Young People and Alcohol E-Book

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 776

Veröffentlichungsjahr: 2011

Beschreibung

Young People and Alcohol is a practical and comprehensive reference for professionals and researchers in the field of alcohol misuse who work with people aged 12 to 25 years. The book provides readers from a range of professional backgrounds with authoritative and up to date information about the effects of alcohol use in the young and, particularly, its management, with an emphasis on interventions whose effectiveness is supported by evidence.

Written by an internationally renowned team of contributors, chapters span five key sections: The Phenomenon and Impact of Youth Drinking; Neurobiology; Prevention and Early Intervention; Assessment and Diagnosis; and Treatment.

FEATURES

• Focus is on treatment, relating the science to everyday clinical practice.
• Evidence-based
• List of further resources
• Tables and flowcharts
• Glossary of key terms and abbreviations

Leseprobe

Contents

Cover

Title Page

Copyright

Contributors

Preface

Glossary and abbreviations

Part I: The Phenomenon and Impact of Youth Drinking

Chapter 1: The phenomenon of youth drinking

Childhood influences

Early teen drinking in “wet” and “dry” countries: transgression or rite of passage?

Learning underage drinking in the company of friends

Is the gender gap closing?

Late teen drinking: binge drinking and integration into the adult night-time economy

The costs of consumption: young people, alcohol, and harm

Conclusion

Chapter 2: Early onset drinking

A working definition of early onset drinking

Early onset drinking: a differentiator for pathways of use and abuse

Risk factors

Protective and promotive factors

Summary

Acknowledgments

Chapter 3: The short- and long-term consequences of adolescent alcohol use

Accidents

Risky sexual behavior, sexually transmitted infections, and pregnancy

Violence and sexual assault

Obesity

Alcohol as a gateway substance

Age of onset of use and consequences

Discussion and conclusions

Part II: Neurobiology

Chapter 4: The biology of alcohol and alcohol misuse

Absorption, distribution, and clearance

Pharmacological effects

Alcohol intoxication

The after effects of alcohol

Alcohol and neurotransmission

GABA

Alcohol and hormones

The long-term effects of alcohol

Laboratory tests

Resources

Chapter 5: Alcohol and the developing brain

Alcohol exposure: vulnerable periods of brain development

The adolescent brain and alcohol

Long-term consequences of adolescent alcohol exposure

Summary and conclusions

Acknowledgements

Chapter 6: Genetic influences on alcohol use and alcohol use disorders

Genetically informative research designs

Heritability of alcohol initiation and use

Comorbidity

Gene by environment interaction

Genomics

Measured genotype by environmental (G × E) interaction

Conclusions

Resources

Part III: Prevention and early intervention

Chapter 7: Alcohol policy and the prevention of harm in young people

Alcohol and harm

Prevention: universal versus targeted interventions

Alcohol policies

Pricing policies

Minimum drinking age laws

Availability of alcohol

Marketing

Harm reduction

Resources

Chapter 8: Community-based approaches to prevention: reducing high-risk drinking and alcohol-related damage among youth and young adults

Evidence

Implementing community-based prevention approaches

Key points on how to proceed

Acknowledgments

Resources

Internet resources

Chapter 9: Brief alcohol intervention in young people

Brief alcohol intervention and young people

The evidence base for brief intervention in young people

Discussion

Conclusion

Resources for youth, parents, and practitioners

Chapter 10: Preventing and responding to alcohol misuse in specific contexts: schools, colleges, the military

The problem

School prevention and intervention programs

Preventing and dealing with college drinking

The military

Resources for practitioners

Resources for patients and families

Part IV: Assessment and diagnosis

Chapter 11: The clinical interview of young people about alcohol use

Building rapport

Gathering useful information in the first minutes of the assessment

A framework for psychosocial assessment

Confidentiality

Taking into account stage of adolescent development

Psychosocial risk

Assessing a young person's alcohol use

Physical examination

Finishing the clinical interview

Motivational interviewing

Resources for practitioners, patients, and families

Chapter 12: Detection, evaluation, and diagnosis of alcohol use disorders

Assessment in practice

Assessment measures in young adults

Screening instruments

Comprehensive measures of alcohol use and related problems

Validity of self-reports

Biomarkers

Part V: Treatment

Chapter 13: Recognition and acute management of severe alcohol intoxication and withdrawal in youth

