Many of the parents I know, both professionally and personally, tell me that that they know they should be talking to their teens about underage drinking but don't know when it's appropriate to open the discussion, or are unsure of what they should say. Parents often ask me whether they should have a conversation before their child starts high school, or if they should wait until their teen is starting college; should they focus on the health risks associated with underage drinking, or the legal implications that drinking underage may have?
The truth is, we don't have a lot of research to answer those questions. However, Dr. Julie Potter and Dr. Karen Soren of Columbia University Medical Center/NY Presbyterian Hospital, with support from Health Alliance on Alcohol, are currently working on a study to untangle the differences among the content and contexts of parent-child conversations about alcohol. The study aims to determine what messages are most effective in preventing problem drinking, such as being drunk underage and binge drinking, in addition to what role attitudes and comfort have in guiding the conversation.
As we wait for the study to be completed and the data to be published, what can we do to be better parents and have more open and honest conversations with our children? Below are suggestions we can make as practicing physicians with extensive experience working with adolescents and their parents.
1. Establish your value message and communicate it clearly. To mitigate problem drinking, the most important message to convey to teens is direct disapproval of underage drinking. This message should be clear and without nuance. Kids hear what we say, not what we think. If you do not approve of your child drinking underage, make sure that they know it.
2. Start talking early. Underage drinking is happening - it is up to us to start guiding the conversation and establishing rules early on. The younger the child, the easier they accept - and adopt - concrete ideas. A twelve-year-old is more likely to latch on to a clear value message than a seventeen-year-old. However, as children mature, the conversation about drinking has to change. For example, parents should consider how their teen's friends and social circles may influence behavior.
3. Make sure it's still a conversation. Make sure you are speaking with your teen and not at your teen, and gauge their eagerness to start a conversation. Be open to answering questions or changing the tone of the conversation if they are hearing something different. Be available when they are ready to talk to you, and don't force them to have a conversation when they are clearly uncomfortable. Establishing disapproval does not mean closing off communication.
4. Be honest. Parents always ask me "what should I say if my child asks if I drank when I was a teen?" I call it the 'hypocrisy dilemma.' You don't want to be a hypocrite but you don't want to condone drinking underage. Teens are quick to spot hypocrisy, so I always tell parents to be honest but know that you don't have to divulge everything. Instead, share a story that highlights why you may regret having drank at the time or discuss the risks that you may have encountered firsthand when you drank underage.
5. Forgive when necessary. Communicating disapproval of underage drinking does not mean you should scare your teen away from approaching you if they have made a mistake. You can say "I do not want you to drink" and also "if you are in trouble, you can always come to me." Those two messages are not contradictory - and teens can hear both. If your adolescent comes to you and confesses to drinking underage, make sure you positively reinforce their decision to speak up. They made the right choice and asked you for help. Later, when appropriate, have a follow up conversation to remind them of why it is important to you that they avoid drinking.