The tragic details of these three cases are echoing in my head when I meet with a young woman I will call Rebecca. Like Laura, Rebecca got clean and sober before she was out of her teens—and like Laura, she has had some disturbing sexual encounters. This thoughtful university student, now twenty-four and five years sober, braces herself several times before she delves into the details of her harrowing story. When she does, it comes out like a machine gun, staccato-style, her beautiful green eyes unblinking as she tells how her early drinking paved the way for other drugs, primarily cocaine and crack, and for what she calls a form of prostitution.
The eldest daughter of a wealthy Toronto family who moved a lot, Rebecca had been to thirteen different schools by the time she was seventeen. She was eleven when she decided to take a vodka bottle from her parents’ liquor cabinet, and down twenty-two shots—twenty-two being her lucky number. All her friends had experienced blacking out, and she wanted to try it as well. “When you move a lot, you want to fit in,” says Rebecca. “I woke up covered in vomit, and for the rest of my drinking life that was how I drank—alone and messy.”
Rebecca was heavy as a child, and she was teased at school. “I developed an eating disorder, and the media had a big effect on me—how I was supposed to look, how long my eyelashes were supposed to be, how skinny my thighs should be. At thirteen, I was drinking Smirnoff Ices, taking caffeine pills, and cutting myself.” That same year, she smoked pot for the first time, but the experience was not good. “I moved to much harder drugs—coke and whatever else was available.” She developed anorexia and bulimia. By fourteen, she had been sent to rehab in California by her parents. “I think I’ve seen more therapists than I’ve seen television shows,” she says with a rueful grin.
With time, the Smirnoff Ice morphed into Jack Daniel’s for breakfast. She was in rehab again at fifteen, at seventeen, eighteen, and finally at nineteen. Says Rebecca: “I had already uprooted so many times in my life. Then I made a lot of recovery connections—and lost them, too.”
As the years went on, she started trading her body for drugs. “Everyone around me was really old—in their forties. I was sleeping with my dealer.” What finally made her quit? “I hated being in my skin,” she says. “As you go on, bad things happen, and you drink to forget the consequences. It’s like being a rat on a wheel.”
There are many consequences to drinking young, not the least of which is vulnerability to sexual assault. Says Jernigan: “If you drink before age fifteen, you’re four times as likely to become alcohol dependent than those who waited until they were twenty-one; seven times as likely to be in a motor-vehicle crash after drinking; eight times as likely to experience physical violence after drinking; eleven times more likely to experience other unintentional injuries like drownings and falls. The bottom line? There’s a strong public health interest in delaying the onset of drinking.”
“Kids who start early are just different,” says Richard Grucza, a renowned alcohol epidemiologist at the Washington University School of Medicine in St. Louis, Missouri. His response is emphatic: “Drinking early is a very strong risk factor for alcoholism. Hundreds of studies show this. In fact, there is a twenty-five percent increase in risk for alcohol dependence in those who drink at an early age.”
Research shows there are influences that make a young person vulnerable to starting young. A recent British study reports that the odds of a teenager getting drunk repeatedly are twice as great if they have seen their parents under the influence, even a few times. In fact, according to Jernigan, the number one influence is the way parents drink. Ask Ali, twenty-two, why she started drinking, and she cites two reasons: because it looked like fun when her parents drank, and it seemed like a good way to deal with her crippling anxiety. At thirteen she started drinking vodka before class. At fourteen she switched to Canadian Club whiskey: “When you’re fourteen, it’s a joke to take CC to school in a water bottle.”
Some parents believe that allowing their sons and daughters to drink at the dinner table will inoculate them against future risky drinking. In fact, a quarter of mothers in a recent American study believed that allowing their third-grader children an alcoholic beverage would discourage them from wanting to drink as teenagers: the taste would put them off. The more educated the mother, the more likely she will be what is known as “pro-sipping.”
