Secondhand Drinking Prevention occurs when we understand what secondhand drinking is, what it does to a person’s physical and emotional health, and how it contributes to a person’s risk factors for developing a drinking problem. [Please note that the concepts in this post apply equally to Secondhand Drugging Prevention, as drug misuse works similarly in the brain, causing secondhand drugging impacts for others.]

First is to Understand Drinking Behaviors

Chronic exposure to secondhand drinking changes the way a child’s brain wires. Secondhand drinking preventions requires helping a child understand how to protect themselves from drinking behaviors. See BreakingTheCycles.com post, “Stress and the Developing Brain.”

These are the behaviors that a person exhibits when they drink more than the brain and body can process because the excessive alcohol in the brain changes the way neural networks in the brain communicate with one another and to and from other neurons in the body via the central nervous system. Some of the neural networks most affected are those responsible for judgment, memory, coordination, pleasure/reward and reasoning. This link explains that process: “Understand How the Body Process Alcohol | Reduce Secondhand Drinking”.

Common drinking behaviors include:

• Verbally, physically or emotionally abusing someone – often a spouse, girlfriend, boyfriend or child
• Doing poorly at work or school because of the drinking or recovering from the drinking
• Fighting with loved ones about the drinking
• Experiencing blackouts
• Being inconsistent in one’s behaviors (more loving or solicitous or more offensive and nit-picking than when not drinking, as examples); pursuing insane, circular arguments or trains of illogical thought
• Getting a DUI; driving while under the influence of alcohol
• Having unplanned, unwanted or unprotected sex; date rape

Drinking behaviors occur with binge drinking, alcohol abuse, alcoholism, and underage drinking of the binge drinking amount. This short video explains the differences between “at-risk drinking” (which is defined as heavy social drinking and binge drinking), alcohol abuse and alcoholism, “Alcoholism is a Disease and It’s Not Alcohol Abuse.” Drinking behaviors have an impact on the person who is on the receiving end of the behavior. [Further explanations below.]

Before you continue, please know this is a long post – you may want to skim through the remainder and then return later to re-read portions and pursue links at your leisure.

The Risk Factors for Developing an Alcohol Misuse Problem

I start this post with the entry points for developing an alcohol misuse problem because many of these entry points are the result of chronic exposure to secondhand drinking. Chronic exposure to secondhand drinking causes serious emotional and physical health problems as a result of the chronically activated fight-or-flight stress response system, which in turn changes the brain – the physical and emotional health – of the person experiencing it, which in turn can make that person’s brain more vulnerable to alcohol misuse. This post explains, “The Health Consequences of Secondhand Drinking | Drugging (SHDD).”

These risk factors – entry points – include:

• Genetics – persons whose parent or sibling are alcoholics are 4-7 times more likely to become alcoholics themselves. It is estimated there are some 25 genes that influence a predisposition to alcoholism, such as lower levels of the liver enzyme that metabolizes alcohol or higher or lower levels of dopamine. Just as we have genetic predispositions to eye or skin color or body type or some cancers, so, too, can a person inherit genetic predispositions to alcoholism.

• Early use – because of the critical brain development that occurs from ages 12–25, an adolescent can become an alcoholic in as little as 6 to 18 months; persons who begin drinking before the age of 15 are four to five times more likely to develop alcoholism than those who wait until 21.

• Social environment – people who live, work or go to school in an environment in which the heavy use of alcohol is common – such as growing up in a home where heavy drinking is seen as ‘normal’ or in a school setting where it is viewed as an important way to bond with fellow students – are more likely to abuse alcohol themselves. This level of drinking may or may not progress into alcohol abuse and/or alcoholism for the reasons of genetics, early use, mental illness and/or childhood trauma.

• Mental illness – just over one-half of persons diagnosed as alcoholics or alcohol abusers have also experienced a mental illness (e.g., depression, PTSD, ADHD, bipolar) at some time in their lives; mental illness causes chemical and structural changes in the brain, as does alcohol abuse or alcoholism. A person with a mental illness often uses alcohol to self-medicate the symptoms of the mental illness. By the same token, alcohol may exacerbate an existing mental illness – for example, alcohol is a depressant which can further depress a person with depression.

• Childhood trauma – verbal, physical or emotional abuse, neglect, persistent conflict in the family (such as that surrounding a family member’s alcohol abuse or alcoholism), sexual abuse and other traumatic childhood experiences can shape a child’s brain chemistry and subsequent vulnerability to addiction.

The Risk Factor – Secondhand Drinking Connection

The more risk factors – entry points – a person has, the more likely they are to develop a problem with alcohol abuse and/or alcoholism. Take a young person who has grown up in a family where there is untreated, unhealthily discussed alcohol abuse and/or alcoholism, for example (and therefore untreated, unhealthily discussed secondhand drinking impacts).

