The long-ingrained message of "Just Say No" should evolve to "Just Say Know" when it comes to alcohol use by teens and young adults, according to substance-abuse researchers at the Medical University of South Carolina and other institutions.

In the know

If you are a teacher or school administrator and would like to book a "Just Say Know" presentation, call 792-2727.Anyone interested in participating in a conference, set Sept. 22 or Dec. 1 at MUSC, to learn how to give "Just Say Know" presentations can call Sylvia Rivers at 792-9531 or e-mail

Scientific evidence over the past two decades consistently demonstrates how alcohol, particularly in large quantities or "binges," damages the developing brain, which is more susceptible to alcohol's effect than the developed brain of an adult.

Despite news that teens are turning to drug alternatives, the one still used the most is alcohol. And when teens drink, they tend to "binge," defined as drinking five or more drinks within a span of a few hours.

Last year, the American Medical Association compiled that evidence in a report on alcohol's adverse effects on the brains of children, adolescents and college students.

"The report's aggregation of extensive scientific and medical information reveals just how harmful drinking is to the developing brain and serves as a wake-up call to parents, physicians, elected officials, law enforcement, purveyors of alcohol -- including the alcohol industry -- and young drinkers themselves," the AMA states on its website.

The report also says the average age of a child's first drink is 12 and that nearly 20 percent of youths ages 12-20 are considered binge drinkers.

"While many believe that underage drinking is an inevitable 'rite of passage' that adolescents can easily recover from because their bodies are more resilient, the opposite is true."

An expert speaks

In March, the MUSC Institute of Psychiatry hosted one of the most pre-eminent researchers on the subject, Dr. Susan Tapert, a neuroscientist at the University of California-San Diego.

Tapert said the adolescent brain is particularly vulnerable because is still developing and more sensitive to the toxic effects of drugs such as alcohol.

In a study published in December 2009, Tapert looked at 12- to 14-year-olds before they had used any alcohol or drugs. Over time, some of the kids started to drink -- a few rather heavily, drinking four or five drinks per occasion, two to three times a month, classic binge-drinking behavior in teens.

After about three years into the study, she compared the drinkers to the nondrinkers. The bingers did worse on thinking and memory tests.

The study also showed a distinct difference between genders. Girls who engaged in heavy drinking during adolescence performed more poorly on tests of spatial functioning, which links to mathematics, engineering kinds of functions. Boys who drank performed poorly on tests of attention.

In another study, Tapert reported abnormal functioning in the hippocampus, a key area for memory formation, in teen binge drinkers. Reflecting their abnormal brain scans, the teens did more poorly on learning verbal material.

Appealing to the kids

In an attempt to take that knowledge from labs and academic conferences to those most affected, the Center for Drug and Alcohol Programs at the Institute of Psychiatry is expanding its "Just Say Know" program. Since starting it 10 years ago, staffers have presented the evidence-based program to 3,500 students in the tri-county area.

Starting this fall, the program will have 25 to 30 trained MUSC students helping make the presentation, which taps into the natural fascination youths have with hands-on science (a real human brain is brought to show how it's a critical but vulnerable organ).

"In our age, drug and alcohol education was focused on fear and negativity," says Dr. Suzanne Thomas, the center's education and outreach coordinator. "This presentation avoids using scare tactics to discourage drug and alcohol use. Instead, it relies on science to teach students how the brain works, and how drugs and alcohol can alter brain structure and function to produce problems including risky behaviors and addiction."

Among the fans of the program is Janet Counasse Leonard, a guidance counselor at Gregg Middle School in Summerville, who describes it as "absolutely phenomenal."

"It really hits home," says Leonard. "The children get so much out of it. We hold it in October, and they will continue to talk about it throughout the school year. It's a great science lesson, too, because the students get to see the brain and talk about it."

The program can be tailored to last 30-50 minutes. It is designed for use in students in the fourth grade and up.

An alternative thrill

While Thomas is working on prevention efforts, the MUSC drug and alcohol center sees its fair share of youths who experience the damage.

Dr. Deborah Deas, psychiatry professor, says alcohol is "toxic" to the brain, which doesn't stop its development until the mid- to late 20s. The brain is particularly vulnerable during the teen years, when heavy drinking damages the white matter that is critical to relaying information among brain cells.

"Adolescence is a period of transition from latency to adulthood," says Deas. "Many (teens) have a sense of immortality and that they can do anything and be OK."

Deas adds that the way teens consume alcohol, by binging two or three times a month, tends to be more damaging as well.

So what can replace the thrill of drinking?

Deas says evidence confirms what many people have known for years. Teens involved in sports are less likely to engage in heavy drinking because they have less idle time and often are more in tune with their bodies and health. Those with a propensity for high risk, she adds, should try water sports and skateboarding.

Drinking age

Deas and others want to counter efforts by several college presidents and chancellors, who are part of the Amethyst Initiative.

The initiative contends that the National Minimum Drinking Age Act, passed in 1984 basically to raise the legal drinking age to 21, is not working and encourages a "culture of dangerous, clandestine 'binge drinking.' " The initiative also notes that adults under 21 are "deemed capable of voting, signing contracts, serving on juries and enlisting in the military, but are told they are not mature enough to have a beer."

Deas says a study published in the July Journal of the American Academy of Child & Adolescent Psychiatry shows that the relative risk for binge drinking among 12- to 20-year-old males has decreased. She said the decrease may be due to the effectiveness of the drinking age act.

"The positive impact of the MLDA (minimum legal drinking age) has been previously demonstrated through an analysis of 241 studies from 1960 to 2000," wrote Deas in the same edition of the journal.

"Whereas the Amethyst Initiative may be well-intended, public health data strongly support the effectiveness of the MLDA. ... Discussions about the MLDA need to take into account the scientific evidence of alcohol's effect on decision making in the context of development."

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