Lena Savoie
Alcohol is the most common drug used by people under 21 in the United States, and it is a leading cause of death for this age group. The minimum legal drinking age in the US is 21, and this law has been credited with saving lives and protecting young people from alcohol-related harm. Research shows that people who start drinking before turning 21 are at a higher risk of developing alcohol use disorders later in life. Underage drinking is associated with a range of negative consequences, including injuries, impaired judgment, increased risk of physical and sexual assault, and interference with brain development. However, despite the legal restrictions, most teens can access alcohol, and the decision to drink or not is ultimately an individual one.
| Characteristics | Values |
|---|---|
| Minimum Legal Drinking Age in the United States | 21 years |
| Number of states with laws that allow people under 21 to drink legally | 31 |
| Number of deaths of people under 21 in the United States every year from excessive drinking | 4,000 |
| People who start drinking before the age of 15 are more likely to develop alcohol dependence compared to those who start drinking at or after 21 | 6 times |
| Adults over 26 who started drinking before 15 are more likely to report having AUD than those who started drinking at 21 or later | 3.6 times |
| Alcohol is a factor in the deaths of people under 21 in the United States | Yes |
| Alcohol affects brain development | Yes |
| Alcohol increases the risk of injuries and health conditions | Yes |
| Alcohol increases the risk of unsafe sexual behavior | Yes |
| Alcohol increases the risk of drunk driving | Yes |
| Alcohol increases the risk of violent behavior | Yes |
| Alcohol increases the risk of physical and sexual assault | Yes |
| Alcohol increases the risk of suicide | Yes |
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What You'll Learn
Alcohol-related deaths and injuries
Alcohol consumption is a leading cause of preventable death and injury worldwide. In 2019, around 2.6 million deaths were attributed to alcohol consumption, with 700,000 of these being injury-related. Alcohol use is a causal factor in more than 200 diseases, injuries, and other health conditions. It is also a significant factor in deaths among people under the age of 21 in the United States.
Alcohol-Related Deaths
Alcohol is one of the leading preventable causes of death in the United States, behind tobacco, poor diet, physical inactivity, and illegal drugs. Excessive alcohol use is responsible for more than 178,000 deaths in the US each year. During the first year of the COVID-19 pandemic, deaths involving alcohol among people aged 16 and older rose by 25.5%, from 78,927 in 2019 to 99,017 in 2020.
Worldwide, alcohol use was responsible for 6.7% of all deaths among men and 2.4% of all deaths among women in 2019. That year, alcohol caused 401,000 cancer deaths and 474,000 deaths from cardiovascular diseases globally. Alcohol consumption increases the risk of several cancers, including breast, liver, head and neck, oesophageal, and colorectal cancers. It is also linked to liver and heart diseases.
Alcohol-Related Injuries
Alcohol-related injuries are a significant problem, particularly among underage drinkers. In 2011, about 188,000 people under the age of 21 in the US visited an emergency room for alcohol-related injuries. Alcohol increases the risk of injury and accidental death, with drowning being a leading cause of alcohol-related death among teenage boys. Alcohol also increases the likelihood of interpersonal violence, unsafe sexual behaviour, and aggressive or violent behaviour.
Alcohol-Related Traffic Accidents
Alcohol-related traffic accidents are a major cause of death and injury worldwide. In the US, about 30% of all traffic crash fatalities involve drunk drivers, with an average of 11,000 people dying each year in drunk-driving crashes over a ten-year period from 2014 to 2023. In 2023, 12,429 people died in alcohol-impaired driving crashes, with one person killed every 42 minutes. Alcohol impairs thinking, reasoning, and muscle coordination, all of which are essential for safe driving.
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Brain development and cognitive function
The human brain continues to develop well into the 20s. Research shows that alcohol can interfere with this development, potentially affecting both brain structure and function. The brain of a person under 21 is not ready to protect them against alcohol. Starting to drink at a young age and drinking heavily can cause cognitive or learning problems and increase vulnerability to alcohol use disorder (AUD).
People who start drinking before the age of 15 are at a higher risk of developing AUD later in life. Adults aged 26 and older who started drinking before turning 15 are 3.6 times more likely to report having AUD in the past year than those who waited until 21 or later. Similarly, youth who start drinking before age 15 are six times more likely to develop alcohol dependence or abuse later in their lives compared to those who start drinking at or after turning 21.
