Episode 10: The Effects of Drinking on Mental Health
According to results from the 2018 National Survey on Drug Use and Health, approximately 1 in 10 young adults ages 18 to 25 meet the criteria for an alcohol use disorder. In this episode, we are joined by Dr. Stephen Pannel, DO, ABPN, ABAM, Chief Medical Officer and psychiatrist at Right Track Medical Group, to discuss the effects of drinking on mental health in young adults. Listen now below, or anywhere you get your podcasts.
EPISODE TRANSCRIPT
Rhes Low, Host:
Hey guys. Welcome back to another episode of South of Fine. As usual, I am your host, Rhes. So, as a lot of you guys know, over the last couple of months, we've spent a lot of time on this podcast talking about the mental health of college students. But one thing we haven't touched on is the role alcohol plays in the mental health of this age group. Maybe we've touched on it, but we haven't really gone in depth about it.
For many young adults, it's in college that alcohol becomes central to their social interaction, but that drinking as we know can often become a problem for them. According to results from the 2018 National Survey on Drug Use and Health, approximately 1 in 10 young adults ages 18 to 25 meet the criteria for an alcohol use disorder. So, to delve into this topic, I am joined today by Dr. Stephen Pannel, Psychiatrist and Chief Medical Officer for Right Track Medical Group. Dr. Pannel is also the former Medical Director at Oxford Treatment Center. Dr. Pannel, thanks so much for joining us today.
Dr. Stephen Pannel, Psychiatrist and Chief Medical Officer for Right Track Medical Group:
Good morning. Thank you for having me.
Low:
Yeah, absolutely. So, as we usually do, let's start with a little bit of context. Obviously, we know that college kids abuse alcohol. I mean, there are entire movies that are based upon that activity. We know that there are a lot of problems associated with that. One of which is just simply drinking too much, but how much is considered too much for an 18 to 24-year-old?
Dr. Pannel:
Yeah. Well, I'm going to start even a little sooner than that, and then we'll kind of go into that. One of the things that we do as a society is we look at college as sort of being a special circumstance or unique environment. We use that as sort of a filter, if you will, that overlays how we view and look at alcohol use. Doctors and addiction specialist and really people in the healthcare community don't necessarily see it the same way. I'll just give an example. Call me old fashioned and more of a traditionalist, but really, I still am one of those people that believes if you're not 21 years old, you shouldn't be drinking at all.
So, a lot of times when parents come to me, and they say, "Well, how much is okay for my son or daughter or somebody to drink?" I always ask them, "Well, how old are they if they're less than 21?" I always tell them that the appropriate amount of alcohol use for anybody under the age of 21 is actually zero. That's pretty hard for a lot of people to even really consider nowadays and time and age. One of the things we've seen as part of that is the acceptance of underage drinking and even teenage drinking has become so common.
The last study that I looked at said, 7 out of 10 high school seniors have already started to drink and to experiment with alcohol and different things like that. Even exposure to alcohol now has become so commonplace in so many areas that by the time a person gets to college, it almost just becomes something that's not even a concern of being "illegal or unhealthy" or those sorts of things. It's usually not until a young person gets a minor in possession ticket, a DUI or some sort of a consequence as a result of their drinking. So, all that to be said, I always tell high school people and parents and anybody that asked me, "If you're not 21, you shouldn't be drinking at all. Anything above zero is considered to be a concern or a problem."
The other part of that is so technically, there's some specifics out there. It gets pretty technical, so I'm going to cover some of those things. But a heavy alcohol use specifically is considered to be anything more than eight drinks per week, anything more than three drinks per day for women. So, it kind of breaks out into a male/female, men and women kind of scenario. But heavy drinking for women if you have more than eight drinks in a seven-day period, or as part of that, if you have more than three drinks in one day, that can be considered heavy drinking. For men, it's 15 drinks per week or anything more than 4 drinks in one day. So, pretty, pretty significant difference there.
Usually, the first question I get asked is, "Why is there such a difference between 8 drinks for women versus 15 drinks for men?" A lot of that dates back to the female body, the liver, the way it breaks down alcohol, the process of that, it takes a much bigger toll on women. They don't metabolize it as effectively. So, one drink for a woman is about the equivalent of two drinks for a man just because of how our livers work differently. That's still to be said, that's considered for people that are 21 and older. The National Institute of Alcohol Abuse and SAMHSA, all these organizations that monitor alcohol use are very clear that what they're talking about is 21 years old and older.
There's a little bit to discuss about that as well. The second thing I usually talk with patients about is, is "Do you really understand what a drink is?" Most of them do not. Just for example, with the way we measure alcohol is very specific, it's a chemical, it's a thing that's out there. So, the way we measure it is very different amongst people to people, person to person, culture to culture, restaurant to restaurant even. So, I'll give you a little example, when we're measuring these drinks, it's what you consider one standard drink.
So, one standard drink is either one 12-ounce beer or it can be one 5-ounce glass of wine or it can be one drink with 1.5 ounces of hard liquor in it. So, the interesting thing is, is some of the restaurants and some of the places that people frequent, they may order one drink or one beverage, but it may have way more alcohol than one standard drink. This is where you'll hear people say, "Well, I only had two or three drinks." Well, if you do the math on the measured amount of what they drank, they could have actually been consuming a lot more alcohol ounces than they realized.
Low:
Absolutely.
Dr. Pannel:
In the South and in the Southeast, a lot of restaurants, you see they don't really measure these things out. They just sort of pour things, they do things. It's a lot of variability. A very few restaurants actually are still measuring these things out. I have noticed in other areas, bigger cities, different places, sometimes you do see that, where bars actually measure out the quantity. That's usually a cost saving-
Low:
Sure.
Dr. Pannel:
... thing that the places will do. So, anyway, that's one of the things that people really don't think much about. Now, when they're drinking beer, drinking things that they open, that they have a specific identified amount in it, that's more specific. When you start talking to patients about drinking wine or drinking hard liquor beverages, it gets a little bit more difficult to track.
Low:
Yeah, I hear you. I think that the first thing that occurred to me when you were talking about the 21 is, "Is there some science behind brains developing? When does the adolescent brains stopped developing?" Can you speak a little bit to that? Because I think that's a very important part of this discussion.
Dr. Pannel:
Sure, sure. I'll be honest with you. I think now if people were looking at alcohol and making decisions about overall healthcare in today's times, the drinking age would more than likely be set a whole lot higher than it is. A lot of what we do with the alcohol age being set at 21 was based off the best data and evidence they had at that time. You got to realize drinking beer and wine and whiskey has been around for a really long time. But the adolescent brain for most parts of what we think as far as developing to a place where it's mature enough to handle social drinking and alcohol use is still around the age of 21 or 22.
Oddly enough, there are some studies out there that indicate that the female brain may develop a little more maturely sooner than the male brain does, or in some households, they say, "The female brain develops at age 21 or 22. The male brain never develops fully," kind of the message so. You're not going to appreciate that. But honestly, I think most of what we know about young people now and when you look at things, really, there's a delineation in the human body at age 25 to 26.
Honestly, I think if you were to put this up to researchers and you really do the study and if you really looked at these things now more than likely, if this was to be able to be looked at again and really based on research and science, more than likely we'd come out with a drinking age, it was probably 25 or 26 years old, which then would almost immediately remove drinking from the college scene sort of on age base pretty quickly. If you think about that, most people that are graduating college graduate by the time they're 25 or 26, unless they get into higher level education programs. So, something that's interesting to see, and we do see that.
The brain sort of develops over the lifespan as an organ, it never stops developing. It never stops changing. But getting to a place where it's not creating pathways, creating very important parts of its structure, you could say that 22 is probably a good age for that. If you waited until 25 or 26, you'd be significantly even more protected by that.
Low:
Interesting. Speaking of the physical effects of alcohol, we understand the consequences of heavy drinking. Especially when we're young, do we really think about the effects that they can have on your mental health?
Dr. Pannel:
No, I don't think so. I think most of our younger population nowadays with the amount of information they have at their fingertips, they are much more exposed to things earlier on now than people used to be. So, their ability to consume information and to be exposed to things is at an all-time high, and it's just getting increased every day. But most young people do not take seriously the effects of alcohol on their brain, their development, how it affects them, how it impacts them.
