Facing ‘The Fear’: Alcohol and Mental Health in

Ireland

This conference is part-funded by the National Office of Suicide Prevention

Adolescent drinking in our Intoxicated State

AAI ConferenceNov 2013

Dr Bobby Smyth

Overview

• Update on some harms

• Culture & Language

• Influence of adults

Correlation = -0.96

P<0.001

Why worry?

“… in the population aged 25–59 years alcohol is the world’s number one risk factor for impaired health and premature death, and far more significant than unsafe sex, tobacco use or diabetes.”

Teens, Alcohol and Depression

Teens, Alcohol and Anxiety

The Adolescent brain – a work in progressGiedd et al, 1999, Nature Neuroscience, 2, 861-863

http://www.nimh.nih.gov/press/prbrainmaturing.cfm

Zeigler DW et al (2004)

"Underage alcohol is associated with brain damage and neurocognitive deficits, with implication for learning and intellectual development"

Casey & Jones (2010)

“Many studies have reported altered brain structure and function in alcohol dependent or abusing adolescents…… smaller frontal & hippocampal volumes……suggesting that early adolescence may be a period of heightened risk to alcohol’s neurotoxic effects”

Learning which shoulder to cry on…..

Summarising harms• Damage to brain development

• Increased risk of later alcohol & drug problems

• Increased risky behaviour -> Accidents

• Hampers acquisition of healthy coping skills

• Lose ability to “have fun” sober…..

Adolescents and Substance Use: The handbook for professionals working with young people

http://www.radcliffehealth.com/shop/adolescents-and-substance-use-handbook-professionals-working-young-people

“This highly practical manual presents an ideal introduction to adolescent substance use. It offers invaluable guidance for all professionals involved with adolescents including social workers, health and social care professionals, family support workers, teachers, counsellors, mental health teams, A&E staff, police and probation officers. The approach these practitioners take in dealing with the problem has considerable influence over outcomes”

Irish Adults & Alcohol

all over the shop, annihilated, Backward, Balubas,Banjoed,Battered, bin towed, binted, bladdered, blasted, Blended, BLITZED, Blocked, Blootered, Blotto, Bollixed, BOMBED, Bunkered,

Buzzing, Cockeyed, Cut, Drunk, Etched, f*cked, f*cked off yer face, floored, Fluthered, FullFull, full as a sheugh, fullers, gee-eyed,

giddy, giggly, goothered, half-cut, HAMMERED, Happy, Hockeyed, in bits, in the horrors, Inebriated, intoxicated, Jarred,

Jayrolled, Jiggered, Jolly, Juiced, just nice, Kaned, Lamped, Langered, Langers, Lashed, Legless, light Headed, Like a monkey

without a tree, Loaded, Locked, Loo-balled, Lorried, Manky, Mellow, merry, mouldy, Muntered, Newted, Nicely, Obliterated, off the scullion, off my head,off me trolley, on the way, ossified,

out of it, Out of your mind, Pajamaed, Pallatic, Paralytic, Phlanxed, Pickled , Piddled, Pished, Pissed, pissed as a fart,

Plastered, PLOWED, Plutered, Poleaxed, Polluted, Rat-arsed, Rinsed, Rotten, rubbered, Sauced, Scuttered, Sh1t-faced, Sideways, Sizzled, Slaughtered, SLOSHED, Smashed, Snattered, Snookered, Sozzled, Spiflicated, Squiffy,

Steamboats, Steaming, Stewed, Stocious, Stoven, TankedTanked, Three sheets to the wind, TIDDLEY, Tight , Tinkered, Tipsey, tired and emotional, TOASTED, TRASHED, Trollied, Twatted, Twisted,

Under the weather, Under the table, Volcanoes, w*nkered, Wangoed, Wasted, wiped out, Woozy, Wrecked, Writ, Wrote off,

Yeltsined, Zonked

Moral language and discourse around alcohol

“Drink Responsibly”

“Drink Moderately”

“Drink Sensibly”

Correlation = -0.96

P<0.001

At what age is that Irish people loose their ability to have the

‘craic’ without alcohol?

van Hout M.C.A. (2009) Rural Remote Health 9: 1171

• Parents underestimate their influence

• View drinking as inevitable

• Give drink in effort to exert control

• Too busy to supervise

Ryan et al, 2010. Systematic Review

1. Parental drinking increases risk

2. Provision of alcohol by parents to their children increases risk

3. Presence of clear rules in the family home reduces risk

4. Parental monitoring of their children’s activities reduces risk

5. Warmth and affection in the relationship between parents and children reduces risk

6. General positive communication between parents and children reduces risk

Mama’s (& Daddy’s) little helper….

“Adult-supervised settings for alcohol use resulted in higher levels of harmful alcohol consequences”

Mediterranean Culture….

• Lost in translation….

Key Messages• Unhealthy drinking is the norm in Ireland• For the first time ever, an Irish government

appears willing to name and tackle this• Our generation of adults has permitted alcohol

use to move earlier into adolesnce• Early onset drinking is associated with mutliple

risks and NO benefits• The more teenagers drink, the more likely they

are to experience anxiety and depressive symptoms

• Parents are a powerful influence, but often misunderstand what they can do to reduce risk.