When it comes to underage drinking, there's a lot of good news. According to the CDC, fewer kids are drinking. Over the past 20 years, the percentage of high school students who have had a drink in the past month has gone from 50.8 percent to 38.7 percent -- and the percentage that have driven while drinking has dropped from 16.7 percent to 8.2 percent. Binge drinking (five or more drinks in a row within a couple of hours) has gone from 31.3 percent to 21.9 percent.
However, these numbers are still too high. Think about it: these statistics mean that in the average class of 20 high school students, eight drink regularly, two have driven while drinking and four binge drink. And speaking of binge drinking.... according to a recent study, while binge drinking is going down, "extreme binge drinking," or having 15 or more drinks at a time, has stayed steady at 5 percent of youth -- or one kid in that classroom.
This is with a legal drinking age of 21. So, all of this is illegal. But the law isn't stopping them.
Drinking alcohol is, sadly, part of youth culture. It's a rite of passage to sneak out with your friends and go drinking -- often not just drinking, but getting drunk. And once at college, well, then it is absolutely part of the culture. It's glorified in books, movies and television shows, in a sort of "kids will be kids" way.
It makes me crazy.
What all that glorification leaves out is the way alcohol can destroy lives -- literally, in traffic and other accidents, or more insidiously through liver disease and other health problems, lost income, lost futures and devastated relationships. I've watched it happen far too many times.
By the time most youth turn 21, they have already had experience with drinking. Because it's illegal, the experience they've had with it is usually unsupervised. And the fact that it's illegal, and not always easy to get, may make some kids more likely to binge drink, drink to get drunk or do other risky things. By the time they are allowed to drink, many youth already have unhealthy drinking habits. There are certainly educational programs and efforts out there, but it's not always easy to engage youth -- and certain programs and teachers are better than others.
Some people say that we should lower the drinking age to 18. While I have to admit that it's a little weird to me that you can vote and be drafted at 18 but can't drink until you are 21, I don't know that making it legal for all those college students to recreate Animal House is the answer. The fact that it's illegal is the only thing we've got right now to stop kids from doing this stuff.
Dr. David Hanson, a sociologist, wrote in a 2011 Los Angeles Times post that we should have "drinking learner's permits" for people 18 and older. He suggested that youth could start by drinking in the parent's home, or only in restaurants, and slowly have fewer restrictions (he also thought they should take an alcohol education course), as long as they have no alcohol-related offenses.
It's an intriguing idea -- but Sharon Levy, MD, the director of Boston Children's Adolescent Substance Abuse Program, doesn't like it. "This would require a lot of parent education for which we are not, as a population, currently prepared."
She has a point. For this kind of "graduated drinking license" experiment to work, the supervising adults would really need to supervise -- and would really need to understand the issues and implications around alcohol. Too many adults just don't.
"I would also want adults to be accountable for poor supervision and its consequences," Levy said too. I'm sure that would go over big.
But the thing is, as parent,s we are accountable. Just as we are accountable for being sure our kids are fed and housed and stay out of the street, just as we are accountable for making sure they get an education, behave appropriately and get the medical care they need, we should be accountable for teaching them how to responsibly use alcohol.
Drinking learner's permits may not be a good idea, or at least not an idea we are ready for. But during high school, parents do need to think about their kids as possible drinkers and actively talk with and teach them about responsible drinking. We can't just turn a blind eye and cross our fingers until they turn 21.
Setting a good example is an important start: if we aren't responsible drinkers ourselves, we can't expect our children to be. Just as important is having lots of conversations -- not just about alcohol, but about everything going on in a teen's life. Because who they hang out with, what they do in their spare time and how they feel about themselves and about life has a lot to do with how they think about and use alcohol. Teens are wired to be impulsive and do things like binge drink. But that doesn't mean we can't do anything about underage drinking. We can.
It's not up to lawmakers. It's up to us.
Follow Claire McCarthy, M.D. on Twitter: www.twitter.com/@drClaire