Facing ‘The Fear’: Alcohol
and Mental Health in
Ireland

This conference is part-funded by
the National Office of Suicide
Prevention
Adolescent drinking in our
Intoxicated State

AAI Conference
Nov 2013
Dr Bobby Smyth
Overview
• Update on some harms
• Culture & Language
• Influence of adults
Correlation
= -0.96
P<0.001
Why worry?
“… in the population aged 25–59 years alcohol is the
world’s number one risk factor for impaired health
and premature death, and far more significant than
unsafe sex, tobacco use or diabetes.”
Teens, Alcohol and
Depression
Teens, Alcohol and Anxiety
The Adolescent brain – a work in progress
Giedd et al, 1999, Nature Neuroscience,

2, 861-863

http://www.nimh.nih.gov/press/prbrainmaturing.cfm
Zeigler DW et al (2004)
"Underage alcohol is associated with brain
damage and neurocognitive deficits, with
implication for learning and intellectual
development"
Casey & Jones (2010)
“Many studies have reported altered brain structure
and function in alcohol dependent or abusing
adolescents…… smaller frontal & hippocampal
volumes……suggesting that early adolescence
may be a period of heightened risk to alcohol’s
neurotoxic effects”
Learning which shoulder to cry on…..
Summarising harms
• Damage to brain development
• Increased risk of later alcohol & drug
problems
• Increased risky behaviour -> Accidents
• Hampers acquisition of healthy coping
skills
• Lose ability to “have fun” sober…..
Adolescents and Substance Use: The handbook
for professionals working with young people
“This highly practical manual presents an
ideal introduction to adolescent
substance use. It offers invaluable
guidance for all professionals involved
with adolescents including social
workers, health and social care
professionals, family support workers,
teachers, counsellors, mental health
teams, A&E staff, police and probation
officers. The approach these
practitioners take in dealing with the
problem has considerable influence over
outcomes”

http://www.radcliffehealth.com/shop/adolescents-and-su
Irish Adults & Alcohol
all over the shop, annihilated, Backward, Balubas,Banjoed,Battered,
bin towed, binted, bladdered, blasted, Blended, BLITZED, Blocked,
Blootered, Blotto, Bollixed, BOMBED, Bunkered, Buzzing,
Cockeyed, Cut, Drunk, Etched, f*cked, f*cked off yer face, floored,
Fluthered, Full, full as a sheugh, fullers, gee-eyed, giddy, giggly,
Full
goothered, half-cut, HAMMERED, Happy, Hockeyed, in bits, in the
horrors, Inebriated, intoxicated, Jarred, Jayrolled, Jiggered, Jolly,
Juiced, just nice, Kaned, Lamped, Langered, Langers, Lashed,
Legless, light Headed, Like a monkey without a tree, Loaded, Locked,
Loo-balled, Lorried, Manky, Mellow, merry, mouldy, Muntered,
Newted, Nicely, Obliterated, off the scullion, off my head,off me
trolley, on the way, ossified, out of it, Out of your mind, Pajamaed,
Pallatic, Paralytic, Phlanxed, Pickled , Piddled, Pished, Pissed,
pissed as a fart, Plastered, PLOWED, Plutered, Poleaxed, Polluted,
Rat-arsed, Rinsed, Rotten, rubbered, Sauced, Scuttered, Sh1t-faced,
Sideways, Sizzled, Slaughtered, SLOSHED, Smashed, Snattered,
Snookered, Sozzled, Spiflicated, Squiffy, Steamboats, Steaming,
Stewed, Stocious, Stoven, Tanked, Three sheets to the wind,
TIDDLEY, Tight , Tinkered, Tipsey, tired and emotional, TOASTED,
TRASHED, Trollied, Twatted, Twisted, Under the weather, Under
the table, Volcanoes, w*nkered, Wangoed, Wasted, wiped out,
Woozy, Wrecked, Writ, Wrote off, Yeltsined, Zonked
Moral language and discourse
around alcohol
“Drink Responsibly”
“Drink Moderately”
“Drink Sensibly”
Correlation
= -0.96
P<0.001
At what age is that Irish people
loose their ability to have the
‘craic’ without alcohol?
van Hout M.C.A. (2009) Rural Remote Health 9: 1171

• Parents underestimate their influence
• View drinking as inevitable
• Give drink in effort to exert control
• Too busy to supervise
Ryan et al, 2010. Systematic Review
1. Parental drinking increases risk
2. Provision of alcohol by parents to their children
increases risk
3. Presence of clear rules in the family home
reduces risk
4. Parental monitoring of their children’s activities
reduces risk
5. Warmth and affection in the relationship
between parents and children reduces risk
6. General positive communication between
parents and children reduces risk
Mama’s (& Daddy’s) little helper….
“Adult-supervised settings
for alcohol use resulted
in higher levels of
harmful alcohol
consequences”
Mediterranean Culture….
• Lost in translation….
Key Messages
• Unhealthy drinking is the norm in Ireland
• For the first time ever, an Irish government
appears willing to name and tackle this
• Our generation of adults has permitted alcohol
use to move earlier into adolesnce
• Early onset drinking is associated with mutliple
risks and NO benefits
• The more teenagers drink, the more likely they
are to experience anxiety and depressive
symptoms
• Parents are a powerful influence, but often
misunderstand what they can do to reduce risk.

