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Underage Drinking

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Underage drinking is a serious public health problem in the United States. Alcohol is the most widely used substance of abuse among America’s youth, and drinking by young people poses enormous health and safety risks.

The consequences of underage drinking can affect everyone— regardless of age or drinking status. We all feel the effects of the aggressive behavior, property damage, injuries, violence, and deaths that can result from underage drinking. This is not simply a problem for some families—it is a nationwide concern.

Underage Drinking Statistics

Many, many young people drink alcohol

  • By age 15, more than 50 percent of teens have had at least 1 drink.1
  • By age 18, more than 70 percent of teens have had at least 1 drink.1
  • In 2009, 10.4 million young people ages 12–20 reported that they drank alcohol beyond “just a few sips” in the past month.2

Youth ages 12 to 20 often binge drink

People ages 12–20 drink 11 percent of all alcohol consumed in the United States.3 Although youth drink less often than adults do, when they do drink, they drink more. That is because young people consume more than 90 percent of their alcohol by binge drinking. Binge drinking is consuming many drinks on an occasion (see box). Drinking alcohol and binge drinking become more prevalent as young people get older.

  • 6.9 million young people had 5 or more drinks on the same occasion, within a few hours, at least once in the past month.
  • 2.1 million young people had 5 or more drinks on the same occasion on 5 or more days over the past month.4

More adolescents use alcohol than cigarettes or marijuana

Column chart showing alcohol, cigarettes, and marijuana by percent past-month usage


SOURCE: Johnston, L.D.; O’Malley, P.M.; Bachman, J.G.; and Schulenberg, J.E. Monitoring the Future National Survey Results on Drug Use, 1975–2009: Volume I: Secondary School Students (NIH Publication No. 10–7584). Bethesda, MD: National Institute on Drug Abuse, 2010.

Drinking patterns vary by age and gender

As adolescents get older, they tend to drink more, and boys generally drink more than girls.

Alcohol use among boys

Column chart showing binge drinking and any alcohol by percent among boys

Alcohol use among girls

Column chart showing binge drinking and any alcohol by percent among girls


SOURCE: Substance Abuse and Mental Health Services Administration. Results From the 2009 National Survey on Drug Use and Health: Volume I. Summary of National Findings (Office of Applied Studies, NSDUH Series H-38A, HHS Publication No. SMA 10–4586 Findings). Rockville, MD: Substance Abuse and Mental Health Services Administration, 2010.

Underage Drinking is Dangerous

Underage drinking poses a range of risks and negative consequences. It is dangerous because it:

Causes many deaths

Every year in the United States, about 5,000 young people under age 21 die as a result of underage drinking.5 This includes:

  • 1,900 deaths from motor vehicle crashes
  • 1,600 from homicides
  • 1,200 from alcohol poisoning, falls, burns, and drowning
  • 300 from suicides

Causes many injuries

In 2008 alone, about 190,000 people under age 21 visited an emergency room for alcohol-related injuries.

Impairs judgment

Drinking can lead to poor decisions about engaging in risky behavior, including drinking and driving, sexual activity (such as unprotected sex), and aggressive or violent behavior.

Increases the risk of physical and sexual assault

Underage drinkers are more likely to carry out or be the victim of a physical or sexual assault after drinking than others their age who do not drink.

Can lead to other problems

Drinking may cause youth to have trouble in school or with the law. Drinking alcohol also is associated with the use of other drugs.

Increases the risk of alcohol problems later in life

Research shows that people who start drinking before the age of 15 are four times more likely to meet the criteria for alcohol dependence at some point in their lives.

Interferes with brain development

Research shows that young people’s brains keep developing well into their 20s. Alcohol can alter this development, potentially affecting both brain structure and function. This may cause cognitive or learning problems and/or make the brain more prone to alcohol dependence. This is especially a risk when people start drinking young and drink heavily.

Why Do So Many Young People Drink?

As children mature, it is natural for them to assert their independence, seek new challenges, and try taking risks. Underage drinking is a risk that attracts many developing adolescents and teens. Many want to try alcohol, but often do not fully recognize its effects on their health and behavior. Other reasons young people drink alcohol include:

  • Peer pressure
  • Increased independence, or desire for it
  • Stress

In addition, many youth have easy access to alcohol. A recent study showed that 93.4 percent of adolescents ages 12–14 who drank alcohol in the past month got it for free. In many cases, adolescents have access to alcohol through family members, or find it at home.6

Preventing Underage Drinking

Preventing underage drinking is a complex challenge. Any successful approach must consider many factors, including:

  • Genetics
  • Personality
  • Rate of maturation and development
  • Level of risk
  • Social factors
  • Environmental factors

Several key approaches have been found to be successful. They are:7

Environmental interventions

Photo of mother and daughter talkin

This approach makes alcohol harder to get—for example, by raising the price of alcohol and keeping the minimum drinking age at 21. Enacting zero-tolerance laws that outlaw driving after any amount of drinking for people under 21 also can help prevent problems.

Individual-level interventions

This approach seeks to change the way young people think about alcohol, so they are better able to resist pressures to drink.

School-based interventions

These are programs that provide students with the knowledge, skills, motivation, and opportunities they need to remain alcohol free.

Family-based interventions

These are efforts to empower parents to set and enforce clear rules against drinking, as well as improve communication between children and parents about alcohol.

The Role Parents Play

Parents and teachers can play a big role in shaping young people’s attitudes toward drinking. Parents in particular can have either a positive or negative influence.

Parents can help their children avoid alcohol problems by:

  • Talking about the dangers of drinking
  • Drinking responsibly, if they choose to drink
  • Serving as positive role models in general
  • Not making alcohol available
  • Getting to know their children’s friends
  • Having regular conversations about life in general
  • Connecting with other parents about sending clear messages about the importance of not drinking alcohol
  • Supervising all parties to make sure there is no alcohol
  • Encouraging kids to participate in healthy and fun activities that do not involve alcohol

Research shows that children whose parents are actively involved in their lives are less likely to drink alcohol.

On the other hand, research shows that a child with a parent who binge drinks is much more likely to binge drink than a child whose parents do not binge drink.

Warning Signs of Underage Drinking

Photo of five students

Adolescence is a time of change and growth, including behavior changes. These changes usually are a normal part of growing up but sometimes can point to an alcohol problem. Parents and teachers should pay close attention to the following warning signs that may indicate underage drinking:

  • Changes in mood, including anger and irritability
  • Academic and/or behavioral problems in school
  • Rebelliousness
  • Changing groups of friends
  • Low energy level
  • Less interest in activities and/or care in appearance
  • Finding alcohol among a young person’s things
  • Smelling alcohol on a young person’s breath
  • Problems concentrating and/or remembering
  • Slurred speech
  • Coordination problems

Treating Underage Drinking Problems

Some young people can experience serious problems as a result of drinking, including alcohol use disorders. These problems require intervention by trained professionals. Professional treatment options include:

  • Seeing a counselor, psychologist, psychiatrist, or other trained professional
  • Participating in outpatient or inpatient treatment at a substance abuse treatment facility or other licensed program

For more information, please visit: www.niaaa.nih.gov

1 Available at http://www.surgeongeneral.gov/topics/underagedrinking/educatorguide.pdf

2 National Survey on Drug and Alcohol Use (NSDUH) 2009, http://www.oas.samhsa.gov/NSDUH/2k9NSDUH/2k9ResultsP.pdf, p.35

3 Available at: http://www.cdc.gov/alcohol/fact-sheets/underage-drinking.htm

4 National Survey on Drug and Alcohol Use (NSDUH) 2009, http://www.oas.samhsa.gov/NSDUH/2k9NSDUH/2k9ResultsP.pdf, p.35

5 Available at http://www.surgeongeneral.gov/topics/underagedrinking/educatorguide.pdf

6 Available at: http://oas.samhsa.gov/spotlight/Spotlight022YouthAlcohol.pdf

7 Available at: http://pubs.niaaa.nih.gov/publications/AA67/AA67.htm

July 2013