What to do about under-age drinking

I refer to the opinion survey on alcohol consumption and young people (The Sunday Times, October 16) and Sedqa's reaction to it (October 23).

It is a fact that young people are consuming more alcohol. The purpose of this article, however, is to try and understand the reasons behind this increase in consumption and why our youths are indulging in binge drinking patterns.

At the Alcohol Conference on Health Inequalities held in London by the UK Presidency of the EU, which I attended, some of the papers presented tried to explain the reasons behind this Europe-wide phenomenon of adolescents and binge drinking.

Spain's representative Alberto Antona Rodriguez, in his paper, said that adolescents are faced with a number of discourses regarding alcohol consumption: one that punishes the consumption (institutional discourse) and another that stimulates it (consumer discourse). This puts adolescents in a contradictory and paradoxical position.

This is further reinforced by the mass media which contribute to forming a positive image about alcohol, while at the same time showing images of the repercussions of possible catastrophes provoked by alcohol consumption.

This paradoxical image of alcohol can be seen practically every day, reinforced by the media. Recently on Sky News a major news item was the 'fact' that for young people to be perceived and seen as cool they need to 'admire Sienna Miller, listen to James Blunt, drink Stella Artois while wearing Diesel Jeans'. Practically the same day, Sky News reported a fatal injury in a hit-and-run case in which the driver was under the influence of alcohol. "This contradiction facilitates the consumption of alcohol because it is in this no-man's-land context", says Rodriguez, "where arguments are made to legitimise alcohol consumption, turning into processes of rationalisation and explanation of the very contradictions that, from this moment onward, stop being contradictions as such."

With this in mind, I seriously appeal to the local media not to exonerate themselves from their responsibility when it comes to publishing articles that can be reinforcing positive messages encouraging under-age and adolescents' drinking patterns.

Rationalisation process

Rodriguez goes on to explain that "alcohol becomes a liberating drug, beginning with its disinhibiting effects, which allow young people to express rage in either a nice or a destructive way. It makes contact with others possible, does away with taboos and facilitates meeting people.

There is a price to pay to open channels of sociability, in the long term; it is the potential risk of disease, and in the short term a hangover. Young people do not object too much to paying this price. When they weigh the benefits and the costs of alcohol consumption, the conclusion is reached that it is the lesser of two evils, and is controllable."

No matter how controversial it might sound, one must admit that there is a lot of truth in this statement. Let us not forget that the consumption of alcohol is also mimetic; it begins with imitation and continues because of one's identification with a group, but we have to be honest with ourselves, especially those involved within the abuse and addiction fields, that most drink because they like it, want to do it, and because they think they are in control.

How do you combat this? How do you influence this behavioural pattern? This is what makes tackling binge drinking behaviour so difficult. There is a constant rationalisation process being done by the adolescent who is drinking. If adolescents are drinking because they feel more sociable, then we have a responsibility to determine what is hindering young people to be sociable.

If young people are full of inhibitions and need alcohol to lower this threshold then we have to understand why adolescents are inhibited. And finally, if young people are drinking to feel a sense of belonging to a particular group, we have to understand why young people are feeling so unattached to everything else and provide them with skills to resist peer pressure.

I also empathise with parents, and understand their feeling of helplessness. The majority of them must surely know that their children are drinking, yet here too a rationalisation process seems to be going on. Parents modify their discourse depending on the age of their children by first prohibiting the consumption of alcohol, but as the children grow, parents become more permissive, and what used to be prohibitions become recommendations or threats: "be careful... do not drink too much." There is a kind of acceptance of the situation.

What to do about such a situation? Are we all truly helpless - parents, agencies, NGOs, health, educators, and enforcement - when confronted with this scourge?

Anti-drinking campaigns can somehow address the awareness of the harm one is causing oneself by consuming alcohol especially in the development phase, up to 23 years of age. The message has to be clear and truthful, and do away with the shocking images which could only reinforce the paradoxical equation explained earlier. Thus emphasis should be on what young people stand to lose by drinking.

Parents' and doctors' responsibility

Parents have a responsibility too which goes beyond simply admonishing. As I mentioned earlier, drinking patterns are mimetic, so the attitude and drinking patterns of parents will undoubtedly influence the children's perception of drinking. Parents, who indulge in binges, especially during feasts, sport activities or other festivities, even though they drink responsibly during the rest of the year, are reinforcing a positive image of drinking associating it with happy occasions. This is quickly absorbed by young people.

Educators and agencies within the addiction field should strengthen their already existing ties and besides the prevention programmes, which are already present in primary and secondary schools, make more emphasis on self-esteem and empowerment sessions, possibly with the participation of parents in small groups. Healthy lifestyles and good nutrition should feature strongly within school-based programmes. The message has to be positive and clear so as not to alienate young people.

Doctors and general practitioners also have a responsibility, in that I am sure they are called privately to treat young people with alcohol intoxications. Here, the role of the GP can be one providing short brief interventions, explaining the risks and damage being done, again clearly and concisely, without the need of unnecessary preaching. I am sure that both the GPs and treatment agencies can get together to exchange information which can be beneficial to both.

Not to be neglected is the role of operators in the alcohol and entertainment industry, who carry an important responsibility. In the absence of legislation addressing advertising of alcoholic beverages, operators should abide by strict ethical guidelines. Depiction of young models setting trends in their advertising campaigns and other positive images should be banned, as should be adverts promoting alcohol use as sexy and attractive. Moreover, alcohol advertising should never be aimed at minors.

The role of these industries has shifted recently to include an integral marketing approach rather than simply utilising advertising. So phrases and practices such as 'to be cool', 'lifestyles', 'open bar' and 'happy hours' are constantly being used by the industry.

The use of advertorials is highly questionable, and media organisations should be more wary as to how such space is used. I also would like to single out the sponsoring of sports and cultural events by the alcohol industry as also being highly questionable.

In a study entitled "Alcohol Marketing and Young People's Drinking: A Review of the Research" by Gerard Hastings, Stirling University, it was unequivocally proved that increased advertising and marketing of alcohol beverages has a direct effect on the increase in alcohol consumption by young people.

Finally, the role of enforcement and legislation should also not be under-estimated. Besides banning the sale of alcohol to minors, the banning of consumption by minors is also advisable. However, other initiatives are also important. These are that the minimum legal age to buy and consume alcohol should be raised to 18 years from the present 16; more random breathalyser testing; lowered blood alcohol count limits; graduated licensing for novice drivers; and administrative license suspension.

In a nutshell, what could possibly work to influence this behavioural pattern is a concerted positive effort by parents, educators, treatment and prevention agencies, health authorities, coupled and backed-up with an effective and adequate enforcement and legislative structure.

With the above in mind, Sedqa will be organising a one-day conference entitled 'Binge Drinking: A Modern Lifestyle?' on January 27, 2006 at the Radisson SAS Bay Point Hotel in St Julian's. I would like to invite all those who are truly concerned about this important issue - parents, educators, health authorities, treatment and prevention agencies, NGOs and legislators - to join Sedqa in drafting a concerted effort to combat under-age drinking. For further information about this conference contact Albert Buttigieg on 2124-4226.

For more information about Sedqa's prevention programmes one can contact the Primary Prevention Team on 2124-4226. Sedqa also offers its care services both within the community and in residential settings. People requiring help regarding problems related to substance abuse can be referred to us or refer themselves to these services or access more information by calling Helpline 151, or by visiting the Agency's Website www.sedqa.gov.mt.

Mr Cardona is Sedqa's operations director.