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Scientists Try to Assess the Impact of Binge Drinking on the Brains of Teens
email this pageprint this pageemail usLaura Hambleton - Washington Post
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December 07, 2010

Darkened areas highlight where binge drinking adolescents had altered white matter on the brain from the control group. (Susan Tapert)
Emergency room nurse Sheila DeRiso stood at the front of the high school auditorium and looked out on her audience of 50 teenagers and parents. From a black nylon bag she pulled out a long, plastic tube, then a stomach pump, a speculum, a catheter and an adult diaper. The group tittered. All these items are used in the ER every day to treat binge-drinking teens, she told them.

Then she yanked out a white body bag and unfolded it: "And this is if you don't make it."

The audience was dead silent.

Binge drinking, or consuming many drinks fairly quickly, has been a hallmark of college life. But students in high school and even middle school are also engaging in it, according to DeRiso, local police officials and experts. In one 2005 study of 5,300 middle school students, about 8 percent of seventh-graders and 17 percent of eighth-graders said they had tried binge drinking during that year.

The results of these bouts of excessive drinking show up in ERs across the region. Most weekend nights - and especially around holidays - young people arrive at the ER injured in car crashes, sick with alcohol blood poisoning, unconscious or barely conscious after binge drinking or engaging in the newest trend of blackout drinking, or drinking to the point of intentionally passing out.

"I am a nurse," DeRiso told her audience at Magruder High School in Rockville. "Alcohol affects your thinking, your coordination and judgment. Alcohol affects your brain."

Exactly how it affects the fast-developing and still malleable brains of young people is a hot scientific question. At a time when binge drinking is an entrenched part of life for many young people, scientists and epidemiologists are looking beyond the bodily injury that DeRiso sees in the ER at Montgomery General Hospital in Olney to the cognitive damage and physical and chemical changes that heavy drinking can cause in the adolescent brain.

Teens consuming alcohol

First, consider these statistics:

Nationwide, people ages 12 to 20 drink 11 percent of all alcohol imbibed in the United States each year - and more than 90 percent of that is consumed in the form of binge drinks, according to a 2008 report by the Centers for Disease Control and Prevention.

Nearly half of Maryland high school seniors say they have tried binge drinking, according to a study published in 2008 by the Maryland State Department of Education. A 2009 report that looked at students in all high school grades found that one in five said he or she had "had five or more drinks in a row within a couple hours on at least one day" in the preceding month.

In Virginia, 76 percent of high school seniors and 64 percent of 10th-graders reported using alcohol in the previous 30 days, according to an annual youth study published in 2006.

In 2005, 1,825 college students ages 18 to 24 died from alcohol-related unintentional injuries, including car crashes, or about five every day, one every five hours, according to the National Institute on Alcohol Abuse and Alcoholism.

l Although binge drinking is often defined as men downing at least five drinks or women four within two hours, a 2006 study of more than 10,000 first-semester freshmen at 14 colleges found that about 20 percent of men had had 10 or more drinks at one sitting and 10 percent of women had downed eight or more at least once during the previous two weeks.

"I'd guess that at least a third of the patients who arrive [in the ER] between midnight and 5 a.m. are intoxicated," said Mary Pat McKay, a George Washington University professor of emergency medicine and public health who works in the ER at GWU Hospital. Many of the patients are university students, she said. "Holiday weekends and weekends after midterms tend to be the worst."

An adolescent brain

What are the consequences of so much drinking when your brain is still developing?

According to scientists, a young brain is incredibly dynamic, creating a multitude of connections among neurons, or brain cells, as a child is exposed to new things every day and learns new skills. Around 12 years old, the brain begins to refine those connections, in a "use-it-or-lose-it" process scientists think involves a kind of pruning, where only the most vital and exercised connections remain.

"There's a lot of chatter going on in the brain with all those connections," said Duke University professor of psychiatry and behavioral sciences Scott Swartzwelder, an author of the 2006 study of binge drinking among college freshmen. "Some of them are unnecessary. I liken it to a marble sculpture: When you chip away the extraneous connections, you reveal what the image really is. The remaining connections become more efficient. You begin to think through things without getting distracted. You begin to think more clearly."

Enter alcohol - large quantities of alcohol - which is a powerful drug that passes quickly into the bloodstream through the stomach and small intestine and makes its way to every organ of the body, including the brain.

"It is a very potent depressant that goes everywhere and affects every system," said Marc Schuckit, a professor of psychiatry at the University of California at San Diego and editor of the Journal of Studies on Alcohol and Drugs. "It affects every neurochemical system in the brain."

For instance, scientists believe alcohol can trigger an increase in dopamine, a chemical associated with pleasure and reward. They believe alcohol disrupts the workings of the frontal lobe, important in coordinating brain functions and modulating reasoning, intelligence and impulses. And since the first drink was consumed centuries ago, people have written about alcohol's ability to interrupt memory and learning, Swartzwelder said.

"Those three systems - learning, reward and the frontal lobe - are areas alcohol can powerfully affect," especially in a brain that is still a work in progress, said Swartzwelder, who has been studying this process in adolescent rats.

The memory deficit

Swartzwelder specifically studies the hippocampus, the part of the brain dedicated to forming memories and learning skills. Because the human hippocampus is similar in structure to a rat's, Swartzwelder has studied rats roughly the comparable age of adolescents and found that large quantities of alcohol can stop the hippocampus from functioning properly.

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