Underage Drinking

Alcohol is the most commonly used and abused drug among youth in the United States.1

  • Excessive drinking is responsible for more than 3,500 deaths among underage youth each year, and cost the U.S. $24 billion in economic costs in 2010.2,3
  • Although the purchase of alcohol 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.4
  • On average, underage drinkers consume more drinks per drinking occasion than adult drinkers.5
  • In 2013, there were approximately 119,000 emergency rooms visits by persons aged 12 to 21 for injuries and other conditions linked to alcohol.6

Drinking Levels among Youth

The 2017 Youth Risk Behavior Survey7 found that among high school students, during the past 30 days

  • 30% drank some amount of alcohol.
  • 14% binge drank.
  • 6% drove after drinking alcohol.
  • 17% rode with a driver who had been drinking alcohol.

Other national surveys

Consequences of Underage Drinking

Youth who drink alcohol are more likely to experience1,5,10,11

  • 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 crashes and other unintentional injuries, such as burns, falls, and drowning.
  • Memory problems.
  • Misuse of other drugs.
  • Changes in brain development that may have life-long effects.
  • Death from alcohol poisoning.

In general, the risk of youth experiencing these problems is greater for those who binge drink than for those who do not binge drink.10,11

Early initiation of drinking is associated with development of an alcohol use disorder later in life.12

Prevention of Underage Drinking

Publications by the Surgeon General1 and the National Academies of Sciences, Engineering, and Medicine (formerly known as the Institute of Medicine)5 outline many prevention strategies for the prevention of underage drinking, 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.


  1. U.S. Department of Health and Human Services (HHS), Office of the Surgeon General. Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Healthexternal icon. Washington, DC: HHS, 2016.
  2. Centers for Disease Control and Prevention (CDC). Alcohol-Related Disease Impact (ARDI). Atlanta, GA: CDC.
  3. Sacks JJ, Gonzales KR, Bouchery EE, Tomedi LE, Brewer RD. 2010 National and State Costs of Excessive Alcohol Consumption.external icon Am J Prev Med 2015; 49(5):e73–e79.
  4. Office of Juvenile Justice and Delinquency Prevention. Drinking in America: Myths, Realities, and Prevention Policyexternal icon. Washington, DC: U.S. Department of Justice, Office of Justice Programs, Office of Juvenile Justice and Delinquency Prevention, 2005.
  5. Bonnie RJ and O’Connell ME, editors. National Research Council and Institute of Medicine, Reducing Underage Drinking: A Collective Responsibilityexternal icon. 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.
  6. Naeger, S. Emergency department visits involving underage alcohol use: 2010 to 2013external icon. The CBHSQ Report: May 16, 2017. Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, Rockville, MD; 2017.
  7. Kann L, McManus T, Harris WA, et al. Youth Risk Behavior Surveillance United States, 2017. MMWR Surveill Summ 2018;67(No. SS-8):1–114.
  8. Center for Behavioral Health Statistics and Quality. 2018 National Survey on Drug Use and Health: Detailed Tables.external icon Substance Abuse and Mental Health Services Administration, Rockville, MD; 2019.
  9. Miech RA, Schulenberg JE, Johnston LD, Bachman JG, O’Malley PM, Patrick ME. National adolescent drug trends in 2019: findings released.external icon Ann Arbor, MI: Institute for Social Research, The University of Michigan; 2019.
  10. Miller JW, Naimi TS, Brewer RD, Jones SE. Binge drinking and associated health risk behaviors among high school students.external icon Pediatrics 2007;119:76–85.
  11. Esser MB, Guy GP, Zhang K, Brewer RD. Binge drinking and prescription opioid misuse in the U.S., 2012-2014external iconexternal icon. Am J Prev Med 2019;57,197-208.
  12. Substance Abuse and Mental Health Services Administration. Report to Congress on the Prevention and Reduction of Underage Drinkingexternal icon. Rockville, MD: U.S. Department of Health and Human Services; 2017.