Alcohol consumption patterns among youth

Alcohol consumption consequences

Clinical features of alcohol poisoning

Alcohol metabolism

Alcohol intoxication

Alcohol withdrawal in youth

Ethical considerations

Acknowledgment

Web resources for youth, parents, health professionals, and researchers

Chapter 14: Working with families of adolescents who misuse alcohol

The role of the family

Involving families in the response

Family-focused interventions

Discussion

Chapter 15: Psychosocial treatment for adolescents with alcohol use disorders

Family-based and multisystemic interventions

Behavioral therapy

Brief interventions and motivational interviewing

Contingency management

Summary

Acknowledgments

Chapter 16: Pharmacological approaches to the treatment of alcohol dependence in the young

Serotonin

Opioids: mu-receptor antagonist—naltrexone

Glutamate

Gamma-aminobutyric acid-B receptor agonist: baclofen

Disulfiram

Summary

Acknowledgments

Chapter 17: Alcoholics Anonymous and young people

Alcohol use in adolescence and young adulthood

Review of the evidence on youth AA participation: benefits and mechanisms

The role of clinicians in promoting AA attendance among young clients

Conclusions and recommendations

Resources

Chapter 18: Epidemiology and management of alcohol misuse comorbid with other disorders

Overview of alcohol abuse/dependence prevalence and comorbidity in adolescence

Alcohol treatment in adolescence: patterns and guidelines

Conduct disorder

Attention deficit hyperactivity disorder

Mood disorders

Conclusion

Index

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Library of Congress Cataloging-in-Publication Data

Young people and alcohol : impact, policy, prevention, treatment / Edited by John B. Saunders MD, FRACP, Centre for Youth Substance Abuse Research, Faculty of Health Sciences, University of Queensland, Brisbane and Faculty of Medicine, University of Sydney, Australia, Joseph M. Rey MD, PhD, FRANZCP Head of Psychiatry, Notre Dame University Medical School Sydney and Honorary Professor, University of Sydney Medical School, Sydney, Australia. p. ; cm. Includes bibliographical references and index. ISBN 978-1-4443-3598-9 (paperback : alk. paper) 1. Youth--Alcohol use. 2. Teenagers--Alcohol use. I. Saunders, John B. (John Barrington), 1949- editor. II. Rey, Joseph M., editor. [DNLM: 1. Alcohol-Related Disorders. 2. Adolescent. 3. Alcohol Drinking. WM 274] HV5135.Y673 2011 618.92′861–dc22 2010049554

Contributors

Arpana Agrawal, PhD Assistant Professor of Psychiatry,Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA

Peter Anderson, MD, MPH, PhD, FRCP Professor of Alcohol and Health,Faculty of Health, Medicine and Life Sciences, Maastricht University,Maastricht, The Netherlands

Andrew Baillie, MPsychol, PhD, MAPS Senior Lecturer and Director of Clinical Psychology, Training Centre for Emotional Health and Department of Psychology, Macquarie University, Sydney, Australia

Bridgette M. Bewick, BA, MA(Hons), PhD Senior Lecturer in Health Research, Leeds Institute of Health Sciences, School of Medicine, University of Leeds, Leeds, UK

Joseph M. Boden, PhD Senior Research Fellow and Principal Investigator, Christchurch Health and Development Study, Department of Psychological Medicine, University of Otago, Christchurch, New Zealand

Yvonne Bonomo, MBBS, FRACP, PhD, FAChAM Clinical Associate Professor and Physician in Addiction Medicine and Adolescent Medicine, Department of Medicine, St Vincent's Hospital, University of Melbourne, Australia

Linda Bosma, PhD President Bosma Consulting, LLC, Minneapolis, MN, USA

Andrew Clark, MD Department of Psychiatry, Medical University of South Carolina, Charleston, SC, USA

Deborah Deas, MD, MPH Professor, Centre for Drug and Alcohol Programs (CDAP), Department of Psychiatry, Medical University of South Carolina, Charleston, SC, USA

David M. Fergusson, PhD, FRSNZ, FNZPS(Hon), FRACP(Hon) Professor and Executive Director, Christchurch Health and Development Study, Department of Psychological Medicine, University of Otago, Christchurch, New Zealand

Norman Giesbrecht, PhD Senior Scientist, Public Health and Regulatory Policy Section, and Social, Prevention and Health Policy Research Department, Centre for Addiction and Mental Health, Toronto, Ontario, Canada

Deborah S. Hasin, PhD Professor of Clinical Epidemiology (in Psychiatry), New York State Psychiatric Institute, New York, NY, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA; Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA

