Young teenagers falling drunkenly around the streets, some passed out in their own vomit, others engaging in risky sexual activity in full view, more turning up in A&E departments with alcohol poisoning and accidental injuries, writes Kate Holmquist.
Tomorrow, when the Junior Cert results are issued, we're likely to see such scenes as some teens spike two-litre orange bottles with litres of vodka or make "Dolly Mixtures" - soft drinks bottles filled with mixes of whiskey, gin, vodka, beer - whatever they can safely sneak from parents' drinks cabinets without being noticed. These 14- and 15-year-olds need to know that alcohol, even in small amounts, causes brain damage, especially in those aged 15 and younger.
"We now have medical evidence to prove that alcohol causes brain damage in teens, especially before the age of 16. Whatever about drinking a beer or two at the ages of 16 and 17, drinking alcohol at age 15 and younger should never, never, never be allowed," warns Dr Conor Farren, consultant child and adolescent psychiatrist at the addiction treatment unit for 15- to 21-year-olds at St Patrick's Hospital, Dublin.
The younger children start to drink, the greater the damage: 13-year-olds who drink alcohol have a four times greater chance of becoming alcoholics than those who start at 19.
Dr Farren says that until recently he, like many Irish parents, would have let his own children have a drink with parental supervision at the age of 15 or 16. "The new research proving that alcohol harms the adolescent brain has changed my mind." His children will be told not to drink until they are 18.
Ireland's lenient, binge-drinking culture means that one in 20 16-year-olds is already a full-blown alcoholic, while one in 10 is a problem drinker at risk not just of alcoholism, but also injury and accidental death (alcohol plays a part in 37 per cent of all drownings).
Irish teens are facing an epidemic of liver disease and mental problems as they reach their late 20s and early 30s, doctors are warning.
"Gastroenterologists are seeing young adults with cirrhosis of the liver, we're seeing paranoia, dementia and brain damage at younger ages, as well as infertility in young women caused by sexually transmitted diseases resulting from unprotected sex while drunk. Alcohol is a drug that affects every organ in the body, so we can expect to see a rise in cancers too," says Joe Barry, senior lecturer at Trinity College Dublin and a member of the Strategic Taskforce on Alcohol. He says there are 128,000 regular drinkers among 15- and 16-year-olds in the country. One-third of all 15- and 16-year-olds binge three times a month or more.
"The amount that many teenagers are drinking now is staggering," says Dr Farren. "In my day, if you had three or four pints, that was considered a heavy session. Today, a good night's drinking is 15 to 20 pints or shorts. Every week I'm listening to kids telling me stories of what they are drinking and what their friends are drinking. It's not unusual to drink 60 pints in a single weekend."
At this level of drinking, alcoholism can develop within two or three years.
"We are facing into an era of increasing mental health problems because teens are drinking younger," says Dr Bobby Smyth, a consultant child and adolescent psychiatrist, who is currently setting up a public alcohol and drug addiction treatment centre for children aged 14-17 in Tallaght, hoping to treat 120 teens annually - if he can find the staff.
Dr Smyth estimates our rate of teen alcoholism at 6 per cent, double the US rate. The definition of teen alcoholism is that the teen has a high tolerance of alcohol, has experienced or caused harm and has life problems as a result of drinking, such as not meeting educational potential or being brought home by gardaí.
Underage Irish girls have the highest binge-drinking rate in Europe, and underage boys the fourth-highest compared with their peers in other countries, but it's the adults who rank highest of all in Europe - with 58 per cent of adult men and 30 per cent of adult women bingeing regularly.
"A binge is defined by the World Health Organisation as three pints. Most Irish men don't consider three pints to be a night's drinking. They have three pints and then consider making a night of it," Dr Smyth says.
The only way to stop underage drinking is to decrease overall alcohol consumption in the entire population, including among parents, says Dr Farren.
Dr Smyth agrees: "It's important not to scapegoat teens. They are drinking in the same way adults are. In Ireland today people are more stressed and we have a work-hard/play-hard culture.
"Alcohol is the drug that causes more damage than any other and by international standards, we use this substance extremely irresponsibly."
"Two years ago, friends would ask 'are you going out on Friday night?'" says James, a 15-year-old in Cork. "Now it's 'are you going drinking on Friday night?' People deliberately go out to get drunk so they'll have a story to tell on Monday morning."
Some teens are more at risk than others. "Young people with an innate high tolerance for alcohol develop problems quicker because their consumption goes up faster. Usually there is a strong family history. It could be that a predisposing genetic factor for tolerance of alcohol has been transmitted from one generation to the next," Dr Farren explains.
The failure of the Government to implement the recommendations of the Strategic Task Force on Alcohol, published one year ago this month, is a symptom of adults' general reluctance to face up to our drinking problem as a society, believes Marian Rackhard, of Alcohol Action Alliance.
"We have been very, very vociferous about the lack of political will to implement the recommendations of the report of the Strategic Task Force on Alcohol. The Government are very slow to do anything effective, while the alcohol industry promotes alcohol as glamorous and exciting. As long as that continues, our teenagers will be at risk."
These recommendations are currently being reviewed by the social partners, which includes business interests, on a special working group appointed by the Minister for Health and Children, Mary Harney.
One member of the working group, which has sub-groups on underage and binge drinking, is Mary Cunningham, director of the Irish Youth Foundation and also a member of the Strategic Task Force on Alcohol.
"I don't get a sense of a significant push to implement the task force recommendations. But our working group wants to see action by the end of the year."
There are 78 recommendations, but the experts believe that the two single most effective ones regarding teen drinking are these: ban all alcohol advertising and sponsorship anywhere that children may be exposed to it, including a total ban on TV advertising; and enforce the law regarding sale of alcohol to underage people.
Many teens themselves want an advertising ban, effective law enforcement and punishment for underage drinkers in order to support those who choose not to drink underage.
Alcohol concerns have been top of the agenda three years running at Dáil na nÓg, a young people's parliament sponsored by the National Children's Office. One of the resolutions: raise the age for the purchase of alcohol in off-licences to 21.
Says Rackhard: "Alcoholics are almost ensnared, from a young age, growing up in a social environment geared around alcohol so that they have learned no other way of coping or dealing with life. We have a high tolerance for the mental and physical harm alcohol does, not just to the drinker, but to others in this country, both within families and in terms of alcohol-related illness, violence, drunk driving and accidental injury. Change will only come when we choose to no longer tolerate this harm to others. And we can do it. We did it with the smoking ban."
Part two tomorrow
