Ask a Teen 2 Questions

What if you could ask any teen two questions about alcohol use and get a pretty good fix on their risk for future abuse?

According to a national expert group convened by the National Institute on Alcoholism and Alcohol Abuse (NIAAA), which just released guidelines for teen alcohol screening and treatment, this is the most effective tool for pediatricians and adolescent medicine specialists to include as part of every routine heath exam.

The questions are:

Do you have any friends who drank beer, wine, or any drink containing alcohol in the past year?

How about you — in the past year how many times have you had more than a sip of beer, wine, or any drink containing alcohol?

Wow, could it really be that simple? Maybe so. There are several reasons why it works, according to the NIAAA website.

  • It detects risk early.
  • It’s based on primary survey research
  • It’s fast and simple.
  • It’s the first screening tool to include friend’s habits.

That last one is big. Pediatric residency training teaches that if you want to know what your average teenage patient is doing, ask about his friends — especially if you’re looking for the truth about stuff he thinks you won’t approve of. So before you ask if he smokes cigarettes, ask if any of his friends smoke. Same for pot and other drugs. Same for sex.

Kids are much more likely to throw their (anonymous and hypothetical) friends under the bus than they are to own up to their own behavior. This is even more true if they have reason to believe you might tell their parents, but more about that later.

As parents, it’s important to realize this simple truth: Whatever your kid’s friends are doing, your kid is doing. Adolescence is the  single most conformist time of life. They dress alike, they use the same language, they listen to the same music and watch the same TV/movies/youtubes.

It’s simply not believable that they’d hang out with a group and not participate in the group’s activities. Yet how many times have we heard some variation of  “yeah, Brendan was drinking beer at the party, but not me.”

Just accept it. Your child is most likely not an observer, but a participant, and the research bears this out. This simple screening tool, and the interventions it may lead to, have been proven more effective in revealing underage drinking than more complicated assessment methods used in the past.

Doctors who treat youth know that alcohol is, by far, their drug of choice, and that drinking is often a marker for other unhealthy behaviors. This new tool is a fast, down and dirty way to learn important information.

So should a doctor who learns that a young patient is drinking disclose to the parents? Typically, pediatricians keep it confidential unless the child is at immediate risk of harm by engaging in daily drinking or drinking and driving. Research shows it works better to help teens find their own reasons to choose healthy behavior, rather than threaten with ultimatums. It’s helpful to encourage kids to include their parents in a plan for added support.

Despite the national drinking age of 21, about 7% of American 12-year-olds have had experience with alcoholic beverages, and by age 18 that number rises to 70%. These two simple questions can make all the difference.



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Ellen and Rachel are two old friends and “expert” mamas—one a pediatrician and one a family therapist—with fifty years of parenting experience between them.

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The Mama ButtonThe information provided by MamasOnCall is not intended as a substitute for professional advice, but is for information purposes only. You assume full responsibility for the health and well-being of your family. Talk with your healthcare provider about any questions you may have regarding a medical or psychiatric condition.