Chapter 16 - ALCOHOL AND DRUGS

During the past year, I've asked a number of adolescent boys, Daniel among them, about their first exposure to alcohol and the pattern of drinking that developed in their lives. After returning from a seventh-grade class trip, Daniel got his older brother to drive him and six of his friends—four boys and two girls—from the school in suburban Boston to the family's vacation home on Cape Cod. Everyone settled into the guest house. One of the boys suggested they all try drinking. The others all said it wasn't a "cool" thing to do, but soon they were bored and started to express curiosity about what drinking was like. One of the boys found some Scotch whisky in a cupboard. Everyone sampled it. Daniel took a couple of sips and told everyone he thought it tasted disgusting. Only one boy drank enough to be really drunk. Others drank small amounts and pretended to be drunk.

When Daniel was a junior in high school, his parents left him alone for a weekend for the first time. He immediately threw a party, which got out of hand. A wall was damaged, cigarettes were stubbed out on hardwood floors, and an outdoor deck was wrecked. Local police broke up the party. Daniel doesn't regret having the party even though his parents were furious. He was drunk at his own party: "I had to be. Otherwise I would have flipped out." In late adolescence, Daniel drinks about three times a month, and when he does, he drinks enough to affect his judgment.

Many of the stories I listened to were consistent with Daniel's account. From the very beginning, boys were primarily curious about the experience of being "under the influence," and they pursued this goal even when they found their first tastes of alcoholic beverages repellent. There is enough peer reputation involved that boys will sometimes pretend to be intoxicated when they aren't; or at least their friends suspect they are faking intoxication.

Even when boys postpone their first drinking experiences to later adolescence, they may harbor the same curiosity as younger boys to put themselves under the influence. Ross drank for the first time a few days after graduating from high school. He had been a member of the Student Awareness Program at his high school, which meant that he voluntarily abstained from using alcohol and drugs, and led discussions among middle school students about the hazards of substance use and abuse.

Once he had graduated, Ross wanted to discover what drinking was like before he went to college. He planned to do it at a friend's house where, for safety's sake, he could stay the night. Of the several age-mates at the friend's house, only three were drinking. Ross enjoyed himself. He was acting silly, and one of his friends followed him around writing down all the funny things he said, which annoyed him at the time but now he's glad to have the record. Two years later, he drinks about once a week; about once a month he drinks enough to affect his thinking.

John Donovan, a psychologist at the University of Pittsburgh who studies teen drinking, believes that peer influence is exaggerated as the cause of underage drinking. The main causes, he believes, are the general cultural acceptance of drinking, the observations a boy makes of drinking in his immediate environment beginning in early childhood, and the way drinking is addressed or ignored in family discussions as a boy is growing up.

In my conversations with boys, however, I found that peer influence appeared to be a strong contributing factor in most boys' introduction to drinking.

Certainly most of their drinking occurred in the company of peers, not adults. Students at Morgan's middle school were allowed to go home for lunch. One day in seventh grade, he and a few of his best friends all went to another boy's home for lunch. There were no adults present. They all poured themselves glasses of Manischevitz (sweet kosher wine). Most of the boys didn't finish their wine, but one of them finished his own and the remains in others' glasses. When the boys returned to school, the friend who had consumed the most acted drunk. Morgan believes he had taken enough to affect his behavior but that he was exaggerating his condition.

Some adolescents merely provide their peers with opportunities to drink, but others exert social pressure. When Ben was fourteen years old, he visited his older brother at college. His brother and some of his brother's friends decided it was their "duty" to get Ben drunk, and they did. Ben remembers thinking it was cool, but not at all his own idea. In late adolescence, he drinks moderately about twice a month, and enough to get drunk about twice a year.

The Well-lubricated Society

Most boys have been observing social drinking since early childhood. Susan Cheever gave one child's account of family cocktail hours in her memoir, Note Found in a Bottle; My Life as a Drinker: "I loved the paraphernalia of drinking, the slippery ice trays that I was allowed to refill and the pungent olives, which were my first childhood treat, and I loved the way adults got loose and happy and forgot that I was just a child."

Two-thirds of adults in the United States consume alcoholic beverages, many of them only occasionally, and a majority of them without causing known significant harm to themselves or others. Two-thirds doesn't mean everyone, but it is a substantial enough percentage to say that, among adults, drinking alcohol at least occasionally is normal rather than exceptional.

