Academic journal article Alcohol Research

Interventions for Alcohol Use and Alcohol Use Disorders in Youth

Academic journal article Alcohol Research

Interventions for Alcohol Use and Alcohol Use Disorders in Youth

Article excerpt

Designing effective interventions for adolescents with alcohol use disorders (AUDs) presents several challenges, not the least of which is the accurate diagnosis of these disorders. Diagnostic criteria for AUDs have been derived largely from clinical and research experience with adults. When these criteria were tested among adolescents, numerous developmental differences were found that may affect the applicability of AUD criteria to this age group. Despite the absence of clear diagnostic criteria for use with adolescents, research has identified interventions that show promise for use with youth. This article examines both environmental- and individual-level approaches to underage drinking prevention, including school- and family-based programs, and macroenvironmental and multicomponent comprehensive interventions. Finally, it describes brief and complex treatment interventions.

KEY WORDS: adolescent; alcohol abuse; alcohol dependence; AOD (alcohol and other drug) use pattern; diagnostic criteria; biological development; psychological development; environmental-level prevention; individual-level prevention; family intervention; school-based intervention; brief intervention; Project Northland

OVERVIEW

The ultimate goal of research on drinking by youth is to reduce the rates of drinking by adolescents and successfully treat those who develop problems linked to alcohol use. Prevention efforts may be aimed at keeping adolescents from starting to drink or at preventing the escalation of drinking and negative consequences. Research can provide the science on which to base the design of interventions and the means for determining which interventions are effective.

A valid diagnostic system is essential for assessing the nature and magnitude of adolescent problem drinking. Existing diagnostic criteria are derived largely from experience with adults, but developmental differences in alcohol use patterns suggest the need to adapt criteria to make them relevant and informative for an adolescents stage of maturation.

Prevention efforts approach the issue of youth drinking in two ways: Environmental-level interventions seek to reduce the availability of alcohol to youth and opportunities to drink, increase penalties for violation of minimum legal drinking age laws, and reduce community tolerance for alcohol use by youth. Individual-level interventions seek to change knowledge, attitudes, and skills so that youth are better able to resist influences that support drinking.

In their efforts to reduce adolescent drinking, schools and families can act at both the environmental and the individual level. School curricula operate at the individual level by trying to provide students with the knowledge, skills, and motivation to resist pressures to drink. At the environmental level, schools can make changes to discourage violation of alcohol rules and engage students' involvement in their schools, a factor that has been found to predict less alcohol and other drug involvement.

The ability of parents to influence whether their children drink is well documented and is consistent across racial/ethnic groups. Family interventions encourage parents to be aware of the risks from underage drinking, communicate with children, clarify expectations, set rules and consequences about alcohol use, and monitor children's activities. In addition to changing the knowledge and skills of young people, families can create an environment that reduces alcohol availability and increases the costs associated with drinking.

Research is providing data on the effectiveness of school- and family-based intervention programs and the elements that successful programs incorporate. One goal of continuing research is to improve investigators' ability to measure outcomes and to compare studies and the methods they use as a means of changing adolescent behavior.

Community-level environmental interventions include strategies such as implementing restaurant/bar server training, checking alcohol vendors for compliance with underage laws, deterring adults from purchasing alcohol for minors, strengthening policies to detect and stop underage drinking parties, and instituting publicity for policies aimed at enforcement of laws against driving under the influence (DUI) and underage drinking. …

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