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Saturday, 17 March 2018

Why are we seeing so many cannabis-related school suspensions and expulsions? Use isn't increasing but attitudes are changing and teens are doing 'stupid things'. What can parents do?

Over the past 12 months I have been contacted by an extraordinary number of schools struggling to deal with cannabis. Regardless of the system - Independent, Catholic or state - it would appear that a growing number of young people are making the foolish decision to take the drug to school. Once they have brought it onto the grounds, they are either choosing to smoke it, usually with a group of friends of their own age, or are selling it, either to others in their year group or younger students. Now many people may be thinking that this is nothing new - if there was an illicit drug that was likely to be used by secondary school students, it would be cannabis. I can certainly remember cannabis being sold or supplied to others when I was at high school and I was a teen in the mid-70s - to be honest some people went to school to buy drugs at that time! But times have certainly changed and if you speak to school principals across the country, they will tell you that having to deal with a student bringing an illegal drug to school is not the norm. The vast majority of schools have not had to deal with this sort of problem for some years ... but that certainly seems to be changing ...

What is interesting is that this is occurring at a time when we are continuing to see some of the lowest rates of cannabis use amongst our young people. The most recent Australian Secondary Students Alcohol and Drug (ASSAD) survey conducted in 2014 (released in 2016) found that although cannabis continues to be the most commonly used illicit substance by students, they are about half as likely to use the drug as they were in the late 90s. Cannabis use, whether it be lifetime or recent (used in the last 12 months), has actually decreased.

If you look at the graph provided, you can see across all year groups, lifetime cannabis use has decreased dramatically since the national survey began in 1996. Now it does need to be acknowledged that amongst the older students (those aged 15 or above), use has risen slightly since 2011 - but that small increase is not enough to explain the situation we are currently seeing ... So it would appear that what we have is continuing low rates of cannabis use but those young people who are using the drug are doing so in a much more risky way. So why is this happening? Why, after so many years, are we starting to see cannabis creeping back into the schoolyard?

I believe it has to do with how we're currently talking about cannabis. There is so much talk about legalizing the drug, as well as the whole medicinal cannabis issue, that young people are 'confused' about the legality of the drug. Now, this is not an article on whether or not the drug should be legalized, or issues around medicinal cannabis - the fact is that cannabis is an illegal drug (as I always say to young people who have strong feelings about the illegality of cannabis and believe the law should be changed - if that's how you feel, do something about it! Join a group that wants the law to change - don't just moan about it and say it's not fair, get up and take action!). It is vital that we ensure young people are aware of the law and what the consequences are should they choose to break it ...

I recently found a study from Norway that attempted to examine why young people take up opportunities to use cannabis - its findings were really interesting. According to the authors, Norway has experienced a decline in cannabis use amongst young people similar to the Australian experience, however, the study found that the proportion of adolescents exposed to 'concrete use opportunities' had increased significantly. At the same time, they found the perception of cannabis-related risks were significantly lower. The authors speculated that this could be "at least partially to the intense and growing international debate concerning cannabis deregulation, which may be interpreted as evidence of its minor harms, de-stigmatization, and use normalization among young." I think we're seeing the same thing here - young people just don't see cannabis as being a particularly risky drug. Ask any teacher and they will tell you when there is any discussion around cannabis, one of the first things that is brought up is "It's a medicine, it can't be bad for you!"

The reality is that, even the pro-cannabis lobby would say that it is best to delay use of the drug for as long as possible. The evidence is pretty clear that the younger you start using the drug, the greater problems you will experience. If you want to disregard the potential physical and psychological cannabis-related harms that teens may experience, the legal and resulting social ramifications of getting caught with the drug can affect a young person's life forever. No school wants to suspend or expel students but bringing illicit drugs to school cannot be ignored ...

Going back to the study, the researchers were also able to identify three 'protective factors' that were likely to prevent those 'opportunity-exposed' young people from taking up cannabis use opportunities and to remain non-users, i.e., when they found themselves in situations where the drug was available and offered to them, they were able to refuse. They were as follows:
  • if they reported that their parents knew where they spend their Saturday nights
  • if they were involved in sports regularly, and
  • if they perceived even minimal or occasional cannabis use to be risky
Not surprisingly, parental monitoring plays a role here with this study supporting previous research that has found the general positive effects of proactive parenting strategies and close parent-child relationships when it comes to cannabis involvement. In addition, when teens believed that there were harms associated with even occasional use, this was a barrier to potential use. If we want to delay (or even prevent) early use of cannabis, or any substance, we must ensure the information we provide to young people is honest, accurate, credible and actually means something to them.

Unfortunately, recent Canadian research has found that, for the most part, youth does not seem particularly concerned about potential cannabis risks. In a qualitative study of young people aged between 14-19 years of age, when asked about the consequences, legal ramifications were rarely mentioned. Very few "felt school presentations and learning about the health, social and legal consequences of use was enough to deter youth from trying ..". Physical risks, such as the potential smoking effects on eyes and throat were acknowledged but downplayed, however it was the psychological impacts on others that were regarded as most important. Changes in behaviour, such as lessening the ability to handle things, decreased motivation, mood swings, and the drug's capacity to make someone closed off and anti-social were raised as issues by those interviewed. Most importantly, young people reported personal experiences among their peers with worsening pre-existing mental health issues such as schizophrenia, psychosis or depression they believed were induced or aggravated by the use of the drug.

Is going down the 'mental health' road the way to go? It certainly is something that I cover when I speak about cannabis but you do have to do it carefully. Like any potential harm, you have to be careful you don't 'over-play' it. The reality is that most young people who use cannabis won't experience these problems - if you start making wild statements like 'everyone who uses cannabis will go crazy and develop a mental health problem', you're going to lose them. Many of them, however, will know someone who is experiencing problems, whether it be becoming social isolated, losing motivation, paranoia, or depression. Highlighting that if you see this in a friend you need to tell someone and get help could be a way of getting across that this is not a 'risk-free' drug.

In the past couple of months I have spoken to so many parents who are really having a tough time with their adolescent in relation to cannabis. The majority of these teens are young men, but there are certainly some young women who have also found themselves in trouble with this drug. Getting a call from the school and facing the nightmare of, at best, having a child suspended, or at worst, having them expelled or asking them to be withdrawn, must be earth-shattering, particularly if you didn't see it coming. For most parents, this is a 'one-off' thing - their child did something stupid with their mates, got caught and they won't do it again. Experimentation is a part of adolescence - that doesn't mean it can't be extremely damaging but it's what some teens will do! Unfortunately, for other parents, this will be the start of a long dark road and it's often really difficult to see the light at the end of the tunnel ... As I always say, if you find yourself in the latter situation, the cannabis use is not usually the problem, but a symptom of a much greater issue that needs to be identified and dealt with. Trying to 'fix' the cannabis issue (e.g., trying to put them into rehab or the like!) without digging deeper and finding out what that underlying problem is will often result in a lot of time-wasting and can destroy families ...

As community attitudes change and we see more countries move to decriminalise and even legalise cannabis, and medicinal use of the drug becomes more widely accepted, young people's perceptions of cannabis-related risks are also changing. Adolescents are at the greatest risk when it comes to cannabis-related harms - the earlier they use, the greater the risk - so it is important to delay potential use for as long as possible. Cannabis use amongst our school-based young people is certainly not 'spiralling out of control' but something appears to be happening, with those who are using, more likely to do silly things like take it to school ... We need to try to address this quickly by ensuring that schools have rules and protocols around bringing drugs to school and that these are clearly communicated to all students. At the same time, we must make sure that cannabis prevention programs are based on best practice and that the information we provide to young people is honest, accurate and credible. Trying to 'scare' teens is not going to work but if the current research is to be believed, it is most probably the mental health consequences that are going to have the most impact on our young people. At the same time, parents need to support these messages, making sure that they also provide balanced messages in this area.