Acutely, when they're under the influence of it, they may have some appreciation for it and maybe somewhat the following day. But I don't think there's many 16, 17 year olds out there looking back over the last month saying, "Wow, I really am doing some potential short-term, mid-term, long-term damage to myself with the weekend binge drinking and things like that." I just don't think young people see it that way.
Low:
Without going super in depth, what are the effects of alcohol on our brain, so excess alcohol, not drinking responsibly, but too much alcohol?
Dr. Pannel:
Yeah. So, the main thing that we know is it interrupts chemical pathways in your brain that helps communication. So, our brain is an organ dissolved based off electricity and different chemical transmitters, neurotransmitters. So, when you put alcohol into your brain, a lot of people for better or worse, they don't realize that in excessive amounts, it can become toxic. So, it can disrupt the chemical balance in your brain, if you will, which really is more of a communication system with how your brain communicates with other parts of your body, how it communicates with coordination, and different things like that.
A lot of people experienced that in the acute onset of it. If they've had too much to drink, they have trouble walking, they have trouble talking, different things like that pretty physically... You can observe that pretty easily. A lot of people underestimate that that can go on for 24 to 48 hours later, that can be some difficulty with coordination, dizzy spells, different things like that. But the main thing is, is in the days after that, you can have mood changes. You have behavior changes. You having difficulty with your thinking, not be able to think clearly. Some of those things can go on for several days depending on the toxicity level that was consumed.
Low:
Wow, really? I didn't know that. That's interesting. So, that would mean that if someone suffers from depression, alcohol can have a massive effect on enhancing that depression.
Dr. Pannel:
Sure, sure. Yeah. Well, the interesting thing we see about "self-medication" and kind of the minimization of alcohol use, if you will, to handle stress and to cope with things and things of that nature, the things that I see as part of that as being the really difficult thing for people to understand is people who are the most vulnerable to it also receive the most benefit in the beginning. So, these are people that will tell you, "I never really drank that much. But when I got into college or got into this situation or that situation, I started drinking wine or I started drinking beer. I started drinking hard liquor." It's usually one of those things that it's not intentional.
It's usually happens as part of the coincidence of where you are, other people are doing it, it's more socially acceptable. It's usually something that people just sort of find themselves doing as part of just that period of time in their life. Oddly enough, the people who get the most benefit from it, I mean, I've had patients that come and tell me that when they started drinking, that the alcohol was the best thing that they had done for themselves in the first year and a half, sometimes two years for making them feel better. So, they get a really profound benefit from it in the beginning, but as it wears off, as it goes away, in those days following, we talked about the effect of not having it around or not having it in their brain, also significantly makes the symptoms worse.
So, you get into this process that as a person, when you drink, you feel a whole lot better. And then when you're not drinking, you feel a whole lot worse than you did before. So, this is why so many people will start to drink almost every day of the week. You'll hear people say, "When I started to drink and drink alcohol, for the first time in my life, I felt normal." And then you'll hear them say that if they weren't drinking every day, they didn't feel normal. Well, the unfortunate traits of alcohol as a chemical is, is that eventually you get to the place where you can't drink enough to feel normal anymore and it becomes very toxic to your overall functioning.
Low:
That's really, really well put. I never thought of it that way, about making you feel normal. But if you're being affected by some sort of mental health problem, then that makes a lot of sense. We talk a lot about anxiety on this show. So, a lot of times you'll go home, and you'll say, "I'm going to have a glass of wine to calm myself down, so I'm less anxious." But drinking two or three glasses of wine could actually enhance that anxiety, am I wrong in thinking that?
Dr. Pannel:
Well, in the short term, it would likely have some lowering effect on the anxiety, but the following day, the anxiety would actually feel worse or could potentially be worse. So, it is one of those things that alcohol as a chemical and as a molecule is a central nervous system depressant. So, it actually calms your brain and your central nervous system down.
So, what people appreciate when they have a few glasses of wine like that is, is that they sort of feel calm, they feel calmed down. They do feel those effects. What they may experience the next morning or even later in the night sometimes for people is they may experience this sort of rebound effect of then a higher level of anxiety, more anxiety, more stress to the system, which then the brain tells them or they sort of start to make this association, "Well, if I drink more, then that will go away and I'll feel better." So that's one of the things we see.
