Thursday, May 26, 2005
Teenagers and drinking, even at graduation, don't mix

By Dr. Anthony Policastro
Nanticoke Memorial Hospital,
Medical director

Graduation will soon be upon us. Every year, local graduates go to Ocean City the week after graduation. Almost as often, some of those young adults wind up being injured. Many of those instances involved the use of alcohol. Given the age of a high school graduate, that means underage drinking. Underage drinking is illegal. It is illegal under any circumstance. High school graduation is not an exception. What is equally important is that it is medically dangerous. I have seen many teenagers who did not realize that alcohol is a poison. They drank to the point of coma. It happens every year on college campuses. Binge drinking and drinking games contribute to this. I have mentioned before that a 100-pound teenager can die from drinking a pint of liquor. I wrote about this just a few months ago. Drinking and driving are well known causes of teenaged death. What a lot of people do not realize is that in adolescent auto accidents, the driver is less likely to die than the passengers. That is because they pay more attention to what is happening in their direct line of vision. Therefore, even a non-drinker can be at risk if he/she accepts a ride from someone else. Even a small amount of impairment from alcohol in an inexperienced driver can add to the risk of accidents. I spent many hours working the emergency room when I was in the Air Force. I frequently saw patients with alcohol related injuries. High alcohol levels not only impair driving ability, but they also impair the ability to climb stairs and to do other motor activities. The result is a high number of accidents in alcohol users. Many of these involve broken bones. However, they can also involve head injury. There is a special problem with head injuries in those patients, who have been drinking. It is difficult to decide whether their poor state of arousal is due to alcohol or head injury. This makes it hard for the physician to decide on the actual nature of the injury.
Alcohol also impairs judgment. Individuals who have been drinking take foolish chances. Once again, this increases the chance of other accidents. It also increases the incidence of sexual activity. An unplanned pregnancy is not a good graduation present for anyone. Parents need to decide what they should do. This issue is similar to any other type of behavior modification issue. Good behavior should be rewarded. Inappropriate behavior should be punished. The biggest mistake a parent can make is to be aware of plans for alcohol use and not condemn it. Some parents do this by telling the adolescent to not drink too much. Others may go so far as to provide the alcoholic beverages. Parental permission does not make underage drinking any more legal in the eyes of the law. A reward for graduation could very well be allowing the graduate to take a trip. Graduation grades should play a role in determining whether such a trip has been earned. Behavior at home and outside of school should also be determinants. This is not a place for being over permissive. If the trip is not truly earned it should not be supported. Support can take the form of concurrence. It can also take the form of financial support. Either or both of these can be withheld if warranted. Your relationship with your graduate should be built upon trust. You cannot be with them 100 percent of the time. You have to trust them to do the right thing. Overprotection can cause as many problems as being over permissive. Because of this dependence upon trust, the biggest consequence of any misbehavior could be a loss of that trust in future similar situations. Other consequences could involve more tangible items. For example the loss of car keys or financial support for summer activities could be appropriate depending upon the type and degree of misbehavior. There is a special problem for those individuals who have not yet turned 18. They have special legal problems. For example, if they get hurt, they may not be able to consent for medical care. Therefore, trust becomes different for this younger age group. Parental decision-making is more complex. Adult supervision of some sort is necessary. A responsible chaperone is appropriate. Consideration should be given for providing a medical power of attorney to that person for the duration of the trip. Graduation is a time for celebration. That celebration should be appropriate and safe. Parents are the ones who will make it so.