Quick Stats
Underage Drinking

Alcohol use by persons under age 21 is a major public health problem (1). Alcohol is the most commonly used and abused drug among youth in the United States, more than tobacco and illicit drugs. Although drinking by persons under the age of 21 is illegal, people aged 12 to 20 years drink 11% of all alcohol consumed in the United States (2). Over 90% of this alcohol is consumed in the form of binge drinks (2). On average, underage drinkers consume more drinks per drinking occasion than adult drinkers (3). In 2005, there were over 145,000 emergency rooms visits by youth 12 to 20 years for injuries and other conditions linked to alcohol (4).

Drinking Levels among Youth

The 2005 Youth Risk Behavior Survey (5) found that among high school students, during the past 30 days

• 1 out of 2 drink some amount of alcohol.
• 1 out of 4 binge drink.
• 1 out of 10 drove after drinking alcohol.
• 1 out of 4 rode with a driver who had been drinking alcohol.

Other national surveys

• In 2006, the National Survey on Drug Use and Health reported that 28% of youth aged 12 to 20 years reported drinking alcohol and 19% reported binge drinking (6).
• Monitoring the Future Survey* in 2007 found that 39% of 8th graders and 72% of 12th have tried alcohol, and that 16% of 8th graders and 44% of 12th graders drank during the past month (7).

Consequences of Underage Drinking

Youth who drink alcohol (1, 3) are more likely to experience

• School problems, such as higher absence and poor or failing grades.
• Social problems, such as fighting and lack of participation in youth activities.
• Legal problems, such as arrest for driving or physically hurting someone while drunk.
• Physical problems, such as hangovers or illnesses.
• Unwanted, unplanned, and unprotected sexual activity.
• Disruption of normal growth and sexual development.
• Physical and sexual assault.
• Higher risk for suicide and homicide.
• Alcohol-related car crash and other unintentional injuries such as burns, falls, and drowning.
• Memory problems.
• Abuse of other drugs.
• Changes in brain development that may have life-long effects.
• Death from alcohol poisoning.

Youth who start drinking before age 15 years are five times more likely to develop alcohol dependence or abuse later in life than those who begin drinking at or after age 21 (8, 9).

Prevention of Underage Drinking

Reducing underage drinking will require community-based efforts to monitor the activities of youth and decrease youth access to alcohol (1, 3). A recent report by the Institute of Medicine outlined several prevention strategies that will require actions on the national, state, and local levels, such as enforcement of minimum legal drinking age laws, national media campaigns targeting youth and adults, increasing alcohol excise taxes, reducing youth exposure to alcohol advertising, and development of comprehensive community-based programs (3). These efforts will require continued research and evaluation to determine their success and to improve their effectiveness.

References:

1. U.S. Department of Health and Human Services. The Surgeon General's Call to Action to Prevent and Reduce Underage Drinking. Rockville, MD: U.S. Department of Health and Human Services; 2007. Available at http://www.surgeongeneral.gov/topics/underagedrinking/. Accessed March 28, 2008.
2. Office of Juvenile Justice and Delinquency Prevention. Drinking in America: Myths, Realities, and Prevention Policy. Washington, DC: U.S. Department of Justice, Office of Justice Programs, Office of Juvenile Justice and Delinquency Prevention, 2005. Available at http://www.udetc.org/documents/Drinking_in_America.pdf* (PDF). Accessed March 28, 2008.
3. Bonnie RJ and O’Connell ME, editors. National Research Council and Institute of Medicine, Reducing Underage Drinking: A Collective Responsibility.* Committee on Developing a Strategy to Reduce and Prevent Underage Drinking. Division of Behavioral and Social Sciences and Education. Washington, DC: The National Academies Press, 2004.
4. Substance Abuse and Mental Health Services Administration. Drug Abuse Warning Network, 2005: National Estimates of Drug-Related Emergency Department Visits. Rockville, MD: Substance Abuse and Mental Health Services Administration, Office of Applied Studies. DAWN Series D-29, DHHS Publication No. (SMA) 07-4256, 2007. Available at http://dawninfo.samhsa.gov/pubs/edpubs/default.asp. Accessed March 28, 2008.
5. Eaton DK, Kann L, Kinchen SA, et al. Youth risk behavioral surveillance—United States, 2005. CDC Morb Mort Surveil Summ. 2006;55(SS-05): 1-108. Available at http://www.cdc.gov/mmwr/PDF/SS/SS5505.pdf (PDF). Accessed March 28, 2008.
6. Substance Abuse and Mental Health Services Administration. 2006 National Survey on Drug Use and Health: Detailed Tables. Rockville, MD: Substance Abuse and Mental Health Services Administration, Office of Applied Studies, 2007. Available at http://www.oas.samhsa.gov/NSDUH/2k6NSDUH/tabs/LOTSect2pe.htm#AlcAge. Accessed March 31, 2008.
7. Johnston LD, O’Malley PM, Bachman JG, Schulenberg JE (December 11, 2007). Overall, illicit drug use by American teens continues gradual decline in 2007. University of Michigan News Service: Ann Arbor, MI. [Online]. Available at www.monitoringthefuture.org*. Accessed March 28, 2008.
8. Hingson RW, Heeren T, Winter MR. Age at drinking onset and alcohol dependence: age at onset, duration, and severity. Pediatrics. 2006;160:739-746.
9. Office of Applied Studies. The NSDUH Report: Alcohol dependence or abuse and age at first use. Rockville, MD: Substance Abuse and Mental Health Services Administration, October 2004. Available at http://www.oas.samhsa.gov/2k4/ageDependence/ageDependence.htm. Accessed March 31, 2008.

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Page last reviewed: April 2, 2008
Page last modified: April 2, 2008
Content source: Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion