“Young people and alcoholism on the rise: serious consequences even in the short term”

What is more frightening is the increase in alcohol abuse in three categories in particular: young women aged 14-17 whose percentage exceeds that of their peers for the first time; young people aged 18-19 of both genders; young women aged 20-24. During 2019, in fact, there were 2573 accesses to the Emergency Department of young people under 18 of male gender and 2150 female, a very worrying figure especially if compared with the previous year, as there is an increase of 18% for males and 25% for females.

But the problem of alcohol abuse has been growing for at least 20 years. We talked about it with Professor Emanuele Scafato of the ISS, Director of the National Alcohol Observatory and the WHO Center for Health Promotion and Alcohol Research.

Professor, the numbers are really scary. The non-reassuring news reports tell us of more and more adolescents in an ethyl coma.

In the European awareness week on the prevention of alcohol-related harm and risks (AWARH), it is important once again to talk about the alcohol and youth phenomenon that has been going on for at least 2 decades. When we began to monitor alcohol-related risks among young people twenty years ago at the Istituto Superiore di Sanità, we knew we had to deal with a new cultural model to counter, favored by millionaire investments in alcoholic beverages advertising made trendy and appealing for minors. .

What is meant by young people?

First of all, we need to distinguish them into three groups: children and adolescents, considered minors under the age of 18 and older ones between the ages of 18 and 25. This is an important distinction because it has to do with an adequate and appropriate assessment of the evolutionary stages, development and maturation in a rational sense of the child’s brain, essential elements for the purposes of respecting the right to health and also legal protection of the child. as well as proper education and prevention in subjects who have a low perception of risk. Neuroscience has shown us that all alcohol consumed between the ages of 12 and 25 ends up in the cognitive future of the adult person because in this period of time the brain changes from an impulsive, emotional, uncontrolled adolescent cognition to an adult, mature, rational thanks to the development of that part of the brain called the ‘prefrontal cortex’, the one that makes us sapiens, which guarantees control, logic, planning. All this matures only around the age of 25 together with conscious responsibility and that critical capacity that allows us to adequately assess the risks associated with behaviors and also the messages that lead to healthy, responsible lifestyles and consumption, incomprehensible to minors. In the period of maximum cerebral vulnerability to the use of alcohol and substances and therefore up to the age of 25, the perceived risk does not find an individual with adequate skills in managing personal actions that protect health and safety and is therefore to be protected and protected from the pressures to drink .

What leads a teenager to consume alcohol?

Alcohol disinhibits and interferes until it completely eliminates, as a function of increasing quantities of alcohol consumed, the already poor physiological capacity of control that may exist in this phase of development and cognitive age group. The boy and the girl consume alcoholic beverages because they discover the pleasure of the efficacy of a chemical substance active on the brain able to disinhibit, to “get high” and to act as a social lubricant in relationships. And this is how the trap of alcohol, damage and addiction was born and developed: linking consumption to the need to reach that level of pleasure, euphoria, disinhibition generated by the single glass, as a function of a physiological inability to metabolizing alcohol which makes it even more psychoactive, the body will require, on the next occasion of consumption, double quantities of alcohol due to a phenomenon known as “tolerance” which requires two glasses and the next time four for lack of superior control of a prefrontal cortex that does not yet exist, until it enters the vortex of addiction. Alcohol lowers the perception of risk in subjects who already have low risk; are also urged to do so by the dominant culture, that ofhappy hours, of the drink-as.much-as-you-can, of the open bar influenced by industry and marketing which has created direct and indirect advertising of alcoholic beverages, in addition to indirect advertising linked to product placement in fiction, to the sponsorship of cultural, musical and sporting events. This value of alcohol is created as something that is inextricably linked to the social, sexual, high-performance success that a boy and a girl who want to be adultized perceive as positive.

