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How to Identify Alcohol Abuse

Alcohol is the substance most widely used among teenagers in the United States, with more than 60% of teens consuming alcohol by the time they leave high school.1

When attempting to identify alcohol abuse, there are certain physical symptoms and emotional behaviors you can look for in your teenager. Determining that your child has a problem is the first step to getting treatment for alcohol abuse. With the right treatment and support, your teen can learn to control the addiction rather than the other way around.


Teens may turn to alcohol for a number of different reasons, including peer pressure, or as a means to gain social acceptance, since they are building their identity during these crucial years. Other factors contributing to teen drinking may include stress or anxiety brought on by schoolwork, participation in sports, part-time jobs, or family issues such as divorce. Drinking behavior may also be associated with other mental health conditions, such as depression, which may have yet to be diagnosed.

There are certain behaviors and warning signs that can help parents spot potential alcohol abuse, but it’s important to note that these signs vary depending on the individual. Teens who are abusing alcohol may exhibit substantial behavioral changes, such as:3

  • A drop in grades, missed classes, or other behavioral issues at school.
  • Loss of interest in extracurricular activities, such as hobbies, sports, or clubs.
  • Increased clashing or opposition toward family at home.
  • Change in friend groups.
  • Severe mood changes.

If you notice these behaviors or other worrying signs, talking to your teen is an important first step. They may be struggling with substance abuse, or they may simply feel overwhelmed by the normal pressures of being a teenager. Establishing an open dialogue is the best way to understand your child’s situation and take steps to help.


Perhaps you already know that your teen is using alcohol, but are unsure of the amount or frequency in which their drinking is occurring, or at what point you should seek professional help.

The CDC reports that youth who start drinking before the age of 15 are 6 times more likely to develop alcohol dependence or abuse than those who start drinking at the legal age of 21.2 Additionally, underage youth who consume alcohol are more likely to experience physical or sexual assault, legal problems such as DUI arrests, and alcohol-related accidents than their non-drinking peers.2

Knowing how medical professionals diagnose alcohol use disorder (AUD) may help you identify problem drinking behavior in your own child. AUD, or alcoholism, is a chronic, relapsing brain condition characterized by continuing to drink despite experiencing significant negative consequences from doing so. This condition can range from mild to severe, and is diagnosed when a patient exhibits 2 or more of the following characteristics in a 12-month period:4

  • Drinking alcohol in larger amounts or for a longer period than intended
  • Making unsuccessful attempts to cut down or stop drinking
  • Spending a lot of time drinking or recovering from alcohol use
  • Experiencing cravings for alcohol
  • Continuing to drink despite negative impact on career or schoolwork
  • Continuing to drink despite strained social, familial, or romantic relationships
  • Giving up or cutting back on activities that were previously important or interesting
  • Drinking alcohol in dangerous situations, such as while driving
  • Continuing to drink despite negative physical and mental health consequences
  • Developing a tolerance to alcohol, meaning they need to drink more in order to feel the desired intoxicating effects
  • Experiencing withdrawal symptoms when drinking is stopped.

Know the Risks

In addition to being an addictive substance, alcohol has been proven to cause significant physical and mental health problems. Some of the more well-known physical concerns include liver disease (including cirrhosis) and stomach ulcers, but there are other risks, including:2,5

  • High blood pressure.
  • Cancer.
  • Heart muscle changes.
  • Increased risk of heart attack or stroke.
  • Increased risk of suicide and violence such as homicide or sexual assault.
  • Depression.
  • Anxiety.
  • Nutritional deficiencies.
  • Cognitive deficits.
  • Death from alcohol poisoning.

Alcohol overdose, also known as alcohol poisoning, can result from drinking a large quantity of alcohol in a short period of time. It can be deadly in certain cases, as elevated blood alcohol content (BAC) causes certain functions of the brain to shut down—including those that govern critical systems such as breathing and heart rate.6 Some critical signs and symptoms of alcohol poisoning include:6

  • Mental confusion.
  • Coma.
  • Excessive vomiting.
  • Seizures.
  • Slow, irregular, or stopped breathing.
  • Hypothermia.
  • Pale or bluish skin color.

Alcohol poisoning is a medical emergency. If your teen is exhibiting the above symptoms, call 911 immediately.

Alcohol withdrawal is another serious health concern among chronic alcohol abusers who have developed a significant amount of physical dependence. These users may experience withdrawal symptoms if they suddenly stop drinking or significantly decrease the quantity of alcohol they drink. Alcohol withdrawal can be fatal, and attempts to detox should always be made under the careful guidance of a medical professional. Symptoms include:7

  • Excessive sweating.
  • Rapid heart rate.
  • Hand tremors, shakiness, or other involuntary movements.
  • Insomnia.
  • Nausea or vomiting.
  • Hallucinations.
  • Anxiety.
  • Grand mal seizures. 

Getting Treatment

Inpatient vs. Outpatient

Many inpatient treatment programs take place on the premises of a residential facility, and last for a period or 30 days or longer. Treatments including detoxification, counseling, therapy, and support groups are all conducted on-site in a 100% sober environment. Certain rehab facilities cater specifically to teenagers, so a certain amount of research could be beneficial in determining the right center for your child.

Outpatient rehab programs offer many of the same services, but on a part-time basis so that patients can continue living at home. Patients attend treatment sessions at the facility on a set weekly schedule, which allows them to still make time for school, work, family, or other demands.

Patients with alcohol dependence may be treated with medication, regardless of whether they’re in inpatient or outpatient treatment. Currently there are 3 drugs approved by the Food and Drug Administration (FDA) for use in alcohol addiction treatment:8

  • Naltrexone: Inhibits the pleasurable effects of alcohol, making drinking less rewarding.
  • Acamprosate: Thought to balance activity in the GABA and glutamate neurotransmitter systems; when taken after the acute withdrawal period, acamprosate helps to increase abstinence rates. May also help with protracted withdrawal symptoms such as insomnia and anxiety.
  • Disulfiram: Interferes with the body’s ability to break down alcohol; the unpleasant reaction to occur should alcohol be consumed while taking disulfiram helps to deter relapse.

Alcohol Abuse Prevention Tips preview

Behavioral Therapy

Detox is an important step in the rehab process, but it’s the behavioral treatments take place in rehab that can help the patient change their drinking behavior and thought processes. These sessions are conducted by mental health professionals, and will help your teen develop skills to stop or reduce their drinking.

There are several therapeutic methods used to help individuals evaluate the root causes of addiction. A good rehabilitation program helps patients to build healthy social support systems, strengthen their motivation and confidence, set reachable goals, repair relationships, and develop skills for coping with or avoiding triggers that may lead to relapse. Some therapeutic approaches that may be used during treatment are cognitive-behavioral therapy (CBT), motivational enhancement therapy, and family counseling.³

While in rehab, patients will likely meet for group counseling sessions several times per week, but the support of a group doesn’t need to end once the patient leaves the facilities. Support groups, such as Alcoholics Anonymous (AA), provide peer support for those attempting to quit or limit their drinking and have helped countless numbers of people struggling with alcohol abuse. There are groups tailored for young adults, as well as support groups for family members and friends of those suffering from substance abuse, such as Al-Anon. 

Don’t Wait

There is no one-size-fits-all solution for alcohol abuse. You can start investigating your options by speaking with your teen’s primary care physician or other medical or mental health professional. They can discuss the best treatment options and make any necessary referrals based on your child’s physical and mental health needs. Getting clean is simply one of the first aspects of recovery. It’s important to remain persistent, hopeful and engaged in the treatment(s) that work best for your teen, because a life-time of recovery is within reach and possible.

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