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Binge Drinking

Brain Cells Killed During Binge Drinking Episodes
Wed Apr 17, 1:18 PM ET
By Melissa Schorr

NEW YORK (Reuters Health) - A few days of binge drinking can lead to the almost immediate death of brain cells, new research conducted in laboratory animals confirms.

"Very high alcohol consumption, even for a short period of time, damages the brain," study lead author Dr. Fulton T. Crews, professor of pharmacology and director of the center for alcohol studies at the University of North Carolina at Chapel Hill, told Reuters Health.

Studies of alcoholics have found that heavy consumption of alcohol can lead to neurodegeneration, death of brain cells and reduced brain tissue mass, and subsequent damaging effects such as a lack of impulse control and difficulty in setting goals.

However, it has not been clear why the association between total alcohol consumed over a lifetime and brain damage was not stronger. Crews and colleagues hypothesized that it is short-term binges, where a person consumes 10 drinks in a day, rather than consistent heavy drinking, that may lead to brain damage.

"I believe it's not the total amount (consumed), it's related to the pattern of consumption," Crews said. "Binge drinking, where you reach high blood-alcohol levels, is when the damage occurs."

The researchers studied 200 lab rats, administering high amounts of alcohol daily for four days to the animals and giving a control group of animals an alcohol-free equivalent diet. The researchers analyzed the animals' brains after two days, four days and then three days after withdrawal, using a variety of microscopic methods.

The results were published in the April issue of the journal Alcoholism: Clinical & Experimental Research.

The researchers reported that the animals forced onto an alcoholic binge experienced significant death of brain cells within two days, beginning with brain cells that control the sense of smell and going on to parts of the brain's cortex after four days. The type of cell death was determined to release inflammatory agents into the brain.

Crews said that previous researchers suggested that alcohol-induced brain damage occurs after alcohol has been consumed, during the period of recovery or withdrawal, when seizures may occur. However, Crews said he now suspects that much of the damage actually occurs during the intoxication period itself.

"We're seeing peak damage during intoxication," Crews said. "In only a few days, we can mimic what's seen in humans after a decade."

Crews said people who consume moderate amounts of alcohol most likely avoid this phenomenon. "If someone is a two-drinks-a-day drinker, I would not expect them to have any brain damage," he noted. However, "people promoting an individual who just turned 21 to have 21 drinks (should realize) that this might have permanent long-term damage.

"It might not just be a one-day celebration," he warned. "Once you've lost these brain cells, they're probably gone forever--how would you ever know?"

SOURCE: Alcoholism: Clinical & Experimental Research 2002;26:547-557.

Parents often clueless on their teens drinking
By Barbara F. Meltz, Globe Staff, 4/25/2002

recently released studies highlight the problem of binge drinking among college students, but binging isn't unique to them. It's also a problem with high school students, including those as young as eighth grade. Researchers say parents tend not to realize how big a problem it is.

If the typical adult drinks to be social, the typical teenager drinks to get drunk.

''Binge is part of the social milieu on weekends for American adolescents. It's how partying is defined,'' says John Kulig, director of adolescent medicine at New England Medical Center.

The University of Michigan's ''Monitoring the Future'' 2001 nationwide survey reports that 13 percent of eighth-graders, 25 percent of 10th-graders, and 30 percent of 12th-graders said they had had five or more drinks in one sitting in the two weeks prior to the survey. Actual consumption could be more.

Binging is so popular that Stephen Wallace, national chairman of SADD (Students Against Destructive Decisions and Students Against Drunk Driving), says, ''Parents should know that any kid today who drinks is at risk for binging.''

One way to keep your child safe is to share these facts:

Alcohol accounts for half of all adolescent deaths. It also increases the incidence of date rape, fights, and motor vehicle accidents.

Teenagers who drink are more likely to become dependent on alcohol faster than adults because the teenage brain is not fully formed. The younger a teenager is when he begins to drink, the greater the risk for alcoholism, says psychologist and psychiatrist Duncan B. Clark of the University of Pittsburgh Adolescent Alcohol Research Center.

For young teens, there usually is some degree of ''normal'' drinking before a first binge; with older students, a binge can be the first drinking experience, says Clark. Although parents typically imagine binges happen at parties, a binge is just as likely to happen with two or three people as with 10.

Wallace muses that the greatest danger from binges may be that teenagers don't think they are dangerous. ''They're at a stage of development where they don't see long-term consequences. I'm not convinced they think four or five or more drinks constitutes a problem,'' he says.

There are several reasons why teenagers say they start drinking: boredom, curiosity, a wish to be more grown up, because their parents do. What young drinkers all have in common, however, is available liquor, usually from an older teenager or a parent's cabinet; a lack of supervision, especially when both parents work; and a friend who's game.