Alcohol is the most common drug used by people under 21 in the United States. About 4,000 young people (under 21) die from excessive alcohol use each year. These deaths are preventable and occur due to underage drinking and its direct health effects. Alcohol use increases the risk of injuries and health conditions due to risky behaviours. It is a factor in deaths from motor vehicle crashes, homicides, alcohol overdoses, falls, burns, drowning, and suicides.
Underage drinking also increases the risk of physical and sexual assault. It is associated with an increased likelihood of being a victim or perpetrator of interpersonal violence. It also increases the risk of unsafe sexual behaviour, which can lead to unplanned pregnancies and sexually transmitted diseases.
The minimum legal drinking age (MLDA) in the United States is 21. This law saves lives and protects everyone, especially young people, from alcohol-related harm. After the national law was implemented in 1984, the percentage of young people (aged 18 to 20) who reported drinking alcohol in the past month dropped from 59% to 40%. The law also led to a reduction in motor vehicle crashes, with a 16% drop in states that raised their MLDA to 21.
The MLDA of 21 helps lower the risk of developing alcohol and other substance use disorders. It also leads to fewer harmful births, lower rates of suicide and homicide, and fewer deaths from alcohol poisoning.
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Risk of developing alcohol use disorder
Underage drinking poses a range of risks and negative consequences. Alcohol is a significant factor in the deaths of people younger than age 21 in the United States each year. About 4,000 young people (under 21) die from excessive alcohol use each year, and underage drinking cost the United States $24 billion in 2010. Alcohol consumption is found to play a causal role in more than 200 diseases, injuries, and other health conditions. It is associated with risks of developing noncommunicable diseases such as liver disease, heart disease, and different types of cancers, as well as mental health and behavioural conditions such as depression, anxiety, and alcohol use disorders.
Research shows that people who start drinking before the age of 15 are at a higher risk of developing alcohol use disorder (AUD) later in life. For example, adults aged 26 and older who began drinking before age 15 are 3.6 times more likely to report having AUD in the past year than those who waited until age 21 or later to start drinking. Youth who start drinking before age 15 are six times more likely to develop alcohol dependence or abuse later in life than those who begin drinking at or after age 21.
Alcohol use disorder (AUD) is a pattern of alcohol use that involves problems controlling your drinking, being preoccupied with alcohol, continuing to use alcohol even when it causes problems, having to drink more to get the same effect, or having withdrawal symptoms when you stop drinking. AUD can range from mild to severe, and it can have a significant impact on a person's life. People with AUD may find it difficult to fulfil their obligations at work, school, or home, and they may have problems with their relationships, finances, and health.
The risk factors for developing AUD include a family history of alcohol problems, early onset of drinking, peer pressure, and mental health issues such as depression, anxiety, or post-traumatic stress disorder (PTSD). People who start drinking at a young age are also more likely to experience alcohol-related problems because their brains are still developing. Research shows that people's brains continue to develop well into their 20s, and alcohol can alter this development, potentially affecting both brain structure and function. This may cause cognitive or learning problems and may increase vulnerability to AUD.
The good news is that there are effective alcohol control interventions, and it is important for people to be aware of the risks associated with alcohol consumption and take individual actions to protect themselves from its harmful effects. Screening youth for alcohol use and AUD is very important and may prevent problems down the road. Early identification of alcohol problems can allow for intervention by trained professionals and can help prevent the serious and persistent problems that can occur throughout life as a result of underage drinking.
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Underage drinking laws and their effectiveness
Underage drinking is a pervasive issue in the United States, with alcohol being the drug of choice among children and adolescents. The minimum legal drinking age in the US is 21, and this law has been in place since 1984. Before the national law was implemented, states that raised their minimum legal drinking age to 21 saw a 16% drop in motor vehicle crashes. After the law was passed, the percentage of young people aged 18 to 20 who drank alcohol in the past month decreased from 59% to 40% between 1985 and 1991. This law has been estimated to save 800 to 900 lives each year.
Despite the law, most teens can access alcohol, and underage drinking poses a range of risks and negative consequences. It is a leading cause of death for people under 21 in the US, including from motor vehicle crashes, homicides, alcohol overdoses, falls, burns, drowning, and suicides. Underage drinking also increases the risk of injuries, sexual assault, and violent behaviour. Additionally, drinking can impair judgment, leading to poor decisions and risky behaviours such as drinking and driving, unsafe sex, and aggressive behaviour.