Many adult parties, ceremonial occasions, and business lunches are events where alcoholic beverages are served. In many families, the adults drink before dinner—and in some households before lunch also—and perhaps consume wine with their meals as well. The ubiquity of drinking is expressed in such folk humor as "Wherever four Episcopalians are gathered, there is sure to be a fifth." Adult consumption of alcohol is so common that people employ the words "drinking" or "drinks" to refer to alcoholic beverages; a group of beverages that might be consumed in place of alcohol have to be distinguished by adding the qualifier "soft."

Adult drinking in public is legal just about everywhere in the United States, although the sale and serving of alcohol is prohibited at certain times and places, and is subject to licensing and government regulation. If adults injure others while acting with impaired judgment or self-control from drinking alcohol, they may be held accountable, criminally or civilly or both, for the harm done. In some jurisdictions, adults can be prosecuted if they allow minors to drink in their homes or give them alcohol elsewhere; they are more liable to be prosecuted if the minors then injure themselves or others.

In addition to individual adults who abstain from drinking alcoholic beverages, there are large groups such as Mormons and Moslems who oppose on religious grounds the use of alcohol and other stimulants or depressants. Boys do have opportunities to see that drinking is optional, that it isn't practiced universally by adults. Unlike the consumption of drugs such as marijuana, cocaine, or heroin, which is illegal for everyone, adult and child alike, the consumption of alcohol is basically legal for adults across the country, and illegal in public places for everyone before their twenty-first birthdays. Many studies confirm, however, that a large proportion of adolescents, especially boys, have consumed alcohol long before they reach majority age.

According to a 1997 survey by the U.S. Department of Health and Human Services, between 8 and 9 percent of eighth graders had drunk alcohol within the past thirty days. There were about 9.5 million current drinkers between the ages of twelve and twenty, 4.5 million of whom could be classified as binge drinkers, and almost 2 million of whom were heavy drinkers—to all intents and purposes minors who are alcoholics. All of these statistics are extremely sobering, but I pay special attention to the binge drinkers. Some of the juvenile alcoholics have probably learned to function adequately even with a high level of consumption. But the binge drinkers are the ones who drink to such excess at parties or on other occasions that they often threaten themselves with alcohol poisoning, assault people, destroy property, and jeopardize the lives of others when they drive.

Seventy-five percent of twelfth graders in the Health and Human Services survey had drunk alcohol within the past year. Only a little more than 40 percent of all twelfth graders thought there was any great risk involved in heavy drinking. One study I consulted put the median age at which boys begin to drink at slightly over thirteen years; another study put the average age of first drink at twelve.

A 1995 Minnesota Department of Health survey showed that nearly a third of high school seniors statewide drank to a state of intoxication at least monthly, or had more than five drinks on a typical drinking occasion. A majority of boys surely think of drinking alcohol as something they are eventually going to do—like driving a car or having sex. The question is not so much whether as when, where, and what type of alcoholic beverage. Once they begin drinking, many adolescents participate in binge drinking, and some progress into alcohol addiction.

In the town where I live, there are eight schools that each combine the first eight grades. Graduates of all these schools converge on one high school campus for ninth grade. The town and school cooperate in providing full-time alcohol and drug counselors for the high school, an implicit admission that teenage drinking and drug use are serious and frequent problems. (Studies I've consulted indicate that a substantial number of students nationwide find ways to bring alcohol to school and consume it on school property.)

One counselor at our high school told me that over 90 percent of the students drink. It's a main way, she said, that kids overcome their discomfort in adjusting to this big, new, strange place. Drinking cuts through every clique and every status group. By the year-end holiday of their freshman year, many are falling apart. By the end of sophomore year, she judged, many have gotten a grip on their patterns of drinking, but I didn't find much reassurance in her estimate of the statistics. Obviously the high school doesn't invite or want the situation; it comes unbidden.

The lesser mass of a boy means that a given amount of alcohol will affect him faster and harder than it will affect most adults. As a story I picked up on the Internet made clear, even boys who are familiar with this general relationship between body mass and intoxication don't know how to apply it in actual situations:

Adult motives for drinking include: easing discomfort or unease in social situations—drinking as icebreaking; providing solace for loneliness or boredom; inducing relaxation or relief from stress—drinking after work, for example; soothing the pain of episodic or chronic unhappiness at work or in family life or other relationships; allaying anxiety about sexual performance; enjoying the sensation or "buzz" a drinker may get from light to moderate drinking; satisfying the body's biological craving for a substance the person is addicted to; appreciating the acquired taste of the beverage itself—a distinctive beer or a prized wine; causing a feeling of release from inhibitions through getting "high"; and neutralizing inhibitions against aggressiveness and other antisocial behavior.