Finally, it is important to acknowledge that for most young people cannabis use will not cause significant issues, they may experiment and use once or twice and then come out at the other end relatively unscathed. Where it does become a problem, however, it is usually life-changing, affecting both the user and all those around them. Take the time to talk to your teen about cannabis - tell them your views and get an understanding about how they regard the drug. Remember those protective factors - knowing where your teen is on a Saturday night; being involved in sport (but realistically involvement in any organised activity, whether it be music, drama or whatever is likely to have a similar effect); and seeing cannabis use as potentially risky. Highlighting realistic and credible cannabis-related risks in a conversation with your child is likely to be helpful ... remember, even though you may think your words may not have an effect, research shows you were their first teacher and will always be an important influence in their lives, even through those difficult teenage years ...

Andreas, J.B. & Bretteville-Jensen, A.L. (2017). Ready, willing and able: the role of cannabis use opportunities in understanding adolescent cannabis use. Addiction 112, 1973-1982.

McKiernan, A. & Fleming, K. (2017). Canadian Youth Perceptions on Cannabis, Ottawa, Ontario: Canadian Centre on Substance Abuse. (PDF downloadable version)

White, V. & Williams, T. (2016). Australian secondary school students’ use of tobacco, alcohol, and over-the counter and illicit substances in 2014. Cancer Council Victoria.

Saturday, 10 March 2018

How do you best handle the 'alcohol issue' at an 18th birthday when there will be many underage young people present?

The 18th birthday is now a far more important event than it once was. For many of us it was the 21st birthday that was the major celebration and our entry into true adulthood but that has now changed, with many teens in their last year of school insisting they need a 'party to end all parties' to mark this major milestone. It certainly makes sense in many ways - they are now officially 'adults', they can vote, drink alcohol legally and no longer be regarded as 'underage' ... Unfortunately, any parent who decides to agree to an 18th birthday has to navigate through the 'alcohol issue' and try to work out how best to deal with a group of young people, some of whom are now legally able to drink alcohol (including their son or daughter) and other underage partygoers who are not ...

When I'm asked by parents for advice in this area, I have to be honest and tell them that if they can possibly get out of holding such an event, that's most probably the best option! Promising your son or daughter an even better 19th birthday party is a great way to go, but not surprisingly, the offer is rarely taken up! The major problem with this issue is that no parent wants to embarrass their teen and insist on rules and boundaries that apparently no-one else imposes, but there are some important legal issues to consider in this area.
We now have 'secondary supply' laws across all states and territories which means it is against the law to 'provide' under 18s with alcohol in private settings without parental consent. What does this mean in a practical sense and how does it affect 18th birthdays? The WA Department of Racing, Gaming and Liquor have provided a series of FAQs on secondary supply laws and I have included a few of these below:
Q: What if a 17-year-old attends the 18th birthday party of a friend and the person whose party it is supplies the 17-year-old with alcohol?
A: The 18-year-old will need consent to do so from the 17-year-old’s parent or guardian – failure to obtain consent will make the 18-year-old liable for at $10,000 fine.

Q: I am having a party at home for my son's 18th birthday and some of the people attending will be under 18 years of age, is it okay for me to give them alcohol if they have a note from one of their parent's giving permission for them to drink alcohol?
A: Yes, provided that you are satisfied that the note has been provided by each juvenile's parent or guardian and not another person (for example a sibling).

Q: I am having a small gathering at my home for my daughter's 18th birthday, a few of her friends haven't turned 18 yet; is it okay for me to serve them alcohol if one of their parents rings me and gives their permission over the phone or provides permission by text message?
A: Yes, but again, provided that you are satisfied that the person you have spoken to, or received the text message from, is each juvenile's parent or guardian.

Q: My daughter is having her 18th birthday party at home, one of her 17-year-old friends told me that her mother had given her permission to drink alcohol, is it okay for me to give her a drink in my house?
A: No. You must obtain the permission from the parent or guardian.

The laws are slightly different in each jurisdiction (e.g., fines imposed for the offence and the definition of 'provide' or 'supply' can vary) but around provision of alcohol at 18th birthdays, they're all pretty much the same. Host parents have to either receive consent from the parents or guardians of those underage attendees, allowing them to drink alcohol, or do their best to ensure that those young people don't drink at all! Neither of those are going to be easy and one of them is likely to cause friction between you and your teen. So let's take a quick look at these two options and the problems associated with each of them ...

If you decide to go down the path of obtaining permission for those underage partygoers to drink,  there is an additional legal responsibility that comes with that choice. This is best explained by another of the questions from the WA Government site:

Q: If I have the permission of a parent to supply alcohol to my son's friend who is still 17 years old, are there any legal responsibilities that I have to be aware of?
A: The new laws require that if you a supplying alcohol to a juvenile you must observe responsible supervision practices at all times; including making sure juveniles don't get drunk (or you do not get drunk yourself) and that you are able to supervise the consumption of alcohol at all times.

So not only do you have to make sure you have received consent where appropriate, you also have to ensure that you are "able to supervise the consumption of alcohol at all times". Ask any licensee and they will tell you that's difficult when you have trained bar staff, CC-TV and security on every door in the venue - it's going to be almost impossible for a parent hosting an 18th birthday party!

I've talked about 'active supervision' before and as far as 18th birthdays are concerned I believe it should involve the following:
  • be there, right in the thick of it - don't plonk yourself in the middle of a group of teens and just stand there! Find reasons for being there, such as carrying food around ... Always consider your teen here as well - do this in an oppressive way and he or she will be mortified and rightly so but those attending are now truly young adults, have a conversation with them if it's appropriate. There can still be a fine line between 'being there' and 'lurking' - try not to cross it!
  • move around - most probably the biggest mistake parents make in this area is to position themselves in one place, justifying their decision by stating that the partygoers will know where to find them if something goes wrong. Having adults regularly moving through the space ensures that all those attending be a little more careful about what they are doing and may be more likely to monitor their drinking a little more carefully
  • talk to those attending - the best way to know what is going on at a party is to talk to as many teens as possible. This should not be intrusive and don't try to be cool - kids can see through that in seconds! Be yourself - ask them how they're going, if they're having a good time and the like. Not only does this help you to get to know your child's friends a little better but it also helps you gauge how the party is going and monitor alcohol consumption
  • most importantly, stay  sober! There is no way that you are able to effectively monitor a houseful of 17 and 18-year-olds if you have been drinking yourself ... 
What about the other option? What if you decide to state clearly that those under the age of 18 will not be able to drink alcohol at the party? This is also not easy (I told you offering a 19th birthday is a better option!) but I have to say, many parents have found ways of making it work. I very much doubt whether all of the underage partygoers actually remained 'alcohol-free' in these cases, but at least the host parents did their best ... Here are some of the ways other parents have navigated through this issue:
  • the trust option - this appears to work best when parents have a strong relationship not only with their son or daughter, but also their friends. It's also much more likely to be successful at smaller parties or gatherings. Alcohol is provided for those who are 18 or over but the invitation states clearly that due to legal issues, the host parents will be asking those who are underage not to drink. Many may be surprised to find out that this can often work - the hosts putting the responsibility back onto the young people and they respond accordingly ... 
  • the wristband system - another popular method of trying to control who is able to drink alcohol or not. Parents using this system have to be organised, usually creating a guest list that separates those who are 18 or over from those who are not. When partygoers arrive they are issued a wristband indicating which group they are in. In my experience, this does not always work well and is regarded by many of the young people I have spoken to as 'restrictive' and 'too controlling'. That said, I have spoken to many parents who have used this option and have found it to be successful - once again, it has so much to do with the parent-child relationship 
  • a bar service where proof-of age has to be given before alcohol is served - I now know of a couple of parents who have used this option and from what they have said, it worked well. It's based on what would happen at a bar or club if you wanted to drink alcohol. There is no BYO and attendees are informed on the invitation that there will be trained bar staff present who will be serving alcohol to those 18 years or over - proof of age will be required. No spirits are allowed, you can only collect one drink at a time and because alcohol is only available from the bar, levels of intoxication can hopefully be monitored. An interesting option ...
  • hold the event on licensed premises - this is the one I often suggest to parents who are really struggling in this area. If you hold an 18th birthday on a licensed premises, even if a parent wants to give consent for their teen to drink, they can't - it is an offence. All those who are 18 or over are able to drink and establishing proof-of-age is no longer your responsibility. The licensee must monitor the young people coming to the party and they also have to ensure that no-one on their premises drinks to the point of intoxication. It's a 'win-win'! This can be an expensive option and some young people don't like it because of the restrictions that will be placed on some of their friends but it does tick all the boxes for a parent!
So there it is - whether you choose to allow those who are underage to drink alcohol at an 18th or you try to prevent it from happening, neither way is going to be particularly easy. Regardless of what you do, involve your teen in the organization process and let them see what actually goes on when putting on such an event. As already said, the success of the event will usually depend on the relationship you have with your son and daughter ...Whatever decision you make, you want a celebration like this to bring you together and certainly not tear you apart!

Friday, 2 March 2018

Why would teens use some of these more 'unusual' substances? How are they accessing them and why would they decide to use them at school?

A couple of weeks ago, many Australian readers of this blog would have seen reports of an 'overdose' incident at a Gold Coast school. Now I need to make it clear that I do not have any connection with that school and I have not been privy to what actually occurred on that day - I only have media reports to rely on, which as we all know are not always entirely accurate. Regardless, it would appear that we can be quite certain of some basic facts, i.e., a group of Year 10 boys took a substance (with Queensland Police confirming that it was Phenibut later in the week) to school and then made a decision to use it while on school grounds. They then had an adverse reaction to the drug with seven of them being taken to hospital, four reportedly in a critical condition. All of the boys have now recovered and according to media reports, have been expelled from the school.

Without a doubt this would have to be one of the most bizarre stories regarding school-based young people that I have ever been asked to comment on ... When I was first asked to be interviewed I asked for a little time to check up that what I was being told by the journalist was actually true! There were (and still are) so many questions about this incident, including the following:
  • why would young men mess around with such a bizarre drug?
  • how did they find out about the drug?
  • did they have any idea about the risks involved with using the substance?
  • where did they get it from and are there many other young people experimenting with it?
  • why did they decide to use the drug at school?
Firstly, it's important to acknowledge that groups of young people experimenting with 'weird and wacky' substances is not unusual. In some of the interviews I was asked if I had heard about this kind of 'mass overdose' situation before. As I said at the time, there have been a number of similar events over the past 25 years, but they usually involved easily accessible household products (e.g., sniffing aerosol cans) or pharmaceutical drugs, usually mixed with alcohol. There have also been a number of cases of naturally-occurring hallucinogens causing similar problems. I pride myself on usually having my 'finger on the pulse' when it comes to what young people are doing and I've never been greatly surprised by the overdoses of the past, but this one floored me ... It is also one of the first that has occurred on school grounds ...

Hardly a week goes past without a young person either asking me a question, either face-to-face or via email, about some new drug - Phenibut however, had never been discussed. So what is it and why would teens want to experiment with it?

Phenibut is a depressant, approved in Russia, Ukraine, and Latvia for the treatment of, amongst other things, insomnia and anxiety. It is not approved or available as a medication in most other countries of the world, including Australia, but is sold online as a 'nutritional supplement'. Although you can find online discussion about the product in chat rooms dealing with drug use, it is on YouTube that the drug is really promoted. Videos with titles such as 'My Phenibut Review – What You Can Expect And What It Feels Like', 'Beginner's Guide To Phenibut' and 'The Ultimate Phenibut Dosage Guide' can all be found there and are easily accessible to young people.

What is interesting is that the majority of people featured in these videos are older, they're certainly not teenagers. Many of the YouTube videos tout the product as an effective treatment for anxiety, some have bodybuilders promoting it is a useful supplement, supposedly stimulating growth hormone, while others claim it is a 'smart drug', useful in helping you prepare for an exam. Other videos discuss the euphoric effect of the drug, similar to that of GHB, a drug also known as 'fantasy' or 'liquid ecstasy' - a drug very well-known in this country for its links to mass overdoses at dance festivals over the years. So, in terms of why young people would experiment with this substance, the answer is most probably its supposedly 'euphoric' effects, although Erowid (one of the best sources of drug information available) states that it is likely to cause a "feeling of wellbeing, relaxation, slight disinhibition comparable to the effects of low-dose alcohol". Not really a ringing endorsement for a substance!

When it comes to access to this drug, all you need to do is to type 'Buy Phenibut' into a Google search and you will find a range of sites that will allow you to purchase the so-called 'nutritional supplement'. This is not a product that you have to search the so-called 'dark web' for - it truly is just a couple of clicks away for anyone with access to a computer! Worryingly, I'm starting to see more young people who are accessing pharmaceutical drugs in exactly the same way (particularly Xanax - a drug that I'm being asked more and more about in recent times) - finding online pharmacies that are extremely easy to access that are more than happy to provide a wide range of medications.

But then we come to the real question that I am still struggling with - why would these young men make the decision to experiment with this drug at school? To be quite honest, if they hadn't and had chosen to use the product at home and had had a similar reaction, they may not have been found and there could have been truly tragic consequences. That said, it is highly unusual for young people to experiment in this way on school property. All of the other 'mass overdose' incidents involving teens and 'strange substances' I can remember usually took place on a weekend in homes, parks or bushland. Now, if you're thinking teens, particularly young men, have always played around with drugs like cannabis at school, that would be true - it was once an issue - but it hasn't been for some time. Recently, however, we have seen this starting to happen more and more, with growing numbers of schools having to deal with students bringing and using cannabis at school, leading to far more suspensions and expulsions than I have seen for many years.

So why is there this change? Why are young people choosing to take the risk of bringing an illicit drug like cannabis or one of these more 'unusual' substances like Phenibut into schools? It truly makes little sense - the chance of them getting caught is much greater and the consequences of having drugs in your possession on school property are very clear. If we look at it purely from a physiological perspective, we need to remind ourselves of how a teenage brain works and why they take risks ... Young people don't take part in risky behaviour because they want to hurt themselves and it's not that they don't understand the dangers - it's just that they weigh risk versus reward differently. As one academic has been quoted as saying - "they don't downgrade the risk, they give more weight to the payoff." This reward increases when around their peers - that is why you usually see groups of young men, not individuals, taking part in such activity.

So why is this all of a sudden a greater problem, haven't teen brains have always been the same? I wish I knew ... certainly many of the schools I work with are really struggling with how to deal with this potentially dangerous behaviour. Interestingly, it appears we are seeing more drugs being brought into schools at a time when use is actually decreasing amongst school-based young people. For some reason, even though less teens are using illicit drugs, those who are choosing to use are doing more 'stupid things' ... Add to that, new substances are being added to the mix on a weekly basis, all of which are discussed and reviewed openly in online chat rooms and various websites. And finally, access is no longer limited by 'who you know'. Although many of these substances can only be purchased via the 'dark web', there are others that can be found by a quick Google search, bought and paid for, arriving at your door via Australia Post! Let's just hope that we don't see a tragedy as a result ...

Saturday, 24 February 2018

Why do parents make the decision to let their teen drink? Is underage drinking 'inevitable' and will providing it be 'protective'?

I've written many times about why parents make the decision to let their teen drink. At a time when we know so much more about the risks associated with teenage drinking and the message we keep sending is 'delay, delay, delay', it is surprising that so many parents buckle and allow their child to drink, sometimes at a very young age. Now, if you believe providing alcohol to your child is the 'right thing to do' - that is your decision and no-one has the right to tell you to do otherwise ... but if you do not feel comfortable with doing this, then 'stick to your guns'! From what I see, the major reason for this behaviour, particularly from those parents who swore till they were blue in the face that they would never do it, is parental peer pressure, i.e., the belief that they're the only ones saying 'no'!

A few weeks ago I gave a presentation at a Parent Information Evening that was piggy-backed onto an Information Night for Year 10 parents. We had a huge turnout and there were many parents who wanted to speak to me afterwards, mostly about their concerns around parties and alcohol. At one point I was speaking to a mother who was trying to cope with a very forceful daughter who wanted to take alcohol to parties. She asked for my advice and I simply turned the question around and said "Do you feel comfortable giving alcohol to your 15-year-old daughter to take to a party?" There was an immediate and very strong "Absolutely not!" in reply. She then quickly added "But I'm the only one who feels like that, all the other parents allow it ..."