Others cite the Mediterranean model of allowing young people a taste as a way of modeling moderation. This, according to one Italian mother, is pure folly. “Young teenagers do not drink with their families at the table the way we did when we were growing up,” says Tiziana Codenotti of Padua. “They drink premixed lemonade and alcohol, and on Friday night they binge. A big group will head to the square and no one knows how to deal with it.”
In other words, parental influence is important, but so too are peers. In a global village, Italian youth are drinking the same way as American youth and Australian youth. All are influenced by the surround-sound marketing environment of Facebook, YouTube, movies, and TV.
Andrew Galloway, a prominent Toronto interventionist, says younger girls are catching up to young men at an alarming rate—and they often drink for different reasons than boys. “Guys drink for the buzz and to be social. Girls drink because of lack of self-esteem, to cope, to feel a part of—and because of peer pressure. If I had a dollar for every time I heard ‘I do the same thing as my friends,’ I’d be a rich man. My answer? Get new friends.”
“It’s easy to capture the trends,” says Elizabeth Saewyc, one of the lead researchers on a recent Canadian study exploring early alcohol use among adolescents. “The multimillion-dollar question is: can you capture the ‘why’? But there are clear triggers,” she says. “Ten-year-olds don’t just voluntarily decide to use alcohol.” Several key factors help tip the scales as to whether a person will drink at an early age. Number one: a history of sexual or physical abuse, or trauma. “If this is your history,” says Saewyc, “you are far more likely to start at twelve or younger. If we could eliminate all violence—bullying, sexual and physical abuse, sexual harassment—we could prevent sixty-six percent of binge drinking in twelve-to eighteen-year-olds. Sexual abuse accounts for twenty percent of binge drinking, and sexual harassment for fifty percent. If we want to get a handle on problematic drinking in adolescence, we have to focus on violence in our society.”
Other key factors related to early drinking: a mental health condition or a chronic physical issue, poverty, identifying as gay, lesbian, or bisexual. “They are more likely to be targets of violence,” says Saewyc, “and more likely to have problems drinking.” Another factor is a family history of attempting suicide. Females who start drinking at a younger age are more likely to report experiencing extreme despair, purging after eating, having suicidal thoughts, and having attempted suicide.
Those who are likely to wait until they are fifteen or older include those who are more connected to family, have friends with “healthy attitudes about risky behaviors,” and have meaningful community engagement of one sort or another. For girls, two other elements are important: cultural connectedness and involvement in organized sports.
Not surprisingly, those who delay their drinking initiation are more likely to have postsecondary aspirations, some connection to a teacher or their school, and are less likely to have unprotected sex. Starting to drink too early matters for a multitude of reasons, not the least of which is that the still-maturing brain is particularly susceptible to heavy alcohol use.
In an ideal world, each young person would educate themselves on their own vulnerability to alcohol. I ask David Goldman, chief of the laboratory of human neurogenetics at the National Institute on Alcohol Abuse and Alcoholism, in the United States, about the role of genes in developing alcohol dependence. Says Goldman: “We can say because of the twin and adoption studies on alcoholism that there is a moderate to high heritability: we know that genes play a strong role. About half the reason a person becomes an alcoholic—half of the liability—
is genetic.” Still, says Goldman: “The strongest single predictor for both alcoholism and depression is having been sexually abused or traumatized in childhood. Genes mediate vulnerability, and there is a series of genes that affect anxiety and emotionality. If a young woman had this gene plus early life stress exposure, the probability of alcoholism increases twofold. But each gene is only a small part of the total risk. Sexual trauma is the strongest predictor.”
And, as Saewyc points out, “Alcohol is the number one date-rape drug. Sexual and physical assault have an impact on hazardous drinking, and drinking to cope—which has a horrible spiraling feedback loop. Potentially, binge drinking exposes the individual to more violence. Those who have experienced sexual violence are more likely to binge drink, and this opens the opportunity to revictimization. Most will grow out of their binge drinking—but a subset will not survive, or they will have diminished opportunities. And others will develop alcoholism.”
