When someone – including a teenager – gets treatment for alcohol and substance abuse, it is standard practice to identify some of the reasons why they started using and the benefits they feel they get from these substances.   This helps them reduce shame and best identify their triggers and areas to focus on. Among the research, most reasons for using alcohol fall into a few broad categories such as mood or personality enhancement, social reasons, and coping reasons. Reviewing personal motivations for using alcohol is often an “ah-ha” experience for the person seeking help but it needs to be handled with care as there is the potential in such a discussion to make alcohol use seem more appealing.

Nowhere is this concern greater than when attempting to prevent alcohol use in teens as many parents have a justified fear that such a discussion will promote alcohol use in kids who may not have otherwise been aware of the potential short-term “benefits” of alcohol. This fear has often caused parents and caregivers to avoid the topic, focus only on the consequences of drinking or minimize the reasons why people drink – especially with younger children. While reinforcing the consequences of underage drinking is always recommended, understanding teen’s motivations can also be useful to parents as a point for both prevention and early intervention of teenage drinking. Below are a few tips on using teen motivations to intervene and connect with your children.

A useful strategy is to ask teens about what they “expect” to get from drinking. Along with perceived risk, your teen’s alcohol use can be predicted by the expectation that one will feel a certain way when they drink. These expectations are reinforced by the media and by your teen’s peers. Expectations are essentially motivating (I want to relax and I will drink because I expect that it will help me relax). The first step is to identify what your teens think about drinking’s benefits or what drinking may give them. If you can identify the reasons they think people drink (or they drink), it is a point of intervention.

Tailor Your Strategy: Based on the motivations or expectations your teen mentions reports there are several options to continue the conversation.

1.  Identify myths about the effects of alcohol: Teens may think that alcohol will help them achieve a particular outcome when in fact the opposite is true in the research. For example, if a teen says he drinks to relax, you can counter that alcohol only has temporary relaxing qualities (and only in moderation) and drinking actually reduces sleep quality which then causes stress. When teens understand that alcohol in fact may not actually give them what they want – they might think twice about drinking for a specific reason.

2. Once you have identified your child’s reason for drinking, encourage him or her to find other activities that will achieve the same outcome without alcohol. This is called “counter conditioning.” So using the above example you can identify other ways that are significantly more effective than alcohol in helping them relax (e.g. exercise, music, yoga). This is important because you will be teaching your teen a valuable coping skill that might prevent them from developing problems later on in life.

3. Lastly, point out that much of the “effect” they get from alcohol is simply based on what they expect they will get when they drink. This is especially effective for the “I want to have fun” motivation. My favorite way to talk about this is to discuss the numerous experiments done on placebo alcohol – yes – that’s right, studies where there was fake beer or tonic water alone and people thought it was actual alcohol. Individuals in these studies reported everything from being more social/sexual to being more confident to even having memory loss. In other words – you get what you expect. So simply being primed and thinking positively will give you what you need without the alcohol. These results are not unique to alcohol either – the placebo effect whether it be through fake surgery or a pill is extremely powerful. Studies even show that people who receive placebos have actual changes in their brain chemistry based simply on the expectation that they are getting what they need to achieve their goals. More importantly, some studies also reveal that people taking a placebo attribute their changes to themselves and not an external substance.

What I have found when I discuss alcohol motivations with teens is that they appreciate hearing a more rounded view of drinking. Teens are smart – they understand that people drink for a reason and if we ignore the reasons for drinking we are going to lose credibility with our teens. Discussions about expectancies and motivation typically also bring up much broader discussions of internal vs. external control. When I was working with college students who were referred to me for binge or excessive drinking – I would ask them to “pretend” they were drunk the next time they went to a party. It was a powerful experience for them to just hold a tonic water and pretend that it was a real drink. It helped them recognize the internal power they have over their actions and to feel more confident and secure. When teens begin to realize that they are in control of their actions they can begin to master the world around them to achieve their goals without a pill or drink.

Related Links:
What Got Me into Treatment? Drug Intervention
Teens Only Listen to One Person…Themselves:  How a Child’s Own Reasons for Change Lead to the Most Success
How to Prepare for a Drug Intervention with Your Teenager

Issues: Smoking

Coalition resources: Data Analysis

Drug type: Tobacco

A new study finds that excessive alcohol consumption cost the United States $223.5 billion in 2006, or about $1.90 per drink. By implementing effective community-based prevention strategies, we can reduce excessive alcohol consumption and its costs.

Excessive alcohol consumption is known to kill about 79,000 people in the United States each year, but a new study released by the CDC and The Lewin Group shows that it also has a huge impact on our wallets as well.