Luckily, there was a line of other Mums and Dads behind her and I asked them whether there was one of them who allowed their son or daughter to take alcohol to a party (remember they were all parents from the same year group). Not one of them said that they did ... There were at least 10 parents in the group and when I suggested they talk and support each other in this area their response was priceless. Almost in unison they turned around and said "But we're the only ones, everyone else does!" Really? Even if every other parent in the year did provide alcohol (which I highly doubt!), there were at least 10 of them that didn't ... couldn't they use that to their advantage?

But what does the research say? Why do parents let their teens drink? I recently came across a US qualitative study that attempted to tease out some of those reasons (Friese et al, 2012). It attempted to try to find out under what circumstances parents allowed their teen to drink at home, so it's important to note that this is not about providing alcohol for parties. None of the findings are particularly surprising but what was really interesting was that two-thirds of those interviewed (69%) indicated that they did not think it was a good idea to allow their teen to drink at home, with their initial response being that they did not condone underage drinking. However, during the interview it became obvious that they all had exceptions!

So what were those exceptions? These are the reasons that Friese and her colleagues identified:
  • drinking on special occasions - this included family celebrations such as weddings, birthdays, holidays and family vacations. Parents said that they felt "more comfortable allowing their teenager to drink when their family was around them". Holidays such as Christmas and New Year were also identified as times when teens were allowed to drink. An interesting one was family vacation, with parents allowing drinking in locations where it was more accepted, such as Europe. Teen's safety and the parents' ability to monitor their child were identified by the researchers as the reason parents allowed drinking at these times
  • teaching drinking practices - this is an 'oldie but a goodie'! The idea that letting them drink with you will teach teens how to drink responsibly, including how to drink in moderation and how to appreciate certain types of alcohol. This is also linked to the idea of 'demystifying' alcohol - removing the 'forbidden fruit'
  • drinking to preserve traditions - in this US study, this was identified in parents of Latin American or European backgrounds. These referenced their childhoods and the drinking culture in their family, with some believing that it had influenced their behaviour and taught them to drink more responsibly
  • parents feeling pressure to let their teens drink - some identified situations where another adult offered their child alcohol without their consent or simply felt pressure to let them drink. Some of these parents identified their partners as overruling them in this area, or other family members offering alcohol to their child at family celebrations. Having older teens was also seen as making withholding alcohol from younger children more difficult
  • parents' belief that underage drinking is inevitable - more than half of those interviewed held this view - it was simply going to happen and there was nothing a parent could do about it!
  • fear of harming their relationship with their teen - others feared that being too strict in this area could have negative consequences. One parent compared alcohol to the 'sex issue' saying "If you put in a rule that's really firm, it's not realistic." She stressed that the best she could hope for was that her son would use good judgment if he drank
  • harm reduction - once again, roughly half of the parents saw drinking as inevitable and wanted to offer advice and approaches on how to stay as safe as possible. Creating a safe place for open discussion appeared to be important to parents
As already said, there really aren't too many surprises here - most of the parents I speak to who have let their teen drink would usually identify one or more of these as the reason for their decision. All of these are valid and, as a parent, if you choose to let your teen drink alcohol, no-one has the right to tell you to do otherwise. Recent research, however, challenges some of the basic ideas behind some of these:
  • underage drinking is not inevitable - the latest statistics show that we have more non-drinkers amongst our school-based young people than we have seen since national data started to be collected. Growing numbers of young people have never consumed alcohol (rising from one in 10 in 1999 to one in three in 2014). The old chestnut of 'everyone will do it' is simply not true. Of course, lots of them will experiment and many will end up drinking regularly but let's not forget those that don't, won't and never have! When parents throw their hands up and give in, instead of supporting those young people who are making the tough decisions, they really are letting their child down ...
  • giving them alcohol will not necessarily teach them to drink responsibly and is not 'protective'. A longitudinal study from UNSW released in January (Mattick et al, 2018) followed 2000 children and parents over a 6-year period through their adolescence and found that as far as parental supply of alcohol was concerned, there was "no evidence of any benefit or protective effect, either directly … or indirectly". It didn't protect from problems in the future, instead, providing alcohol to children was "associated with subsequent binge drinking, alcohol-related harm(s) and symptoms of alcohol use disorder". Most importantly, the idea that when you give teens alcohol "you'll know how much they're drinking" was also found to be false. The research found that parental supply "is associated with increased risk of other supply, not the reverse", i.e., if you give them alcohol, they're more likely to go and find more!
I'm sure that some people believe that I am some sort of wowser and that I'm 'anti-alcohol' - I'm really not, I really couldn't care what adults do in terms of drinking. It's a legal product and you can do what you want, as long as you don't hurt anyone else ... Why I try to challenge parental beliefs in this area is that I meet an extraordinary number of school-based young people that have had the most terrible things happen to them when they have gone out on a Saturday night and messed around with a product that they simply don't have the maturity or brain development to deal with. Senseless violence, sexual assaults, horrific accidents and falls, and children as young as 13 being placed on life-support because they've stopped breathing after drinking so much are just some of the things I have seen ... I challenge anyone to not change their views about the provision of alcohol to teens after speaking to a 15-year-old girl tell you that she was sexually assaulted when drunk, usually after her parents gave her a couple of drinks to take to a party or she went to an event where alcohol was permitted or tolerated ... I can tell you, it's a devastating experience!

You have to make the decision about what you do around the provision of alcohol to your child. Make sure that whatever you do it is based on the best information possible. Underage drinking is not inevitable - far from it - and research has found that it's not protective and does not necessarily teach them how to drink responsibly in the future! And remember, no matter what your child says, you're not the only one who makes the decisions you do!


Friese, B., Grube, J., Moore, R., & Jennings, V. (2012). Parents' rules about underage drinking: A qualitative study of why parents let teens drink. Journal of Drug Education 42, 379-391.

Mattick, R. P., Clare, P. J., Aiken, A., Wadolowski, M., Hutchinson, D., Najman, J., Slade, T., Bruno, R., McBride, N., Kypri, K., Vogl, L., & Degenhardt, L. (2018). Association of parental supply of alcohol with adolescent drinking, alcohol-related harms, and alcohol use disorder symptoms: a prospective cohort study. Lancet, published Online January 25, 2018 S2468-2667(17)30240-2.

Friday, 16 February 2018

Alcohol and school functions: Do they go together?

As the school year comes to an end it is not unusual for me to receive a flurry of emails from parents regarding the provision of alcohol at school functions. Last year was no exception, so I thought I'd share a couple of these and let you know how I responded.
"At my son's school's Awards Night, which all parents and their sons were encouraged to attend, both my wife and I were surprised to see alcohol being served. As we entered the school's auditorium, prior to the actual ceremony, we were both offered a free glass of champagne. A bar had been set-up where you could purchase alcohol throughout the night, including spirits, and it seemed as though most of the adults present were drinking. Our son is 14 and has only recently joined the school and we were quite taken aback. What was most concerning to us was that we saw a number of parents either pass a half glass of champagne to their son (in school uniform) to finish off and, in one case, actually purchase a beer for them. By the end of the night (drinks continued to be served after the ceremony), there were a number of parents who were obviously intoxicated. We're not prudes (we both like a drink but didn't drink that night because we had our son with us) but found the whole thing quite bizarre. Is this usual practice at other schools?" 

Here's another one ...

"We recently attended a primary school 'Year 5 dinner' with our 10-year-old daughter at a very expensive Melbourne private school which was, in effect, primarily an adult cocktail party where free champagne was served at the start and alcohol was being sold by the bottle throughout the night. The only other available drink was water and cordial for the children. By the end of the night all adults who drank (my estimate 95%, excluding myself and a couple of others) seemed at least a bit tipsy and a few inebriated. I would be grateful for your view on this topic ... "
I must admit that I find both of these a little shocking ... If I had received these in the 90s I most probably wouldn't have batted an eyelid but to get these in 2017 is a bit bizarre! Attitudes around the provision of alcohol at school functions have changed greatly in the last decade, with many of the schools I have a relationship with significantly changing their policies in this area. That said, however, I've sent both of these anecdotes through to a number of principals across the country and asked for their response and the majority of them have got back to me with something along the lines of 'Welcome to my world!"

