Intervening With Teen Drinking

LIANE HANSEN, host:

Gail D'Onofrio is one of the health care professionals who conducts alcohol interventions, or wake-up calls, for underage drinkers. Dr. D'Onofrio is chief of the Section on Emergency Medicine at the Yale University School of Medicine, and she's on the line. Welcome to the program.

Dr. GAIL D'ONOFRIO (Section on Emergency Medicine Chief, Yale University School of Medicine): Thank you.

HANSEN: How do you do an ER intervention? What's involved?

Dr. D'ONOFRIO: Well, ED interventions are really just involved in bringing up the subject to the person, to the teen, and also acknowledging that they can participate in the conversation. And we give them some feedback about their drinking. And we ask them if they can find a connection between their visit and their alcohol use or anything about their health problems and their alcohol use.

And then we try to motivate them to change their behaviors. And then we negotiate, advise a plan. Then we ask them to continue the conversation with their provider, health care provider, whoever that is.

HANSEN: How do the teens and their parents respond to these interventions?

Dr. D'ONOFRIO: Well, we haven't done anything with the parents per se, we just work with the patients themselves. And most of the times, teens will listen if you have a conversation with them. And in general, scare campaigns and fear appeals do not work. But when you can actually have an open conversation with them about things that have happened to them, about making these links between certain behaviors and what can happen with alcohol - so, for example, some may not realize that their reaction times are slow with alcohol, that it impairs their judgment.

And when you kind of connect that impaired judgment with what happened to them and may have brought them to the ED, they might be more willing to listen to you and change their behavior. Sexual risk is a big thing in teens. So, many times girls will have sex when they wished they hadn't. Depression is another big deal with teens and certainly car crash is the most important thing. So we accentuate and talk about each one of those areas.

HANSEN: How many teens or underage drinkers might you see in the ER on an average weekend?

Dr. D'ONOFRIO: Well, that would be hard to say. I'd tell you that an average weekend on Thursday, Friday and Saturday nights, we will see at least 30 percent of our ED having something to do with alcohol and drugs.

HANSEN: Does that number increase at certain times of the year? I'm thinking, you know, prom season's coming up, graduation's coming up.

Dr. D'ONOFRIO: Yes, it does. It is seasonal. We see a lot during the summer months, particularly when it's nice outside, people are drinking quite a bit. We know also at proms it's a big deal. It's less likely during, really, dead of winter when people kind of stay in, they don't go out.

HANSEN: Have you seen the survey that Kelley Weiss mentioned in her story, and if so, do the numbers gel with what you've seen in the ER?

Dr. D'ONOFRIO: Yes, I have seen the survey. I haven't really noticed a difference one way or the other. In New Haven, we went back to look at some of our numbers. So - but it is an epidemic and we need to deal with it. And I think the most important thing is that parents need to have conversations with their children. They need to understand how alcohol affects their teens, more than it may even have adults.

They have to have safety plans with their teens so that teens know that they can call you when they have a problem, and you're not going to make a huge deal of it. You still need to talk to them about it. But they need to feel like there's a low risk that they can call you.

HANSEN: How do you talk to kids that just see this as a rite of passage?

Dr. D'ONOFRIO: This conversation can't be one of only one conversation. Parents have to have open conversations with their kids, really starting at the ages of 11 to 12. They have to be open and understand that drinking is going to occur. They're going to be in situations where there's lots of alcohol around. You understand why they drink. You know that it's a social norm. And then you come up and say, but I'd like to tell you about some of the things that scare me about your drinking.

So you have to have this opportunity to listen to what they have to say and then kind of draw out what are these motivators that would be, for them, not to drink as much, or to have a safety plan in place.

HANSEN: In Kelley Weiss's story, we also heard about the marketing behind alcopops. Do you think kids are that susceptible to advertising?

Dr. D'ONOFRIO: I think kids are very susceptible to advertising, but it's really the social norms and the focused alcohol events. So when you see any type of game on TV, if it's a football game or if it's a baseball game, they're advertising for alcohol.

HANSEN: Some states have actually tried to tax alcopops or change the laws about how the drinks can be marketed, Maryland, Illinois, California come to mind. What kind of laws do you think would work?

Dr. D'ONOFRIO: I think the no tolerance laws in terms of driving, really has worked. We've really seen a decrease in teens dying with drinking and driving. So I think that no tolerance law definitely works. I think that in other types of laws it's going to be very difficult because, in general, kids are going to get this. And we know that kids often get it in the house, so we have to figure out what the laws are for parents who are serving underage kids in their home.

HANSEN: Gail D'Onofrio is chief of the Section on Emergency Medicine at Yale's medical school.

Thank you so much.

Dr. D'ONOFRIO: Oh, you're welcome. Transcript provided by NPR, Copyright National Public Radio.