Oddly enough, like we talked about just a moment ago, when you're really vulnerable to having a really profound effect from this, it's very, very interesting to see, because patients or people who don't feel that way just tend to drink less. So, there's a lot of people just to kind of say the other part of, there's a lot of people that have the same sort of thing like you're sitting there a minute ago. Come home and drink a few glasses of wine. Well, oddly enough, people that are not as vulnerable to alcohol as becoming a problem for them, they don't get the same benefit.
So, a lot of people who don't really drink that much, just by the nature of their bottles, you don't drink that much, because it didn't really help them, it didn't really make me feel better, didn't really have the same effect or the same impact if you will. You've met people like this too. You've run across people every day in your life that you'll say something, and you'll just notice there's always groups of people out there that just don't seem to drink as much as other groups do. Part of that is a lot of those people have tried, it just didn't work for them. It became more of a waste of time, energy and money more so than was effective for them.
So, oddly enough, the people who find drinking to be very, very helpful and very useful tend to congregate together. So, our social groups, people who drink more, tend to hang out more with each other who do drink more. People who don't drink as much tend to hang out with other people who don't drink as much. You actually see this in adult groups and cultures. A lot of people don't look at it from an overall theme like this, but you'll see this. Even on college campuses, you have a large number of people who hang out together, and a lot of that social activity is built around alcohol. But there's also large components of college age students who have done that, tried that, it was not beneficial to them. So, they hang around in larger groups doing other things, other interests. So, it's an interesting phenomenon.
Low:
Yeah, that's great to point out, especially for these college students who enter... A lot of people in enter into college thinking that's kind of a rite of passage-
Dr. Pannel:
Sure.
Low:
... for their experience. When in fact, it's not. You can have a great time without experiencing any of that. So, I think we can all answer this easily, but is there an association between drinking too much and suicidal thoughts, I guess, if you're prone to that sort of thing?
Dr. Pannel:
Yeah, one of the things we know about suicidal thoughts, suicide attempts and even suicide completions is there's usually a level of external influence or being under the influence of something. In most cases and a large number of cases, that is alcohol related. Alcohol is readily available. It's one of the most readily available things out there for people to buy and use and consume and to feel different. So, in most cases, in a lot of cases, not necessarily in all, but a lot of times when you drink heavily and you become impaired, it actually lowers your ability to think clearly and it lowers your inhibitions.
I mean, we all know about people who drank too much, who did things that were embarrassing or other things that they wouldn't do had they not otherwise been under the influence. That can have the same impact if you're very, very depressed or very, very anxious or if you've been in a place where as a completely unimpaired person, you've been close to suicidal thoughts or suicidal acts or even attempts. Alcohol or really any other drug could also be the very thing that sort of removes that last barrier of protection from yourself. So, a lot of times, and especially in the emergency rooms and in different places when people are in that place, usually, impairment from alcohol or some other chemical is usually a piece of that as well.
Low:
On a completely opposite into the spectrum, a lot of these, especially in college and even as adults have social anxiety. We have been told throughout the ages that having a cocktail may help improve that social anxiety and loosen us up a little bit. Are other ways that you could suggest dealing with that, rather than having a drink, especially for those that don't want to drink and those of us that may take it too far?
Dr. Pannel:
Yeah, sure. It sort of depends on how significant it is. I think, when you say that, what comes to my mind is I think about people who have very severe and kind of high levels of social anxiety. A lot of people have a milder or lower level that they can kind of work through or once they start to talk to people or once they sort of get comfortable in the environment, it sort of goes away and it may not be that much of a barrier to them to be there and to be present.
But for a lot of people that have moderate or severe levels of social anxiety, it can really be something that prevents them from talking to people, engaging in the situation. Depending on what they're there for, they have to give a speech or talk to coworkers or different things like that. So, social anxiety disorder is one of the biggest things out there that is really, really responsive to therapy, individual therapy. It's very responsive to medications, if those are indicated and needed. But one of the other things is there's all kinds of things that they can learn to do in those environments, practice them, be prepared for it.
The main thing with the social anxiety is people just usually feel very afraid and overwhelmed by the nature of what's going on. There's usually an external factor to that, the environment, the people, the location, the strangeness, all these things that make us anxious. There's also an internal component to that as well. Your breathing speeds up. Your heart rate speeds up. You get hot. You get sweaty. You get all these things going on on the inside that makes it really hard to function in those environments.
Fortunately, there's ways to teach yourself to navigate both the external environment and the internal environment. That's one of the things we do with the individual therapy is teach people breathing exercises, calming exercises, things that you can literally do in the room internally that nobody else around you even knows what's going on to calm yourself, to get yourself through those situations.
Low:
Cool. Yeah, those are great ideas. So, let's get to the meat of this. This is really interesting to me. What are some of the long-term effects of heavy drinking on our brain and our mental health? Maybe that can help a student to think twice about going down that road.
Dr. Pannel:
Long term effects of heavy sustained, even weekly use on a young person's brain can lead to difficulty with information retention, difficulty with information recall. One of the biggest features of college is usually it's very hard, the classes are hard, there's a lot of information. From an academic perspective, it's the first place that people find themselves to be in where they may be very challenging to them. A lot of the things that college students talk about is, is that high school was difficult, but they studied. With the structure and support of their parents, the family home and things like that, it was pretty easy for them. They did very well.
When they come to college, it's a very new experience. Sometimes the information, the academic component is much more difficult than what they were used to. And then if you combine that with drinking three to four days, a week or so or maybe even just one or two days of really heavy drinking like that, one of the things students will find or they'll describe is they'll say, "I just don't feel like I can learn things how I was in high school. I don't feel like I can do as well on the test and things like that."
A lot of times, they may not have very much understanding that studying and being a very good student on Monday, Tuesday and Wednesday can really be impacted by drinking on Thursday, Friday, Saturday. It's just one of those things that we see, so. Really long term, we know from looking at the brains of our older population, people who chronically drink alcohol for a longer period of time have a higher rate of dementia. They have higher rates of cognitive problems, cognitive declines. It's toxic on your brain.
So, when you look at a person's brain who's 65 or older, who's drank heavily for a really long period of time, structurally and anatomically, their brain looks very different than the brain of somebody in that same age group who's not drunk much over the lifespan. The brain is smaller, it's shrunken down. You can just tell it's had a negative impact from the toxicity of long-term alcohol exposure.
Low:
What are some coping skills that students could employ?
Dr. Pannel:
Well, this is the things I like to say that people hate to hear. So, one of the things, it's been around since the beginnings of healthcare, diet, exercise, lifestyle, those sort of things are always the first things that I think about. One of the biggest things that leads to stress and increased dysfunction of our bodies nowadays is very poor diet. You have to work very hard to eat healthy and to be healthy in today's times with quick, easy food, convenience, different things of that nature.
So, when I say diet, I don't mean in the way of losing weight or trying to change your weight, but strictly of what you eat, what you put in your body and trying to make that as healthy as you possibly can. When I talk to a lot of people out there, a lot of them are not eating very healthy at all. They may eat one or two meals a day or really just one decent meal a day. The other parts of their food intake during the day is just sort of secondary to whatever the day brings them.
Exercise is one of the things that after people leave their home and get out into college and different things like that can fall away off. You have a lot of people that play organized sports and do organized athletic activities through high school, and then when they get to college, they don't do any of those things. So, exercise can be really, really one of the best coping skills out there. It helps increase serotonin. It increases norepinephrine. It increases dopamine. It really increases the neurotransmitters in your brain that makes you feel better.
And then the other part of it is just creating a new social network support, creating an environment and a group of people around you that also help you to feel better. Colleges have lots of groups and lots of organizations that people can participate in, but even in the community, there's things that people can do and get involved in. One of the things of a coping skill is to have as much of these things around you as you can. So, that by doing a little bit of them every day, you feel better overall.
Low:
If you're a student athlete, I think that binge drinking is probably a big part of how alcohol affects student athletes, because like you said, they're working out. They have training. They have goals that they have to accomplish for whatever particular sport they're doing. Does binge drinking have the same effect that we've been talking about on these kids as just daily drinking? Which I guess a lot of what all college kids do is binge drinking. Is that affecting the mind the exact same way?
