Alcohol-induced impairment in adolescents admitted to inpatient treatment after heavy episodic drinking: effects of age and gender.

OBJECTIVE: In Germany and many other countries, the number of adolescent heavy episodic drinking-induced hospital admissions (HEDHA) in pediatric units markedly increased during the past decade. A low level of response to alcohol in young adults is associated with high risk for later development of alcohol use disorders (AUDs). METHOD: We performed a retrospective chart review of all 1,123 HEDHA cases in adolescents aged 11-17 years who were admitted to one of the pediatric inpatient units covering the cities of Dresden, Pirna, and Rostock, Germany, between 2000 and 2008. Blood alcohol concentration (BAC) and Glasgow Coma Scale (GCS) measures on admission were documented in 846 cases. RESULTS: The mean (SD) BAC was 155 (50) mg/100 ml full blood, and M (SD) GCS was 12.21 (3.02). These parameters were negatively correlated with each other (r = -.256, p < .001), indicating more impairment at higher BACs. To describe a numerical estimate of how severely a subject was compromised relative to his BAC, the GCS scores were inverted (making high scores indicate severe impairment) and divided by BAC. The resulting alcohol-induced impairment index (AIII) was significantly influenced by an interaction between age and gender, decreasing with age in boys but increasing in girls. CONCLUSIONS: During adolescence, alcohol-induced impairment develops differently in boys and girls, which may be because of the girls' developmental edge. The high variability of observed AIII might help to predict the risk for later AUDs in the emergency department, simply by measuring BAC and GCS.

A retrospective analysis of psychosocial risk factors modulating adolescent alcohol binge drinking.

BACKGROUND/AIMS: Adolescent alcohol binge-induced hospital admissions (BIHAs) are an increasing problem in Europe. We investigated whether psychosocial factors (e.g., drinking situations, drinking occasions and neighborhood unemployment) are associated with particularly risky patterns of alcohol or substance use. METHOD: We performed a systematic retrospective chart review of all the respective cases in 2003-2008 (n = 586; age range: 12-17 years) from both pediatric hospitals in the city of Dresden, Germany. RESULTS: The vast majority of adolescent BIHAs were associated with drinking together with peers at weekend parties. Compared to this 'typical' drinking pattern, adolescents drinking 'atypically' (i.e., drinking either alone, to cope or despite the fact that the next day was a school/work day) more often had already used alcohol and illegal substances before and were more often diagnosed with substance use disorders and other mental disorders prior to BIHA. The unemployment rate in the patients' neighborhood was positively related to the incidence proportion of adolescent BIHAs in the respective subdistricts (r(s) = 0.61). CONCLUSION: Adolescent atypical drinking may indicate an increased risk for the development of alcohol and substance use disorders. This information is quickly accessible and can alert clinicians to initiate psychosocial aftercare; their infrastructure should address the strong relation between BIHA probability and neighborhood unemployment rates.