The conventional view is that men get drunk, and then when they are drunk and "don't know what they are doing," they become violent. My jazz colleague, Tony Pringle, told me once of a regular Saturday night gig he played at an English pub where it was expected the evening would end in a brawl. The evening-ending fight was so routine that the band played the same song, "Don't Go Way Nobody;' when it broke out.

For some males, I believe there is a degree of intentionality involved in drinking and then provoking a fight, or in drinking and then initiating aggressive, uninvited sex. The drinking is counted on in advance to neutralize any inhibitions and then to provide an excuse: I didn't know what I was doing. Alcohol is very intimately associated statistically with criminal activity. It can function to allay the criminal's anxiety beforehand and to deliberately override his superego or conscience; it may be associated with his being excessively aggressive during the crime; and then afterward used as an excuse.

Curiosity about the experience of being high or drunk may motivate a boy's first consumption of alcohol, but even in adolescence boys may drink for any of the reasons adults manifest. Artemis, a college student, recalls that during the three months she dated Brian in their senior year in high school, he would sometimes be drunk but hide it so well that she couldn't tell for sure. "Brian is very shy, and he came to rely on alcohol as a means to overcome his shyness. I found out after we broke up that Brian wouldn't even call me for the first month we were going together without drinking first." Despite the history of alcoholism in his family, Brian could not be deterred in his drinking habits—or maybe because of the family history. He regarded himself as "stone cold sober" after drinking four beers, and would tell Artemis casually that he'd done a few shots of whisky by himself to prepare for later partying.

As males sometimes drink in order to fortify their nerve to pursue the sex they desire, so they may encounter girls who drink in order to override the reservations they feel about having sex. As Caroline Knapp wrote in her memoir, Drinking: A Love Story, "The first time Meg had sex, her best friend advised her: 'Just get drunk. It'll be easy.' So that's exactly what she did. She got drunk then, and she got drunk the next time and the time after that, and after a while the idea of having sex with a man without getting drunk first seemed pretty much impossible."

Drinking to alleviate loneliness or boredom is a well-known adult theme, but one should not discount its significance among adolescents. As one sixteen-year-old boy put it, "I don't do drugs, but a lot of my friends do. I do drink on occasion, but, hey, nobody is perfect. Parents tend to blame the media for these problems, but seeing a couple of cute frogs reading a Budweiser billboard is not going to make me want to drink. Boredom will, though. The main reason why we do these things is because we have nothing better to do. Movies and arcades are fairly expensive. Going to the mall isn't all that much fun because the security guards follow us around like we had trouble written on our foreheads. So what do we do? We go to a friend's house and drink or get high just to pass the time. Do discipline us when we get caught, but as a preventative, give us something to do."

To the list of motives for drinking that adults and adolescents may share, I would add a few others that are more characteristic of adolescents (or even preadolescents) than of adults. Drinking can be an act of rebellion by kids. They know it is a hot button to push. But just as some may wish to flaunt their drinking, many others, knowing what a hot button it is for adults, do their best to hide their drinking. Leif first drank beer in seventh grade at the home of a classmate whose Italian-American parents were accustomed to having children drink alcohol—mainly wine—in small quantities. The parents weren't home. His friend's older brother bought beer for a few boys. Leif drank enough to get sick. His friends tried to take care of him quietly so that his parents wouldn't learn of it; but they were unsuccessful. Leif endured a prolonged grounding.

Another motive of youthful drinking is to adopt a badge of faux maturity. Many boys like to pretend they are older than they are. Drinking for some is a pretend-to-be-adult activity.

More than is true of adults, I believe, boys also drink as deliberate risktaking. They know that it is risky, although many feel that they are magically immune from the downside of risks. They have seen adults drink and drive without accidents—why can't they?

"It was the summer after my freshman year in high school," Gary, now a freshman at Northwestern, said to me. "I had just finished adjusting to that hellish transition that comes with any major change in life. I was beginning to get into a new rhythm of living. I felt socially comfortable, reasonably confident in my maturity and decisionmaking ability. Until that summer, I had been completely against any form of substance abuse, from drugs to alcohol to cigarettes. Most of my friends were two or three years older than I, and well used to partying. I had grown quite used to hanging out with my friends when they got drunk and high. Many times I had an invitation to partake, always I refused.