Adolescent drinking in our intoxicated State

  • 1.
    Facing ‘The Fear’:Alcohol and Mental Health in Ireland This conference is part-funded by the National Office of Suicide Prevention
  • 2.
    Adolescent drinking inour Intoxicated State AAI Conference Nov 2013 Dr Bobby Smyth
  • 3.
    Overview • Update onsome harms • Culture & Language • Influence of adults
  • 5.
  • 6.
  • 8.
    “… in thepopulation aged 25–59 years alcohol is the world’s number one risk factor for impaired health and premature death, and far more significant than unsafe sex, tobacco use or diabetes.”
  • 9.
  • 10.
  • 11.
    The Adolescent brain– a work in progress Giedd et al, 1999, Nature Neuroscience, 2, 861-863 http://www.nimh.nih.gov/press/prbrainmaturing.cfm
  • 12.
    Zeigler DW etal (2004) "Underage alcohol is associated with brain damage and neurocognitive deficits, with implication for learning and intellectual development" Casey & Jones (2010) “Many studies have reported altered brain structure and function in alcohol dependent or abusing adolescents…… smaller frontal & hippocampal volumes……suggesting that early adolescence may be a period of heightened risk to alcohol’s neurotoxic effects”
  • 14.
  • 15.
    Summarising harms • Damageto brain development • Increased risk of later alcohol & drug problems • Increased risky behaviour -> Accidents • Hampers acquisition of healthy coping skills • Lose ability to “have fun” sober…..
  • 17.
    Adolescents and SubstanceUse: The handbook for professionals working with young people “This highly practical manual presents an ideal introduction to adolescent substance use. It offers invaluable guidance for all professionals involved with adolescents including social workers, health and social care professionals, family support workers, teachers, counsellors, mental health teams, A&E staff, police and probation officers. The approach these practitioners take in dealing with the problem has considerable influence over outcomes” http://www.radcliffehealth.com/shop/adolescents-and-su
  • 18.
  • 22.
    all over theshop, annihilated, Backward, Balubas,Banjoed,Battered, bin towed, binted, bladdered, blasted, Blended, BLITZED, Blocked, Blootered, Blotto, Bollixed, BOMBED, Bunkered, Buzzing, Cockeyed, Cut, Drunk, Etched, f*cked, f*cked off yer face, floored, Fluthered, Full, full as a sheugh, fullers, gee-eyed, giddy, giggly, Full goothered, half-cut, HAMMERED, Happy, Hockeyed, in bits, in the horrors, Inebriated, intoxicated, Jarred, Jayrolled, Jiggered, Jolly, Juiced, just nice, Kaned, Lamped, Langered, Langers, Lashed, Legless, light Headed, Like a monkey without a tree, Loaded, Locked, Loo-balled, Lorried, Manky, Mellow, merry, mouldy, Muntered, Newted, Nicely, Obliterated, off the scullion, off my head,off me trolley, on the way, ossified, out of it, Out of your mind, Pajamaed, Pallatic, Paralytic, Phlanxed, Pickled , Piddled, Pished, Pissed, pissed as a fart, Plastered, PLOWED, Plutered, Poleaxed, Polluted, Rat-arsed, Rinsed, Rotten, rubbered, Sauced, Scuttered, Sh1t-faced, Sideways, Sizzled, Slaughtered, SLOSHED, Smashed, Snattered, Snookered, Sozzled, Spiflicated, Squiffy, Steamboats, Steaming, Stewed, Stocious, Stoven, Tanked, Three sheets to the wind, TIDDLEY, Tight , Tinkered, Tipsey, tired and emotional, TOASTED, TRASHED, Trollied, Twatted, Twisted, Under the weather, Under the table, Volcanoes, w*nkered, Wangoed, Wasted, wiped out, Woozy, Wrecked, Writ, Wrote off, Yeltsined, Zonked
  • 23.
    Moral language anddiscourse around alcohol “Drink Responsibly” “Drink Moderately” “Drink Sensibly”
  • 24.
  • 25.
    At what ageis that Irish people loose their ability to have the ‘craic’ without alcohol?
  • 26.
    van Hout M.C.A.(2009) Rural Remote Health 9: 1171 • Parents underestimate their influence • View drinking as inevitable • Give drink in effort to exert control • Too busy to supervise
  • 27.
    Ryan et al,2010. Systematic Review 1. Parental drinking increases risk 2. Provision of alcohol by parents to their children increases risk 3. Presence of clear rules in the family home reduces risk 4. Parental monitoring of their children’s activities reduces risk 5. Warmth and affection in the relationship between parents and children reduces risk 6. General positive communication between parents and children reduces risk
  • 28.
    Mama’s (& Daddy’s)little helper….
  • 29.
    “Adult-supervised settings for alcoholuse resulted in higher levels of harmful alcohol consequences”
  • 30.
  • 31.
    Key Messages • Unhealthydrinking is the norm in Ireland • For the first time ever, an Irish government appears willing to name and tackle this • Our generation of adults has permitted alcohol use to move earlier into adolesnce • Early onset drinking is associated with mutliple risks and NO benefits • The more teenagers drink, the more likely they are to experience anxiety and depressive symptoms • Parents are a powerful influence, but often misunderstand what they can do to reduce risk.