Bankole A. Johnson, DSc, MD, PhD, MPhil, FRCPsych Alumni Professor and Chairman, Professor of Neuroscience, and Professor of Medicine, Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA, USA

Rose A. Juhasz, PhD Department of Psychiatry, Addiction Research Center, University of Michigan, Ann Arbor, MI, USA

Eileen F. S. Kaner, BSc(Hons), MSc, PhD Professor of Public Health, Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK

John F. Kelly, PhD Associate Professor in Psychiatry, Harvard Medical School, Boston, MA, USA; Associate Director, MGH-Harvard Center for Addiction Medicine, Massachusetts General Hospital, Boston, MA, USA; Program Director, Addiction Recovery Management Service, Massachusetts General Hospital, Boston, MA, USA

Katherine M. Keyes, MPH, MPhil New York State Psychiatric Institute, New York, NY, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA

Michael T. Lynskey, PhD Associate Professor, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA

Fiona Measham, BA, MA, PhD Senior Lecturer in Criminology, Lancaster University, Bailrigg, Lancaster, UK

Sonja Memedovic, BPsychol(Hons) Research Officer, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia

Louise Mewton, BA (Psychol)(Hons) Doctoral Candidate, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia

Jeanette Østergaard, PhD SFI -- The Danish National Centre for Social Research, Copenhagen, Denmark

Robert F. Saltz, PhD Senior Scientist, Pacific Institute for Research and Evaluation, Prevention Research Center, Berkeley, CA, USA

Shauncie M. Skidmore, PhD Department of Psychiatry, Addiction Research Center, University of Michigan, Ann Arbor, MI, USA

Linda Patia Spear, PhD Distinguished Professor, Department of Psychology and Developmental Exposure Alcohol Research Center (DEARC), Binghamton University, Binghamton, NY, USA

Rockan Sayegh, MA Center for Trauma and Injury Prevention Research, University of California Irvine, School of Medicine, Orange, CA, USA

Tim Slade, BSc (Psychol), PhD Senior Research Fellow, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia

Maree Rose Teesson, PhD Professor and NHMRC Senior Research Fellow, Assistant Director, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia

Lorna Templeton, MSc, BSc Research Manager, Mental Health Research and Development Unit, Avon & Wiltshire Mental Health Partnership NHS Trust and the University of Bath, Bath, UK; Independent Research Consultant, Bristol, UK

Federico E. Vaca, MD, MPH Professor of Emergency Medicine, Department of Emergency Medicine, Yale University School of Medicine, New Haven, CT, USA

Julie D. Yeterian, BA MGH-Harvard Center for Addiction Medicine, Massachusetts General Hospital, Boston, MA, USA

Robert A. Zucker, PhD Professor of Psychology, Departments of Psychiatry and Psychology; Director, University of Michigan Addiction Research Center; Director, Substance Abuse Section, Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA

Preface

In the United States in 2008, 8 million adolescents—almost one-third of all people aged 12–17—drank alcohol. On an average day, 205 adolescents presented to hospital emergency departments as a result of their alcohol consumption, often because of alcohol poisoning. Each day, 76 sought substance abuse treatment.1 Ian Gilmore, President of the Royal College of Physicians, London, UK, said, “The nation's growing addiction to alcohol is putting an immense strain on health services, especially in hospitals, costing the NHS [National Health Service] over £2.7 billion each year.” He added, “This burden is no longer sustainable”—costs had doubled in less than 5 years.2 A specialist clinic for children with problems related to alcohol misuse was to be launched in the Netherlands following a marked increase in admissions to hospital of children younger than 16 years because of alcohol poisoning.3 In Thailand, formerly a low alcohol consuming country, consumption of alcohol increased 32-fold between 1961 and 2001 (from 0.26 to 8.47 L per capita, respectively), with a consequent rise in health and social problems, particularly among young women.4 These events and data draw attention to the fact that youth alcohol use is a growing concern worldwide.

Although consumption varies between countries and among cultural and ethnic groups, patterns of use among the young seem to be converging due to the influence of the mass media, marketing, growing affluence, and globalization. The Surgeon General's Call to Action to Prevent and Reduce Underage Drinking5 highlights that the highest prevalence of alcohol abuse and dependence in any age group is among people aged 18 to 20. The report goes on to stress that adolescents use alcohol differently from adults, that they react uniquely to it, and that alcohol has a powerful attraction for adolescents, with often unpredictable and potentially devastating outcomes.5 The medical costs of underage drinking (below 21 years of age) in the United States are estimated to be in excess of $5 billion a year. Notwithstanding all this, alcohol problems in the young are often ignored or minimized. For example, Australian data6—similar to data elsewhere—show that parents are the most common source of alcohol among school students.

