Alcohol in Children and Adolescents

ICD-10 codes: 

Mild F10.10

Moderate to severe: F10.20

Alcohol use disorder is grouped within the cluster of diagnoses called the substance-related and addictive disorders.  Substance-related and addictive disorders are characterized by a maladaptive pattern of substance use manifested by recurrent and significant adverse consequences related to the use of substances. These problems are persistent and occur repeatedly within the same 12-month period.

The term substance can refer to a drug, a medication, or a toxin. In addition to alcohol, types of substances to which individuals may become addicted include:

  • Tobacco
  • Caffeine
  • Cannabis
  • Hallucinogens
  • Inhalants
  • Opioids
  • Sedatives
  • Stimulants

Substance-related disorders are divided into two groups:

  • Substance use disorders (SUD)
  • Substance-induced disorders—intoxication, withdrawal, and other substance/medication-induced metal disorders (psychotic disorders, bipolar and related disorders, depressive disorders, anxiety disorders, obsessive-compulsive and related disorders, sleep disorders, sexual dysfunction, delirium, and neurocognitive disorders).

The essential feature of a substance use disorder is a cluster of cognitive, behavioral, and physiological symptoms indicating that the individual continues using the substance despite significant substance-related problems. An important characteristic of this disorder is an underlying change in brain circuits that may persist beyond detoxification, particularly in individuals with severe disorders. The behavioral effects of these brain changes may be exhibited in the repeated relapses and intense drug craving when the individuals are exposed to drug-related stimuli.  

What is alcohol?

Alcohol is classed as a depressant, which slows down vital functions (resulting in slurred speech, unsteady movement, disturbed perceptions and an inability to react quickly).

Alcohol has significant impact on the mind, reducing the ability of children and adolescents to exercise normal judgment and think rationally. Although classified as a depressant, when consumed in small to moderate quantities, it may produce a stimulant effect. In other words, children and adolescents may be attracted to the use of alcohol in order to achieve a feeling of being energized or to “loosen up.”

What is alcohol use disorder?

The diagnosis of alcohol use disorder is assigned to children and adolescents who are dependent on alcohol.  Alcohol use disorder is a problematic pattern of alcohol use leading to clinically significant impairment or distress, as manifested by at least two of the following, occurring within a 12-month period:

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Understanding Alcohol Use Disorder

By the time they are seniors, almost 70 percent of high school students will have tried alcohol. According to a 2013 study by the National Institute of Alcohol Abuse and Alcoholism, 86.8 percent of people ages 18 or older reported that they drank alcohol at some point in their lifetime; 70.7 percent reported that they drank in the past year; 56.4 percent reported that they drank in the past month. There are many reasons children and adolescents use alcohol, including the desire for experimentation, an attempt to cope with problems or perform better in school, or peer-pressure. 

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Health Consequences of Alcohol Use Disorder

Early exposure and addiction to alcohol can negatively impact brain development and overall physical health in children and adolescents. In addition, the use of alcohol puts children and adolescents at increased risk for the following types of problems:

  • school failure
  • conflict within family and social relationships
  • loss of interest in normal healthy activities
  • impaired memory and judgment
  • increased risk of contracting an infectious disease through risky sexual behavior
  • other substance use disorders
  • alcohol poisoning or overdose

How is alcohol use disorder treated?

Clinical Research suggests that treatment of alcohol use disorder in children and adolescents should address social influence/peer pressure to drink, include norm setting, include developmentally appropriate information, utilize peer-led components, be interactive, and provide parent and teacher training. 

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