When is it OK to let kids taste alcohol? - (11/16/2021)

By Dr. Ron Gasbarro

Ms. Van was in the pharmacy getting her cough syrup refilled. The pharmacist asked her if she also wanted her 7-year-old daughter’s cough medicine refilled as well, since both still had hacking coughs. “No,” Ms. Van said. “I’ve been giving Amy some of my cough medicine.” “But your medicine has alcohol in it!” the pharmacist exclaimed. “She doesn’t like the taste of hers,” the parent responded. “In fact, she likes the medicine in one of my small cordial glasses. So, we each sip it like a cocktail. I even drop a bit of my sherry into each of our glasses. She sleeps all night and doesn’t cough at all.” Upon hearing this story, if the pharmacist did not have most of his shift to finish, he would have fainted dead away. 

Why the extreme reaction to giving this youngster an alcoholic beverage? There are at least several. First, children do not metabolize alcohol the same way adults do. Unlike healthy adults who imbibe alcohol, the levels of blood glucose (sugar in the blood) plummet dangerously in a youngster. When the brain cannot get enough glucose to keep it running smoothly, seizures and coma can occur. However, despite the age of the drinker, alcohol affects the central nervous system. Staggering when they walk, talking incoherently, appearing to be sleepy can be signs of a drunk child. Judgment may be impaired while standing at the top of a staircase or chasing a ball across the street. Whether the adult feels the beverage is innocuous – for instance, beer is not as potent as vodka – the child’s reaction will depend on their current age and brain development. 

Second, researchers have thumb-wrestled for years as to whether alcoholism runs in families. Is there a provable genetic basis? Or is it environmental in that there is always booze in the house or that there are a half-dozen liquor stores on one’s block? In the mix and match of some 20,500 genes that make up any one of the possible 4 trillion human personalities, sure, there is a remote possibility a formula for alcoholism exists. More likely, alcohol abuse is a combination of genetic and environmental factors. A child may observe that a cup or two of wine at the Purim feast is happily appropriate. Or a kid may see that her mother passes out at her birthday party, causing her embarrassment. Without getting into the psychobabble of 5-syllable forgettable terms, let’s just say that one child may remember that alcohol was an escape from an uncomfortable experience. Whether or not the child picks up that association and transfers it to her own habits may be a matter of heredity. Or it may be a warning that it is something that should not be imitated. 

Third, is Mrs. Van crazy? While the pharmacist is not labeling Ms. Van an alcoholic, her actions seem to indicate that she does not respect alcohol as the “controlled substance” it can be. No, one does not need a prescription to acquire it. The official age for drinking alcohol in the US is 21, although the age can vary from state to state. Keeping alcohol away from teens is difficult enough without willingly offering it to them in a tea-party setting. According to the Cleveland Clinic, underage drinking is a significant public health problem. In recent years, researchers have discovered that among high school students: approximately 1 in 3 drink alcohol, almost 1 in 5 have ridden in a car with a driver who has been drinking alcohol – and sadly, that can include the parent of a child who has been drinking – and 1 in 20 have driven after drinking alcohol. According to the CDC, drinking under age 21 contributes to death from alcohol poisoning, unintentional injuries, such as car crashes, drowning, as well as violence and sexual assault. 

So, as cute as it may be to serve Amy’s cough syrup in one of Mommy’s cordial glasses, the practice sets a bad precedent. Kids will find booze if they want it. The idea is for them to respect its potency and the consequences that go with this it. And doesn’t this start with the parents? 

Ron Gasbarro, PharmD, is a recovering pharmacist and writer-in-residence at Rx-Press. 

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