Underage Drinking
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, about 33 percent of teens
have had at least 1 drink.1 » By age 18, about 60 percent of teens
have had at least 1 drink.1 » In 2015, 7.7 million young people
ages 12–20 reported that they drank
alcohol beyond “just a few sips” in
the past month.2 More adolescents use alcohol than cigarettes or marijuana
Percent Past-Month
Alcohol, Cigarette, or Marijuana Use Youth ages 12–20 often binge drink
People ages 12 through 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. How much is a drink?
In the United States, a standard drink is one that contains
about 14 grams of pure alcohol, which is found in:
» 12 ounces of beer with 5 percent alcohol content
» 5 ounces of wine with 12 percent alcohol content
» 1.5 ounces of distilled spirits with 40 percent
alcohol content
Unfortunately, although the “standard” drink amounts
are helpful for following health guidelines, they may
not reflect customary serving sizes. A large cup of beer,
an overpoured glass of wine, or a single mixed drink
could contain much more alcohol than a standard drink.
In addition, while the alcohol concentrations listed are
“typical,” there is considerable variability in alcohol
content within each type of beverage (e.g., beer, wine,
distilled spirits). 50
40 35.3 30
21.5 20
10 21.3
14.8 9.7
3.6 11.4 6.3 6.5 0
8th 10th
Grade
Alcohol Cigarettes 12th
Marijuana SOURCE: Johnston, L.D.; Miech, R.A.; O’Malley, P.M.; et al. Monitoring the Future National
Survey: Trends in 30-Day Prevalence of Use of Various Drugs in Grades 8, 10, and 12, 2015.
Ann Arbor, MI: Institute for Social Research, University of Michigan, 2015. Available at: http://
www.monitoringthefuture.org/data/15data/15drtbl3.pdf. Accessed 01/06/2016. NIH . . . Turning Discovery Into Health®
National Institute on Alcohol Abuse and Alcoholism
www.niaaa.nih.gov • 301.443.3860 »
» 5.1 million young people reported binge drinking, for males 5 or more drinks and for females
4 or more drinks on the same occasion within a few hours, at least once in the past month.2
1.3 million young people reported binge drinking on 5 or more days over the past month.2 Drinking patterns vary by age and gender
As adolescents get older, they tend to drink more. Prevalence of drinking by boys and girls is similar,
although among older adolescents, boys binge more than girls.
Alcohol use among boys Alcohol use among girls 30 30 20
14.4 15
8.9 10 0.7 15 0
14–15 Years Old
Boys by Age Binge Drinking 16–17 Years Old 11.5 9.8 5 1.9 12–13 Years Old 22.1 20 10 4.6 5
0 25 22.2 Percent Percent 25 0.9 4.5 2.2 12–13 Years Old Any Alcohol 14–15 Years Old
Girls by Age
Binge Drinking 16–17 Years Old Any Alcohol SOURCE: Center for Behavioral Health Statistics and Quality. 2013 National Survey on Drug Use and Health Public Use File. Rockville, MD: Substance Abuse and
Mental Health Services Administration. Underage Drinking Is Dangerous
Underage drinking poses a range of risks and negative consequences. It is dangerous because it:
Causes many deaths
Based on data from 2006–2010, the Centers for Disease Control and Prevention (CDC) estimates
that, on average, alcohol is a factor in the deaths of 4,358 young people under age 21 each year.4
This includes: »
»
»
» 1,580 deaths from motor vehicle crashes
1,269 from homicides
245 from alcohol poisoning, falls, burns, and drowning
492 from suicides Causes many injuries
Drinking alcohol can cause kids to have accidents and get hurt. In 2011 alone, about 188,000 people
under age 21 visited an emergency room for alcohol-related injuries.5
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 youth who drink 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. NIH . . . Turning Discovery Into Health®
National Institute on Alcohol Abuse and Alcoholism
www.niaaa.nih.gov • 301.443.3860 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. What is
“binge drinking?” Increases the risk of alcohol problems later in life
Research shows that people who start drinking before the age of 15
are 4 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 may have easy access to alcohol. In 2015,
among 12-14 year olds who reported that they drank alcohol in the past
month, 95.1 percent reported that they got it for free the last time they
drank.6 In many cases, adolescents have access to alcohol through family
members, or find it at home. For adults, binge
drinking means drinking
so much within about
2 hours that blood
alcohol concentration
(BAC) levels reach
0.08 g/dL, the legal limit
of intoxication.
