Mason Delacroix
Alcohol is the most common drug used by people under the age of 21 in the United States. In 2023, 12.6 million people between the ages of 12 and 20 (33.1% in this age group) reported that they had consumed alcohol at least once in their lives. This figure includes 6.1 million males (31.1%) and 6.5 million females (35.3%). Alcohol use among teens can have several negative consequences, including interference with brain development, an increased risk of alcohol use disorder, injuries, sexual assaults, alcohol overdoses, and even death. While the majority of American teens do not drink alcohol, with 67% reporting that they have never consumed alcohol as of 2024, the prevalence of alcohol consumption among teens is still a cause for concern.
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What You'll Learn
Binge drinking among teens
Binge drinking is defined as having 5 or more drinks in a row by males or 4 or more drinks in a row by females at least once in the previous 2 weeks. Heavy binge drinking includes 3 or more such episodes in 2 weeks. Binge drinking among teens is a serious public health problem in the United States, as alcohol is the most widely used substance of abuse among American youth. Alcohol use and binge drinking among high school students have generally decreased in recent decades, with the rate of high school students reporting they have been drunk in the past month decreasing by 69% since 1991. However, in 2023, 3.3 million youth ages 12 to 20 reported binge drinking at least once in the past month, and approximately 663,000 youth in this age group reported binge drinking on five or more days over the past month. This is particularly concerning as research indicates that alcohol use during the teenage years can interfere with normal adolescent brain development and increase the risk of developing alcohol use disorder. Additionally, underage drinking contributes to a range of acute consequences, such as injuries, sexual assaults, alcohol overdoses, and deaths, including those from motor vehicle crashes. About 4,000 young people (under 21) die from excessive alcohol use each year in the United States.
Many teens have easy access to alcohol, with 84.3% of adolescents aged 15 to 17 reporting that they got alcohol for free the last time they drank. In many cases, adolescents obtain alcohol from family members or find it at home. Implementing prevention strategies during early adolescence is crucial to address this issue, as early alcohol use is associated with a higher likelihood of alcohol-related consequences. If a teen believes they or a friend has a binge drinking problem, it is important to seek help from a trusted adult, such as a parent, doctor, school counsellor, or another supportive individual.
While the majority of American teens do not drink alcohol, with 67% reporting that they have never consumed alcohol, the prevalence of binge drinking among teens remains a significant concern. It is important to address this issue through education, prevention strategies, and supportive environments to reduce the harmful consequences of underage drinking.
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Alcohol-related harms
The risks associated with alcohol consumption are heightened for young people. Alcohol is a factor in the deaths of thousands of people under the age of 21 each year, including motor vehicle crashes, homicides, and suicides. Alcohol increases the risk of injury and fatal accidents, with half of all drowning deaths among teenage boys linked to alcohol use. The combination of alcohol and drugs, including cannabis, can also lead to increased risk-taking, such as driving or swimming under the influence, which endangers both the teenager and others.
Furthermore, alcohol consumption among teens is associated with a higher likelihood of sexual activity and unprotected sex, leading to potential unplanned pregnancies and sexually transmitted diseases. Teens who drink are also more prone to health problems, including obesity and high blood pressure, and are more likely to engage in fights and commit crimes.
The prevalence of alcohol consumption among teens has been declining over the past few decades, with a significant drop during the COVID-19 pandemic. However, the issue remains prevalent, and in 2023, 12.6 million people aged 12 to 20 reported having at least one drink in their lives, with 5.6 million reporting drinking beyond "just a few sips" in the past month.
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Alcohol-related deaths
Alcohol is the most common drug used by young people in the United States. According to the 2023 National Survey on Drug Use and Health (NSDUH), 12.6 million people aged 12 to 20 (33.1% in this age group) reported having had at least one alcoholic drink in their lives. This includes 6.1 million males (31.1%) and 6.5 million females (35.3%).
While the majority of American teens do not drink alcohol, and the long-term declines noted over the past few decades continued in 2024, alcohol-related deaths among teens remain a serious issue. Alcohol use during adolescence can interfere with normal brain development, increasing the risk of developing alcohol use disorder. It also contributes to a range of acute consequences, such as injuries, sexual assaults, alcohol overdoses, and deaths, including those from motor vehicle crashes. In 2010, there were 189,000 emergency room visits for injuries related to underage drinking, and 4,300 deaths annually are caused by underage drinking.
Underage drinking cost the United States $24 billion in 2010, the most recent year for which data is available. Alcohol is a factor in the deaths of thousands of people younger than 21 in the United States each year. This includes 1,345 deaths from motor vehicle crashes involving an alcohol-impaired driver. Teen car accidents are the number one cause of death for teens in the United States, and unrestrained drivers aged 16 to 20 are over three times more likely to be alcohol-impaired than drivers of that age who use seatbelts.
In addition to the direct impact on health and safety, underage drinking also has social, academic, and legal consequences. Young people who drink are more likely to engage in risky behaviours, experience school absences and lower grades, and face legal issues. They are also more likely to misuse prescription drugs or use illicit drugs, which can have serious health effects when combined with alcohol.