Dr. Pannel:
Yeah, in college athletes, it affects the mind in exactly the same way. Given their level of physical health and endurance, they likely get over it. They likely recover from some of the other physical effects more quickly or more effectively than others. It just sort of depends. Sometimes the consumption and the level of consumption there can be very high, but on a cognitive level, the brain is susceptible to it the same way as it is in other brains.
I mean, we're all unique and we're all different, we're all individuals, but at a biological level, everybody's brain is vulnerable to the same toxic things and toxic effects of things out there. But from a physical standpoint, I would estimate that student athletes, people who are in better physical health and in physical condition are going to recover from the physical effects of it a little bit more quickly, which you can see in athletes.
If you talk to a lot of athletes, and oddly enough, a lot of professional athletes really focus on the diet, the exercise and nutrition, of course. They don't put anything into their body that considered to be chemicals, because they can see the negative impact on their performance. So, sometimes if college athletes are being honest, they'll tell you that after they've had long weekends or been exposed to alcohol or other substances as in the days after that, the training, the weight training, the speed, some of the things that they measure themselves upon, they notice a difference. They notice a difference in their endurance and in their physical capabilities.
One of the things you see over time is the more and more you expose yourself, the longer and longer it takes to get over these effects. So, an 18-year-old college freshman may recover in a day or two. A senior 22-year-old college athlete has been doing this now for four years, it may take days to weeks for that performance to come all the way up. But oddly enough, a lot of athletes after some of the initial exposures and after some of these things, that's really one of the things that motivates them away from alcohol use is they noticed that impact on their sport.
Low:
Yeah, right. They have that monitor daily workouts to see how it does affect them so profoundly and decrease their performance.
Dr. Pannel:
I do want to say something there just to follow up. We talked about heavy drinking a little bit early in the beginning. One of the things we didn't address was binge drinking. I'm just going to just throw that out there just for completeness. So, as part of binge drinking, the main thing we look at with that is that it's about a quantity of drinks, but it's really about the quantity over a certain amount of time.
So, for women, somebody that drinks four drinks or four of those standard drinks that we talked about earlier or more in a two-hour period is considered to be binge drinking. So, this would be the case if you go out, you're very excited, you sit down. Next thing you know, in an hour and a half to two hours, you've had had four drinks or more in that timeframe. Now, this also includes shots and different things like that. It's one of the things that people don't realize that one of those shots that you take is a 1.5 ounce of alcohol. Those usually are measured out, but usually, people are taking those very quickly. So, you can pretty quickly get over the binge drinking level limit.
For men, that's considered to be five drinks in that same two-hour period. The reason this can be important is the speed at which you consume alcohol is also connected to the toxicity level or the impairment level. So, you have people that really in two to three hours can impair themselves by putting in so much alcohol so fast that it can lead to intoxication and different things like that. This is where some of the blood alcohol levels and some of these come from is that to have a blood alcohol level in your system that's high enough that you shouldn't operate vehicles or heavy machinery and those sort of things, part of that is based off how much you drink and how fast. That's where sort of the binge drinking concept came from.
If people do this more than five times a month, it's considered to be alcohol abuse, or they could have a full-blown alcohol use disorder. One of the beliefs about this is, is that young people in high school and other places, they start this trend of trying to consume a lot of alcohol quickly as to be able to avoid detection, to be able to get away with it. Even in 18-year-olds in college towns, it's not very realistic to go in and sit somewhere as an 18-year-old and slowly socially and appropriately consume alcohol.
Most of these cases, they're doing this at home or they're doing this somewhere else or they're trying to sort of get the sand quickly to start the process. So, I did want to just touch on that a little bit. That's what we see in a lot of people that are under 21, frankly, is the speed and the rate of consumption is very high. It's very strong and it's very fast, which can lead to intoxication from binge drinking.
Low:
Yeah, I'm glad you brought that up. What or where can a parent or a student find help for any sort of drinking problem that they have or a friend? What steps do they take? Where do they go?
Dr. Pannel:
Yeah, well, that's a very good question. In most cases, the best thing that you can do in your local area... Oddly enough, the colleges and college campuses have a wide array of places that you can contact and talk to people. Most people have on college campuses now student health centers. Some people have different groups and organizations where you can go in and talk to people about that. A lot of this is done as part of the orientation during the freshman year. They talk about if you start to have trouble, where you can reach out and access services. In the community level, you can always go to any kind of healthcare organization, urgent cares, primary care locations, different places like that.
