Numerous studies have documented what is called neuropsychological deficits – brain damage – in adult heavy drinkers. Only recently have researchers begun to investigate the potentially damaging influence of alcohol on adolescent neurological development and cognitive functioning. Findings recently published in Alcoholism: Clinical & Experimental Research are alarming: alcohol-dependent teenagers may be exposing their brains to the disruptive effects of ethanol at the very time that their brains are at critical phases in development.
"We chose to look at adolescents of 15, 16 years of age because that is a relatively circumscribed period of brain development," said Susan F. Tapert, project scientist and research fellow at the University of California, San Diego and one of the study’s lead authors. "Certain brain developments, such as the refinement of neural connections, are completed by about age 16. Developments in the frontal lobes – parts of the brain that are important in judgement, planning and problem solving – continue until about age 16. This potentially important time for brain development is also a time when some teens start drinking quite a bit."
It can be misleading to call alcohol a "gateway drug" for youth simply because it often precedes the use of illicit drugs. As reported in the July 1997 edition of Alcohol Alert, a survey of 4,390 high school seniors found that approximately 80 percent reported getting drunk, binge drinking, or drinking and driving within the preceding year. The national Monitoring the Future Study, 1975-1997 found that more than 34 percent of high school seniors reported drinking to intoxication in 1997. The 1998 Alcohol and Youth issue of Alcohol Health and Research World noted that incidents of both drinking and getting drunk seem to not only increase as teens age, but that overall adolescent alcohol use appears to have increased in recent years, despite an earlier period of decline. Regardless which statistic you may choose, adolescent drinking merits significant attention not only for what problems it may lead to, but also for the problem that it is.
"The biggest difference we found between the alcohol-dependent and the non-abusing teens," said Tapert, "had to do with memory functions. Mostly, the alcohol-dependent youth did a poorer job at recalling new information."
Tapert noted that the study’s findings are important for adolescents, parents, and those who work with teens. "Ideally, at age 15 to 16, youth should be in school, learning things that will help them chart their future by guiding academic and career decisions. But if students are drinking so heavily that it’s affecting their brain functioning, they may not be able to get as much out of educational opportunities. This could significantly disrupt their future choices, chances of going to college, and ability to get a good job. It could also perpetuate their drinking problem. We know that youth who don’t do well in school are more likely to be truant, hang out with others who are truant, and drop out of school. Not staying in school leads to an even greater risk of developing and/or maintaining a problematic lifestyle."
Taking into consideration the cognitive effects of alcohol, lead author Sandra A. Brown, chief of psychology at the VA San Diego Healthcare System and professor of psychology and psychiatry at the University of California, San Diego, has designed and is directing "Project Options." A high school "intervention" funded by the National Institute of Alcohol Abuse and Alcoholism, the project’s purpose is denoted by its name: to provide appealing, multi-media information to kids about options to drinking, skills for resisting peer pressure, and methods for reducing drinking if it has already begun.
Another promising option is called "recovery of function," an area of research that Mark S. Goldman, distinguished research professor of psychology at the University of South Florida, has studied. "Not only can we see spontaneous neuropsychological recovery in adults who have stopped drinking," said Goldman, "but there are ways of accelerating the improvement by helping the brain do the equivalent of ‘weight lifting.’" Goldman explained that, after isolating the individuals’ areas of brain deficits due to heavy drinking, they are given specific tasks that will ‘work’ that area, improving through repetition. "Recovery actually happens more when you give the brain things to do," he observed. "This counters the notion that when you’re recovering from something, you want to just sit around and be passive and let recovery happen."
In reference to the adolescent drinking and brain deficit study, Goldman noted that several important research questions remain. "There’s good reason to believe that because these are adolescents," said Goldman, "their brains are still developing and this will actually help with recovery. On the other hand, because their brains still haven’t fully developed, they could be more vulnerable and show less recovery than slightly older adults might."
Another finding in Tapert and Brown’s study had to do with a link between withdrawal experiences and adolescent neuropsychological functioning. For example, youth who had shakes, headaches or vomiting after a heavy-drinking episode were more likely to have poorer test results. The reasons for this association are unclear. Tapert and Brown are currently using brain scanning techniques to uncover exactly which brain regions may be most affected by heavy drinking during adolescence.
"This study and the issues it raises about the influence of alcohol on neuropsychological performance in adolescents are all just the tip of the iceberg," Goldman said. "Specifically, the question of the "reversibility" of these effects is huge. If we see deficits in a 50- or 60-year old, that’s sad, but somehow less compelling than a 15- or 16-year-old who has alcohol-induced brain deficits that will cause them problems over their entire life."
Funding for this Addiction Science Made Easy project is provided by the Addiction Technology Transfer Center National Office, under the cooperative agreement from the Center for Substance Abuse Treatment of SAMHSA.
Articles were written based on the following published research:
Brown, S.A., Tapert, S.F., Granholm, E. & Delis, D. C. (1999, February). Neurocognitive functioning of adolescents: Effects of protracted alcohol use. Alcoholism: Clinical and Experimental Research, 24(2), 164-171.