BALTIMORE — For as many as a third of adolescents who report riding in a car with a drinking driver, that driver may well be a parent rather than a peer.
That finding, based on a cross-sectional questionnaire of 2,100 adolescents, highlights “a profoundly underrecognized and undertreated public health problem,” Dr. Celeste R. Wilson said in a poster presentation at the annual meeting of the Pediatric Academic Societies.
“Primary care providers need effective counseling strategies for adolescents exposed to parents who drive while intoxicated and more training in how to deal with parents who are placing their children at risk by engaging in this behavior,” said Dr. Wilson, of the Center for Adolescent Substance Abuse Research at Children's Hospital, Boston.
The study sample was recruited from among 12- to 18-year-olds who arrived for routine primary care visits at one of nine primary care practices in Massachusetts, Vermont, and New Hampshire during 2005-2008. They completed computerized questionnaires as part of a larger study on substance abuse. The total 2,100 adolescents who completed the 20-item survey had a mean age of 16 years, and two-thirds were female. Half had at least one parent with a college degree, and 69% lived with both parents.
Of the 2,100 total respondents, 22% reported having ridden in a car in the previous 90 days with a driver who had been drinking. Of those 459 respondents, 41% identified that driver as someone living in their home. And of those 189 respondents, 91% (172) said that the drinking driver living in their home was an adult who was over 21 years of age. Because of institutional review board concerns about study subject protection, the survey did not directly inquire whether the drinking driver was a parent or guardian. Instead, the descriptions “an adult over 21 years of age” and “living in your home” were used as proxies, Dr. Wilson explained.
Adolescents who reported riding with a drinking driver who was an adult living in their home were more likely to be female, to be white, and to have a parent with no college degree. Younger adolescents were more likely than older ones to report riding with a drinking “parent.”
Although the exact nature of the relationship between the adult drinking driver and the adolescent could not be confirmed, other questionnaire data supported the supposition that most of these were indeed parents. The risk for having ridden with a drinking driver who was older than 21 and living in the teenager's home was more than three times greater for those who agreed with the statements “I have a parent whose use of alcohol or other drugs worries me,” “I have a parent who gets drunk or high,” and/or “I have a parent who needs treatment for alcohol or other drug problems.” The risk was more than double for those who said, “I have a parent who uses alcohol or drugs soon after getting up in the morning.”
Still, Dr. Wilson acknowledged that at least in some cases, the drinking driver might be an older sibling or a parent's romantic partner who is not the teen's parent. Nonetheless, “I think the key issue is that an adult who is well known to the adolescent is engaging in behavior that's potentially putting the adolescent at risk. Such behavior is of grave concern, as it not only threatens the adolescent's safety but also inadvertently sends a powerful yet erroneous message that it is acceptable to drink and drive.”
This study was funded by grants from the National Institutes of Health and several private foundations. Dr. Wilson said she had no financial disclosures.
Clinicians need counseling strategies for teens who are exposed to parents who drink and drive. ©Dmitriy