For women, this
typically takes about
4 drinks, and for men,
about 5. But, according
to recent research
estimates, it takes fewer
drinks for children to
reach these BAC levels.
For boys:
» Ages 9–13:
About 3 drinks
» Ages 14–15:
About 4 drinks
» Ages 16–17:
About 5 drinks
For girls:
» Ages 9–17:
About 3 drinks 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 NIH . . . Turning Discovery Into Health®
National Institute on Alcohol Abuse and Alcoholism
www.niaaa.nih.gov • 301.443.3860 Several key approaches have been found to be successful. They are:7
Environmental interventions
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 » Connecting with other parents about sending
clear messages about the importance of not drinking alcohol »
» 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 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. NIH . . . Turning Discovery Into Health®
National Institute on Alcohol Abuse and Alcoholism
www.niaaa.nih.gov • 301.443.3860 Warning Signs of Underage Drinking
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 disorder. 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 Substance Abuse and Mental Health Services Administration (SAMHSA). 2015 National Survey on Drug Use and Health (NSDUH). Table 2.19B—Alcohol Use in Lifetime, Past
Year, and Past Month, by Detailed Age Category: Percentages, 2014 and 2015. Rockville, MD: SAMHSA, 2016. Available at: http://www.samhsa.gov/data/sites/default/files/
NSDUH-DetTabs-2015/NSDUH-DetTabs-2015/NSDUH-DetTabs-2015.htm#tab2-19b
2  Substance Abuse and Mental Health Services Administration (SAMHSA). 2015 Key Substance Use and Mental Health Indicators in the United States: Results from the 2015
National Survey on Drug Use and Health. Figure 24. Rockville, MD: SAMHSA, 2016. Available at: http://www.samhsa.gov/data/sites/default/files/NSDUH-FFR1-2015/NSDUHFFR1-2015/NSDUH-FFR1-2015.htm#fig24
3 Centers for Disease Control and Prevention (CDC). Fact Sheets: Underage Drinking. Available at: http://www.cdc.gov/alcohol/fact-sheets/underage-drinking.htm
4 Centers for Disease Control and Prevention (CDC). Alcohol and Public Health: Alcohol-Related Disease Impact (ARDI). Available at: http://nccd.cdc.gov/dph_ardi/
Default/Report.aspx?T=AAM&P=f6d7eda7-036e-4553-9968-9b17ffad620e&R=d7a9b303-48e9-4440-bf47-070a4827e1fd&M=AD96A9C1-285A-44D2-B76DBA2AE037FC56&F=AAMCauseGenderUnder21&D=H
5 Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Behavioral Health Statistics and Quality. The DAWN Report: Highlights of the 2014 Drug
Abuse Warning Network (DAWN) Findings on Drug-Related Emergency Department Visits. Rockville, MD: SAMHSA, 2014. Available at: http://www.samhsa.gov/data/sites/
default/files/spot143-underage-drinking-2014/spot143-underage-drinking-2014/spot143-underage-drinking-2014.pdf
6 Substance Abuse and Mental Health Services Administration (SAMHSA). 2015 National Survey on Drug Use and Health (NSDUH). Table 6.70B – Source Where Alcohol Was
Obtained for Most Recent Use in Past Month among Past Month Alcohol Users Aged 12 to 20, by Age Group: Percentages, 2014 and 2015. Available at: http://www.samhsa.
gov/data/sites/default/files/NSDUH-DetTabs-2015/NSDUH-DetTabs-2015/NSDUH-DetTabs-2015.htm#tab6-70b
7 National Institute on Alcohol Abuse and Alcoholism (NIAAA). Underage drinking: Why do adolescents drink, what are the risks, and how can underage drinking be prevented?
Alcohol Alert, No. 67. Rockville, MD: NIAAA, January 2006. Available at: http://pubs.niaaa.nih.gov/publications/AA67/AA67.htm NIH . . . Turning Discovery Into Health®
National Institute on Alcohol Abuse and Alcoholism
www.niaaa.nih.gov • 301.443.3860
September 2016

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