Responsible Party Assailly

Young people, alcohol and health

Dr. Jean-Pascal Assailly, psychologist, researcher and expert for the World Bank

Are YOU well

informed about it?

Sources

• ESPAD Study: www.espad.org• HBSC Study: www.hbsc.org/• ESCAPAD Study (french only):

www.ofdt.fr/BDD/publications/docs/eisxstra.pdf • YOUNG PEOPLE AND ALCOHOL, trends, causes, consequences

and strategies of prevention, Dr. Assailly• WHO Global status report on alcohol and health, 2011 : www.

who.int1.Alcoholism - epidemiology. 2.Alcohol drinking - adverse effects. 3.Social control, Formal - methods. 4.Cost of illness. 5.Public policy. I.WorldHealth Organization.

http://www.espad.org/

http://www.hbsc.org/

http://www.hbsc.org/

http://www.ofdt.fr/BDD/publications/docs/eisxstra.pdf

http://www.who.int/

http://www.who.int/

http://www.who.int/

Sociological, medical and psychological aspects

Differences young men/women

GIRLS DRINK LESS ALCOHOL FEWER ALCOHOL RELATED PROBLEMS DRINKING FOLLOWS THE AGENDA OF FEMINISM HIGHEST VOLUME IN NORDICS COUNTRIES

BOYS HIGHER CONSUMPTION ON THEIR MOST RECENT

DRINKING DAY THAN GIRLS BINGE DRINKING DURING THE PAST 30 LAST DAYS

MORE COMMON AMONG BOYS THAN GIRLS

General Trends


General Trends

GIRLS AND BOYS SIGNIFICANT DIFFERENCES

FOUND IN ALL COUNTRIES HIGHER INTOXICATION SCORE IN

A COUNTRY GIRLS ARE FOLLOWING THE BAD EXAMPLE OF BOYS

GENDER DIFFERENCES DRINKING AS A MARKER OF

MASCULINITY


Beverage type: beer and spirits

GIRLS 33% OF GIRLS’ CONSUMPTION: SPIRITS

BOYS 50% OF BOYS’ CONSUMPTION: BEER

Causes of alcohol misuseGIRLS

NEGATIVE INTERNAL STATE FAMILY CONFLICTS

BOYS PEER PRESSURE SOCIAL EXPECTANCIES


Consequences

GIRLS CONSEQUENCES OF HEAVY ALCOHOL USE OR

USE DISORDERS MORE NEGATIVE FOR WOMEN• MORE PHYSICAL HARM AND SEXUAL

ASSAULT• RANGE OF REPRODUCTIVE PROBLEMS

Alcohol-related brain damage

Young ‘at-risk’ drinkers: vulnerability markers?

Definition Alcohol-related brain damage (ARBD) is a result of

chronic excessive alcohol misuse

Alcohol-related brain damage

Specific drinking patterns in young people

Critical period in brain development particularly vulnerable to alcohol misuse

Influence of substance use on mental health: vulnerability

Early prevention and treatment

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Is alcohol use a risk factor or a risk marker?

Age of onset of regular drinking

CONSEQUENCES

Immediate consequences of alcohol use (blackouts, hangovers) Brain deficits School failure Alcohol dependency Traffic accidents (related to alcohol) and violations Delinquency and antisocial behavior

Individuals who start regular alcohol at 14 years and

before are at increased risk of developing alcohol use

disorders

→Positive consequences at least as strongly associated with drinking as negative consequences.

→Possible role of Fun/Social consequences in the escalation and maintenance of high-risk drinking.

The types of the consequences of drinking

Fun/social Relaxation/coping Positive image

Physical Behavioral Driving

The beliefs of students about drinking

Copying with internal state

(anxiety)Copying with external state (social

situation)

Enhancement of internal positive state (pleasure)Enhancement of

external positive state (friendship)

Positive global effects

Reduction of negative emotional

states

Activation and agression

Activation and sexual pleasure

Relaxation and tension

reduction

The “false” consensus

Overestimation by students of the extent of their fellow students' alcohol consumption Campaigns measuring and communicating the real prevalence have produced positive effects on binge drinking, changing the perceived social norm (20% instead of 80% !!)

Definition Overestimation of the prevalence of drinking on the campus

Peers influences on drinking behavior

Important role models of friends and siblings

Strong similarity in drinking between best

friends and adolescents but best friends are

not permanent!

Ambivalent value of popularity among peers

Importance of alcohol in peer-selection

processes

Drink and driving

Presence of alcohol in 30% of fatal traffic accidents of young people: first cause of death of young people, important cause of license suspension

Driver designation: no data on students about this impact

Mobility offers: no data on students about the impact of alcohol consumption

Second hand” and environmental effects”

Direct impacts of campuses with many binge drinkers Having sleep or study interrupted Having to take care of a drunken student Being insulted or assaulted Being the victim of unwanted sexual advances Having personal property vandalized

Impacts on universities

More alcohol outlets within a mile, lower socioeconomic status environment, lowered quality of neighborhood life

Impacts of alcohol outlets Importance of the number of nearby alcohol outlets mediating the

relationship between universities

Effects and impacts of drinking

Consequences of drinking on health

SHORT TERM CONSEQUENCES

Acute alcohol intoxication

Young people less body mass than adults and more likely to lose control

and to take risks

Young people more vulnerable than adults

Sedative effect of alcohol less important for young adults compared to adults

Blackouts or loss of memory due to an episode of heavy drinking

Alcohol myopia


FOCUS ON TWO CONSEQUENCES

BLACKOUT MYOPIA

25% of university students who drank reported blackouts during the school year.

Incidence doubled (54%) among frequent binge drinkers.

Blackout for girls with an average of only 5 drinks. Males averaged 9 drinks per occurrence.

More blackouts and forgetting events among young people than adult drinkers

Intoxication Underestimation of the possible

negative consequences of decisions and overestimation of the positive consequences

Applied to all types of decision-making

Conjunction with pre-existent individual characteristics, type of relationship with the partner and motivations


LONG TERM CONSEQUENCES

SLEEP DEPRESSION

ACADEMIC PERFORMANCE SOCIAL RISKS TAKING (unprotected sex)

FRIENDSHIP

What is moderate and what is excessive? It’s ok because it’s light!

How to define what is moderate and excessive drinking?

No more than 4 drinks in one occasion Being able of abstinence one dayDaily use not excess 20 g of pure alcohol


MODERATE?

WOMENno more than 2 units

per day

MENno more than 3 units

per day


BUT…No consistent definitions of moderate or heavy drinking

Underestimations of the volume of alcohol included in standard drinks

Inconsistencies in research reports about the relative benefits and harms of different types of alcoholic beverages

Differences in the way self-reported “drinks” different across different countries, within countries, and between different beverage types and in different drinking settings

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THANK YOU FOR YOUR ATTENTION!

Questions welcome…but answers not guaranted!!

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