“This is what makes the human experience so different from that of the lab rat,” says Goldman. “If a rat makes the right choice nine out of ten times, you are pleased. If a human makes the right choice nine out of ten times, they can fall down a well out of which it is impossible to climb. All that a young woman has to do is drink too much and end up in bed with the wrong person. The consequences can be so severe for minor slip-ups in judgment. We now have emergent strains of antibiotic-resistant gonorrhea. Globally, about half the assaults are committed by those who are intoxicated. And if a woman is drinking, she is likely drinking with a man—and likely to bear the brunt of his aggression.”
If you head outside Minneapolis to Hazelden—one of the world’s most renowned treatment centers—Brenda Servais will mince no words when asked for an assessment of what’s happening. Says the counselor for sixteen- to twenty-one-year-olds, “Trauma? Not one hundred percent. But there’s a lot of sexual trauma, whether they were sober or under the influence. They think if they were drunk, it doesn’t really count because it was their fault. A lot of rape. Certainly, a lot of PTSD. And we can see a rise in substance use right after the event.”
Counselors at Caron Treatment Centers in Pennsylvania agree: of their younger clients, nine out of ten report blackouts, and a lot of shame about how they got into trouble. They were completely vulnerable to sexual assault. Says psychologist Maggie Tipton, “If they’re college age, sexual assault is a norm: the majority of our patients, in fact—whether they experienced it as abuse or not. Anxiety is huge.” Adds her colleague Janice Styer: “A lot of young girls report that their use of alcohol is not to party. Life is hard, and it’s a way to put life in the corner.”
Not everyone who experiences trauma develops a drinking problem, and not everyone who has a drinking problem has trauma. But young people who have drinking problems generally have some distress or abuse in their lives. “How do we prevent the circumstances that lead to a young person thinking this is a good way of coping?” asks Saewyc. “We very seldom teach young people how to deal with stress. We teach them to read and write, but not how to heal from traumas that have happened to them, or to prevent what we can prevent. Or we teach them with a pill. Programs that do address stress have a very good effect: mindfulness in the classroom is one example. And if you’re lucky, you have a family who helps you deal with these issues.”
For those without that support, Saewyc helped develop a remarkable program called the Runaway Intervention Project (RIP). Based in St. Paul, Minnesota, RIP was designed to help sexually exploited or sexually assaulted young runaways—aged twelve to fifteen—put their lives back together. Young girls were being picked up when the police did drug raids. Often these girls were put in jail or juvenile detention. Says Saewyc, “The question was: what services were targeted to twelve-year-olds who had more partners than most have in a lifetime—and none by consent? Kids who run away get disconnected from school, and from caring adults.”
The idea was to catch these girls early, before they became deeply entrenched in the street lifestyle. These young girls had severe health problems: the majority had PTSD; two-thirds had attempted suicide or considered it. Almost universally, they were involved in binge drinking, often in the context of sexual abuse. Says Saewyc, “Alcoholism, if not already happening, was highly likely. Substance abuse, definitely. And yet they’ve been able to turn their lives around.”
Each young girl in RIP is returned to her family, or placed in foster care if there was abuse in the family home. A nurse practitioner makes regular home visits, helping her deal with health issues, acting as her advocate, offering emotional support and the information she needs. She is taught ways to cope with stress. The nurse practitioner also supports the girl’s family. Some girls get hooked up with treatment. All go back to school and are connected with someone caring there. Says Saewyc: “As well, each girl is involved in a girls’ empowerment group, with a bunch of girls with the same hairy history. The idea is to do normal things: artwork, your nails, go to movies together. We work from a strength perspective. Because they have been sexually exploited, they are at a huge risk for revictimization—and they don’t always recognize dangerous people.”