The latest research demonstrates a compelling need to address alcohol use early, in the context of human development, and using a systematic approach that spans childhood through adolescence and into adulthood. The coming tide of medium- to long-term health consequences of increased youth alcohol use is tragically illustrated by Gary Reinbach, a 22-year-old Englishman from Dagenham, Essex, UK. This young man died in hospital after he was refused a liver transplant because he could not prove he had not drunk alcohol for at least 6 months—one of the requirements for liver transplant in the United Kingdom. Mr. Reinbach had been admitted to hospital 10 weeks earlier with cirrhosis of the liver. His family said he had started drinking at 11 years of age and drank heavily after the age of 13.7 Most physicians, educators, policymakers, youth workers, teachers, and parents underestimate this problem and are poorly equipped to deal with it. This book aims to fill this gap by providing workers from a range of professional backgrounds working with people aged 12–25 years with authoritative and up to date information about the effects of alcohol use in the young and, particularly, its management, with an emphasis on interventions whose effectiveness is supported by evidence.

The first three chapters deal with the sociological and developmental aspects of alcohol use. Chapter 1 examines the phenomenon of youth drinking in the context of youth culture in the twenty-first century, highlighting recent changes in drinking patterns, a convergence between wine-, beer-, and spirit-drinking cultures, and the novel phenomenon of drinking specifically to become intoxicated as quickly as possible. While Chapter 2 considers the factors associated with early onset drinking and its consequences, Chapter 3 reviews the research on the short- and long-term consequences of adolescent alcohol use; in particular, how much of these outcomes can be actually attributed to alcohol use and how much to other confounding factors.

The next three chapters focus on the biological aspects of alcohol use. Chapter 4 describes how alcohol is handled by the body, its effects on consciousness and behavior, and summarizes the neurobiological mechanisms by which alcohol exerts its acute effects and leads to dependence. Chapter 5 examines a considerable body of new research showing that alcohol has specific effects on the developing adolescent brain. Chapter 6 discusses advances in our understanding of the genetic contributions to alcohol use across the life span but with a focus on adolescence and early adulthood.

Chapters 7–10 describe in some detail prevention and early intervention strategies. Chapter 7 focuses on universal preventive measures such as alcohol policies, legislation, and their effect on youth drinking and on preventing harms such as motor vehicle accidents. There is currently much discussion in the literature and in several countries' media about minimum pricing policies, thus far rejected by legislators on the incorrect belief that they unfairly penalize moderate drinkers. Chapter 8 describes the practicalities of how to mobilize community resources to develop and implement prevention policies and programs in a specific community. Chapter 9 deals with brief alcohol interventions in young people and their effectiveness, with a particular focus on those that can be delivered using new technologies such as the Internet and cell phones. Finally, Chapter 10 examines preventative interventions in schools, colleges, and military, which are receiving considerable attention in the clinical and policy domains. For example, there is a widespread belief that college life encourages heavy drinking.

The next two chapters deal with the assessment and diagnosis of alcohol use disorders in youth, including diagnostic concepts and the classification of alcohol use disorders in the international diagnostic systems (Chapter 12). This chapter also describes the use of scales, diagnostic interviews and biological markers. Chapter 11 outlines the clinical interview of young people who misuse alcohol and emphasizes the importance of empathy and understanding of the young person's experiences with alcohol.

The final 6 chapters address various aspects of treatment, with an emphasis on those that have demonstrated effectiveness or show promise. Chapter 13 deals with the acute management of alcohol intoxication and withdrawal, highlighting the early signs of alcohol poisoning. Chapter 14 draws attention to the importance and issues involved in working with families of adolescents who misuse alcohol. Chapter 15 reviews the large body of literature on the psychological approaches to the treatment of adolescents who misuse alcohol that are the current mainstay of treatment, and offers practical advice on the implementation of these interventions in youth.

The last 10 years have witnessed a dramatic renewal of interest on the pharmacological approaches to the management of alcohol use disorders, resulting in a burgeoning literature. Although research targeting adolescents and young adults is still limited, these efforts are presented in Chapter 16. Chapter 17 describes the evidence for using 12-step programs such as Alcoholics Anonymous and advises clinicians on how to make them more attractive for adolescents and youth. Finally, Chapter 18 gives an excellent picture of the problems managing alcohol use disorders comorbid with other conditions, a very common occurrence in clinical practice.