That young person potentially experiences three of these risk factors: Genetics, Childhood Trauma and Social Environment. That young person may also experience depression or anxiety as a consequence of the craziness that can exist in a family with untreated alcohol abuse and/or alcoholism, which presents a fourth risk factor – Mental Illness. If that same young person decides to experiment with alcohol in middle school or high school because that’s what their peer group is into or they are provided alcohol by a drinking parent who has a skewed view of drinking, anyway, and finds that drinking helps to relieve their sad and anxious feelings (at least while drinking), that young person now is faced with a fifth risk factor, Early Use, which can develop into an alcohol abuse and/or alcoholism drinking pattern – especially in the presence of the other key risk factors. With the exception of genetics, each of these risk factors is likely a secondhand drinking impact — a ripple effect of someone else’s alcohol abuse and/or alcoholism.

Remember – alcoholism (like other addictions) is a developmental disease. When a person abuses alcohol, they chemically and structurally change the way their brain works. This makes their particular brain more susceptible to the key risk factors for developing alcoholism explained above, which are the entry points to the disease. Many of these risk factors are the result of secondhand drinking.

Secondhand Drinking Prevention – Follow the Secondhand Smoking Prevention Model

Preventing or mitigating the entry points reduces the secondhand drinking impacts, which in turn, reduces the likelihood of a young person engaging in underage drinking, alcohol abuse and/or developing the disease of alcoholism. A bold claim, I realize, but we have a very successful model to follow for this approach — secondhand smoke.

When we were focused on trying to get the smoker to stop smoking, it was easy for those in their sphere to dismiss the problem as, “I don’t care if she smokes. Doesn’t bother me.” Once new research proved the impacts of a person’s smoke on the health of others (i.e., secondhand smoke), there was a whole new appreciation for the far-reaching harm caused by an individual’s decision to smoke, and a whole new shift in society’s view and tolerance for secondhand smoke.

It is my opinion that if more of us understand the new brain research (see “What’s Changed” below) and secondhand drinking, we will have a key to reducing alcohol abuse, underage drinking and alcoholism – much the same way secondhand smoking campaigns changed America’s smoking culture. Yes, this is a bold claim, but think about that same young person, again. And let me be clear, secondhand drinking prevention is not about prohibition, it is about preventing drinking behaviors.

Now back to that same young person…

If his (or her) elementary school’s substance abuse education program had a piece on the new brain research that explains alcoholism as a chronic, often relapsing brain disease and just what that means, that young person may have been able to separate his parent (whom I’ll now refer to as his father) from his father’s drinking behaviors. He may have been able to understand it was his father under the influence of alcohol, not his father doing and saying the crazy, mean things. He may have been able to understand his mother’s behaviors (some of them just as crazy as his father’s) were the result of her reactions to his father’s drinking behaviors, not because he hadn’t cleaned his room or gotten all A’s or was always forgetting to put the toilet seat down.

In other words, he may have understood it was not him causing his parents’ behaviors — it was his father’s chronic relapsing brain disease – alcoholism – and his mother’s reactions to it (in other words, the secondhand drinking impacts his mother experienced/experiences). He would have also learned his mother’s reactions were ‘normal’ when a person does not understand the disease of alcoholism or the condition of alcohol abuse, but they are not healthy or productive. He’d have understood his mother’s behaviors were the result of her desperate attempts to do something — anything — to make it stop; an impossible task that left her feeling angry, sad and frustrated every time she failed to do so. He and his parents may have understood through secondhand drinking education information passed along through articles, school work, snippets in the PTA newsletter, posters, tweets, short videos and FB updates about Protecting Yourself from Secondhand Drinking.

All of this knowledge might have reduced that young person’s depression and anxiety because he would have understood early on that as long as his father drank and his mother did not understand a healthier way of coping with it, his father would continue those drinking behaviors and his mother would continue her reactions (some even more hurtful than his father’s behaviors!). Knowing this would have helped that young person understand that the only thing he could do was to get help with developing healthy coping skills himself, which his teacher and school counselor would have been aware of, given the enhanced substance abuse education programs that would have incorporated those, as well. [Check out Understand Brain Maps | Change a Habit | Change Your Life.]

Or if that young person’s pediatrician had received this new addiction education in medical school (something that does not occur, in most cases, by the way) and insurance companies covered the cost of a pediatrician taking an extra 15 minutes beyond a covered visit, the pediatrician would have been able to use brief assessment tools to gently probe substance use in the child’s family. If the child opened up about what was going on, the pediatrician could have helped the child understand what alcohol abuse and/or alcoholism is and is not, thereby helping the child recognize their anxious and sad feelings were likely the consequences of his father’s drinking behaviors and his mother’s reactions to them.

The pediatrician would also have been able to explain to the child the idea of genetic predisposition and thus the need for the child to be wary of early use of alcohol, because – you guessed it – the pediatrician could have explained the critical brain development that occurs from ages 12-25 and why alcohol abuse during that time is especially problematic — especially for a child whose parent is an alcoholic. And, like the teacher and school counselor, the pediatrician would have known resources that could have helped their young patient learn healthier coping skills. Check out this post, “Alcohol Abuse Going On In the Family? If Only My Doctor Had Asked.”