People in healthcare are becoming more aware of this and more helpful to young people and to students. If you move to a new town and you don't have a regular doctor yet, one of the things that I've taught with young people about is that you're 18, you're an adult. As part of being here in college town and on campus, you need a regular healthcare provider to help you to continue to take care of yourself. So, you can always reach out to those locations.
The internet's always great. There's a lot of places and support. Resources out there have websites, they have addresses you can get online. A lot of times find a number to call or interaction to do that's free and over the phone in the beginning just to reach out and get help and support. Those are some places I think about.
From a website standpoint, for alcohol specifically, we do have a National Institute on Alcohol Abuse and Alcoholism. That's a long kind of name for an organization but has a lot of good information out there. A lot of people like to look at things on the internet, do a lot of self-research. So, it's a good place to start if you just have some overall questions for yourself or for a family member. It breaks it down and very easy to read, very easy to understand information. So, that you could have kind of look at your situation or look at this situation of a family member if needed.
Low:
Cool. We'll put a link for that in the show notes. So, last thing as a parent, do you have any suggestions for them as to how they talk about alcohol with their children before they send them off to school? Because this is an appropriate conversation that needs-
Dr. Pannel:
Sure.
Low:
... and must be had.
Dr. Pannel:
Yeah, I think my advice with parents on that is to start very young with young people. One of the things we notice now is that people are exposing themselves to alcohol earlier and earlier every year, even down to as early as 12 and 13 years old. So, one of the things I talk with parents about is at an early age, to start to talk about alcohol and the seriousness of it. Really, if you think about the driving age and getting a driver's license as being sort of the first big real-time of responsibility and those sort of things out there.
So, one of the things I encourage parents to do is to talk about not drinking and not driving, not being impaired behind the wheel of a car and the responsibility that that requires. A lot of young people don't necessarily think about that aspect. So, one of the things I've talked with parents about is just because, to start to set that that tone and that expectation with young people, that the privilege to drive as a 16 year old is also connected to the responsibility to not drive impaired. And then in the household, we've talked about this a little earlier, if you're not 21, you shouldn't be drinking. You shouldn't be drinking with your parents, you shouldn't be drinking in other places.
The conversation I think for them to have as young people is just a message of if they do find themselves engaging in that, to have a safe plan, have a safe activity, have somebody that they can call if they need help, whether it's a parent or whether it's somebody in the local community. But the main thing is just also not to underestimate the responsibility of those things, because in college towns, at 18, a lot of the things that go on, the legal ramifications and the legal aspects out of things are very clear where they are on those things. People can get themselves into pretty significant problems with universities in different places, different things.
I think just having an open honest conversation about it, one of the things we know is to be honest and direct in the communication with young people about it. They'll have questions. You don't necessarily have to have answers for every question they may have, but just being able to discuss it and talk with them about it to remove some of the fear factor from it, to remove some of the things that are there. A lot of young people when they go to college are scared. It's the first time they've been away from parents for a really long time. They don't really know what to expect or how things may happen. So, sometimes just having a plan, what to do if they find themselves in these situations, the different peer pressure situations, the different things that go on, that can be a step in the right direction.
Low:
Absolutely. That's a good point. I mean, a lot of these kids, that peer pressure is a big deal. They're very concerned with wanting to fit in and drinking is a part of that "fitting in" or that's how they feel. So, yeah, I think those conversations, honest conversations with parents would help alleviate that fear, to some degree. We talk about this a good deal on the show to is the more open and honest we can be as parents, the better off our children will be.
I think too for a lot of those children that are engaging in drinking, it's a great day and age that we have Uber and Lyft. So, if you found yourself being irresponsible, make sure to remember that those two companies are available for you as well.
Dr. Pannel:
Yeah, that would be part of the plan. I mean, one of the things we still interact with is most places now and some of your bigger cities and some of your bigger areas, maybe not quite as much, but in the majority of United States, most people, transportation still is a big component of that. I mean, most people are going to either drive or ride somewhere to and from their locations depending on things. So, sometimes that's a very good point is just to have a plan for a safe mode of travel. That's very important. That's been one of the biggest reasons I think Uber and Lyft has been so readily acceptable in a lot of areas and towns is because it does provide people an alternative. We have transport options now in places where there were no options before. So, that's something to look at.