"That certain summer evening felt different. I was feeling bold, rebellious, curious. I was beginning to get fed up with the 'just say no' propaganda. I felt no need to 'fit in.' I had spent all year trying to do that in other ways. I was not being pushed by my friends. I had had numerous conversations and debates relating to drug use, and they all knew my position well. I was simply...curious. I wanted to branch out, try something new. It was a matter of exploring my world, not an instance of another world invading mine.

"Three friends and I piled into a van and drove to see the Allman Brothers. It was my first big-arena concert without adult supervision. I felt giddy and free. I had never seen anything like this before. Bikers and burnt-out hippies were there in abundance, but so were kids our age. New people, new clothing, new music, new style, new culture, new drugs. . . new everything! The whole atmosphere seemed to shout HAPPINESS! Let yourself go!

"The concert was a blast. We set up our blankets on the lawn overlooking the stage. I had already made up my mind—I was going to smoke pot. The sun began to set, the light grew dim, and the music started. The driver packed some nugs into his bowl, passed it around, and I inhaled...

"I didn't get high the first time, or the second or third. It took a while. I loved it. Every time after that, I smoked because I was with close friends and wanted to share an experience with them. Only once did I find myself developing a habit. I noticed the trend and stopped it. I tried alcohol and cigarettes as well, and as of now use the three occasionally. I am addicted to nothing except coffee, nor have I ever used marijuana to the point of addiction. For me, drug use is not the fiendish addiction of junkies, nor the mindless wasting of so many of my classmates. It is an occasional pleasure to be enjoyed among friends, and remains a subtle, yet exciting, part of my social life."

Gary's story reminds me that just as parental permission to spend the night after the prom at a hotel is an implicit permission to drink or use drugs and have sex, so parental permission to attend many popular music concerts in big arenas without chaperones is implicit permission to drink and use drugs.

The statistics on drug use by adolescents in the United States are as troubling as those on alcohol—both in terms of use and in perception of risk. From the 1997 Department of Health and Human Services survey: Fifty-four percent of twelfth graders have used illicit drugs at least once. The same is true of 47 percent of tenth graders, and a fraction less than 30 percent of eighth graders. Marijuana is the most widely used illicit drug in the United States and tends to be the first used by children and teenagers. Almost 6 percent of twelfth graders use marijuana daily. Slightly over 1 percent of eighth graders use it daily. Only 25 percent of eighth graders think there is any great risk involved in trying marijuana.

One of the drug counselors at our local high school says that, as with alcohol, over 90 percent of the students have tried marijuana. Its use is not by any means confined to kids doing poorly academically; many "top-of-the-line" kids come to her for consultation, she says. A large number consume alcohol and drugs on school premises, and many of them prefer marijuana to alcohol because it's easier to conceal.

Children and adolescents who do not like the taste of alcoholic beverages but want the experience of being under the influence can alter the taste with mixers, and some companies have facilitated matters by selling sweet-tasting coolers with plenty of alcohol in large containers. Smoking marijuana can't be sweetened up, but kids will persist through unpleasant first experiences, if Grant's story from tenth grade is representative: "I really wanted the experience. We all sat in a circle and I saw my first bong. I was intrigued and nervous—didn't want to betray my inexperience. I watched carefully, trying to work out the method. When the bong got to me, I did manage to take a hit, although my form was not good. I think I smoked out of it two or three more times. I remember getting lightheaded in a very pleasant way. The world around me looked more vibrant. I had perma-grin. Somehow we ended up watching MTV. I lay on a couch and found out what happens when you smoke too much. I got clammy and nauseous. 'Give It Away' by the Red Hot Chili Peppers was on the TV. The sick feeling finally passed, but it was not pleasant. This experience did not turn me off the drug, though. It acted as a cautionary measure, showing me the cost of abuse as well as the pleasures of responsible use."

A majority of those who try marijuana do not go on to sample other drugs. But over 12 percent of eighth graders and 17 percent of tenth graders have tried stimulants such as amphetamines and methamphetamines at least once. Between 8 and 9 percent of twelfth graders have tried cocaine at least once.

