Stigma and alcohol misuse during adolescence

Stigma associated with alcohol misuse can have serious consequences for adolescents, who may be at risk of developing abuse and dependence disorders. Adolescence is a period that involves wide use of psychoactive substances. During this developmental phase, adolescents are strongly influenced by peer group norms, which do not necessarily stigmatize alcohol use. Unintentionally, a significant subgroup of adolescents may develop problems that are a result of alcohol misuse. The stigma about alcohol problems may keep adolescents from admitting that their difficulties are exacerbated by misuse of alcohol. When their behavior crosses the line from norm to inappropriate, the label of alcoholic may be applied and the stigma that is attached to the label will have additional consequences. This includes withdrawal of social supports and even access to treatment. Adolescents with alcohol use problems may be reluctant to identify themselves with these difficulties, because of their concern about being rejected. These adolescents may present with emotional or behavioral problems, rather than alcohol concerns. Clinicians may avoid inquiring about alcohol use, because of their own negative and pessimistic perceptions of this disorder. Clinicians can be important resources for these adolescents, but this requires that clinicians examine their own prejudgments about alcohol abuse and dependence. This can facilitate meaningful inquiry about alcohol use and begin to offset the stigma and negative self-worth of these adolescents.