Also, from getting food, getting other services, one of the things I've been impressed with as part of the whole pandemic is that people have now started to lean on these services a little more to get the food brought to them, get things brought to them. It's interesting that you can use these services now. Maybe you've had things going on during the day or during the evening that you shouldn't really get out and drive and go get food or something like that. Now you have a service you can reach out to that will bring it to you. Some cities and places have their own organizations that have created these delivery services as part of this, everything from food to groceries or whatever a person might need.
Low:
Right, yeah. There's a lot of good options out there to keep yourself safe. The best option being don't drink if you're under 21.
Dr. Pannel:
Sure.
Low:
As you said multiple times, yeah, and the science backs that up, I believe. But we care so much about our college students. I live in a college town. You work with Right Track Medical Group, and you all are in college towns. You all support a lot of these students. So, this is a very important conversation for those campuses and for those students, and as universities that you work very closely with, where we recently had a conversation with some folks out of [inaudible 00:40:29]. I enjoyed it quite a bit, because they collaborated. They were communicating with each other, both Right Track and the university. It was pretty neat to see that level of support that's out there for our kids and for us as parents. We'll have kids hopefully go to college at some point.
Low:
Well, Dr. Stephen Pannel, thank you so much. Is there anything you'd like to end with, anything you'd like to add before we take off?
Dr. Pannel:
No, the thing I focus on, you made a good point there about our locations in the college towns and those sort of things. One of the reasons we did that is a lot of people don't realize this about everything that we deal with from a mental health standpoint, illness as a process for humans is mostly something that happens later on in life, most people, 45, 50, 55 and older. Fortunately for us in this country and people in general, most of our healthcare conditions actually occur and happen much later on in life.
With the things that we take care of, it's actually exactly the opposite of that. A lot of these things start to develop in early years, teenage years, but most significantly, everything that we work with and take care of for a lot of people out there, it's very, very unique and developing for them between 18 and 26 years old, 18 and 30 years old.
So, part of that is where a lot of this comes from is difficult, because young people were not used to being in that situation where they have those symptoms. Parents are not used to dealing with that. I mean, mostly, we were used to taking care of our parents and grandparents and the older generation. So, that's one of the things I'd like to point out too as part of this is there's so much going on for young people from the age of 18 to 26, especially. But really even from 18 all the way up to 35 years old, there's so much development and different things that go on for people. That is one of the things that can be very scary and unexpected and those sort of things.
So, that's one of the things I do like to point out every chance that I get, is that from a healthcare perspective, it is something that usually starts to impact people earlier on in life, not necessarily everybody. I mean, some people will experience this later on in life as well. But for a lot of our young people we take care of, the adults that we take care of, it can be a very delicate time between 18 and 30 years old. So, a lot of people are in college and then they're in the master's programs, graduate programs, professional schools, different things during that timeframe. So, it's going to be something just for people to be aware of.
Low:
Yeah, absolutely. Great point. Dr. Pannel, thank you so much for spinning. I know, I kept you quite a long time, we're reaching about 45 minutes here, but your insights were very worthwhile. I know a lot of students and parents will be so appreciative of what you've given us here today. So, thanks.
Dr. Pannel:
Thank you. Thanks. Thanks for having me.
Low:
Absolutely, I enjoyed it. All right, everybody. If you find yourself struggling with mental health now or ever and are having a difficult time coping, don't be afraid to reach out for help. If you have questions about mental health and the COVID-19 pandemic and all that's going on right now that you'd like our providers to answer in a future episode, please email southoffine@righttrackmedical.com.
Dr. Stephen Pannel, thank you so much for your time.
Dr. Pannel:
All right. Great, thank you.
Low:
If you have questions about mental health and COVID-19 pandemic that you'd like our providers to answer in a future episode, please email southoffine@righttrackmedical.com. If you like more information about Right Track Medical Group or the South of Fine Podcast, please visit righttrackmedical.com.
Thanks to our production team, Kelley Hunsberger, Caitlyn Clegg, Carol Ann Hughes, Aleka Battista and Reese Lau. Special thanks to Squadcast for providing superior remote interview services.
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