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What’s the biggest risk factor for underage drinking?


Adapted from the MD Mama blog on

Do you know what the biggest risk factor for underage drinking is?

It’s having a best friend who drinks.

I read an interesting article in Pediatrics, the official journal of the American Academy of Pediatrics, about ways to predict when adolescents will have their first drink of alcohol. It was mostly about screening tools that doctors might use, and was heavy on statistics, but there was information that parents should know.

First of all, it turns out that kids who have their first whole drink (not just sips) before age 15 have a four times higher risk of developing alcoholism. Four times. That’s huge. Given how alcoholism can devastate not only the life of the alcoholic but the lives around them, it’s really important that parents know the risk factors.


The biggest risk factor is having a best friend who drinks, which makes sense. Peer pressure is huge for adolescents. There’s also the matter of availability: You have to be able to get the alcohol to drink it, and having friends who drink makes that more likely.

What this means for parents is that you need to know whom your kids hang out with. Really know them. Now, it’s not always possible to know everything about your kids’ friends (my parents didn’t know everything about mine), but you can ask questions. You can try to make your house kid (teen)-friendly so that they hang out there and you can get to know them. You can get to know their parents (not in a creepy way — but introduce yourself at school gatherings or when you drop off or pick up your kid). The point is: Who your kid hangs out with matters.

You can’t dictate your child’s friendships, of course (you can try, but you will probably not be very successful). But you can certainly try to steer them toward activities, like sports and clubs, where they will meet motivated kids who are less likely to drink. Not that kids in sports don’t drink (our town had an issue with the football team), but getting kids involved generally helps protect them against alcohol use.


There were two other big risk factors for having that first whole drink early. The first: having a family member with high-risk drinking behavior. That doesn’t necessarily mean alcoholism, although alcoholism does run in families. It means any unhealthy or risky drinking. Families need to be willing to take a long, hard, honest look at themselves.

The next factor is having a conduct problem, like being defiant, lying, stealing, skipping school, using drugs, and otherwise getting into trouble. That means that parents really need to take these kinds of behaviors seriously, and not just write them off as a phase.

What the authors of the article were trying to do is find ways to pick out the kids who most need help and get them help. That’s exactly what parents should do if they think their child could be at risk for underage drinking: Get help. Talk to your doctor about resources in your community to support your child — and you.

For more information on how you can talk to your child about alcohol and prevent drinking problems, check out “Make a Difference: Talk to Your Child About Alcohol” from the National Institute on Alcoholism and Alcohol Abuse.


And remember that what makes the biggest difference is you. Your relationship with your child can go a really long way toward helping them not just now, but in giving them the best future possible.

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