In September, the world watched as Brett Kavanaugh testified under oath about the actions he took as a high school student. Given the seriousness of the accusations against him— and the fact that Dr. Ford claimed they occurred while Kavanaugh was intoxicated— senators were particularly interested to learn about Kavanaugh's drinking habits as a teenager.
“I drank beer with my friends,” Kavanaugh testified about his high school days. “Almost everyone did. Sometimes I had too many beers. Sometimes others did. I liked beer. I still like beer.”
The hearings heightened existing divisions within an already-divided nation. But no matter who you believe was telling the truth, one thing is certain— the hearings put a spotlight on teenage drinking.
Is adolescent drinking in America a normal rite of passage, or an out-of-control epidemic?
First, the good news: adolescent drinking has been going down for the past 20 years:
(source: National Institutes of Health Monitoring the Future Study, 2014)
The results were reinforced by a study conducted by the Adolescent Substance Use and Addiction Program at Boston Children’s Hospital which found that the percentage of high school kids in their final year who have never tried alcohol increased fivefold from 1975 to 2014.
Lead study author Dr. Sharon Levy observed:
“The message that substance use is unhealthy seems to be gaining in popularity and ‘sticking’ with kids."
Even binge drinking— defined as consuming 5 or more drinks in a row —has significantly decreased among adolescents over the past 20 years according to the NIH's 2017 Monitoring the Future report:
So teen drinking is not a problem… right?
“Underage drinking is a massive issue," says Jason Breed, President of Digital Futures Initiative. "Because it doesn't receive the same amount of attention as e-cigarettes and marijuana, there is a tendency to treat teen alcohol use as background noise. In reality, it's a serious problem that, frankly, deserves a lot more attention.”
The National Institutes of Health concur, calling underage drinking a "pervasive and persistent problem with serious health and safety consequences." It also warned that "...alcohol use during the teenage years could interfere with normal adolescent brain development and increase the risk of developing [alcohol use disorder] ...underage drinking contributes to a range of acute consequences, including injuries, sexual assaults, and even deaths—including those from car crashes."
The Centers for Disease Control echo the serious toll alcohol use takes on adolescents, attributing over 4,300 deaths each year to underage drinking.
Yet with over 10.1 million underage drinkers in the United States, alcohol remains the drug of choice for adolescents— more than tobacco or illicit drugs.
Albert's observation that underage drinking gets normalized explains part of the problem. Teenage drinking has become seen as a rite of passage, like getting a driver's license or going to prom. This destigmatization encourages kids to experiment with alcohol— especially when such experimentation is considered normal or even tacitly approved by parents.
But this societal acceptance masks a troubling fact: alcohol consumption interferes with adolescent development in ways we are only beginning to understand.
“We should not minimize this as normal adolescent behavior," argues Albert. "These substances are very dangerous for adolescents, mostly because of brain development.”
Amy Herrold, research assistant professor of psychiatry and behavioral sciences at Northwestern University’s Feinberg School of Medicine, agrees.
“The parts of the brain that are really important for making decisions … are rapidly developing during this time frame. That is why it’s so important for adolescents to treat their brain very carefully.”
To counter the decline in underage drinking, alcohol companies have increased advertising budgets, including product placement in film and TV. A 2013 study published in JAMA Pediatrics found that alcohol product placement "...was found increasingly in movies rated for youth as young as 13 years, despite the industry’s intent to avoid marketing to underage persons."
Last year, Dartmouth University professor James D. Sargent found that 72 percent of PG-rated films and 46 percent of G-rated films surveyed depicted alcohol use. Alcohol depiction in film has almost doubled over the past 20 years— mainly from paid product placement.
"Alcohol is the next frontier," says Cristel Russell, an assistant professor of marketing at American University who works with the National Institutes of Health to study the effect of alcohol product placement on teenagers. Research published in the journal Pediatrics shows that teens who watch a large number of movies that include alcohol scenes start to drink earlier than their peers, and that they are also more likely to binge drink.
Recent films targeted toward younger audiences increasingly feature protagonists who drink alcohol:
-- Batman and Wonder Woman drinking whiskey to celebrate their victory in Justice League
-- Elastigirl drinking alcohol with the character Evelyn Deavour in the Disney's animated film, Incredibles 2.
-- T'Challa's love interest, Nakia, ordering a whiskey in Black Panther
-- Thor and Erik Selvig getting into a drinking contest in Thor
-- Thor watching in amazement as Valkyrie downs a large bottle of alcohol in a few seconds in Thor: Ragnarok
-- War Machine, Tony Stark, and Thor drinking alcohol together in Avengers: Age of Ultron
-- Pepper Potts describing her ideal dirty martini to Tony Stark in Iron Man (Stark, himself, is portrayed as having a history of excessive drinking.)
For beverage companies alarmed at the decline in underage drinking, product placement offers an easy way to circumvent advertising restrictions and unofficially target people under 21.
How can we reconcile the dire realities of underage drinking with the positive trends we saw earlier? The late professor of international health, Dr. Hans Rosling, once explained that some situations require us to hold two seemingly contradictory images in the mind at the same time:
"It seems that when we hear someone say things are getting better, we think they are also saying 'don't worry, relax' or even 'look away.' But when I say things are getting better, I am not saying those things at all. I am certainly not advocating looking away from the terrible problems in the world. I am saying that things can be both bad and better."
The percentage of adolescents who drink alcohol has been consistently declining over the last 20 years. More than ever, teens realize the dangers of underage drinking, and their disapproval is credited for helping push the trend down. At the same time, too many adolescents are falling into the well of underage drinking, putting themselves, their friends, and their loved ones at risk.
When it comes to underage drinking, the story is bad— but better.