"I'm drinking too much too fast when I go to parties. What can I do to slow down?"

I don't talk about standard drinks when I speak to students - as much as I think it's important for people to be aware of the concept, realistically they're not particularly useful to young people. If you ask most adults who use standard drinks in their day-to-day life, they're usually used in relation to driving and staying under the legal limit (secondary school students can't have any alcohol in their system at all when they drive so talking to them about them as far as driving is concerned makes little or no sense). I could be wrong but I don't think I've ever met anyone who uses them in terms of maintaining a healthy life! They certainly provide important information for drinkers (and alcohol companies love the concept because it looks like they're doing something in terms of responsible drinking) but in reality we have absolutely no evidence (as far as I'm aware) that they encourage teens to drink more responsibly. In fact, I believe that they do just the opposite in many cases, with some young people comparing two drinks and looking which one gives them 'more bang for their buck' - 'the one that has the highest number of standard drinks will get me drunk faster!'

The only time I do touch the subject is when I speak to Year 12s and tell them the story of a young women I met in Adelaide a number of years ago who simply wasn't aware that when she drank Smirnoff Double Blacks she was actually drinking vodka! She had approached me after my talk with some classmates who were all very concerned about their vodka consumption. During the talk I had told them about the risks associated with vodka - high alcohol content and easy to drink - and they were asking me how they could possibly minimise the risks. When they left, she remained, quite proud of herself because she didn't drink vodka - she drank Smirnoff Double Blacks! When I told her that was vodka she was very surprised but when I asked her how many she was drinking, her answer floored me ... when she drank, she was drinking 4 or 5 in a session! When I say this to Year 12s the usual response is 'so what's wrong with that?' - when I then tell the audience that if they have ever drunk 5 Smirnoff Double Blacks in a night they have actually drunk almost half a bottle of vodka to themselves, they are stunned! A bottle of vodka is around 22 standard drinks, a Smirnoff Double Black is 1.9 standard drinks (almost two shots per can), drink 5 and you have consumed almost 10 standard drinks, just under half a bottle of spirits! Most students I speak to have certainly been taught about standard drinks (usually in Year 9 or 10) but the concept is quite abstract and they simply don't seem to be able to look at what they're drinking in that way ...

This week I met a young woman, who had recently turned 18, who was quite distressed after my Year 12 talk - the information on how much she was drinking came as quite a shock and she wanted my help. This is how the conversation went ...

I don't drink very often but when I do, I find myself drinking very quickly. I drink Smirnoff Double Blacks, mainly because it's what everyone else drinks, I had no idea how much alcohol was in them. If I'm honest, I would say that I usually drink about 4 in the first hour and a half of the night, sometimes more, and a few more after that. I don't drink to get drunk - I can't imagine anything worse than getting drunk and feeling sick - I drink purely to be social. I've never got sick after drinking so I didn't think I was drinking that much. What you said about half a bottle of vodka (and I'm obviously drinking even more than that) is scary. I'm very concerned that I drink so quickly - I pick up a drink and before I know it I've finished it. As soon as I've done that I get another one and before I know it I have finished a 4-pack! What can I do to slow down?

When I was talking to one of the teachers about the conversation afterwards she was quite shocked that the girl could drink that much and still be standing, let alone not feel sick. As I've said many times before, young people are able to drink more, for longer periods of time, than adults due to them being less susceptible to the sedative effect of alcohol. The brain mechanism of this effect are not completely clear, but it is believed to be due to the neurotransmitter GABA. In an adult brain, consuming alcohol increases GABA production, reducing energy levels and calming everything down (a depressant effect). It is now believed that final levels of GABA receptors are not reached in the brain until early adulthood, once the brain is fully developed, and therefore adolescents have fewer GABA receptors on which alcohol can act. There isn't as much of a release of GABA when they drink and they are therefore able to stay awake and unfortunately drink more!

This young woman was not drinking for the effect, that was very clear, she was drinking to be social, to 'fit in' with her peer group. She admitted that she felt uncomfortable at a party without something in her hand and told me that a water bottle or a soft drink would simply not do - that would even make it worse - those girls who didn't drink were often socially excluded or asked lots of questions about why they weren't drinking. The problem was that when she had the bottle in her hand she just couldn't stop drinking it - to be honest it sounded like she was quite an anxious girl and nerves simply got the better of her in this situation. I really do believe that we underestimate how much social anxiety influences young people's drinking behaviour, particularly young women.

I gave her a couple of suggestions, one of which she felt really comfortable with ...

• I told her about the mother I had met years ago who had a daughter who was an elite athlete who in Year 12 was beginning to find herself socially excluded because she chose not to drink alcohol. In response and to help her daughter 'save face', the mother would buy ready-to-drinks (RTDs) like Smirnoff Double Blacks, empty them out, refill them with soft drink and recap them and give them to her daughter to take to parties
• Find lower alcohol content drinks with greater volume (Bacardi Breezers for example are only 1 standard drink, half the alcohol content of her current drink of choice) and take those to parties instead. Drink exactly the same number of drinks in a night and you are drinking half as much as you were previously - a very positive outcome
• Holding a water bottle all night may be 'social suicide' but picking it up and drinking a bottle between drinks to help space out your alcohol intake may not be so problematic
• Don't drink out of the can or bottle - instead pour the alcohol you take into a glass and only half fill it, then top it up with soft drink. Once again, you will be reducing your alcohol intake dramatically over the night but still manage to retain your social standing with your peer group

She loved the idea of drinking lower alcohol content drinks (which interestingly she didn't know even existed!) and when she learnt that she would half her alcohol consumption by doing this she looked relieved! Taking 'fake alcohol' worried her as she was concerned that she could be found out ("How do you make sure no-one picks up one of your drinks and catches you out?" she asked). The water bottle, even in between drinks, just didn't seem an option for her (what pressure must there be in some of these groups?) and although she thought the glass option was a really good idea she was concerned about the possible risk of drink spiking.

There is great pressure on young people to drink alcohol, with some groups feeling this pressure from a very young age. Do all of them want to get rolling drunk and feel sick the next day? Of course not - for many it is simply the social nature of drinking that is attractive. Unfortunately that doesn't make it any less dangerous. To my mind, teaching Year 9s and 10s about standard drinks is a huge waste of time - it is an abstract concept that they find difficult to match to their own lives. The Year 12 I met this week had been taught about standard drinks (she'd done the old favourite classroom activity of pouring drinks when she had been in Year 10) but was not able to relate that to her own drinking and the dilemma she was currently facing. Realistically I don't think there's much more a school can do in this area - it really is up to a parent to sit down with their teen and help them navigate through the pressures of drinking when they're this age. As I always say, give kids the information they actually want and they will listen ... this young woman wanted some options when she was informed about the risks - I truly believe that she will now change her drinking behaviour to some extent because she got information that was helpful to her at the time she needed it!