My first experience with the whole alcohol and school functions issue was in the late 1990s. A group of Year 12s from a Catholic boys' school had apparently 'gone on the rampage' after drinking too much at an end-of-year function and it had all been caught on CCTV. The tabloid press grabbed the story and the school found itself in the centre of a PR nightmare. The principal was quick to react and contacted a number of 'experts' in the area of adolescent behaviour and alcohol and other drugs (myself included) and asked us to help them with a response. We surveyed the school community - students, staff and parents - to try to find out what was going on with alcohol, looked at their policies and procedures and a report was provided with a series of recommendations. One of those was around the provision of alcohol at school events.

What became glaringly obvious when looking at the school's social calendar was that alcohol was at the centre of almost every event, regardless of the time of day or whether students were present or not. Presentation nights, sporting events, information evenings and even parent-teacher meetings - alcohol was provided. To promote good role modelling and to try to send a positive message to the students (i.e., you can socialize without drinking alcohol), one of the recommendations suggested that the school consider making those parent functions where students were present alcohol-free. For some reason (and I've never worked out why), the principal decided to take this one step further and ban alcohol at all school functions (even those not held on school property) - completely! About two months later I had a phone call from a friend of mine who worked at the school to tell me that the ban had been lifted. Apparently, they had to reverse the decision as they had had two parent functions since the ban had been implemented and no-one had turned up - not even the Organising Committee! Extremely sad, but true - alcohol wasn't available so no-one came!

Over the years I have seen a number of principals almost lose their jobs as a result of their decision to try to make changes in this area. But change has occurred for the most part and many schools have now tightened their rules around the provision of alcohol on school property and, most particularly, at any event where students are present. This all came to a head in 2013 when the national media ran a story about teachers at primary and secondary schools in Melbourne reporting 'drunken parents' assaulting a staff member at a school activity and disrupting a valedictory function. As a result of the incident, the school banned alcohol at all future events. Around the same time, one of the schools I visit narrowly avoided similar media attention when an ambulance was called to their Year 12 Graduation Night after one of the mothers became so drunk she was found unconscious in the toilet. Hopefully things have moved forward since then ...

Unfortunately, the exception appears to be in primary schools. I have emails from parents from Independent, Catholic and state primary schools who talk about Mothers' Groups who go through bottles of wine on school property, school fetes which have a number of bars running through the day, Mums and Dads who take champagne to the Swimming Carnival and the list goes on and on. I was recently speaking to a primary school principal who told me that when she had recently tried to change the culture and make events held at her school 'alcohol-free', she was told in no uncertain terms that if she moved ahead with the plan that would be the end of seeing any fathers at events!
So do alcohol and school functions go together? 
I think this is a fairly simple and straightforward issue to deal with and find it hard to understand why parents have so much of a problem with it. Firstly, if there are students present, regardless of age, that event should be alcohol-free. Awards nights, graduation dinners, information evenings, mother-daughter breakfasts, sporting events during school time or on the weekend - it doesn't matter - if kids are there, alcohol isn't! If the parents don't show up, it's their loss, no-one else's. If they really are not going to show up to one of their child's key milestones because there's no alcohol, they have a problem plain and simple ... And to anyone who says that providing alcohol at these events can demonstrate 'responsible drinking', I simply ask them to attend one of these events and see how much alcohol some of these people drink! There are very few Parent Information Evenings that I present at now where alcohol is provided but on the rare occasion when it does happen it astounds me how many glasses some people can 'down' before the talk begins ...
For parent-only events I see no problems with alcohol being provided or sold. Alcohol is a legal product and it plays a key role in many Australian adults' socializing. Why shouldn't alcohol be made available? The only proviso I have in this area is when these functions are held on school grounds. There have been a number of times over the years where I have rolled up at a school on Monday morning to find literally crates and crates of empty bottles piled up against a wall, all left from a weekend event. That is not a 'good-look' and what message does it send to the students? Years ago, I would have suggested that all school functions that provided alcohol be held off school grounds but that's just not the reality anymore. So many schools, particularly those in the private sector, have now built function centres for such events. Once again, it's quite simple, if alcohol is going to be made available, make sure it's cleaned up afterwards ...
So what about primary schools? As an ex-primary school teacher, the stories I am now hearing about what is happening across the country simply blows my mind! I hate to sound like my Dad but 'you wouldn't have seen that in my day!' The idea of any parent bringing a bottle of wine to drink at a primary school's Mothers' Group or a sporting or swimming carnival during the day is just abhorrent! What must these people be thinking? If you want to meet up with a group of other women and share a bottle of wine at 2pm in the afternoon - go for it, you're an adult and you can do what you want - but do it off school property and away from children. 
As a parent you are your child's most important teacher. Every word and action, especially during the primary years, helps shape their ideas in all sorts of areas. They will mimic your behaviour, both good and bad, so positive role modelling is vital. Alcohol is a part of our culture and any non-drinker will tell you that it's extremely difficult to avoid social situations which don't involve drinking. It would be wonderful if schools, particularly primary schools, were able to provide events or functions that were alcohol-free - to allow our kids to see for themselves that it is possible to socialize and have a good time without drinking. Even though we've come a long way, it seems as if we have a way to go yet before we see real change ...

Friday, 9 February 2018

The difference between having a 'good time' and ending up on life-support could be just one drink: If you think your teen may be drinking alcohol, have the conversation

About 18 months ago you may remember quite a remarkable story out of the US that got a great deal of coverage right across the world. Hannah Lottritz, a 21-year-old from Nevada, uploaded a photograph of herself on life-support together with a blog entry titled 'Drinking Responsibly' in an effort to warn others about the risks associated with drinking to excess. The article and the photograph went viral with both being picked up by news agencies across the world. The reason behind her decision to share this disturbing image is clearly explained in the opening paragraph of the piece ...

"I am writing this because I didn’t realize the importance of drinking responsibly until I was waking up from a coma, and I don't want anyone to go through what my family and I went through. I ask that you share this with your friends, family or anyone who may benefit from reading this. If I can help just one person by sharing my experience, then I will be absolutely ecstatic."

Sadly, I meet many young people who have had similar experiences - most who are totally mortified about what happened and many completely mystified by how it happened. As I say to young people, I've never met someone who wanted to end up in an emergency department - every single one of them made a silly mistake, some believing that they drank exactly the same amount as they had done on other occasions and others having just one or two more than usual. It sounds 'pat' but it's true - the difference between having a 'good time' and finding yourself on life-support in hospital could be just one drink ...

Hannah's story is not unusual. She had gone to a music festival and made the mistake of trying to play 'catch-up' with her friends in regards to alcohol. She then drifted away from the people she knew and ended up with another group, who she then promised she could "outdrink". This included skolling whiskey straight from the bottle. From then on she has no memory of what happened and had to rely on friends to fill in the gaps. Shortly after skolling the whiskey, she collapsed and stopped breathing. She was taken to the event's medical tent, intubated and flown to hospital. Her parents were contacted by police and told that she was in a critical condition, suffering from acute respiratory failure and acute alcohol intoxication.  As she says in her article:

"My blood alcohol concentration was .41 when I arrived at the hospital, five times over the legal limit. The doctors thought I was brain dead because I was completely unresponsive. My pupils were sluggishly reactive, I had no corneal reflex and I wasn't responding to verbal or painful stimuli"

What has really upset me in the last year or so is the number of young people who actually wear the fact that they have been taken to hospital like a 'badge of honour'. Somehow they think it is 'cool' to have this experience, with some actually bragging about apparently having their stomachs' pumped. When I see this behaviour I take great joy in letting people know that pumping the stomach is rarely, if ever, used for someone suffering from alcohol poisoning. There's a number of reasons for this, including the fact that it is quite labour-intensive and requires more staff than is normally on hand in an emergency department, but most importantly it is a process that is considered more dangerous than beneficial in most cases. Now to be honest I certainly have heard of doctors and nurses telling young people that their stomach had to be pumped - but according to one nurse I know, this is often done for dramatic effect more than anything!

