Did you know?

* It is legal for people to drink alcohol from the age of five

* About 30,000 people die each year in the UK from alcohol-related causes - more than 10 times the number from drug-related causes

* Each year around 50,000 teenagers are admitted to hospital accident and emergency units with acute alcohol intoxication - and the number is rising

* Nearly one third of 12 to 17-year-olds say they have either committed acts of vandalism or got into arguments or fights after drinking alcohol

* Young people see drinking as conformist and safe compared with drugs, although they tend to define safe drinking sessions as those that remain uninterrupted by adults or the police

Binge drinking among secondary school pupils is becoming a national phenomenon, with hangovers a feature of school life. Young people are drinking an increasing amount, often with the specific aim of getting drunk. They regard drunkenness as socially acceptable and less hazardous than taking drugs, although 10 times as many people die from alcohol-related causes in the UK (30,000 a year) than from drug-related causes. An independent inquiry into drugs classification by the Police Foundation in 2000 placed alcohol in the class A category (the most harmful), alongside heroin and cocaine, even though it is legal to drink alcohol from the age of five.

What is binge drinking?

According to the Royal College of Physicians, binge drinking is when males regularly drink 10 or more units and females seven or more in a single session, more than double the daily sensible drinking benchmark. But there is little consensus about what the term means when applied to children and young people, although it is often defined as five or more units in a single session. The trouble is, teenagers don’t pour drinks in regular units, but more likely by the tumbler-full at a friend’s house. Binge drinking is now generally used to mean drinking a lot of alcohol in a single session. Its value as a term lies in its recognition that most of the short-term harm linked to alcohol comes from single episodes of drunkenness rather than drinking more than the safe weekly levels.

Who does it?

Large-scale studies confirm that drinking begins at ages eight to 12 but that the mid-teens (13 to 16) are the years in which young people switch to independent drinking away from their families, and the potential for harm through bingeing is at its greatest. Between the ages of 16 and 18, young people rapidly acquire adult drinking habits. There is no marked increase at 18, when it becomes legal to buy alcohol and drink in licensed premises. Indeed, 16 to 18 is the peak age for young women’s drinking, and the gender gap between male and female drinking is closing. Anecdotal evidence suggests that clubs encourage under-age women as customers, and promote the sweet, pre-mixed alcoholic drinks that appeal to them as a way of attracting men on to the premises.

In general, binge drinking largely affects young white people. For example, 55 per cent of young white people aged 16 to 19 binge drink at least once a week, compared with 29 per cent of African-Caribbeans and 13 per cent of Asians.

Is it on the increase?

Definitely, although binge drinking is not new. In 1750 we consumed 11 million gallons of gin. What has changed is the nature of young people’s drinking. While the proportion of 11 to 15-year-olds who say they have had a drink in the past week has remained unchanged for the past 10 years (25 per cent), the amounts consumed in single sessions have gone up substantially. A recent report by Communities that Care, based on a survey of 14,000 pupils, revealed that four out of 10 students in Year 10 and more than half of those in Year 11 had taken part in at least one binge in the previous month, and a quarter had joined in three or more binge sessions (five or more alcoholic drinks in a single go) - including 5 per cent of boys and 3 per cent of girls who admitted to 10 or more sessions in the space of a month. In 1990 the amount consumed by all 11 to 15-year-olds was 0.6 units a week. In 2000, that had tripled to 1.8 units.

Peter Walker, headteacher at Abbey school, Kent, and a spokesman on alcohol and drugs issues for the National Association of Head Teachers, says schools’ own surveys show that three times as many 15-year-olds take alcohol on a regular basis than take drugs.

What are the short-term effects?

Each year, about 50,000 teenagers are admitted to accident and emergency units with acute alcohol intoxication - and the number is rising. Teenagers often weigh less than adults and will more rapidly achieve higher blood-alcohol levels. Novice drinkers will have little physical tolerance to alcohol and are susceptible to coma at lower blood-alcohol levels than adults. They can also develop hypoglycaemia (low levels of blood sugar), hypothermia and breathing difficulties. Alcohol’s depressant effect will more readily produce a fatally toxic overdose in young people; the amount of alcohol needed to do this will be less in younger, lighter, irregular drinkers, especially if they are female. Women have less of the enzyme that breaks down or “deactivates” alcohol and have less water in their bodies than men to dilute the alcohol.

Heavy-drinking young people are more likely than their more moderate peers to experiment with drugs - about 15 per cent of 14 to 15-year-olds have taken drugs and alcohol together. Mixed with depressants, alcohol can lead to coma; with stimulants, it further reduces the ability to make safe decisions; with ecstasy there is an increased risk of dehydration.

Research carried out more than 20 years ago calculated that 500 young people a year die while drunk. More recent figures are unavailable because research into the extent to which the effects of alcohol are implicated in the deaths of young people is in short supply. While relatively few young people die from the direct effects of alcohol, many more die from the indirect effects - particularly accidents, suicide and violence. The rise in teenage male suicides has been attributed to the rise in alcohol consumption. Almost one in three 12 to 17-year-olds have reported committing acts of vandalism or getting into arguments or fights after drinking alcohol.

