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When Alcohol Causes the Most Harm

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 Meet The Team >

Alcohol can damage the brain and body at every age and stage of life. Addiction to alcohol – also known as alcohol used disorder (AUD) – increases the problems alcohol causes. Long-term daily exposure to alcohol can lead to significant dysfunction, disability, and, in some cases, death. A 2020 study identified three specific time periods when alcohol does the most harm. These include:

1. Pregnancy

Drinking – even moderately – at any stage during pregnancy can lead to psychological and behavioral issues in children. About 15% of pregnant women drink alcohol. Doing so puts their children at risk of facial abnormalities, cognitive impairment, and central nervous problems like low birth weight and behavioral problems, among other issues.

2. Later Adolescence (ages 15-19)

Alcohol can have a significant negative impact on the teen brain. During late adolescence through the early 20s, the brain develops at a rapid rate, particularly the frontal lobe, which is the area that controls decision-making, impulse control, and other important functions. This remodeling of the brain affects teens’ decisions whether to drink or not, how much they drink, and in what type of situations they choose to drink. It also makes the brain more vulnerable to damage from alcohol during adulthood.

In addition, late adolescence is the age when many young people begin experimenting with alcohol and other drugs. About one-quarter of 14 to 15-year-olds have had at least one drink.

Although teens tend to drink less often than adults, they’re more likely to binge drink, which is defined as consuming 4-5 drinks in a two-hour period. Binge drinking accounts for more than 90 percent of drinks consumed by youth. It’s common in teens because they’re less sensitive to some of alcohol’s effects, such as sleepiness and loss of motor control, that help signal it’s time to stop drinking. Binge drinking takes a greater toll on adolescent brain development than moderate drinking and increases risk-taking behavior.

Some of the problems adolescents can develop as a result of drinking include:

  • Cognitive deficits or learning problems that can lead to impaired decision-making
  • Memory problems, especially the ability to form new, lasting memories and recall facts and events
  • Reduced brain volume and poor white matter development
  • Poor academic performance or dropping out of school
  • Social withdrawal or problems like fighting
  • Unsafe sex or sexual assault
  • Legal problems such as DUI or violent behavior
  • Alcohol-related injuries caused by accidents
  • Disruption of normal growth and physical development
  • Death caused by alcohol-related car crashes, overdoses, falls, drowning, and suicides

For these reasons, it’s important to set a firm no alcohol rule with teens.

The effects of teen drinking can be lifelong. Repeated exposure to alcohol during adolescence increases the likelihood of alcohol-related memory problems during adulthood. It also changes the brain’s long-term responsiveness to some of alcohol’s effects. The earlier someone starts drinking, the more likely they are to develop addiction later in life. This is particularly true for teens who start drinking by 14 or 15 years old.

It’s even more impactful to discuss the science that informs this rule. Delaying the first drink buys time for the teen brain to develop, so they can make better decisions in a few years.

Teens will soon grow into young adults and they will have to decide what kind of relationship they’ll have with alcohol. Some will drink small amounts or not at all, some will drink in moderation, and others will develop dangerous drinking habits. Parental attitudes, rule-setting, and family norms – combined with real information about the dangers of alcohol, as listed above – influence what relationship a teen has with alcohol.

3. Older Adulthood (65+)

About 40% of adults over 65 drink alcohol. Our brains and bodies don’t cope with alcohol’s effects as well as we age. Drinking alcohol puts older adults at higher risk of several problems, including:

  • Dementia-like symptoms such as forgetfulness and confusion
  • Falls, fractures, and car accidents, often caused by the body’s lower tolerance for alcohol as we age
  • Changes in the heart and blood vessels that would set off earlier warning signs of heart attack

Drinking can be particularly dangerous for seniors who have existing health problems, drink heavily, or take medications that interact with alcohol.

Parents Set the Tone

The brain is vulnerable to the effects of alcohol throughout life, but during these three time periods, it’s particularly important to be mindful of alcohol consumption. Parents of teens should share everything they know about alcohol with their teenage children. Awareness and education give teens the knowledge they need to make informed, responsible decisions about alcohol consumption. And of course, parents need to stress the fact consuming alcohol is illegal for anyone under the age of 21.

If you or a loved one struggles with heavy drinking, especially at these high-risk ages, contact a counselor or alcohol treatment program. Parents of teens should find an adolescent treatment center that specializes in teen addiction. Getting help now can help prevent consequences that could impact the rest of their lives.

Our Behavioral Health Content Team

We are an expert team of behavioral health professionals who are united in our commitment to adolescent recovery and well-being.

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