Age 21 Minimum Legal Drinking Age
A Minimum Legal Drinking Age (MLDA) of 21 saves lives and protects health
Minimum Legal Drinking Age (MLDA) laws specify the legal age when an individual can purchase alcoholic beverages. The MLDA in the United States is 21 years. However, prior to the enactment of the National Minimum Drinking Age Act of 1984, the legal age when alcohol could be purchased varied from state to state.1
An age 21 MLDA is recommended by the:
• American Academy of Pediatrics2
• Community Preventive Services Task Force4
• Mothers Against Drunk Driving5
• National Highway Traffic Safety Administration1
• National Prevention Council8
• National Academy of Sciences (National Research Council and Institute of Medicine)9
The age 21 MLDA saves lives and improves health.3
Fewer motor vehicle crashes
- States that increased the legal drinking age to 21 saw a 16% median decline in motor vehicle crashes.6
- After all states adopted an age 21 MLDA, drinking during the previous month among persons aged 18 to 20 years declined from 59% in 1985 to 40% in 1991.7
- Drinking among people aged 21 to 25 also declined significantly when states adopted the age 21 MLDA, from 70% in 1985 to 56% in 1991.7
- There is also evidence that the age 21 MLDA protects drinkers from alcohol and other drug dependence, adverse birth outcomes, and suicide and homicide.4
Drinking by those under the age 21 is a public health problem.
- Excessive drinking contributes to more than 3,900 deaths among people below the age of 21 in the U.S. each year.10
- Underage drinking cost the U.S. economy $24 billion in 2010.11
Drinking by those below the age of 21 is also strongly linked with9,12,13:
- Death from alcohol poisoning.
- Unintentional injuries, such as car crashes, falls, burns, and drowning.
- Suicide and violence, such as fighting and sexual assault.
- Changes in brain development.
- School performance problems, such as higher absenteeism and poor or failing grades.
- Alcohol dependence later in life.
- Other risk behaviors such as smoking, drug misuse, and risky sexual behaviors.
Drinking by those below the age of 21 is strongly associated with alcohol-impaired driving.
The 2019 Youth Risk Behavior Survey14 found that among high school students, during the past 30 days
- 5% drove after drinking alcohol.
- 17% rode with a driver who had been drinking alcohol.
Rates of drinking and binge drinking among those under 21
The 2019 Youth Risk Behavior Surveillance System found that among high school students, 29% drank alcohol and 14% binge drank during the past 30 days.14
In 2021, the Monitoring the Future Survey reported that 7% of 8th graders and 26% of 12th graders drank alcohol during the past 30 days, and 3% of 8th graders and 12% of 12th graders binge drank during the past 2 weeks.15
In 2014, the New York City Department of Health and Mental Hygiene and the New York State Liquor Authority found that more than half (58%) of the licensed alcohol retailers in the City sold alcohol to underage decoys.17
Enforcing the age 21 MLDA
Communities can enhance the effectiveness of age 21 MLDA laws by actively enforcing them.
- A Community Guide review found that enhanced enforcement of laws prohibiting alcohol sales to minors reduced the ability of youthful-looking decoys to purchase alcoholic beverages by a median of 42%.16
- Alcohol sales to minors are still a common problem in communities.
- National Highway Traffic Safety Administration. Determine Why There Are Fewer Young Alcohol Impaired DriversExternal. Washington, DC. 2001.
- Committee on Substance Abuse, Kokotailo PK. Alcohol use by youth and adolescents: a pediatric concernExternal. Pediatrics. 2010;125(5):1078-1087.
- DeJong W, Blanchette J. Case closed: research evidence on the positive public health impact of the age 21 minimum legal drinking age in the United StatesExternal. J Stud Alcohol Drugs. 2014;75 Suppl 17:108-115.
- Task Force on Community Preventive Services. Recommendations to reduce injuries to motor vehicle occupants: increasing child safety seat use, increasing safety belt use, and reducing alcohol-impaired drivingCdc-pdfExternal [PDF-78 KB]. Am J Prev Med. 2001;21(4 Suppl):16-22.
- Mothers Against Drunk Driving (MADD). Why 21? 2018; https://www.madd.org/the-solution/teen-drinking-prevention/why-21/External. Accessed May 3, 2018.
- Shults RA, Elder RW, Sleet DA, et al. Reviews of evidence regarding interventions to reduce alcohol-impaired drivingCdc-pdfExternal [PDF-2 MB]. Am J Prev Med. 2001;21(4 Suppl):66-88.
- Serdula MK, Brewer RD, Gillespie C, Denny CH, Mokdad A. Trends in alcohol use and binge drinking, 1985-1999: results of a multi-state surveyExternal. Am J Prev Med. 2004;26(4):294-298
- National Prevention Council. National Prevention Strategy: Preventing Drug Abuse and Excessive Alcohol Use [PDF-4.7MB]. Washington, DC: US Department of Health and Human Services, Office of the Surgeon General; 2011.
- Bonnie RJ and O’Connell ME, editors. National Research Council and Institute of Medicine. Reducing Underage Drinking: A Collective ResponsibilityExternal. 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.
- Centers for Disease Control and Prevention (CDC). Alcohol-Related Disease Impact (ARDI) Application website. Accessed April 19, 2022.
- Sacks JJ, Gonzales KR, Bouchery EE, Tomedi LE, Brewer RD. 2010 national and state costs of excessive alcohol consumptionExternal. Am J Prev Med. 2015;49(5):e73-79.
- Miller JW, Naimi TS, Brewer RD, Jones SE. Binge drinking and associated health risk behaviors among high school studentsExternal. Pediatrics. 2007;119(1):76-85.
- Department of Health and Human Services. The Surgeon General’s call to action to prevent and reduce underage drinkingExternal. Department of Health and Human Services, Office of the Surgeon General;2007.
- Centers for Disease Control and Prevention. Youth Risk Behavior Surveillance — United States, 2019. MMWR Suppl 2020;69(1):1–83.
- Johnston LD, Miech RA, O’Malley PM, Bachman JG, Schulenberg JE, Patrick ME. Monitoring the Future national survey results on drug use, 1975-2021: Overview, key findings on adolescent drug useexternal icon. Ann Arbor: Institute for Social Research, The University of Michigan; 2022.rnal ico
- Elder R, Lawrence B, Janes G, et al. Enhanced enforcement of laws prohibiting sale of alcohol to minors: systematic review of effectiveness for reducing sales and underage drinkingExternal [PDF-4MB]. Transportation Research E-Circular. 2007;E-C123:181-188.
- The New York City Department of Health and Mental Hygiene. Alcohol & Health website. Accessed October 18, 2016.