Around 1,000 young people a week suffer serious facial injuries as a result of drunken assaults. And after drinking alcohol, one in seven 16 to 24-year-olds reports having unprotected sex; one in 10 is unable to remember if they had had sex the night before. The high rate of teenage pregnancy in the UK - the highest in Europe - has been linked to patterns of alcohol consumption.

And the long-term?

Effects are unclear and little researched. While the regular consumption of alcohol in high volumes over a long time is known to have a detrimental effect on almost every organ in the body, the effect of current patterns of binge drinking in young people has not been thoroughly studied. Anne Lingford-Hughes, a senior lecturer in biological psychiatry and addiction at Bristol University and a consultant to the city’s alcohol services who carries out research on brain transmitters and structure, says that although young people’s livers can recover from episodic binge drinking, the effects on the brain are unknown. “The rapid increase in blood-alcohol levels and the equally rapid decrease, which is a mark of binge drinking, could have a permanently damaging effect on the brain, which is still plastic and developing in young people.

“We worry about the effect of alcohol on the foetus. Similarly, we should worry about the ability of young people’s brains to cope with the rapidity of change associated with binge drinking.” Despite the increased dangers, Ms Lingford-Hughes says alcohol-related research is the poor relation to illicit drug-related research, and alcohol health services for young people are woefully inadequate.

Why is binge drinking increasing?

There are various theories. One view is that young people see alcohol as a means of “getting high” or scoring a “buzz”, as with some drugs. Another is that binge drinking secures a release, a blotting out of increasing stresses and strains. The drinks industry itself, some have argued, has engineered such drinking behaviour in response to the market threat from the ecstasy culture, by producing, packaging and marketing sweet drinks with a high alcohol content that appeal to youngsters who haven’t yet gained a taste for beer or spirits.

Research soon to be published shows that sweet, pre-mixed drinks, so-called “alcopops”, are also absorbed into the system relatively quickly. Studies indicate that alcopops are most popular among 13 to 15-year-olds but become much less popular as teenagers get older. But they are a relatively expensive option and, as teenagers frequently tend to go for the greatest hit on the least amount of money, cider, fruit wines and confectionery vodkas have become more popular.

Do adults play a contributory role?

British parents are the least likely of European parents to know where their sons and daughters go on a Saturday night, according to Professor Martin Plant, director of the Alcohol and Health Research Centre at the West of England University, Bristol. He says research shows that teenagers whose parents don’t keep track of their children’s movements are likely to be the heaviest drinkers. Moreover, parents will often sanction teenage drinking, and will supply the money or drink, thankful at least that they are not taking drugs. Research also shows that even when young people move into drinking as the norm within their peer groups, family influence continues to play an important role. A sensible drinking example set by parents seems to be particularly important. Heavy-drinking parents or abstainers tend to have heavy-drinking children. The most favourable family environment to promote “socially competent” drinking is one in which moderate levels of control are on offer to support sensible drinking, and in which heavy or risky drinking is not condoned.

To what extent is education affected?

Schooling is being disrupted - not especially by an increase in the number of drinking incidents on school premises, but by the after-effects of binge drinking at home or in neighbouring streets and parks. Teenagers are increasingly turning up to school with hangovers, or are unable to complete homework because of excessive drinking. Schools say there is a sense of bravado among teenagers who openly boast of heavy drinking exploits and see drunken behaviour and vomiting as an acceptable part of their socialising. Girls will talk readily about holding back each other’s hair when they are being sick.

What can schools and teachers do?

* In an emergency: Children who become unconscious should be placed in the recovery position to avoid choking on their own vomit. But don’t move them if they have fallen. Check their breathing and their airways. Keep them warm, but not too hot. And don’t be afraid or embarrassed to involve the emergency services. If they are conscious, ask them what they have had to drink, when they drank it and if they have taken any other medicines or substances. Stay with them to make sure they do not become unconscious. Encourage them to drink water and, if they fall asleep, make sure they lie on their side. Do not leave them to sleep it off alone. Do not give them tea or coffee, or induce vomiting, or allow them to go home alone. Do not leave them under the supervision of another child or young person.

* With pupils who are regular binge drinkers: Make it possible for them to talk to someone they trust, but make sure they realise that confidentiality cannot be guaranteed. Secure their agreement before referring them on to specialist alcohol services (which are limited for children and young people). Involve parents whenever possible.

* With pupils who have alcohol in school: Staff can legally search pupils’

lockers or desks, although some local education authorities advise against this. Pupils themselves must not be searched, even if they consent to it. Every effort should be made to persuade them to hand over the alcohol voluntarily. If they have alcohol in school, they have broken a rule, not a law.

What about preventing it in the first place?

Alcohol education should be set within the cultural context. Drinking plays a central role in British social life and is perceived as an acceptable part of it. Ninety-five per cent of British men and 89 per cent of British women drink alcohol. Teachers should realise that young people see drinking as conformist, a normal way of socialising - and safer than drugs - although they tend to define safe drinking sessions as those uninterrupted by adults or the police. But the greatest risks are associated with unsupervised drinking, and the aim of any harm-reduction approach should be to delay this by giving youngsters knowledge and skills to make informed choices.

