Tough Questions

Real Questions, from Real Parents
Some teens may choose to drink because it’s part of their social scene; others may succumb to peer pressure, against their better judgment

Which teens are more likely to have more problems with alcohol?

Research shows that certain children are more at risk for using and having problems with alcohol, Kids:

  • Whose parents have had problems with alcohol or depression
  • Who have problems with attention or impulse control
  • With aggressive temperaments
  • Who are already engaged in other risky behaviors like substance abuse, early sexual activity, and skipping class
  • Adolescents with mood disorders (such as depression) are also more likely to drink and develop later problems with alcohol.

Is there something different about today’s world that exacerbates the problem of underage drinking?

Alcohol is now adolescents’ substance of choice.

In the past ten years, adolescent use of other illegal substances has gone down, as many illegal drugs have become more potent and potentially more harmful. Because of this, many teens turn to alcohol for experimentation.

Although kids are drinking slightly less than 20 years ago, some who are feeling pressured to succeed in today’s complicated environment might actively seek situations in which they can relax and forget about the pressure – and often these situations involve the use of alcohol.

When should the education process and conversation about alcohol begin?

It is never too early to start, that’s for sure. Kids are observant – they see you drinking around them, and might even see adults acting tipsy or drunk.

Kids are also curious – how does alcohol taste, why do people drink, can’t they see how silly and even scary they become when they drink too much?

It is a good idea to answer children’s questions when they arise – in a developmentally appropriate way. The conversation will change over time as your child grows, but it is never too early to start the discussion.

How can a parent model good behavior for children? Since actions speak louder than words, should adults not drink in order to set an example?

Parents who tell children not to drink at all, and then drink themselves, possibly excessively – may be sending confusing double messages to their kids. Be careful and be aware of the “hypocrite challenge” with which your child may confront you. It is important to be honest, to be a role model, and to remember that keeping your child safe is of utmost importance.

Deciding whether or not to drink is a personal decision. Just keep in mind that the decisions you make are being observed and could shape your own child’s decisions. If you choose to drink, please remember to make responsible choices and most certainly do not drink and drive.

Since I drank as a teen and turned out OK, why should I worry about my teen having a few drinks at a party?

Your child may be concerned about a friend and how much that friend is drinking.

If you read the paper or watch the news today, you know that underage drinking is a major threat to teen safety.

Kids often drink to excess, and can become ill or even die from alcohol poisoning - even first time drinkers. Teens who drink are also more likely to be involved in accidents or engage in risky behaviors. And remember – we often look back on our own childhoods through rose-colored lenses.

Many teens in previous generations did not make it either. Parents – think back and perhaps you can remember some of your own friends or acquaintances who were arrested, severely injured, involved in car crashes – some fatal, or whose lives were destroyed by excessive drinking.

How should parents respond when their teenagers confide in them about their friends’ experiences with alcohol or other risky behaviors?

Again, emphasizing safety may be the way to handle this conversation. Your child may be concerned about a friend and how much that friend is drinking.


  • Listen sympathetically and non-judgmentally,
  • Offer your child some strategies to help that friend.
  • If at any point your child feels that a friend may be in real danger, discuss ways that your child, perhaps with your help, can notify an important adult who can take action.
  • Also, remind your teen not to allow him/herself to be put at risk because of another’s bad decisions. For example, your child should never get into a car with a friend who has been drinking.

Some parents have differing views on alcohol (some provide alcohol to teenagers, or allow them to drink at their homes after collecting car keys) - how should a parent respond?

The issue of liability is often the most effective and compelling one in curtailing the serving of alcohol to minors.

Some parents think that if their kids are drinking, it might as well be under their own roof and supervision. And, some parents believe that as long as teens don’t drive, it is okay for them to drink. Unfortunately, accidents and injuries do not always involve a car – other serious consequences of underage drinking include alcohol poisoning, involvement in fights, falls, burns, and property damage. Beyond that, the owner of the home can be legally liable when accidents or injuries occur.

This can mean jail time, loss of employment and/or loss of personal assets. The issue of liability is often the most effective and compelling one in curtailing the serving of alcohol to minors.

The reality is that other adults may have opinions about underage drinking that differ from your own. First, it is important to talk to your own child and emphasize your own rules. When talking to other parents, you may want to share your opinions and clearly state your own family’s rules. Emphasizing the potential dangers and legal consequences can help. And you can always just not allow your child to attend a party if you think underage drinking may take place.

What conversations should parents have with their children before their teen leaves for college, especially if their kids have had no prior experience with alcohol?

Some teens are completely unfamiliar with drinking prior to going to college. Others, who may have experimented with alcohol in high school, can be particularly challenging in that they may feel that they know more than you. For both types of teens, having a conversation about what to expect regarding college drinking is crucial.

First, you may want to investigate how your child’s college is addressing underage drinking on campus (information is often provided to parents in a Parent Handbook, or accessible on-line on the college website). Then, it is smart to discuss with your child what the college expects. Make it clear that these are college policies with consequences, and that you support these policies. Brainstorm with him how he will react to situations where alcohol is around. Emphasize the dangers of binge drinking – often adolescents who have not been around situations with alcohol during high school are caught unaware and may overindulge – with negative health, social and academic consequences.

Emphasize the dangers of binge drinking – often adolescents who have not been around situations with alcohol during high school are caught unaware and may overindulge...


Karen Soren, MD
Associate Professor of Pediatrics and Public Health
Columbia University Medical Center
Director of Adolescent Medicine
NewYork-Presbyterian Morgan Stanley Children's Hospital


  1. Youth Risk Behavior Survey: 2007. Available from: URL:
  2. Masten AS et al. Underage drinking- a developmental framework. Pediatrics 2008; Volume 121, Supplement 4.
  3. Brown RT. Risk factors for substance abuse in adolescents. Pediatr Clin North America 2002; 49:247.
  4. Nash SG, McQueen A, Bray JH. Pathways to adolescent alcohol use: family environment, peer influences, and parental expectations. J Adolsc Health 2005; 37:19-28.
  5. Monitoring the Future, National Survey Results on Drug Use, 1975-2006. Volume II: College Students and Young Adults Ages 19-25. National Institutes of Health, US Dept Health and Human Services, 2007, available from: URL: http://monitoringthe
  6. Nagel BJ, Schweinsburg AD, Phan V, Tapert SF. Reduced hippocampal volume among adolescents with alcohol use disorders without psychiatric comorbidity. Psychiatry Res. 2005; 139 (3); 181-190.
  7. National Institute on Alcohol Abuse and Alcoholism. Trends in underage drinking in the United States – 1991-2005, available from: URL:
  8. National Highway Traffic Safety Administration (NHTSA), Dept. of Transportation (US). Traffic safety facts 2006: young drivers. Washington (DC), available from: URL:
  9. Insurance Institute for Highway Safety (IIHS). Fatality facts: teenagers 2005. Arlington (VA): The Institute; 2006, available from: URL: http//