alcohol treatment for adolescents.

But we need to back up for a moment to clarify something. The teens who drink at prom and at parties – and on that random Tuesday just one time – are all engaging in illegal activity and putting themselves at risk of a host of problems associated with underage drinking. Drinking at any time increases the risk of using other drugs, becoming the victim of intimate partner violence, and being involved in an alcohol-related automobile accident.

The Facts on Problem Drinking Among Teens

Given that teen drinking is so common, how do parents know when their teen crosses over from experimentation to problem drinking? How do they know when they should seek support from a teen rehab center that offers alcohol treatment for adolescents?

We’ll answer those questions in a moment.

First, we’ll define who’s at risk of developing an AUD – and in case you aren’t up on the latest terminology, alcohol use disorder (AUD) is the way we now refer to the condition we used to call alcoholism.

The Substance Abuse and Mental Health Services Administration (SAMSHA), breaks teen drinking down into three categories:

  • Non-drinkers. Teens who reported no alcohol consumption in the last 30 days
  • Light drinkers. Teens who reported consuming at least one, but fewer than five drinks on one occasion in the last 30 days
  • Binge drinkers. Teens who reported consuming five or more drinks on at least one occasion and no more than four occasions during the last 30 days.
  • Heavy drinkers. Teens who reported consuming five or more drinks per occasion on five or more days in the previous 30 days.

Let’s further clarify this further. A drink is defined by a serving of alcohol that includes at least 14 grams of pure alcohol, which corresponds to:

  • 12 ounces of beer with ~5% alcohol content
  • 5 ounces of wine with ~12% alcohol content
  • 5 ounces of liquor (distilled spirits) with ~40% alcohol content

Now let’s outline what increases the risk of problem drinking – a.k.a. developing AUD – among teenagers. The following information comes from SAMSHA and the National Institute on Alcohol Abuse and Alcoholism (NIAA).

AUD Risk Factors: Teens

  1. Genetics. Teens with parents who have AUD are at higher risk of developing AUD than teens whose parents do not have AUD.
  2. Brain markers. A specific brain wave called P300 correlates with early initiation of alcohol use in boys.
  3. Early initiation. Teens who initiate alcohol use before the age of 15 are four times more likely to develop AUD.
  4. Behavioral signs. Children who display extreme aggressiveness and uncontrolled impulsiveness in early years (under age 5) are at increased risk of developing AUD as adolescents.
  5. Mental health disorders. Teens who have a mental health disorder or psychiatric condition such as anxiety, depression, and behavior/conduct disorders are at increased risk of developing AUD.
  6. Attitude toward drinking. Teens with a positive view of drinking – i.e. they think it’s cool and don’t understand the health and social risks – are at increased risk of developing AUD.
  7. Family dynamics. Teenagers who experience a lack of parental support, communication, and engagement are at increased risk of developing AUD, as are teens who experience parental hostility, rejection, and inconsistent, authoritarian parenting.
  8. Teens who experience sexual abuse, physical abuse, and violence are at increased risk of developing AUD, as are teens who witness any of the above traumatic events.

Parents reading this article should now have a clear idea of what constitutes problem drinking and understand the known risk factors for AUD in teens. Let’s connect this first set of dots here. If a teen experiments with alcohol, becomes a binge or heavy drinker as defined above, and is in a known high-risk category, then parents should consider seeking support from a teen rehab center that specializes in alcohol treatment for adolescents.

Teen Drinking: Warning Signs

There are more dots to connect. Sometimes parents don’t know their teen drinks alcohol or has started experimenting with alcohol. This section is for those parents.

The following signs are potential indicators that a teen has crossed over from experimentation to problem drinking. Parents who see the following signs – and know their teens are in one of the risk categories above – may need to consider seeking professional support from a teen rehab center that offers alcohol treatment for adolescents.

Signs of alcohol abuse in teens include:

  • Changes in mood. Extreme or uncharacteristic anger, irritability, and defensiveness
  • Academic issues. Skipping school, sudden drop in performance, disciplinary problems
  • Opposition/rebellion. Sudden or uncharacteristic resistance to family rules and norms
  • Peer group. Change in friends, withdrawal from old friends, and an unwillingness to share or discuss new friends
  • Sudden or uncharacteristic change in hygiene: from neat and tidy to disinterested or uncaring
  • Self-isolation. Withdrawal from friends, hobbies, and activities they used to love.
  • Presence of alcohol. Finding alcohol or empty alcohol containers in their bedroom or backpack.
  • Indications of intoxication. Odor of alcohol on breath, slurred speech, glassy eyes, lack of coordination, excessive giddiness, disorientation.
  • Physical and mental impairment. Memory issues, poor concentration, impaired decision making, decreasing impulse control.

Please note that some of these warning signs can be due to other things, such as high stress or an underlying mental health issue. Some are signs of typical adolescent behavior and what’s called differentiation, or the process of creating a personal identity distinct from parents and siblings.

However, if you suspect your teen uses, misuses, or abuses alcohol – and you can see evidence of the warning signs above, then it’s important to arrange a full assessment and evaluation with a healthcare professional.

Teen Alcohol Abuse: The Dangers

As we mention in the first section of this article, parents who seek alcohol treatment for adolescents understand that alcohol consumption is inherently dangerous for their teens. We mention several of the dangers above. We’ll now offer a more robust list of dangers associated with teen – or underage – drinking.

According to the NIAA, underage drinking can:

  • Cause death:
    • Statistics show that every year, alcohol use is among teens is a factor in deaths from car crashes, homicide, overdose, drowning, accidents, and suicide.
  • Cause injury:
    • Statistics from 2011 show that 188,000 people under the age of 21 went to a hospital emergency room for alcohol-related injuries.
  • Impair judgment:
    • Drinking can lead to risky sexual behavior, violent behavior, and aggressive behavior.
  • Increase risk of assault:
    • Alcohol consumption increases the chance of being both a victim and perpetrator physical or sexual violence.
  • Lead to more problems
    • Drinking increases the likelihood of using other drugs and having problems at school and with authorities (i.e., the police).
  • Increase risk of AUD in adulthood:
    • People who initiate alcohol use before age 15 are five times more likely to develop AUD as adults than people who initiate use after age 21.
    • Impair brain development:
  • Impair brain development:
    • Early alcohol use impairs brain structure and function, and can lead to problems in learning, memory, cognition, impulse control, and rational decision-making.

The dangers of underage drinking are serious. Parents who suspect their teen abuses alcohol should arrange a full assessment and evaluation with a healthcare professional. They should also consider seeking support at a teen rehab that specializes in alcohol treatment for adolescents. Parents who see the signs should not: they should take action to prevent further escalation and avoid the dangers of alcohol we list above.

How to Find Alcohol Treatment for Adolescents

The first thing for parents to do is confirm the presence of an AUD. That requires a full professional evaluation from a mental health professional. The result of the evaluation will determine the next step. The clinician who conducts the evaluation may refer the teen for outpatient treatment, inpatient treatment, partial hospitalization treatment, or residential treatment.

All these options can help adolescents with AUD.

If the evaluation indicates the presence of alcohol addiction, please read this article:

My Teenager Has an Addiction Problem: How Do I Find a Quality Treatment Program?

We wrote that article for parents seeking treatment for teens with any kind of addiction problem. However, it also applies directly to parents seeking alcohol treatment for adolescents. Read that article from beginning to end and follow the steps we recommend. It contains the most up-to-date information on high quality alcohol treatment for adolescents and includes practical advice on how to find the best support available.

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