Teenagers will ignore advice that simply tells them not to drink. But there is evidence that an approach accepting that people drink and enhancing the ability to identify and deal with risky drinking, and which increases knowledge about alcohol and its uses and abuses, can affect how much young people drink. For example, Tacade (Teachers’ Advisory Council on Alcohol and Drug Education), a leading charity in the field of personal, social, health and citizenship education, produces educational materials that are realistic about young people’s attitudes to drinking (see Resources).

Schools should also consider that good role-modelling can have the greatest influence. Staff should think about their own drinking behaviour, and schools should place alcohol education within an overall ethos. An alcohol policy should encompass issues such as staff and parent drinking at school events and on school trips.

USEFUL ORGANISATIONS

* Tacade (www.tacade.com) produces three alcohol education packs. Alcoshots is photo-based and has a Factfile to encourage group discussion among 12 to 15-year-olds; Respect It! contains 15 lessons plans for Years 7 to 11 and covers aspects of drinking and alcohol effects; Ask is a drug education pack for 11 to 14-year-olds with low literacy skills. 1 Hulme Place, The Crescent, Salford, Greater Manchester M5 4QA. Tel: 0161 745 8925; email: ho@tacade.demon.co.uk.

* The Schools Health Education Unit’s website (www.sheu.org.uk) has much on alcohol and young people. See the report Young People in 2000. Tel: 01392 667272.

* The Health Development Agency website (www.wiredforhealth.gov.uk) has pages on alcohol education, including lesson plans. Tel: 020 7430 0850.

* Health Promotion England (www.wrecked.co.uk). Details about the risks of alcohol are offered in an interactive format. The organisation has a free leaflet about alcohol for young people and their parents.

* Institute of Alcohol Studies (www.ias.org.uk) has factsheets about alcohol and the young. Alcohol for the Young, from the Royal College of Physicians and the British Paediatric Association, reviews harm caused by adult drinkers to children and excessive consumption among the young. Can be ordered for pound;7.50 from the Institute of Alcohol Studies.Tel: 020 7222 5880.

* Puke! (Prevention, Understanding, Knowledge and Education) is a CD-Rom that explores alcohol issues in a non-judgmental way with games, video footage, stories and quizzes (www.alcohol-services.co.uk).Tel: 01582 723434.

* Alcohol Concern (www.alcohol concern.org.uk) is a national agency on alcohol misuse that helps problem drinkers and their families. It has factsheets on young people’s drinking and advice leaflets for teenagers. Waterbridge House, 32-36 Loman Street, London SE1 0EE. Tel: 020 7928 7377; email: contact@alcoholconcern.org.uk.

* The theatre in education group, CragRats (www.cragrats.com), tackles bullying, drugs, alcohol awareness and sexual health. Tel: 01484 686451; email: kate@cragrats.com.

Books

* Teenage Kicks: young people and alcohol, by Tim Newburn and Michael Shiner (Joseph Rowntree Foundation, pound;9.95).

* Opportunities for Drug and Alcohol Education in the School Curriculum and Alcohol: support and guidance for schools (Alcohol Concern and DrugScope). Tel: 020 7928 1211; email: www.drugscope.org.uk.

* Adolescent Drug and Alcohol Abuse: how to spot it, stop it, and get help for it, by Nikki Babbit (O’Reilly, pound;12.50). Offers parents clear information on adolescent drug and alcohol abuse.

* Alcohol, by Sarah Lennard-Brown (Hodder Wayland, pound;11.99). Presents medical facts about alcohol and social issues relating to alcohol use and abuse.

* All About Drink and Drug Abuse, by Alexander McCall Smith (Macmillan Education, pound;5.75). Discusses drink and drug abuse and its effects.

* Learn to Say No: alcohol, by Angela Royston (Heinemann, pound;5.99). Facts about alcohol for eight to 12-year-olds.

* Need to Know: alcohol, by Rob Alcraft (Heinemann, pound;6.99). Informs youngsters (10-plus) about a range of drugs.

* We’re Talking About Alcohol, by Jenny Bryan (Hodder Wayland, pound;4.99). Encourages children (12-16) to consider alcohol-related questions, using case studies to explore the issues.

* What Do We Think About: alcohol?, by Jen Green (Hodder Wayland, pound;4.99). Explains what alcohol is, why people drink it and the effect it can have on people’s health and behaviour.

* Why do People Drink Alcohol?, by Julie Johnson (Hodder Wayland, pound;10.99 and pound;5.99 paperback).

* Wise Guides: drinking, by Matthew Whyman (Hodder, pound;4.99). A guide about peer pressure for 11 to 14-year-olds and the ways alcohol can affect your body.

fiction

* Someone Else’s Baby, by Geraldine Kaye (Scholastic, pound;4.99). This is Teresa’s diary. She is 16 and pregnant after having too much to drink at a party.

For a full list of resources, visit www.tes.co.uk