At the beginning of each chapter, there is a list of “key points” that summarize the thrust of the chapter. At the end, when appropriate, there is a list of sound resources for practitioners, patients, and families, mostly available in the Internet free of charge. We also provide a glossary explaining the abbreviations and some of the technical terms used in this very broad field.

We would like to finish by thanking the contributors very much; they generously agreed to share their wisdom, knowledge, and clinical experience and adhered to a demanding and tight schedule. We are in their debt.

John B. SaundersJoseph M. Rey

References

1. The OAS Report. A Day in the Life of American Adolescents: Substance Use Facts Update. Rockville, MD: Substance Abuse and Mental Health Services Administration; April 29, 2010. http://oas.samhsa.gov.

2. Anonymous. Rising alcohol addiction costs `could cripple the NHS'. BBC News January 1, 2010.

3. Sheldon T. Dutch paediatrician launches clinic for children with alcohol problems. BMJ 2006; 333:720.

4. Casswell S, Thamarangsi T. Reducing harm from alcohol: Call to action. Lancet 2009; 373:2247–2257.

5. US Department of Health and Human Services. The Surgeon General's Call to Action To Prevent and Reduce Underage Drinking. Office of the Surgeon General, Department of Health and Human Services: Washindton, DC, 2007.

6. White V, Hayman J. Australian Secondary School Students' Use of Alcohol in 2005. Melbourne: The Cancer Council Victoria; 2006.

7. Rouse B. Alcoholic, denied liver transplant, dies at age of 22. Irish Examiner July 21, 2009.

Part I

The Phenomenon and Impact of Youth Drinking

Chapter 1

The phenomenon of youth drinking

Fiona Measham1 and Jeanette Østergaard2

1Lancaster University, Lancaster, UK

2SFI – The Danish National Centre for Social Research, Copenhagen, Denmark

Key points

Wide variations exist in young people's drinking and attitudes to alcohol around the world, influenced by family, peers, schools, ethnic and religious upbringing, media, advertising, and national and cultural contexts.Uptake of alcohol consumption in early adolescence can mark both a rite of passage between childhood and adulthood and a phase of limit-testing, transgression, or deviance from adult social constraints.Cross-national studies have noted the emergence of heavy sessional consumption or ‘binge drinking’ for both young women and young men, in higher and lower income groups, with drunkenness in some youth cultures seen as an intended and desirable consequence rather than negative side effect of heavy drinking.It has been suggested that the reason for the growth in young people's heavy sessional consumption is the globalization of cheap and high-strength alcoholic beverages across the world, associated with the expansion of an increasingly alcohol-oriented night-time economy appealing to youth and young adults.Evidence of convergence in drinking patterns between young women and young men in some developed countries has been linked to young women's growing educational and employment opportunities. However, gender remains significant to aspects of consumption, such as beverage choice and attitudes to public drunkenness.

For young people, alcohol is a potent symbol both of socialization into adult society and of transgression and rule breaking. In many societies, the uptake of alcohol is a developmental rite of passage, a period of adolescent experimentation that forms part of a broader phase of transgression that precedes individual consolidation of the cultural and social norms for that society. Drinking is sometimes one of a cluster of teenage risk-taking or deviant activities associated with rebellion, including smoking, risky sexual activities, and experimentation with illicit drugs. This chapter explores the themes of socialization and transgression, looking at both continuity and change in patterns of youthful alcohol consumption, following young people from early adolescence through to young adulthood, and from underage to legal purchase age and beyond. Drawing on examples from across the globe, these changes include increased binge drinking, determined drunkenness, gender convergence, global branding, and the acute and chronic health and social problems associated with such drinking patterns. While particular reference is made to the European and the North American literature, the authors would also like to note the challenge of making meaningful generalizations both within countries and across continents.

Table 1.1 Legal drinking age in selected countries.

Age: on premiseaAge: off premisebFrance1818Italy1616Portugal1616Spain18/1618/16England18 (16)c18Irelanda1818Denmark1816Finland1818Norway18/2018/20Latvia1818Canada18/1918/19United States2121aICAP list (2010): On-premise sales refer to consumption on site; e.g., bars, pubs and restaurants. bICAP list (2010): Off-premise retail sales refer to sales of alcohol for consumption elsewhere; e.g., wine shops and supermarkets. cIn the United Kingdom, 16 for drinking with meals, accompanied with an adult.

Childhood influences