Smoking cigarettes shouldn't be left out of a summary of addictive drugs. The side effects of cigarettes on concentration, memory, alertness, and ability to perform complex tasks may not be as great as with other drugs, but the longer range health risks are considerable. Nine percent of eighth graders smoke daily: 3.5 percent smoke a half-pack or more. By twelfth grade, the percent of daily smokers has climbed to 25: over 36 percent have smoked within the past thirty days. Of the 62 million Americans who smoke, over 4 million are kids aged twelve to seventeen.

In Chapter 6 I told about a fellow pediatrician here in Boston, Nicholas Kriek, who grew up in South Africa—how his father told him at age twelve, after he had been involved in an incident of neighborhood vandalism, that he had to be accountable for his actions if he broke the law; his father was not going to rescue him. Nick remembers being surprised by that; he had thought of parents as people who came to your rescue no matter what. His own parents, Nick felt, were in many ways not particularly good models for him when he became a parent himself. But he remembers their emphasis, as poorly educated immigrants to South Africa, on his education. "They regarded the school system and teachers as being larger than life in character. I had the view as a kid that teachers were important and serious, an authority to be respected."

The time came when Nicholas Kriek's oldest son, Tommy, collaborated in some vandalism at the middle school, and Nick found himself sitting in the principal's office. She said the police would have to be notified. "If it's a police matter, then go to the police," Nick agreed. "Maybe he will learn a lesson." On the day of Tommy's court appearance, to his son's surprise, Nick did not accompany him because he had a long-standing engagement to present a paper in Washington, nor did he send a lawyer as some parents did. His son was learning something about accountability. But there were trying days to come for Tommy's parents.

"When Tommy went to high school, he got terribly involved in drugs and his schoolwork suffered. He had a terribly rebellious adolescence. He was never a problem at home. There, he was helpful and good-natured, but covertly defiant When he was outside the house, he did his own thing. Neither my wife nor I grew up around drugs. In South Africa, getting caught using drugs was a felony offense. So I can tell you honestly that throughout that period we were bewildered and dazed. We asked ourselves over and over again, 'What did we do wrong, what are we doing wrong?' We were naive. Today, if there were an unexplained deterioration in a son's school performance, I would think first of all to look for drugs or alcohol, or both.

"Somehow among our circle of friends, one of the mothers discovered that our kids were doing a lot of marijuana and drinking as well. A meeting of several kids and their parents was called, and this horrific scene was laid out for us. The kids acknowledged what they were doing. The plan was to see if, as a parental group, we could help all of them. We met with a psychiatrist a few times. There was improvement, but Tommy did not stop using drugs.

"Approaching his senior year, Tommy got very interested in art and decided he wanted to go to art school in Maryland after graduation. No sooner had he arrived in Maryland than it was obvious he wasn't certain he'd made a good choice. He was quite depressed. I remember talking to him many times because I was quite concerned he might attempt suicide. In his first year there, he developed a burst appendix that caused life-threatening peritonitis. I got a call from a Baltimore emergency room asking permission to do surgery.

"The surgeon was marvelous. It turned out that his own son, an expert skier, had died in an avalanche. We had frank discussions of the challenges of raising our sons. When Tommy was better, the surgeon took him to a ball game. I know that my son admired him immensely as a human being, as a model. Tommy dropped out of art school after that year, worked as a waiter, moved in with some friends in Boston, and got very depressed again. But when he recovered his equilibrium, he decided to go to college. He had a very shaky first semester because he had lousy study habits. Then he just got stronger and stronger, graduated summa cum laude in three years, got a scholarship to Stanford and became a serious citizen. Now, with his new Ph.D., he's ready to teach philosophy.

"My boys—I think if you were to ask them about their dad, they would describe me as a moralist, as too moralistic. I have found thinking about morality essential to finding my own path in life—where to go, how to behave. Without it, I'm lost. If I've given my kids anything of value, it's that I've tried to set an example in my own behavior. You can't tell them one thing and do something different yourself. I know parents who make that mistake. If you want your kids to behave in a certain way, then behave that way yourself and there is a chance that they will think well of you and follow in that path."

Parents faced with sons in trouble over poor behavior or for drinking or taking drugs can veer to extremes. Some parents wish to dissociate themselves from misbehaving sons; they abandon them to their own devices, which is a very different thing from holding them accountable for what they have done but supporting them nonetheless. Other parents rush indiscriminately to their sons' defense in full confidence that there's no misbehavior for which a person can't escape the consequences if he has a good enough lawyer or an aggressive enough parent.