In short, alcohol was chosen not by chance by young people …

For years we have been reporting together with the Italian Society of Alcoholism that young people are not protected by the world of competent adults, indifferent to the evident manipulation of the fun that starts in the afternoon with the happy hours and then forces them to impossible hours in the night, pushes them and forces them to follow the rituals of the high in the places of youth gathering where the only alternative is an alcoholic drink that has an even lower price than the non-alcoholic one and the ever-present risk of cannabis and illegal substances circulating with controls that fail to address the problem of compliance with legality. The boy receives alcoholic beverages despite the prohibition on selling to minors under the age of 18, which is the most disapplied rule in Italy, due to the inadequacy of controls and sanctions and also of the culture of the competent authorities, of trade union ordinances that fail to supervise and to severely punish those who violate the law and place a substance in the hands of minors that is toxic, carcinogenic and is the leading cause of death of young people in Italy. Furthermore, messages are adopted that are incomprehensible to the brain developmental age of young people.

What messages are you referring to?

At “Drink responsibly” for example. Where “drink” is an imperative and a “responsibly” devoid of any value meaning for an age group in which, as we have seen, the sense of rational responsibility has not yet been constructed in the brain, a message that is also improperly allowed to enter schools, conveyed by programs in the world of production, deemed inappropriate by the WHO, which are allowed to have access to minors against any logic of mandate and protection that is typical of the public health sector which should never be influenced by logic or commercial interests that some school managers and regional education offices do not consider in terms of role and ethics, of protection of the minor. Protection that should be the school and family educational agencies, but also the institutions to demand.

During the lockdown period there was an increase in alcohol consumption among young people …

It is a culture that has consolidated year by year and in lockdown has worsened: in isolation, people at home have increased the volume and frequency of drinks consumed. Not only. The possibility of home delivery has been given: sites that sell alcoholic beverages and take them home to you or deliver them to you in an external box from which you can pick them up. And anyone can do it because there is no age control. Anything that is prohibited for the protection of minors by law is mortified by these commercial logics: there has in fact been a 400% surge in online sales and it has been verified by industry experts that this habit has concerned and continues to concern especially young people, registered from the age of 18, never being able to actually verify the sale to minors, who buy from mobile devices and on weekends.

What are the short- and long-term harms of alcohol abuse for young people?

In the long run, addiction certainly. But before you get addicted if you are a weekend away binge-drinker, that drinks to get drunk more than 6 alcoholic beverages in a single context, that alcoholic intoxication has a direct action: young people do not have the ability to metabolize alcohol, the greatest danger lies in the fact that boys do not dismantle alcohol as the adults. Therefore that quantity that circulates unchanged in the blood reaches the neuronal membranes and has a detergent action: it takes away the membrane phospholipids and causes direct damage to the hippocampus which is a highly specialized area, which will not reform again, and it is responsible for memory and face-spatial orientation. If we take a measurement through the neuropsychological batteries, which are used to identify the deficits, to a boy who over time has been binge drinking (and two three months on weekends are enough), we notice a 10-20% reduction in memory and the ability to orient ourselves. The problem increases in women.

Because?

They are the ones most exposed to the risk of alcohol abuse due to the hormonal storms that occur at that age. If they have a benign breast lesion sustained by an overproduction of estrogen, alcohol acts on the receptors in the breast tissue, increasing the risk that that lesion can turn into malignant. Reason for which in young girls, starting early binge-drinking, already at 20-21 years old they record the need and urgency of the use of mastectomy interventions: it is also valid for young women who see an increase of 7 -27% risk of breast cancer for each glass following the first, and not just because they started exposing their breast tissue too early to excessive amounts of alcohol that acts as a stimulant.

How can children be educated not to expose themselves to alcohol consumption?

Personally I go to schools and show images that make people understand the risk, because they need to develop their own critical ability. But those who know about public health must go to schools and not the world of production with the “responsible drinking” campaigns. This kind of education is of proven ineffectiveness and connotes, according to the WHO, a conflict of interest on the part of those who obviously aim for profit, do not have a mandate for prevention, competence and professionalism aimed at protecting public health. Only through a culture that respects the child, the person, the consumer and his right to truly informed choices and not supported by the many, too many fake news on alcohol can we, as the WHO indicates through the SAFER initiative, object of the European week awareness of the harm caused by alcohol, build new healthier and safer realities that keep the person and their right to health and well-being protected from the health and social consequences of alcohol use at the center.