The girls are then assessed every three months. After six to twelve months, their trauma symptoms subside: less running away, less cutting, fewer suicide attempts. “It’s common for runaways and street-involved kids to struggle with suicide because of the violence and trauma they experience,” says Saewyc. “These girls get better school grades, have better relationships with their parents, and don’t get pregnant as often. This intervention meets them where they’re at. The most distressed girls, with fewest connections to family and school and the lowest self-esteem, improve the most. And in fact, the girls are so much better that they’re indistinguishable from those who have never been abused. Last year, five of the first fifteen girls won scholarships to local community colleges.”
We’re living in the era of Jenna Marbles—real name Jenna Mourey. The reigning queen of YouTube, Marbles is the star of such videos as “Drunk Makeup Tutorial”—with more than 15 million views as I write—and “Drunk Christmas Tree Decorating.” According to the New York Times, the former bartender and go-go dancer has more Facebook fans than Jennifer Lawrence and more Instagram friends than Oprah. Her fan base is the thirteen-through seventeen-year-old crowd, and she gets more than a million clicks a day for such memorable lines as “I’m going to get drunk and I’m going to teach you all the tips and tricks of how to put your fucking makeup on when you’re hammered,” and “People are going to be just like, ‘She’s drunk, she fucked up her makeup!’” Or this gem: “Sometimes you need to put some shit on your shit.” Classic.
In one video, Marbles brandishes a red Solo cup, the icon of college drinking games, gets loaded, and then puts on fake eyelashes crooked. “You remind me of the girl in Bridesmaids,” writes one young girl in the comments section. This draws a chorus of “lol.”
When it comes to talent, Jennifer Lawrence is a far cry from Jenna Marbles. Still, on the night she won the Oscar for best actress, Hollywood’s new “it girl” gave a shoot-from-the-hip performance in her strapless Dior gown. After a few gaffes at her post-win press conference, she confessed she had just downed a shot, giggling, “Jesus!” In subsequent interviews, she talked about wanting “to sit on my couch and drink and not change my pants for days at a time.” Said the twenty-two-year-old star: “I see my couch. I see TV. I see a bottle of wine!” Perfectly honest. Still, it’s hard to imagine Grace Kelly or Audrey Hepburn delivering these lines.
Times have changed. We live in an alcogenic culture. Which makes it tough to be Melanie. At seventeen, she’s wrestling with her sobriety. A diminutive redheaded private school girl, sporting a silver bracelet from Tiffany’s, she meets me at Starbucks a little earlier than we had first planned. She’s on a tight schedule. She has tons of homework, a major presentation in two days, plus volleyball finals in the next twenty-four hours.
For that reason, we get straight to her story
. When she was fifteen, her mother took her to Miami for the weekend, on what Melanie thought was a “mother-daughter bonding trip.” Turns out, it was an intervention. At four thirty the next morning, two burly fellows woke her and whisked her away to Utah, where she ended up for the next fourteen months. What started with a three-month wilderness retreat ended in extended rehab. “It was traumatizing,” she says. “I cried the entire time.”
Melanie started drinking at twelve. “I just wanted to fit in,” she says. From there, she moved almost immediately to marijuana and painkillers, stealing the latter from family members and friends’ parents. “I took them from people who needed them,” says Melanie. Her worst incident: she took two OxyContins with a Tylenol 3, downing them with some alcohol at school. She says: “I could have had a heart attack and died. Instead, I just puked in class—which was embarrassing. Usually, I puked in the bathroom.” There’s more. “I was hospitalized for three months with a very severe eating disorder—a combination of bulimia and anorexia. And my mother caught me selling drugs.” She pauses. “And I got eighteen percent that year in math,” says the straight-A student.
Today, she thinks about heading to university as a sober young woman, a member of Alcoholics Anonymous. She grins her shy grin and bites her lip. “It’s hard. I feel like I never got enough experience with alcohol to know that I could never drink again,” she says. “I feel, ‘Why am I missing out on something?’ I am so young. I feel like I might want to drink again—I’m an anxious sort of person, and it’s sort of tempting.” I ask her: what’s the appeal? “I don’t know how to explain it.” She pauses. “I would just really like to drink.”
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