To combat underage drinking, various policies and sanctions have been implemented at the federal, state, and local levels. These include laws prohibiting the purchase, possession, or consumption of alcohol by minors, as well as laws targeting the use of false identification and providing alcohol to minors. Law enforcement officials employ techniques such as "Cops 'N' Shops" to catch youth attempting to purchase alcohol and identify those using false identification. The STOP Act authorized $18 million in federal funds to address underage drinking through interagency coordination, media campaigns, and community coalitions.
Research has shown that people who start drinking before the age of 15 are at a higher risk of developing alcohol use disorder (AUD) later in life. Alcohol can interfere with brain development, which continues well into the 20s, potentially affecting brain structure and function and increasing vulnerability to AUD. Screening youth for alcohol use and providing early intervention can help prevent and address alcohol-related problems.
While the minimum legal drinking age of 21 has been effective in reducing underage drinking and its associated harms, it is important to continuously evaluate and strengthen enforcement efforts to further protect the health and safety of young people.
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Social and behavioural impacts of drinking
Underage drinking poses a range of risks and negative consequences. Alcohol is a significant factor in the deaths of people younger than age 21 in the United States each year, including deaths from motor vehicle crashes, homicides, alcohol overdoses, falls, burns, drowning, and suicides. Research shows that people who start drinking before the age of 15 are at a higher risk of developing alcohol use disorder (AUD) later in life. Alcohol can alter brain development, affecting both brain structure and function, and increasing vulnerability to AUD.
The social and behavioural impacts of drinking alcohol are significant. Firstly, alcohol increases aggression and violent behaviour. This can lead to interpersonal violence, with underage binge drinking associated with an increased likelihood of being a victim or perpetrator of violence. Alcohol also increases sexual risk-taking, with teens more likely to have unprotected sex, leading to unplanned pregnancies and sexually transmitted diseases. Alcohol impairs judgment and increases the likelihood of risky behaviours such as drinking and driving, affecting both the drinker and those around them.
Alcohol consumption can also negatively impact academic performance and sports performance, with drinking affecting coordination and the ability to study effectively. Teens who drink are also more likely to get into fights and commit crimes. Additionally, alcohol can cause people to do embarrassing things, such as throwing up or wetting themselves, which can be a source of ridicule or social stigma.
The impact of alcohol on social behaviour is complex. Research suggests that alcohol impairs the information processing needed to inhibit response impulses, making it harder to foresee negative consequences and recall inhibiting standards. This can lead to more extreme or excessive social responses when under pressure or conflict, increasing the likelihood of negative outcomes.
The context in which alcohol consumption occurs is also important. Societal factors such as cultural and social norms, availability of alcohol, economic development, and enforcement of alcohol policies all play a role in shaping drinking behaviours and related problems. Interventions and treatment options need to reflect the diverse needs of different groups, addressing multiple levels of an individual's environment, such as family and schools, to effectively reduce alcohol-related harm.
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Frequently asked questions
Drinking alcohol can cause injuries and increase the risk of accidents, including motor vehicle crashes, falls, drowning, and alcohol overdoses. It can also lead to violent behaviour, unsafe sexual behaviour, and poor academic performance. Alcohol consumption can also cause long-term health problems, including cognitive and learning difficulties, and increase the risk of developing alcohol use disorder (AUD).
The legal drinking age varies across different regions and is influenced by cultural, social, and historical factors. In the United States, the National Minimum Drinking Age Act of 1984 established 21 as the minimum legal drinking age nationwide. This decision was made to address the issues of impaired driving and underage drinking, and it has been effective in reducing alcohol-related harm and saving lives.
Alcohol consumption can interfere with brain development, affecting both brain structure and function. This can lead to cognitive and learning problems and increase the vulnerability to developing alcohol use disorders. Additionally, underage drinking is associated with an increased risk of mental health conditions and risky behaviours that can have short- and long-term consequences.
Underage drinking is influenced by social and cultural factors, including peer pressure, family influence, and societal norms. The perception of drinking alcohol as a rite of passage or a sign of maturity can contribute to its appeal among youth. Additionally, the availability and accessibility of alcohol play a role, as teens may have easier access to it despite legal restrictions.
Delaying alcohol consumption until after the age of 21 can have several benefits. It allows the brain to fully develop without the potential disruptions caused by alcohol. It also reduces the risk of developing alcohol use disorders and other substance use disorders. Additionally, it can lead to better decision-making, as individuals over 21 are more likely to assess risks and engage in responsible drinking behaviours.
