Showing posts with label alcohol. Show all posts
Showing posts with label alcohol. Show all posts

Tuesday, October 13, 2015

Substance Use and Beliefs in Middle School Influence Risk of Driving Under the Influence: A Concerning Set of Longitudinal Survey Data

By: Lewis First, MD, MS; Editor-in-Chief     

          Risk-taking behaviors are certainly high on our anticipatory guidance radar when we see adolescents for health maintenance visits.  Even though we are concerned that a risk-taking behavior in early adolescence can portend other risk-taking behaviors in later adolescence—has it ever really been demonstrated?  Ewing et al. (doi: 10.1542/peds.2015-1143) have done just that using surveys of over 1100 teens given at ages 12 and 14 looking at alcohol and marijuana use as well as beliefs about their use and then compared these results to how often these same teens at age 16 drive under the influence (DUI) or ride with someone else who is drinking and driving (RWDD).  Even beginning at age 12, if a teen felt positively about marijuana use, let alone by age 14 was using it or drinking alcohol—there is a dramatic higher risk of DUI AND RWDD in these teens. 
Do you broach these risk-taking behaviors at age 12?  Do you wait until teens are older?  If the latter, you may be too late in offering the education these teens need to make better choices when confronted by peers with risk-taking opportunities for substance use and abuse.  How early do you begin to discuss marijuana and alcohol use with preteens and have you found talking to preteens is making a difference in a positive sense?  Share with us your thoughts on this interesting, but sad look at early adolescence through a response to this blog, an e-letter or posting a comment on our Facebook or Twitter sites.

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Friday, September 25, 2015

Parental Supervision (or Lack Thereof) and Alcohol Intoxication in Early Maturing Girls


By: Lewis First, MD, MS; Editor-in-Chief        

          When teens mature early, there may be a tendency to assume they are more adult-like in their ability to make decisions than they really are.  As a result, some parents may decide to assume their children can have more autonomy than perhaps they deserve—but at what cost?  This week Dickson et al. (doi: 10.1542/peds.2015-1258)) describe the results of four consecutive years of surveying more than 950 adolescent girls in Sweden starting with their first year of secondary school and tracking them on their perceptions of how autonomous their parents make them feel and in turn their experience with alcohol intoxication.  
        The fact that girls who matured early and felt they had more autonomy from their parents were three times more likely to experience higher rates of alcohol intoxication than those who felt least autonomous should give you all you need to want to read more about this interesting study.  In addition, a commentary (doi: 10.1542/peds.2015-2658) by adolescent specialist Dr. Terry Bravender provides some additional insight into what this study tells us. More importantly, it suggests that some parental education about their early maturing teens (and the need for parents to be even more aware of the importance of laying down guidelines and ground rules for helping teens deal with their peers and risk-taking behaviors) are in order when you see your adolescent patients, and have the opportunity to speak with their parents or guardians.   
        Parent concerns about their teens drinking need not be a fine “whine” if you can educate them even before adolescence on the important role they play in making sure their teens autonomy doesn’t get advanced sooner than it needs to be, even if their teens are maturing and looking more adult-like sooner than later.

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Thursday, September 10, 2015

Educating Patients about Alcohol Consumption in Underage Drinkers, Can A Computer Do Better?


By: Lewis First, MD, MS; Editor-in-Chief 

          Many believe that the best place to try to educate a teen is when they recognize the error of their ways and don’t want to get themselves into a similar situation.  One place where this is seen is the ED where teens can come in with complications of their risk-taking behaviors.  One such behavior is risky drinking of alcoholic beverages, and this week Cunningham et al. (doi: 10.1542/peds.2015-1260) share with us the results of their randomized controlled trial in the emergency department (ED) of a brief computer education intervention compared to use of a therapist to reduce alcohol consumption in these underage teens. 
      The intervention addressed the consequences of using alcohol, including driving under the influence and concomitant drug use.  The good news is that both methods made a difference—and a significant difference at that.  Just what happened 3 months and 12 months after the intervention are detailed in this fascinating study.  In fact, to add insight into the findings and ramifications, Drs. Scott Hadland and John Knight (doi: 10.1542/peds.2015-2713) who are experts on this subject, share their perspective in an accompanying commentary.  
      There are benefits and costs to using this type of technology in the ED, and reading this study and commentary will provide you with what you need to know to have a discussion with your local ED as to whether this is something they might want to consider for patients seen for underage drinking.

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Monday, August 31, 2015

Use of Marijuana and Alcohol among Youth with Chronic Illness, Especially Those Non-Adherent to Treatment

By: Lewis First, MD, MS; Editor-in-Chief 

          Adolescent risk-taking is something we all work hard to talk about and prevent with our teen patients during routine health maintenance visits.  But how often do we focus on risk-taking prevention in our teens with chronic illness such as cystic fibrosis, diabetes, inflammatory bowel disease and others? 
      Weitzman et al. (doi: 10.1542/peds.2015-0722) share with us the results of a cross-sectional study of more than 400 chronically ill preteens and teens ranging from 9 to 18 years who completed a self-administered survey that enabled correlation of risk-taking behaviors with disease knowledge and treatment adherence behaviors while controlling for possible confounders like mental health co-morbidities.  
      The results are concerning and show high school aged teens with chronic illness demonstrating more usage of alcohol and binge drinking as well as marijuana use than you might expect and things get even worse in those teens who forget or skip their routine medications.  There’s lots more to be learned and then shared with your patients with chronic illness with the hope of curbing their risk-taking so at no risk—read this article and learn more.   
     Are you finding your non-adherent teen patients with chronic illness are similar to those in this study when it comes to risk-taking behaviors?  Share your thoughts with us by responding to this blog, sending us an e-letter or posting on our Facebook site or Twitter.

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