Sue Hubbard, M.D.

Colleges are back in session, high schools are getting ready for homecoming and the incidences of binge drinking continue to climb. Why put these topics in the same sentence? Underage and excessive drinking by high school and college students has been recognized as a problem for a long time, but recent studies only confirm that binge drinking continues to rise.

One report from a 2002 task force on drinking stated that "abusive drinking by college students is widespread, dangerous and disruptive." Drinking excessively is associated with date rape, unintentional sex (surely an oxymoron), violence and poor academic performance.

What is binge drinking? By definition it is drinking "five or more drinks in a row for men, and four or more drinks in a row for women." But this definition doesn't take into account the length of time over which the alcohol is consumed or a person's body weight.

A better definition now defines binge drinking as "a pattern of drinking alcohol that brings blood alcohol concentration (BAC) to 0.08 percent or above." This typically occurs within a two-hour window of excessive drinking.

Underage drinkers typically tend to drink on fewer occasions than their older peers but have more alcohol-related problems than students of legal drinking age. Sadly, more than 1,700 college students age 18-24 die each year from unintentional alcohol -related injuries and more than 5,000 underage youth die from alcohol misuse.

Another alarming statistic is that an underage youth dies in an alcohol-related incident every two hours. We've already seen news reports this fall about the death of a 17-year-old girl just prior to starting her freshman year of college in New York City. Unfortunately, there will be more such stories to come.

With these sobering statistics at hand, it's incumbent upon parents to begin educating their children, even at early ages, about alcohol use and misuse. Our children need to know that alcohol is a legal psychoactive drug that changes brain chemistry and may have long-term effects on the still maturing teenage brain.

Alcohol effects both the pre-frontal cortex (the brain's chief decision maker) and the limbic system. MRI studies on youth from age 14 to 21 who are frequent alcohol drinkers show definitive changes in both of these areas. Due to the fact that a teen's brain is still developing, it is surmised that there might be permanent physiologic and psychological damage to an adolescent brain from early alcohol abuse. There are ongoing studies looking at whether this damage is reversible.

Teens also need to know that because alcohol is a "drug" it may cause over-dosage and death, similar to other drugs. Many teens don't realize that you can die from binge drinking -- not from a car accident or from falling out of a window -- but due to the central nervous system depression from high blood alcohol levels, which then "turn offs" vital areas in the brain, resulting in coma and death.

Talk to your teens about the signs of "alcohol over-dosage," which may include vomiting, cold and clammy skin, shallow breathing and unresponsiveness. Letting a friend "sleep it off" after a night of heavy drinking is never the right idea.

A good resource for parents to help educate their teens and college students about binge drinking is www.gordie.org. The site recently released an app, The Gordie Check, that reviews the signs of alcohol poisoning, stores emergency contacts and can help locate nearby medical facilities or call 911. Pass this on to your college student(s) (and high school student(s), for that matter).

Lastly, as binge drinking continues to rise among high school and college students, and more youth are reporting drinking in their early teens, parents must discuss their views on underage drinking and also model the behavior they want to see in their children. In other words, teach your children about responsible drinking when they become of age.

When talking to my teenage patients about alcohol, they often say, "Dr. Sue, why don't you talk to my parents about coming home drunk, and then they can talk to me!" Truer words could not be spoken.