One of the brewing civil wars in the field of drug education and prevention is the inability of practitioners, researchers, and educators to agree on a precise definition of what prevention is. The word “prevention” has different meanings to different people. The guy sitting next to me on a flight who asks what I do for a living thinks I get kids off of drugs – a noble goal, however not prevention in my eyes, but intervention and treatment. Another person thinks about the D.A.R.E (Drug Awareness Resistance Education) program – a nationally recognized anti-drug program aimed primarily at elementary and middle school aged children. Yet another person thinks about immunization shots or medical related issues. At the time of this writing, I lost track of the number of definitions I have read about prevention. It seems as if each researcher or program establishes a definition of prevention to best supports their agenda. For the purposes of this book I use the word prevention as a descriptor of any program, attitude, behavior, activity or approach that attempts to support and encourage those students choosing not to drink, and/or aims to reduce the negative impact of drinking and other drug use by teenagers, and/or aims to reduce the frequency and amount of drinking by teens.
You will notice that I say, “Alcohol and other drugs” not “alcohol and drugs”. This particular phrasing itself is controversial. The former expression is often scene as an attempt to stigmatize alcohol by associating it with likes of cocaine and heroin. It is true that alcohol is a drug and use by adolescents should be taken seriously. My wording “alcohol and other drugs” is not a political gesture or an attempt to align myself with a particular philosophy. I’m merely making an attempt to point out that alcohol is a drug, not to demonize alcohol. It is my opinion that alcohol is neither good nor bad. For most people (there are exceptions) alcohol’s risk is in how it is used, frequency of use, how much is used and the environment in which it is used.
Binge drinking is a term that most people are familiar with today. In the minds of the most people, binge drinking either describes a person on an extended drinking spree lasting more than 24 hours or a person that drinks a lot on a given occasion. The term binge drinking originated from the Harvard School of Public Health somewhere during the 1990’s.
The current definition of binge drinking is (5) or more drinks for men and (4) or more drinks for women in a single sitting. Now, this is where we run into trouble. What is a single sitting? If a woman has two drinks with dinner and then three glasses of wine over the course of four hours that evening, is she a binge drinker? Or take my dad for instance. He is a big guy. Consuming five or more beers in a single sitting – again how long is that – a round of golf? – is not normally considered a risk for my dad. We could spend all day defining binge drinking. I will use the term dangerous drinking
in this book. I think we can all agree that dangerous drinking implies drinking beyond your physiological limit with unintended and undesirable consequences. Would dangerous drinking include any amount of alcohol consumed by a minor because they are breaking the law thus putting them at risk of arrest? I’ll let you decide that. How you decide matters, more on that later.
Social drinking/drinker is another term that is used quite often. How best to describe social drinking or a social drinker? I often say social drinking is any drinking that is done is a manner that does not impair social, cognitive or physical functioning. However, the science that informs the drinking and driving debate suggest that impairment begins on the first drink. Also, all of us know someone whose personality changes after one drink. Maybe they become more relax, more social and at ease. Is this still social drinking? Or is alcohol doing something for them that they can’t and should do for themselves? Are you starting to see why this gets a little fuzzy? Our struggle to understand and define these behaviors and attach simple labels eludes many and drives the confusion among adults.
Substance use versus substance abuse is another sticky issue. Many people believe that any substance use by an adolescent is abuse because of the illegality. Using the public policy model (breaking the law) the answer would be yes. Neurologically speaking, one could argue abuse and use vary from person to person and amount and duration of the substance use. Where do you stand? These are important questions to think about. Many kids have asked me what is worse for you pot or alcohol? What they are really asking is what is worse for you getting drunk or getting high. My answer is neither; it is like switching seats on the Titanic. However, there is an abundance of science that supports the position that getting drunk is far worse than getting intoxicated on marijuana. Would you share that with a group of tenth graders? However, getting high on marijuana causes potential neurological impairment and personality change that social drinking does not. New research on adolescent neurological development is suggested there is no such thing as a safe amount of alcohol or other drugs in the teenage brain. Is this abuse of marijuana? How about getting stoned, but no unintended or undesirable consequences happened? Use or abuse of marijuana? Talking to kids becomes a process infused with agendas, falsehoods, and socially constructed taboos. The illegality of substances has very little to do with its addictiveness, think of alcohol and tobacco – compounding the complexity of prevention work with teens. Addiction Specialist Stanton Peele describes addiction as a consequence of involvement with absorbing experiences that provide essential emotional satisfactions but that detract from people’s ability to cope with their lives.
How we define terms or understand these controversies matters. It shapes your approach as a practitioner, informs your belief system as an administrator shaping school policy and it affects the decisions you make as a parent. It is useful to think about how you may have defined these terms previously and give some additional thought to how you feel about them now. I suggest you sit down with your spouse or partner and discuss these terms and clear up any areas of conflict. If you and your spouse/partner are on separate pages regarding these issues, that will be picked up by your kids. You are and will be for a long time the primary influence in your child’s life. Most of the research on adolescent drinking and other drug use shows that parents have the most influence on a teen’s decision to drink and use other drugs. We must understand how we feel about these terms to be better communicators.