Of course, their bravado and 'big talk' could simply be due to embarrassment but nevertheless we need to make sure that young people are aware that there is nothing glamorous about ending up in hospital on life-support.
Usually the hospital staff have to cut off the patient's clothing, if they haven't wet or messed themselves, they have vomited and need to be cleaned up and put into a hospital gown. They are then intubated - this is where a small tube is inserted through the mouth or nose, then threaded through the oesophagus and into the stomach. This tube is placed on suction, decompressing the stomach which helps reduce the risk of vomiting. The person is also put on an IV drip to help with hydration. As you can imagine this is all extremely unpleasant and certainly not glamorous.
As Hannah writes in her article ...
"I finally woke up about 24 hours after I arrived at the hospital. I had a tube down my throat and my hands were restrained so I couldn't pull it out. I was unable to talk with the tube down my throat, making it hard to tell my parents and the nurses that it was extremely uncomfortable. I had to pass a respiratory test to prove I could breathe on my own before they removed it. I failed the first respiratory test I took, and I had to wait several hours to take another test." 
Last year I received an email from a young woman named Georgia who found herself in a similar situation. She had got extremely drunk, became unconscious and thankfully due to a couple of her quick-thinking friends, an ambulance was called and she was rushed to hospital. She wanted to share her story, telling me that I could use it in my school talks, but it was what she wrote right at the end of the message that really had an impact on me.

"I drank far too much and I will never forgive myself for my stupid decisions that night. But it is my friends and, most importantly, my Mum and Dad that I feel really bad about. I don't have any memories about the really bad stuff. I blacked out well before I was taken to hospital but it was my friends who had to try to look after me at the party who I put into such a terrible position who had to deal with the situation. My poor parents had to sit my hospital bed for almost 24 hours and be told that I may not make it through the night. I just feel so selfish ..."

As I wrote back to Georgia, it is important that she forgives herself for her error of judgment. She made a mistake, she needs to apologise to those people she feels she needs to say sorry to and then brush herself off and get on with life. Beating yourself up for mistakes like this gets you nowhere. Waking up in a hospital room with tubes down your throat and your parents standing over the top of you in tears must be devastating though ... it's a tough thing to recover from.

So when it comes to alcohol poisoning and the risk of ending up in hospital, what should a parent be saying to their teen in an effort to keep them protected or at the very least, aware of the dangers? Here are just a couple of key points that could be raised:
  • if you're going to drink, make sure you eat something beforehand. Young people need to eat a 'fistful of food' before they go out - that's about the size of their empty stomach. That's enough to keep you protected to some degree, slowing down absorption but not interfering with the actual alcohol experience. Something 'carbohydrate-heavy' like a small bowl of pasta or rice, even a sandwich or burger is best ...
  • it can't sober you up but making sure that water is a part of every alcohol experience your teen has is extremely important. Make sure the first drink they drink is a glass of water (it prepares them for the dehydrating effect of alcohol and also fills them up a little so they are less likely to gulp that first bottle or can down as fast) and try to get them to get into the habit of having another glass between each alcoholic drink. Once again, we usually tell young people this is all about rehydrating but realistically it's most probably more important in that it can help slow their drinking down just a little ...
  • remember that alcohol is like any other drug, it can affect you differently every time you drink it. You could have exactly the same amount of alcohol on two different occasions and have completely different experiences. So many people find this hard to believe and when something does go amiss are convinced that it couldn't be the alcohol that caused the problem. Make sure your teen gets this message early - just because they had a 'good time' when they had a couple of shots last week does not mean it'll necessarily be the same this week!
  • avoid drinking games and shots. Unfortunately, for some young (and even not so young) people this is just part of their alcohol experience and there's little we're going to be able to do to change that. That said, make your views clear on this kind of drinking behaviour - we know that your opinion can actually make a difference
  • when it comes to other people drinking, encourage them to intervene when necessary. People just don't suddenly become drunk and lose consciousness - there will be warning signs. This is a gradual process for most people. If you see a friend who you think is getting into trouble, step in and say something. It's not even about telling them not to drink, saying something as simple as "slow down" could make all the difference. Try to get them away from the alcohol by suggesting you go for a walk together, send them a text to distract them or get others to help you - don't let it get to the stage of having to call an ambulance if you can possibly help it
  • most importantly, make sure they know they have your total support should something ever go wrong and they need to call for help. Many young people don't call 000 because they're frightened their parents may find out - that's so sad and must be devastating for parents to hear. Nobody ever wants their child to be put into a situation where they need to call an ambulance but every parents wants to know that if they were, they'd do it without hesitation!
Having a conversation about alcohol and all the things that can go wrong is never going to be easy. Acknowledging that your teen may be drinking, without necessarily condoning the behaviour, can be extremely difficult but it is necessary. That one conversation could prevent the one person you love most in the world from ending up being transported to hospital and that's worth all the discomfort in the world ...

Saturday, 3 February 2018

"Does my drinking affect how my child drinks? Should we stop drinking or not drink around them?"

One of the talks that I have written to deliver at Information Evenings this year attempts to answer the five top questions I get asked by parents about alcohol based on the most recent research findings. The talk will cover questions about the provision of a 'sip of alcohol', whether allowing a child to drink at a wedding or a NYE celebration is appropriate and the latest information on alcohol and the teen brain. One query that regularly comes up is about the impact, both positive and negative, parental drinking has on a child. Some of the questions I get asked in this area include the following:

·       "Should I stop drinking around my child? Am I sending the wrong message when I drink alcohol?"
·       "We always take a bottle of wine out with us when we go out for dinner. What message is that sending to our kids?"
·       "We don't drink a lot, mainly with meals … is our daughter learning anything positive from that?"

Firstly, most parents start thinking about this issue far too late … From the moment they are born children are learning by watching the world around them and by the time they are toddlers, they will be constantly asking questions. Parents are their children's first and most important teacher. Every word and action, even at a very early age, will help shape their ideas in all sorts of areas, including alcohol. To start worrying about drinking in front of them when they hit their teens is most probably a bit of waste of time – they've picked up an awful lot of information already!

More importantly, why should you stop drinking in front of them? You're an adult and, as long as you're not hurting anyone else, you can do what you wish. If alcohol is a part of your life, trying to hide that from your child makes little sense. It's a legal product and it plays a significant role in many Australians' lives. As already said, your child learns so much from you, both positive and negative. If you and your partner drink responsibly, your child is likely to learn something from that. Of course, if you drink to excess or regularly come home drunk from social events, that is a completely different story. If you have reached a point in your life when you want to stop drinking and it just so happens to coincide with your child entering their teens – fantastic, go for it! But if you still enjoy a drink and you don't want to stop, it makes little sense …

So, what does the research about the impact of parental drinking on their children is? Well, the good news is that as far as light to moderate drinking is concerned, Mahedy and colleagues found that there is "no support for an association between parental alcohol use during childhood and conduct and emotional problems during childhood or adolescence". In terms of major behavioural issues, if you drink in moderation, your child is not going to be affected. As far as impact of your drinking on your child's future drinking is concerned, however, the evidence is not so positive. A 2016 review of the literature by Rossow and others found the following:

"Almost all prospective studies on this topic have found that parental drinking predicts drinking behaviour in their children; that is, when one or both parents drink more, their offspring are more likely to report more drinking or more alcohol-related problems later on than others …"

Essentially, the more parents drink, the more the child will drink and the more problems they'll have with their drinking in the future. Although the authors of this study said that this could be due to other factors such as where you live, cultural or religious factors or even genetics, it's pretty clear that your attitudes and values around alcohol are going to have an impact on how your child views the issue, as well as their drinking behaviour. Interestingly, studies have found that the impact of parental drinking could be mediated by specific parenting practices, such as parental monitoring, (i.e., knowing where your child is, knowing who they're with and when they'll be home) and discipline. Talking about alcohol with your child also had a positive impact. These strategies had the greatest impact in early adolescence, with the impact being greater at 14 than when they were older. So what this essentially means is that if you're worried that your child could have picked up some potentially negative attitudes around alcohol from you, putting some basic parenting strategies into place in their early teens could reduce the risk of problems developing in the future.