The COVID-19 pandemic had an unintended positive consequence, with unprecedented declines in underage alcohol consumption among American teens. The 2024 Monitoring the Future study found that the prevalence of alcohol consumption among America's youth continued a long-term decline, with lifetime, annual, past month consumption, and binge drinking levels below pre-pandemic levels and at historic lows.
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Underage drinking by race and ethnicity
Alcohol is the most widely used substance of abuse among America's youth, and drinking by young people poses enormous health and safety risks. Research shows that alcohol use during adolescence can interfere with brain development and increase the risk of developing alcohol use disorder. It also contributes to a range of acute consequences, such as injuries, sexual assaults, alcohol overdoses, and deaths, including those from motor vehicle crashes.
According to the 2023 National Survey on Drug Use and Health (NSDUH), 12.6 million people aged 12 to 20 (33.1% in this age group) reported that they had consumed alcohol at least once in their lifetime. This included 6.1 million males (31.1%) and 6.5 million females (35.3%). When broken down by race and ethnicity, the numbers show:
- American Indian or Alaska Native: 68,000 people (23.6%)
- Asian: 563,000 people (23.7%)
- Black or African American: 1.4 million people (26.0%)
- White: 6.9 million people (37.0%)
- Two or more races: 495,000 people (36.5%)
- Hispanic or Latino: 3.2 million people (32.0%)
It is worth noting that estimates for Native Hawaiian and other Pacific Islander people were not included due to a small number of respondents or a large margin of error.
While the overall trend in underage drinking is declining, with 67% of American teens reporting they have never consumed alcohol, there are still racial and ethnic disparities in alcohol consumption patterns. For example, at age 14, White, Black, and Hispanic youth are equally likely to drink. However, by age 18, White and Hispanic youth are twice as likely to drink as Black youth. Additionally, Native Americans and Hispanics have higher rates of high-risk drinking and alcohol use disorders compared to other ethnic groups.
Furthermore, the consequences of drinking appear to be more profound for some ethnic groups. For instance, Native Americans, Hispanics, and Blacks experience higher rates of recurrent or persistent alcohol dependence once it occurs. Disparities in alcohol treatment utilization are also more apparent for Hispanics. These differences are likely influenced by various factors, including risky drinking behaviours, immigration experiences, racial/ethnic discrimination, economic and neighbourhood disadvantage, and variations in alcohol-metabolizing genes.
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Alcohol use and brain development
Alcohol use among teens is a significant public health concern, with approximately 12.6 million people aged 12 to 20 (33.1% in this age group) reporting that they have consumed alcohol at least once in their lives. This vulnerable period of brain development, which continues into the mid-20s, makes adolescents more susceptible to the negative effects of alcohol.
Adolescence is a critical period of brain development, marked by widespread changes in brain organization and functioning. These changes bring about the cognitive, emotional, and social skills necessary for young people to navigate the complexities of adulthood. However, the very nature of these rapid changes may also increase the adolescent brain's vulnerability to alcohol exposure. Research has shown that alcohol use during the teenage years can interfere with normal brain development, impacting both brain structure and function. This interference can lead to cognitive and learning difficulties, increased vulnerability to Alcohol Use Disorder (AUD), and a higher risk of developing mental health disorders such as anxiety and depression.
The adolescent brain is particularly susceptible to the effects of alcohol due to its increased plasticity and the heightened activity in the reward and stress response systems. The prefrontal cortex, which is responsible for planning and decision-making, is one of the last areas of the brain to mature, typically not reaching full development until the mid-20s. This imbalance between the reward-seeking and decision-making areas of the brain may contribute to adolescents' increased risk-taking behaviors, including alcohol experimentation.
The impact of alcohol on the developing brain can have both immediate and long-term consequences. Alcohol-induced blackouts, for example, are a common occurrence among adolescents, affecting one in five older adolescents who drink. These blackouts occur due to alcohol's disruption of memory consolidation in the hippocampus. Additionally, early initiation of alcohol use has been linked to unsafe alcohol-related behaviors, such as drinking and driving, unsafe sexual behavior, and other substance use, which can result in injuries, sexual assaults, and even death.
The widespread nature of alcohol use among teens underscores the importance of prevention strategies and education during early adolescence. By delaying the onset of alcohol consumption, we can reduce the potential lifetime risk of substance use and mitigate the negative consequences associated with underage drinking.
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Frequently asked questions
According to the 2023 National Survey on Drug Use and Health (NSDUH), 12.6 million people aged 12 to 20 (33.1% in this age group) reported drinking at least one alcoholic beverage in their lifetime. This includes 6.1 million males (31.1% of males in this age group) and 6.5 million females (35.3% of females in this age group).
The 2024 Monitoring the Future study found that the prevalence of alcohol consumption among American youth continued a long-term decline. For 8th, 10th, and 12th graders combined, the proportion of students reporting current drinking (within the past 30 days) decreased to 13% in 2024.
In 2023, 3.3 million youth aged 12 to 20 reported binge drinking at least once in the past month. Additionally, 663,000 youth in this age group reported binge drinking on five or more days in the past month.
