Quick Clips with Dr. Kilmer: 10. Situational Tolerance, Part 2

In this series we talk with Dr. Jason Kilmer, professor of psychiatry and behavioral sciences at the University of Washington School of Medicine. He specializes in the development, implementation, and evaluation of substance use prevention and intervention efforts on college campuses and among 18–25 year olds.   

While Dr. Kilmer focuses on college campuses, his insights are universal and particularly helpful for parents with teenagers of any age. Share these recordings with your parenting peers as you all navigate this exciting time in human development (ages 14–25) and work to help your kids navigate away from alcohol and other drugs.

The video mentioned in this episode that further explains situational tolerance can be found at https://gordie.studenthealth.virginia.edu/learn/alcohol-education/situational-tolerance (created by Dr. Susie Bruce and her team at the Gordie Center).  

This podcast is brought to you by the Substance Abuse and Mental Health Services Administration (SAMHSA). The views expressed here are not necessarily those of SAMHSA or the U.S. Department of Health and Human Services. For questions or comments about this podcast, please contact WhatParentsAreSaying@gmail.com. 

Transcript

Quick Clips with Dr. Kilmer: 10. Situational Tolerance, Part 2

[00:00:00] Debbie: Welcome to Quick Clips with Dr. Kilmer. Today we are continuing our conversation about situational tolerance. It's not necessary to understand this episode, but if you haven't already, you may find our past episode. Why? Teaching my kids to drink is not a thing useful. Tell us more. Dr. Kilmer about situational tolerance and holding one's liquor.

[00:00:27] Dr. Kilmer: The important thing to realize is that this is not unique to college students, though. I mean, we think about. Look at what happened during the pandemic. If adults that drank said, for a whole year, I, I made my own drinks. Someone measuring a drink, putting it into a shaker, pouring that drink, those are all self-administration cues.

[00:00:44] We heard so many people say, the first time I went to a bar or a restaurant in a year. Or the same drink I'd had for the past year at home. And it hit me way, way, way, way, way harder. I don't think the drink was stronger, what was happening. That's what was happening. Those self-administration cues weren't there.

[00:01:01] A road trip, brand new environment, anything that changes, a shift in cues can make a difference. And there's even research outta Canada that shows that taste and smell can be a cue if someone has a favorite drink. That taste and smell of that favorite drink signals to the body. We're about to have our favorite drink.

[00:01:20] If they have a drink they've never had before, the body won't make that same condition. Compensatory response. A novel drink could actually hit someone harder than a drink they're more familiar with. 

[00:01:32] Debbie: It's fascinating. I, I love this research. It just satisfies my scientific side of my brain. But then in, from a parenting standpoint, there is some.

[00:01:44] I think it's legitimate belief or want to believe that I can prepare my kid for life. And I think those are justified thoughts by parents. And I think what this says is there's just some areas where our encouraging behavior is not going to prepare them. 

[00:02:05] Dr. Kilmer: I, I, I learned that some parents were doing this.

[00:02:07] I was speaking at a parent event in a community here in Washington and a parent raised their hand and said, my kid's gonna school a month. Um, this was the parents' words. I don't want my kid to be in quotes, a lightweight and so I'm ho I'm saying we're gonna have you, if you're gonna drink at parties, do it here.

[00:02:26] And their hope almost was I want the kid to be able to hold their liquor. 

[00:02:32] Debbie: Yeah. 

[00:02:32] Dr. Kilmer: And I was struck because I'm like, I don't want this person to feel bad as I present this research. Right. But I need them to understand why it could have completely the opposite effect. Here's the other thing that's so striking about tolerance.

[00:02:42] When we look at the concept of a alcohol use disorder, I think when people are often very surprised to find out is one of the criteria for a substance use disorder is tolerance. 

[00:02:51] Debbie: Hmm. 

[00:02:51] Dr. Kilmer: And so when someone says, I can hold my liquor. From a risk standpoint of an addiction standpoint, there's one criteria down one to go because it takes the, it takes meeting two criteria to have a, a substance use disorder.

[00:03:05] So even though some people might view tolerance as kind of a statusy thing, you know, I can hold my liquor, that person's in quotes, a lightweight from a risk stand standpoint,

[00:03:18] Debbie: right.

[00:03:24] Mechanisms that keep them from Overdrinking, you know? 

[00:03:28] Dr. Kilmer: Absolutely. You know, we're not a fan of labeling people in that way, and I, again, I put that in quotes as the term that parent had used. But tolerance, you're not getting those cues that say, Hey, maybe slow down, maybe call it a night. Yeah. And a person's friends aren't getting the cues that heads up.

[00:03:43] Our buddy might need to call it a night. So someone without tolerance. Gets those cues that say I need to slow down. Someone without tolerance may not be getting that. So I mean, you said it really well. It could be well intended. It could have not the intended outcome, unfortunately. 

[00:03:56] Debbie: Right. Excellent. Thank you, Dr.

[00:03:59] Kilmer. 

[00:04:00] Dr. Kilmer: Thank you.