A 2013 study examined parental alcohol role modelling and its impact on binge drinking and found that the " … most important factors in the alcohol socialization process are parental alcohol behaviour. Alcohol habits with a high frequency but low intake per occasion seem to be transmitted to offspring in the same manner as binge drinking, and these drinking practices followed our respondents into adulthood." Children were continuing to pick up their parents' drinking behaviours during their teens, but most disturbingly, these were being taken into adulthood.

So, the evidence is pretty clear that you do have a major influence on your child's future drinking behaviour and you should never underestimate that influence, even during the teen years. You may not think your teenager cares about what you do or say during adolescence, but research shows that even though peers are becoming much more important, you will always play an important role in your child's life.

With that in mind, here are some of the simple things you can do to be a positive role model around alcohol and socializing are as follows: 

·       limit your alcohol use whenever you can. It's not necessarily about stopping drinking but 'get smart' in this area and always remember, children don't only pick-up bad habits from watching you and others, they can also learn a lot from observing 'responsible drinking'
·       do not get drunk, especially in front of your children
·       sometimes decline the offer of alcohol. This is a great one and can involve just quietly putting your hand over the top of a glass at a family 'get-together' or the like and saying "I'm not drinking tonight." Don't try to make it a grand gesture ("Look at me, look at what I'm doing!") - it needs to come naturally and not look like you're making a supreme sacrifice (you're not curing cancer!). But when your child sees this refusal of a drink in a social situation (and let's make it clear, it does not count if you're the designated driver'!) they get the message that you don't always need alcohol to socialize - so simple, yet so powerful!
·       provide food and non-alcoholic beverages if making alcohol available to guests. Always try to associate alcohol with food when you can. Not only does eating slow down absorption of alcohol, helping to prevent poisoning and the like, it also sends the message to young people that drinking should not be an isolated activity
·       organise events with family or friends where alcohol is not available. This is a great one, particularly for parents of younger children, but it needs to be said it can be difficult to do, with many parents telling me that if they say 'no alcohol', people often refuse to attend! Scary but true!
·       never drink and drive 
·       do not portray alcohol as a good way to deal with stress. This can be the most difficult one for many parents to try to do but it is so important. The one thing that almost all parents want is that if their child is going to drink alcohol, that they do it for the 'right' reasons. Drinking to 'cope' or de-stress is not healthy. Flopping down in front of the TV on a Friday night after a big week and saying "I need a glass of wine" is not good modelling. Of course, sometimes it's just going to happen - you're not perfect - but if you can avoid it, that's great. At the same time, try to use healthy ways to cope with stress without alcohol, e.g., exercise, listening to music, or talking things over

Remember, as already said, you are your child's first and most important teacher. They learn from watching you and others around them from a very early age. You're not going to get it right all of the time but doing a couple of simple things can really lay down some great foundations for the future ...


Mahedy, L., Hammerton, G., Teyhan, A., Edwards, A.C., Kendler, K.S., Moore, S.C., Hickman, M., Macleod, J., & Heron, J. (2017). Parental alcohol use and risk of behavioral and emotional problems in offspring. PLoS ONE 12(6): e0178862.
Pedersen, W. & von Soest, T. (2013). Socialization to binge drinking: A population-based, longitudinal study with emphasis on parental influences. Drug and Alcohol Dependence 133, 587-592.
Rossow, R. Keating, P., Lambert, F., & McCambridge, J. (2016). Does parental drinking influence children’s drinking? A systematic review of prospective cohort studies. Addiction 111, 204–217.

Friday, 26 January 2018

Starting high school: The importance of parents being involved, staying involved and talking to one another

This time last year I wrote an article on the importance of a 'smooth transition' from primary to secondary school. Research has shown that by Year 10, those students who managed to get through this difficult transition period without too many issues are likely to have higher levels of school attendance, better academic results, low behavioural problems and lower rates of substance abuse. What happens in the first few months of high school can play an important role in how their future plays out …

I recently read a wonderful research paper by Anne Coffey that discussed the key to a successful transition being 'relationships'. In the article, the author identified a number of potentially 'negative' changes that can occur during the move from primary to high school including the following: 

·       a decline in self-esteem due to changes in learning environment and more demanding schoolwork
·       a "dip in academic performance and motivation", and
·       a disruption of existing friendship networks, with peer groups forming and reforming in the new school setting

The last point is what I discussed last year – the fact that this is a period when existing peer groups will often go through major changes and young people will 'bounce' from group to group in an effort to find one that, not only do they want to be a part of, but is also willing to accept them. The so-called 'popular group' is always pretty easy to identify and it's sad but true that no matter what your age, most of us would secretly love to be a part of the 'cool group'. But that's not going to happen for most of us and in the first few weeks of high school there's going to be a mad scramble to find out what group you'll end up in …

At this stage of development, it is becoming increasingly important to gain acceptance from peers and many will establish peer groups at this time that they will take through their whole secondary school experience. All parents hope that their sons and daughters end up with a 'great group of friends' – but what does that really mean from a parenting perspective? Realistically, you want them to 'hang out' with peers who have similar values and attitudes as you have hopefully tried to instil in them. Sadly, that doesn't always happen and when it comes to alcohol and parties, that can end up being a nightmare for some parents!

Coffey states that research has found that, not surprisingly, one of the chief concerns of students at this time is 'making new friends and fitting in'. If they've come from other schools, some will grieve for the friendships they had there and even if they go to a K-12 school, there is always a significant influx of new students that will undoubtedly impact upon existing friendships. It's important to note that this concern has usually disappeared by mid-way through Term 1 as the friendship groups start to settle and the students 'find their place'.

Now, you can't choose your child's friends for them (as much as I'm sure many of you would like to!) but I did suggest that there are a few simple things you can do to ensure you know as much as possible about what is going on in this area. Remember, what happens during this period is really going to help you in the years ahead around socializing. So, do your best to do the following:

·       keep talking to your child and show an interest
·       be involved
·       meet their new friends
·       meet their new friends' parents
·       don't be afraid to express concern if you're worried about who they're hanging out with - if you don't feel comfortable with their friends, let them know but do it carefully and respectfully but, if it doesn't feel right, it most probably isn't and you need to let your child know how you feel

Coffey agrees that parents' participation is critical in the whole transition process. According to the research, parents who are involved at this time are more likely to remain a participant in their child's secondary schooling. Evidence clearly shows that this partnership increases the likelihood that students will achieve at a high level, be well-adjusted and are less likely to drop out of school. We've been talking about the difficulties that young people face during this time, but it is also important to remember that it can be difficult for parents as well. They need to forge relationships with either a new school and/or new teachers. All of a sudden, you're not dealing with one classroom teacher – you're dealing with many, some that your child may have a great relationship with and others not so much. 

So, it's not just me saying that parents should be involved at this time – the research backs me up! The problem is that we know so many parents do just the opposite and instead of maintaining and building upon the relationship they may have had with their child's primary school and teachers, they pull away when they hit high school – some never to be seen again!

I get it – your child is growing up and they need to develop independence, they also don't really want you to turn up at the school, no matter what the reason! This is a time, however, when parents not only need to be well-informed about the school and procedures, they also need to develop effective parent networks. These are incredibly important and can assist you in all sorts of areas, particularly parties and gatherings and, of course, alcohol. Do this early and identify like-minded parents who have similar values and attitudes to you and it'll be so helpful in the future. Your kids are going to try to 'silo' you as much as possible, telling you that you can't call the parent hosting a sleepover or making sure they limit the amount of information they give you about any upcoming event – don't 'silo' yourself! Get involved, stay involved and keep talking to one another.