Armed with all of this new information, that child may have overcome and/or avoided entirely the risk factors he was facing as the consequence of secondhand drinking. And, who knows…that child’s teacher sending home some of the education materials may have helped a parent or two think about their own drinking patterns enough to change them or helped another parent or two better understand what alcoholism and/or alcohol abuse were really all about and what they could or could not do to help their spouse stop drinking. (Okay, okay, YES, this is an oversimplification… but you get the idea.)

What Has Changed – Why Hasn’t Secondhand Drinking Prevention Been Done Before?

The connection to and understanding of brain changes associated with drinking behaviors and the risk factors for developing a drinking problem is so very, very new. Making the connection between a person’s drinking behaviors and the impacts of those behaviors on others (secondhand drinking) was something I started in 2009 in an attempt to raise awareness about the “realness” of these impacts.

Thanks to new brain imaging technologies of the past 10-15 years, neuroscientists and medical professionals can now study the live human brain like never before. Some of the resulting discoveries and research findings (many in just the past decade) are:

• shedding new light on brain functioning and development, explaining how a person can become an alcoholic before age 21 and why a person who abuses alcohol ‘thinks’ and behaves the way they do
• providing the visual evidence of the chemical and structural changes that occur in the brain as a result of alcohol abuse and/or alcoholism
• radically altering our understanding and/or treatments of
  – alcoholism (now understood to be a chronic relapsing brain disease),
  – alcohol abuse (now understood as something distinct from alcoholism), and
  – secondhand drinking, a term I’m using to describe the impacts of a person’s alcohol misuse on families, friends, co-workers, fellow students and society at large.
• showing us the brain impacts and health consequences of chronic stress – the kind of stress that occurs when a person is chronically exposed to secondhand drinking (The Health Consequences of Secondhand Drinking).

How Can We All Be Part of the Solution?

I urge all of us to be open to this new research and this new approach. I urge all of us to learn as much as we can and to share this new research with others. Because the most important thing about ALL of THIS is that we be talking about it – all of it. Why? Because the numbers, the consequences of not are significant.

It is estimated that over one-half of American adults have a loved one who drinks too much and one in four children will live with alcohol abuse or alcoholism before the age of 18.  These are the estimated numbers of Americans whose lives will typically be impacted by secondhand drinking. Through many of these people, the secondhand drinking ripple effect carries into the workplace, the classroom, the place of worship – the very fabrics of our society.

Looking at the numbers of individuals with the potential to cause SHD, we take NIAAA’s estimate of about 18 million Americans having an alcohol use disorder, classified as either alcohol dependence—perhaps better known as alcoholism—or alcohol abuse (not to be confused with alcoholism). The scientific nature of alcohol use disorders is little understood by the general population. It’s little understood by the medical profession, as well. As such, secondhand drinking stealthily continues because of the secrecy, shame and misinformation that surround these drinking patterns and the belief that all alcohol misuse is willful.

When we include NIDA’s $235 billion³ cost estimates per year of the negative consequences of alcohol misuse for individuals and for society, including productivity and health- and crime-related costs, as well as the staggering breadth of the associated public health and safety implications of alcohol misuse, “such as family disintegration, loss of employment, failure in school, domestic violence, and child abuse,” [NIDA], we can better appreciate that every one of us is likely touched in some way by secondhand drinking.

When considered in these terms, we see that secondhand drinking knows no socio, economic, racial or cultural boundaries because alcohol misuse knows no socio, economic, racial or cultural boundaries.

So… together…

• We need to be taking the disease of alcoholism out of the closet and exposing it for what it is — a chronic, often relapsing brain disease.
• We need to be talking about alcohol abuse for what it really is — a stage of drinking distinct from alcoholism — the stage at which secondhand drinking impacts for others begins.
• We need to be pealing away the secrecy and shame that surrounds this disease — a disease that affects the entire family and through them, fellow students, co-workers, friends and society at large.
• We need to be tackling the disease at its entry points — early use, mental illness, childhood trauma, social environment and genetics — where it can be arrested — before the person experiencing or exposed to the entry points suffered the consequences.

Who knows, with this approach, together we just may be able to cause a sea change in the drinking culture in much the same way tackling secondhand smoke changed the smoking culture in America. Now wouldn’t that be something…

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Note: This post was originally published on February 23, 2013. It was updated January 27, 2020. Some comments may have been posted on the original post.

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Lisa Frederiksen

Author | Speaker | Consultant | Founder at BreakingTheCycles.com

Lisa Frederiksen is the author of hundreds of articles and 12 books, including her latest, "10th Anniversary Edition If You Loved Me, You'd Stop! What you really need to know when your loved one drinks too much,” and "Loved One In Treatment? Now What!” She is a national keynote speaker with over 30 years speaking experience, consultant and founder of BreakingTheCycles.com. Lisa has spent the last 19+ years studying and simplifying breakthrough research on the brain, substance use and other mental health disorders, secondhand drinking, toxic stress, trauma/ACEs and related topics.

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