Recently I heard of a fourteen-year-old boy who was expelled from a private school for misconduct involving drugs. When he applied for admission to another private school, the school contacted his former school for academic records and comments on his overall performance. The old school forwarded the grades but refused to comment further; the boy's parents had threatened to sue the school if administrators divulged to anyone the cause of the boy's expulsion, or even that he had been expelled. It isn't hard to guess what a boy might infer from this: He can count on parental help to avoid the consequences of any delinquent behavior.

Many parents who face one or another of such behavioral crises will feel just as surprised, shocked even, as the Krieks felt. Unless parents remind themselves to look carefully into the culture their children are living in, they may blithely coast along assuming their children's adolescence will be very much like their own as remembered from twenty or more years earlier—until evidence surfaces that their children's lives are very different from what parents expected.

In the face of unexpected behavior by his sons, Nick Kriek did a number of things in exemplary fashion. He honored the laws and institutional rules about such things as vandalism, drinking, and drugs that circumscribed the boys' lives, making clear to them that they were accountable for their behavior if they were caught violating the rules. He didn't take the fence-straddling position that the laws and rules are ill-advised or too strict, therefore the issue is not whether one heeds the rules but whether one gets caught.

I mentioned to him the episode I describe in Chapter 18 of several high school seniors in our town who were caught with alcohol at the prom and excluded, as promised, from graduation ceremonies with their classmates. "I would like to think," said Nick, "that if my kid was one of those who transgressed knowing what the rules were, that we would be upset that something the whole family was looking forward to had been ruined, but we would say that the rules were known to everyone and the consequences have to be accepted."

With respect to drinking alcoholic beverages, there are different rules for adults than for minors. The reason for the variation in rules needs to be explained to kids—and can be explained in terms of the relative maturity needed to handle the effects of alcohol on the body and behavior, and the threat of addiction. But if kids observe their parents drinking to the point of intoxication or serving other adults enough alcohol that they become intoxicated, the moral authority of the adults, on this issue at least, is pretty badly compromised. Parents don't have to practice abstinence from alcohol to be effective models, but they do have to practice sobriety; and if they fall below that standard, to their children's knowledge, they should take the initiative in acknowledging their slip and its consequences for their being a good model.

Forewarned and Well-prepared

When I talked with the Melvins, I learned about another family that prizes clarity about rules. "Our boys (Ben and Ed are aged twelve and ten) know that we have expectations for their behavior," Patricia said. "We're not shy about letting them know. Many kids in this community are not really sure what their parents expect. Parents don't think they can put their foot down and say, 'I expect you not to drink alcohol on Saturday night.'" "We all make mistakes," George Melvin interjected. "I've told our kids on numerous occasions that they are going to make mistakes, and they have to be willing to admit to them. That's a crucial part of development."

George's viewpoint about both accountability and slips has a poignant background. His father died of alcoholism and was abusive when drunk toward George's mother and the children. George is a recovering alcoholic himself. Ben and Ed know the family history. "They know that my father, their grandfather, was not able to live a full life, not able to show that he loved people, not able to hold down a good job. I grew up with it as 'the big secret.' You really pay a big price for not talking about it." "Years ago," Patricia volunteered, "Ben said to me, 'Do you think I'm going to be like you, Mommy, and drink alcohol, or do you think I'll be like Daddy and have a problem with alcohol?' And I said, 'That's something we don't know. We do know that when a mom or a dad is an alcoholic, there is a greater chance that their child might have a problem.' Our kids know that they are at greater risk.

"George made a deliberate decision to be the man his father was not:' Patricia remarked. "That was hard fought and hard won:' "The kids are aware that we've made choices that our parents didn't make:' George added. "I'm trying to say to them that you have to make choices. To us, the kids are top priority—teaching them that it's not about having a fancy car but about taking time to be with your family. That's basic stuff."

Patricia Melvin, who is a high school alcohol and drug counselor, pointed out the connections between alcohol and sexual experience among adolescents. "One of the things I do is teach a sexuality and health class at the high school. There was community support for it, and also community fanaticism about some of the topics we discuss. We let all the kids know that many kids have been drinking when they have their first sexual experience. We talk about how the sex might have been consensual, but would the person have made the same choice if he or she had not been drinking?"