If your child is just about to start high school, make sure you try to:  

·       attend as many information evenings as you can now and later – they're important! No school puts these on because the teachers want to stay on school grounds for longer – they're held for a reason. They provide valuable opportunities for parents to be positively involved in the transition period and beyond
·       grab every opportunity to meet other parents through school events – as your child makes new friendships during this time, establish contact with other parents. If you were a parent who walked your son or daughter to school every day when they were in primary, that provided you wonderful opportunities to meet others who did the same thing. That doesn't happen during the secondary years and so you've got to find other ways to meet parents and create those vital networks


Coffey, A. (2013). Relationships: The key to successful transition from primary to secondary school, Improving Schools 16, 261-271.

Friday, 12 January 2018

8 things parents need to tell their teens about alcohol and vomiting

The response to last week's blog that asked parents 'Would your teen know what to do if something went wrong at a party?' was amazing! Well over 20,000 people read the piece over a 2-day period and the content seemed to really resonate with parents. The incredibly sad story of the 15-year-old girl who choked to death on a bed while being watched by four of her friends is particularly powerful and, as a result, many readers forwarded the link to their teens. Amongst all the comments was one that I found particularly interesting:

" … Death by vomiting is a real danger. I must have been lucky as a young bloke to not have died. My life was saved several times whilst vomiting unconscious. I had good mates who looked after me. A wife who saved my life three times. I no longer drink at all. The fun aspect disappeared long before I got the help I needed. I don't think all that much has changed over the past 50 odd years ... I quite like young folk. Times change. Kids don't. I believe a lot of oldies forget their youthful years."

What a great comment – "Times change. Kids don't." … Of course, he's absolutely right – nothing really changes - it's just that we now know far more about the potential risks. As a result, we can try to ensure our kids are far more informed than we were and hopefully, if they do get into trouble, at least they'll have a better idea what to do!

Getting drunk and subsequently vomiting is not something new. When I talk about the potential risks around alcohol in schools, teachers often come up afterwards and say something like, "I was so lucky" or "How did we ever make it through? We did all those things and were never aware of what could have gone wrong". Unfortunately, getting drunk and dying as a result is not new either. Deaths caused by choking on vomit after a heavy drinking session have been happening since man first started using alcohol. A number of famous people have died this way, including Led Zeppelin drummer, John Bonham, who reportedly drank 40 shots of vodka and subsequently choked to death in his sleep and of course, AC/DC lead singer, Bon Scott who passed out in a friend's car and inhaled his own vomit.

Most people have vomited at least once in their lives and many have a great 'vomit story' – particularly relating to alcohol! Even though it is incredibly unpleasant, it is important to remember that there is a reason for this bodily function. So, what is that reason? Why do we vomit when we drink too much?

Most alcohol is metabolized by the liver, where an enzyme called alcohol dehydrogenase (ADH), breaks it down into acetaldehyde, a toxic chemical that can make a person feel sick. This is then broken down by another enzyme into acetate, which is excreted. Although acetaldehyde is usually broken down quite rapidly, when you drink alcohol it builds up in the body, causing nausea. When you drink too quickly, these toxins accumulate, and your body gets the message that it needs to get rid of them. You then vomit – expelling the contents of the stomach, including the toxins!

If a young person is going to look after someone who is vomiting, they've got to have an understanding of why it is happening … Now trying to explain all about ADH and acetaldehyde is going to bore them to death and many won't understand it. So, although this is an oversimplification, a good way of explaining what is going on is as follows ... When you drink too much, alcohol 'turns off' the brain areas that control consciousness and breathing, resulting in unconsciousness, coma and, in extreme cases, death. You've been poisoned! Our bodies try to protect us from getting that far by making us vomit and getting rid of unabsorbed alcohol before it reaches the brain. It prevents further poisoning and in the process, save your life.

When it comes to educating teens about anything I'm of the view that we should 'start from where they're at', i.e., begin by talking about something they've experienced themselves and when it comes to alcohol, that's vomiting! Even if they've never drank alcohol, most young people who have attended a party or met a group of friends in a park on a Saturday night have seen someone else drink too much and end up being sick. If it's not their friends, it'll be a family member. That's why a conversation about alcohol and vomiting is far less likely to be 'shut down' by your teen. They're going to know what you're talking about and there's a better chance they're going to listen.

So, what should you be telling them? Here are 8 key points about alcohol and vomiting that every young person should know:
  • vomiting can be life-threatening. Although many look back at a night of vomiting and laugh about their experience, it is vital that teens understand that it can be extremely dangerous. Apart from choking to death, dehydration and salt imbalances are the biggest concerns in most vomiting episodes
  • if someone is vomiting, or it looks as though they may start, stay with them – never leave them, not even for a few seconds. It can take just seconds for someone to choke on their own vomit, so it is vital you stay with them and monitor them closely at all times
  • don't force them to drink lots of water. For some reason, young people (and adults too) believe that water is going to fix everything. Of course, if they are not vomiting and just feel unwell or nauseous, ensure they replace lost fluids. It is also important to ensure they rehydrate once they have finished vomiting, but if they're forced to drink water while they are being sick, it is highly likely that they will simply vomit it back up relatively quickly. Soak a t-shirt or cloth in cold water and have them suck on that in between vomits. That way, they are still rehydrating, as well as getting rid of the horrible taste in their mouths
  • vomiting won't sober someone up. Getting rid of unabsorbed alcohol from your stomach is not going to sober you up. Certainly, some people report that immediately after vomiting they can feel clear-headed and some even believe they are now sober enough to drive! This effect is believed to be due to the flood of endorphins that are released when vomiting but usually disappears quite quickly
  • never prop a drunk friend onto a toilet bowl to vomit. Too often, people end up with a range of facial injuries (losing teeth, breaking their noses, etc) when left lying over a toilet and either pass out or fall to sleep, smashing their faces onto the porcelain. Drunk friends should be taken to a safe and well-lit place and given a plastic bucket or bowl
  • try to keep them comfortable - if they are feeling sick they are likely to be feverish. Putting a cold compress (or even a cold-water bottle) on the back of the person's neck can reduce their temperature and make them feel a little better. On the other hand, if they start to feel cold, make sure there is something warm to wrap around
  • if you see blood in the vomit, call 000 immediately. Although, this can be caused by something as simple as the person biting the inside of their mouth or tongue, it could also be something far more serious, such as retching tearing the small blood vessels of the throat or the oesophagus. This usually looks like small red streaks in the vomit, like nose bleed blood. Although this may not be life threatening there is no way of knowing for sure without seeking medical attention
  • if in any doubt, call 000. It's hard to be too specific here as everyone is different when it comes to what constitutes a 'medical emergency' but 'if it doesn't feel right, it usually isn't!'. As a parent, make it clear to your child that you support them in their decision to call 000, then they need to call you. Even if the ambulance arrives and the situation has resolved itself – it's better to be safe than sorry.

How do you know if a person is just drunk or actually suffering from something much more serious - like alcohol poisoning? It's difficult, but if you see one of the following, call 000 immediately – this is not something an adult can deal with, let alone a teenager:
  • the person is unconscious and can’t be awakened by pinching, prodding or shouting
  • the skin is cold, clammy, pale or bluish or purplish in colour, indicating they are not getting enough oxygen
  • the person is breathing very slowly, if there are more than 10 seconds between breaths – this is an emergency
  • vomiting without waking up
Many parents reading this will remember a drunken night out when they were in their teens (or early 20s) when everything went wrong. We usually learn by our mistakes and a night of vomiting after a big drinking session can often lead to long-term changes being made when it comes to alcohol. Sadly, that one drunken night can sometimes result in a death. We need to make sure our kids know more than we did. This is not necessarily going to be an easy conversation but it's an important one ... Remember, if you want to have a better chance of success, frame the conversation around looking after a friend and avoid talking about their own drinking behaviour (that's another conversation altogether!) ...

If parents are interested in learning more, there are two fact sheets specifically developed for young people on the DARTA website that may help. One is called 'How do you look after a drunk friend?' and the other is 'How do you look after a drunk vomiting friend?'