It's not that peers actively lobby each other to drink. Rather, teenagers tend to assume the behavior of their own peers is what's normal, so the pressure they feel is internal. Wallace says, ''A lot of kids who binge look around to see what others are doing. Drinking games. Multiple shots of sweet-flavored drinks. Beer. Just because it's beer doesn't mean it isn't a problem. Not when you have five or more.''

There is good news in the midst of all this. Although parents have less influence over a teenager than, say, over a 10-year-old, we have more influence than we realize. To exert it, though, we need to overcome the reality gap.

''There's a disconnect between the real world kids live in and the world parents think their kids live in,'' says Wallace. He tells of one study repeated around the country where teenagers were interviewed in one room and their parents in another. Over and over, he says, ''You'd have a kid saying he drinks every night, every weekend, and his mother across the hall saying, `I'm lucky my son doesn't drink.'''

In fact, the typical parent assumes his or her child will drink during high school. Studies show that's a fair assumption: 80 percent will at least have tried alcohol by the time they graduate. Studies also show, however, that 53 percent of parents think there's nothing they can do about it. Wallace calls this the ''myth of inevitability'' and he says it's just plain wrong.

''Our research shows parents can have extraordinary influence,'' he says.

Even though teens may say they don't want to hear what parents have to say, they don't mean it, says Wallace. ''When you back off,'' he says, ''kids conclude, `My parents don't really care if I drink, so I will.''' Teenagers whose parents talk to them frequently about alcohol report that when they are faced with a decision to drink or not, or to take the second or third drink, they often hear a parent's voice in their head. In other words, says Wallace, conversations can be deterrents.

Start having those talks when your children are in elementary school, says Kulig. (He fears the newest figures from the Monitoring the Future study will show drinking is beginning even earlier than eighth grade.) ''It's much better when communication is part of normal interactions than if you wait until something bad happens,'' he says. Besides, the younger children are when you start the conversations, the more likely they are to absorb your values.

There are three important points to convey:

Alcohol is an adult beverage unlike any other because it can make you act differently than you normally do, including stupidly.

Adults can drink a little and be OK, but you have to be an adult to be able to make that judgment.

If you drink, talk about why you do and how you keep it under control. If you have a problem, or someone in your family does, be honest. Studies show children of alcoholics are not only genetically predisposed but also at risk because of their socialization to it.

With teenagers, Kulig says, ''It's a terrible idea when parents think, `They'll drink anyway, let them do it here and be safe.' All that does is condone inappropriate behavior. Remember the 17-year-old girl who died in 1998?'' She drank 15 beers at a friend's North Andover home and then fell down the basement stairs and cracked her skull. The friend's father had supplied the alcohol.

It helps to give teenagers reasons why they shouldn't drink, not just orders not to: ''I love you and I care about you and I don't want you to drink because it could impair your judgment, or damage brain cells, or affect your memory forever.'' Believe it or not, says Wallace, teenagers like it when parents rehearse refusal skills with them. (''I have a blood disorder, I can't drink'') and rescue plans (a teenager who calls home and asks, ''Did grandpa have to go to the hospital?'' is code for, ''Come get me, no questions asked.'')

Perhaps the single most important tip for parents is to be awake to greet your teenager when she comes home at night, what Wallace calls ''the tough duty.'' It's not so much that a teen will debrief with you, although some will; more importantly, it's a deterrent to know she has to face you. It's also a way to pick up clues: Does she smell from alcohol? Is her speech slurred? If she does comes home intoxicated (or even just smelling of beer), give her whatever help she needs and save a conversation for the next day. Otherwise, you're likely to impose consequences you can't or won't enforce (''You're grounded for the rest of the year!''), which tells her it isn't really a big deal.

As with any misbehaviors, the best limits are ones that are clearly defined before the fact; with teenagers, they also are negotiated, not imposed. Wallace thinks one reason parents aren't clear enough about alcohol and drug behavior is that we feel compromised by our own teenage indiscretions. ''What you did is irrelevant,'' he tells parents. ''Your job now is to help your child make safe decisions.''

The responsibility for keeping teenagers safe does not rest solely with parents. Ralph Hingson, associate dean for research at the School of Public Health at Boston University and lead author of a major college drinking study released two weeks ago, urges parents to connect with other parents, and to work in the community to push for stronger seat-belt law enforcement and increased community education and enforcement.

Spring is a time of year, for instance, when teenage drinking increases. Are you talking to parents of friends about their policy on alcohol? About party supervision? Do you have an agreement to call a parent if a child is intoxicated? Many parents and communities are extra vigilant on prom or graduation night. What about tonight?

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