The biological and biochemical effects of alcohol can alter brain function and in turn produce psychological effects. The positive effects can provide an incentive to drink and include feelings of pleasure, reduced anxiety, sedation and positive changes in social interaction (Alcohol Concern, 2002a). On the other hand alcohol affects an individual's ability to process sensory information (leading to focusing on only part of their experience / situation) and reduces intellectual ability. This can impair a person's ability to form rational thoughts, judgements and impairs co-ordination (Social Issues Research Centre, no date). As a result adolescence are prone to injuries from accidents (WHO, 2001) and are also more likely to take part in risk taking activities such as unprotected sex (Alcohol Concern, 2002b). A study in Finland by Pirkola et al (1999) also found that young persons were more likely to be intoxicated when they committed suicide (cited in Jernigan, 2001).
Alcohol consumption has also been linked to aggressive and antisocial behaviour in young people. Research by the Home Office states that binge drinkers were twice as likely to have participated in an augment and four times as likely to take part in a fight than other regular drinkers (Richardson & Budd, 2003). Similarly, the Youth Lifestyles Survey 1998-99 revealed that 15% of all 12 to 17 year olds had been involved in antisocial behaviour (fights and arguments) during or after drinking (Harrington, 2000). It also showed that those who frequently drank alcohol, age 12-15, were more likely to have been expelled or truanted from school compared with non-drinkers.
However, the link between alcohol and antisocial behaviour is not straightforward. Not every teenager who drinks alcohol exhibits these antisocial characteristics. Some research has suggested that a person's underlying personality combined with environmental factors plays an important role in the expression of antisocial behaviour (Social Research Centre, no date). Situations that could trigger aggressive behaviour in teenagers could include, peer pressure and unfriendly behaviour from other people. For example, a benign gesture could be misinterpreted, by a person under the influence of alcohol, as being threatening or aggressive.
Little evidence can be found to support the effectiveness of alcohol abuse prevention programmes targeted at young people (Foxcroft et al, 2003). In a briefing by the Health Development Agency, it is suggested that there is some evidence for the success of certain types of school based prevention programs (Waller et al, 2002). These relatively successful programmes were more complex than traditional education based programmes. They include methods such as peer led, rather than teacher led schemes and interactive programmes which focus on developing young peoples' interpersonal skills (Waller et al, 2002 & Prime Minister's Strategy Unit, 2003).
However, there is more evidence to suggest the effectiveness of brief interventions. Brief interventions involve a few minutes of counselling and advice on the adverse affects of alcohol. These usually take place in hospital A&E departments or at GP surgeries. Research carried out by Nurses at Cardiff Dental Hospital found that 50% of male patients (aged 16-35) changed their drinking habits as a result receiving a brief education session (Sadler, 2002). Research by Freemantle et al (1993) also showed that the effect of brief interventions and estimated that they result in a 24% fall in alcohol consumption (cited in Chick 1993).
In conclusion it can be seen that alcohol produces a range of biological, psychological and social effects in adolescents. These effects combined with an individual's underlying personality and immediate environment can result in antisocial behaviour. There is clearly a need for more research on the effectiveness of prevention programmes if a national strategy is to be developed. The research into the effectiveness of brief interventions is encouraging and therefore Health Care Professionals should give out appropriate advice to at risk patients whenever possible.
References
ALCOHOL CONCERN. (2002a) Fact Sheet 8: The Health Impacts of Alcohol [on-line]. London: Alcohol Concern. Available from: <http://www.alcoholconcern.org.uk/files/20030819_153746_health%20effects.pdf> [Accessed on 22 November 2003].
ALCOHOL CONCERN. (2002b) Alcohol and Teenage Pregnancy [on-line]. London :Alcohol Concern. Available from: <http://www.info.doh.gov.uk/tpu/tpu.nsf/e0181c6367f5036280256d09005b2d28/497423e707bc982180256dc9002c74ad/$FILE/Teen%20Pregnancy%20Briefing.pdf>
[Accessed on 22 November 2003].
CHICK, J. (1993) Brief Interventions for Alcohol Misuse. British Medical Journal 307, 27, p1374. 27 November.
FOXCROFT DR, IRELAND D, LISTER-SHARP DJ, LOWE G, BREEN R. Primary prevention for alcohol misuse in young people (Cochrane Review). In: The Cochrane Library, Issue 4, 2003. Chichester, UK: John Wiley & Sons, Ltd
(cited as instructed)
HARRINGTON, V. (2000) Underage Drinking: Findings from the 1998-99 Youth Lifestyles Survey [online]. London: Research, Development and Statistics Directorate, Home Office. Available from: <http://www.homeoffice.gov.uk/rds/pdfs/r125.pdf>
[Accessed on 20 November 2003].
HIBBELL B, ANDERSSON B, AHLSTROM S et al. (2000) The 1999 ESPAD report: alcohol and other drug use among students in 30 European countries. Stockholm: The Swedish Council for Information on Alcohol and Other Drugs (CAN) and The Pompidou Group at the Council of Europe.
INSTITUTE OF ALCOHOL STUDIES (2003) Fact sheet: Young People and Alcohol [on-line] Cambridge: IAS. Available from:
<http://www.ias.org.uk/factsheets/young-people.pdf>
[Accessed on 2 December 2003]
JERNIGAN, D.H. (2001) Global Status Report: Alcohol and Young People [on-line] Geneva: World Health Organisation. Available from: <http://www.who.int/substance_abuse/PDFfiles/globsta_alcoyoung%20people.pdf>
[Accessed on: 22 November 03].
MACDONALD, L. (1999) Executive Summary: Overview of the Health Issues Related to Alcohol Consumption. In: MACDONALD, I. ed. (1999) Health Issues Related to Alcohol Consumption. 2nd Ed. London: Blackwell Science.
Prime Minster's Strategy Unit (2003) Alcohol Harm Reduction Project: Interim Analytical Report [online] London: Prime Minster's Strategy Unit. Available from: <http://www.pm.gov.uk/files/pdf/SU%20interim_report2.pdf>
[Accessed on: 19 November 03].
RASSOOL, G.H. & WINNINGTON, J. (2003) Adolescents and alcohol misuse. Nursing Standard 17, 30, 46-50. 9 April.
RICHARDSON, A & BUDD, T (2003) Home Office Research Study 263: Alcohol, crime and disorder: a study of young adults [on-line] London: Communication Development Unit, Home Office. Available from: <http://www.homeoffice.gov.uk/rds/pdfs2/hors263.pdf>
[Accessed on: 20 November 03].
WALLER, S. NAIDOO, B. & THOM, B. (2002) Prevention and reduction of alcohol misuse: Evidence Briefing [online] London: Health Development Agency. Available from: <http://194.83.94.67/uhtbin/cgisirsi.exe/1069514509/0/520/EBBD_Alcohol_pdf_ft>
[Accessed on: 20 November 03].
WORLD HEALTH ORGANISATION (2001) Declaration on Young People and Alcohol [online] Denmark: World Health Organisation Regional Office for Europe. Available from: <http://www.euro.who.int/AboutWHO/Policy/20030204_1>
[Accessed on: 20 November 03].
SADLER, C. (2002) Sobering thoughts. Nursing Standard. 16, 50. 28 August.
SOCIAL ISSUES RESEARCH CENTRE. (no date) Alcohol and Violence [online] Oxford: Social Issues Research Centre. Available from: <http://www.sirc.org/publik/alcohol_and_violence_5.html>
[Accessed on: 20 November 03].