As involved as she is in dealing with issues of sexuality, drinking, and drugs at the high school, Patricia Melvin still thinks the parental role is pivotal. "We can hire as many counselors as we want, but unless the families are behind us we will not get very far. We do run programs for parents through the school system, but often it's 'preaching to the choir.' At a PTA meeting I meet the parents who do know where their kids are on Friday and Saturday night—but not the parents who stopped having a curfew in tenth grade because the kids didn't like it and there was too much arguing about it. My greatest concern is that parents don't have any discussions with their kids before the problem hits them."

I asked Patricia what she thought about parents who allow kids to have parties with alcohol in their homes. "I think they sincerely believe they are providing a safety net for the kids," she replied. "They honestly believe they are doing a service by saying, 'You can come here, the keg is ready, and we will take the keys so you can't drive home.' My impression is that it's happening less than it used to. Many parents think the kids are going to drink anyhow, so there might as well be some safety built in. It's the same mindset as invented the designated driver—which is a way of saying that if the driver is reasonably sober, everyone else can get drunk. I agree that designated drivers are good for safety, but I think it's a poor overall message."

In her work with adolescents and young adults, Patricia Melvin emphasizes practical considerations: "Alcohol and drug issues are health issues with some fairly dramatic negative consequences. There are moral consequences, too. On all health issues I think in terms of the idea of moderation. Of course I see our society's ambivalence weaving through the issues of alcohol and drugs. I think it's very important to spell everything out—expectations, consequences, values, attitudes—so kids don't have to figure everything out for themselves." Her logic appeals to me. Let the morality flow out of information about what alcohol and drugs do to body and mind, and out of known potential consequences of impaired action and judgment, rather than beginning with a moral message that alcohol and drugs are bad, so "just say no." I believe adolescents respond to accurate information of obvious gravity better than to scare tactics.

When I asked George and Patricia how they were preparing their boys, who are on the edge of adolescence, to deal with its social pressures, they said they were aware that they were steering Ben and Ed away from an indiscriminate wish to be popular. "When I think of the 'cool kids' at even the elementary or middle school levels," Patricia says, "I think of kids who care more about what they look like, who wear designer labels. I think of a group of kids who will cut other kids to make themselves bigger. I think Ben is not comfortable with that kind of behavior. I don't think he wishes he was in this crowd or that. He has some friends who are thoughtful, nice kids, and he's happy with that. He doesn't do a lot of socializing on weekends. He's not talking about dating yet, but some of his classmates are. The kids that will be the partying kids in eighth or tenth grade, who will drink and smoke pot earlier—these are not the kids he gravitates toward, nor do they gravitate toward him. We've talked to the kids about how they only get to be kids once, and it should be fun, not high risk or high anxiety. I think the notion of letting them be kids as long as they can be is high up on my list of important things."

The Krieks and the Melvins are both deeply attentive to the lives of their children. All four of them take with utmost seriousness their responsibility to model behavior as an intentional inspiration to their sons. All of them treat laws and rules about alcohol and drugs with respect and hold their sons accountable for behavior in violation of the rules. That said, the two families have approached adolescent drinking and drugs from very different backgrounds and mindsets. The Krieks were not mindful of the extent to which alcohol and drugs pervade adolescent social groupings, nor did they have any experience with drinking and drugs from their own adolescence to bring to bear on their sons' lives. Their sons were growing up in an environment in which a very large majority of students consumed both alcohol and drugs. Before they knew it, they were in the middle of a crisis with Tommy. It would have taken very carefully thought out parental strategies if the Kriek boys had gotten through high school without falling under the influence.

The Melvins were not hindered by naïveté. George knows from three generations of his family's history how much devastation addiction to alcohol can wreak. Patricia deals with the issues professionally every workday. She is particularly aware that pressure to use alcohol and drugs can vary considerably depending on what cliques and crowds a boy belongs to. In many adolescent groups, consumption of alcohol and/or drugs is virtually the price of admission. So the Melvins have family discussions and recite family history. Though the daughter of a minister, Patricia tends to her spirituality privately. It is George who takes the boys to church. The three males in the family are so engaged in the life of their congregation that Ben and Ed say it is their biggest support outside the immediate family and a further support for sobriety. With all their concern, however, the Melvins are not sure what lies ahead for Ben and Ed. "I remember our having a conversation about a year ago:' George says to Patricia, "and I think I was more willing to say it is okay to let our boys be the odd one out; and you were the one saying, well, they've got to live with all these kids, so maybe we need to chill out a little bit. I don't know what adolescence will be like for them. Perhaps they will feel that Mom and Dad are a little too far off target."