The cost of excessive alcohol consumption in the United States reached $223.5 billion in 2006 or about $1.90 per drink. Almost three-quarters of these costs were due to binge drinking. Binge drinking is defined as consuming four or more alcoholic beverages per occasion for women or five or more drinks per occasion for men, and is the most common form of excessive alcohol consumption in the United States.

The researchers found that the cost of excessive drinking was quite far-reaching, reflecting the effect this dangerous behavior has on many aspects of the drinker’s life and on the lives of those around them. The costs largely resulted from losses in workplace productivity (72% of the total cost), health care expenses for problems caused by excessive drinking (11% of total), law enforcement and other criminal justice expenses related to excessive alcohol consumption (9% of total), and motor vehicle crash costs from impaired driving (6% of the total).

The study analyzed national data from multiple sources to estimate the costs due to excessive drinking in 2006, the most recent year for which data were available. The study did not consider a number of other costs such as those because of pain and suffering among either the excessive drinker or others that were affected by their drinking, and thus may be an underestimate. Nevertheless, the researchers estimated that excessive drinking cost $746 for every man, woman, and child in the United States. in 2006.

What You Need to Know About Binge Drinking

• Binge drinking is reported by about 15% of U.S. adults.
• Binge drinking is most common among men, 18- to 34-year-olds, whites, and people with household incomes of $75,000 or more.
• Most binge drinkers are not alcohol dependent.

How Can We Prevent Excessive Alcohol Consumption and Reduce Its Economic Costs?

There are many evidence-based strategies that communities can use to prevent excessive drinking, including the following:

• Increasing alcohol excise taxes.
• Reducing alcohol outlet density.
• Reducing the days and hours of alcohol sales.
• Holding alcohol retailers liable for injuries or damage done by their intoxicated or underage customers.

By implementing these evidence-based strategies, we can reduce excessive alcohol consumption and the many health and social costs related to it.

More Information

• Learn more about effective strategies communities can use to prevent excessive drinking and its costs.
• Find tools and resources related to the surveillance and prevention of excessive alcohol consumption and its costs.
• Article: Economic Costs of Excessive Alcohol consumption in the U.S., 2006.
• Binge Drinking Vital Signs Report
• Binge Drinking Fact Sheet
• Binge Drinking Video
• Binge Drinking MMWR
• CDC Alcohol and Public Health Program
• The High Price of Excessive Alcohol Consumption [PODCAST - 01:27 minutes]

Stephen Peterson, Special Agent with the Drug Enforcement Administration, provides a brief history of Red Ribbon Week, which takes place this year from October 23rd to 31st.  For more information about how you can get involved in local Red Ribbon Week activities, check out Tim Shoemaker’s latest blog post. 

Red Ribbon Week is the longest-standing and largest drug prevention program in the nation, reaching millions of Americans with substance abuse prevention and awareness messages.  Taking place during the last week of October, community members wear red ribbons and participate in a number of community anti-substance abuse events.  Young people often take this time to pledge that they will live a drug-free lifestyle.

Red Ribbon Week pays special tribute to DEA Special Agent Enriqué “Kiki” Camarena, an 11-year veteran of the DEA assigned to the Guadalajara, Mexico office where he closely trailed the country’s most dangerous marijuana and cocaine traffickers.  In 1985, he was kidnapped, brutally tortured and murdered by Mexican drug traffickers.  His tragic death caused many Americans to deeply consider the dangers of drugs.

Shortly after Kiki’s death, Congressman Duncan Hunter along with a close friend of Kiki’s launched a local program in which people gathered in Kiki’s hometown and pledged to lead drug-free lives to honor Kiki’s commitment to the cause.

What started as a small club soon became a widespread initiative—the original members presented the program to First Lady Nancy Reagan.  In turn, several state parent organizations called on community groups to wear red ribbons during the last week of October as a symbol of their drug-free commitment.  In 1988, the National Family Partnership coordinated the first National Red Ribbon Week, with Nancy Reagan and President Ronald Reagan at the helm serving as honorary chairpersons.

Today, more than 80 million people across the country participate in Red Ribbon events each year.  The campaign allows communities to stand together against substance abuse.  Individual communities have their own ways of celebrating Red Ribbon Week, including holding essay and poster contests, organizing races and walks, decorating buildings in red, handing out red ribbons around town and generally publicizing the importance of living a drug-free, healthy lifestyle.

My organization, the Drug Enforcement Administration (DEA) joins with community coalitions and prevention groups to plan and carry out Red Ribbon activities, which range from small classroom events to stadium-sized rallies.