The question of how much to monitor adolescents' activities is a delicate one. I remember when my daughter was in high school and invited to a party where, we ascertained, there were not going to be chaperones and were sure to be alcohol and marijuana. We told Mary Helen that she couldn't go, and she was not happy with our decision. But a couple of days later she said she was glad Carolyn and I had made the decision we did; she had heard that the party got very rowdy, and she knew she would have been uncomfortable. One of the things we can do for adolescents is stay in close contact with them, and, in the interest of protecting them, sometimes make decisions they might hesitate to make for themselves. They should be aware from frequent reiteration that we would as parents do everything possible to rescue them from situations where they feel endangered or pressured to act against their best judgment. I know this is a difficult balancing act, because the parent wants to be an ally, not a heavy-handed spoilsport. But the teenager's world is a dangerous place, which Joy Dryfoos captured in the title of her book, Safe Passage: Making it Through Adolescence in a Risky Society.

The best example of where a parent doesn't want to end up in relation to an adolescent comes from the boy I quoted earlier: his parents were following him around the house to make sure he didn't sneak a drink or smoke pot in the bathroom. The parent as policeman is not a happy role. Recently I saw an ad for an in-home drug test kit. If a parent mails an adolescent's urine and hair samples to the lab, a report will be issued within three days on traces of marijuana, cocaine, PCP, and heroin use-and, on request, no doubt for an extra charge, LSD and alcohol. "Parents can give their teen a reason to say no to drugs," the ad says: "'My parents drug test me.'" Mind-boggling.

The power of the youth drinking and drug culture is such that every strategy needs to be employed to help boys from getting entangled: early and continuing family discussions; clearly articulated family norms of respect for rules and laws regarding mind- and mood-altering substances; honest accountability for breaking the rules; parental modeling with respect to abstinence or moderation in consumption of alcohol and abstinence from illegal drug use; professional counseling as suggested by known problems within the family; monitoring of teens' activities, particularly in concert with other parents from their groups.

All of these techniques are needed to counter the capacity of these substances to affect adolescents' development adversely through habituation and addiction, through diversion and distraction from the central process of forming a personal identity, and by interfering with the making of good choices, the benchmark of character.

Yet for all the attention that has to be paid to the intrinsic and insidious effects of alcohol and drugs, that is not the main issue. Adolescents, like adults, drink and drug themselves to treat a wide variety of vicissitudes: boredom, loneliness, anger and resentment, anxiety, a sense of purposelessness, feelings of powerlessness, sexual frustration, and not having a useful enough role in society. If we could magically remove alcohol and drugs from adolescents' lives, those vicissitudes would scream even louder for attention; and if we would more forthrightly address these feelings and the social realities in which they are lodged, we would remove a fair amount of the incentive to resort to alcohol and drugs at appallingly young ages.

Notes
Chapter Sixteen: Alcohol and Drugs

J. Donovan and R. Jessor, "Structure of Problem Behavior in Adolescence and Young Adulthood," Journal of Consulting and Clinical Psychology 53 (1985),890-904.

S. Cheever, Note Found in a Bottle: My Life As a Drinker (New York: Simon and Schuster, 1998).

United States Department of Health and Human Services, Drug Use Survey Shows Mixed Results for Nation's Youth. Report of the 23rd annual Monitoring the Future Survey. Posted on the Internet December 20,1997, at www.hhs.gov.

Prevention Resource Center, Minnesota Department of Public Health. Interview of Jean Funk, Project director, by Julia Jergensen-Edelman, posted on the Internet by sci@gartland.com (1998).

C. Knapp, Drinking: A Love Story (New York: Dell, 1996),83.

J. Gans, America's Adolescents: How Healthy Are They? (Chicago: American Medical Association, 1990).

L. Johnston, J. Bachman, and P. O'Malley, Monitoring the Future: Questionnaire Responses from the Nation's High School Seniors, 1993 (Ann Arbor, Mich.: Institute for Social Research, 1994).

U.S. Department of Health and Human Services, Youth Risk Behavioral Surveillance-United States, 1995, 45:ss-5.

From “The Men They Will Become"
Eli H. Newberger, M.D.

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From “The Men They Will Become" Eli H. Newberger, M.D.

Web design by flyte new media email Web Master

From “The Men They Will Become"
Eli H. Newberger, M.D.

Web design by flyte new media
email Web Master