Arielle Cruz
Alcohol is the most widely used substance among American youth, and it can cause enormous health and safety risks. Alcohol use during adolescence can interfere with normal brain development and increase the risk of developing alcohol use disorder (AUD). According to the 2023 National Survey on Drug Use and Health, about 14.6% of people aged 12 to 20 reported drinking in the past month, with 1.7% reporting heavy alcohol use. While the number of American teens drinking alcohol is declining, with nearly 88% reporting no consumption in the past 30 days, it is important to address the issue of underage drinking to prevent the associated risks and ensure the well-being of young people in America.
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What You'll Learn
Alcohol use disorder (AUD) statistics
Alcohol use disorder (AUD) is a serious problem among American youth, with a high risk of developing AUD later in life if alcohol consumption starts early. According to the 2023 National Survey on Drug Use and Health (NSDUH), 757,000 youth aged 12 to 17 (2.9% of this age group) suffered from AUD in the past year. This includes 270,000 boys (2.0%) and 487,000 girls (3.8%).
The rate of alcohol consumption increases with age, with 1.2% of 12-13-year-olds consuming alcohol, 6% of 14-15-year-olds, 13% of 16-17-year-olds, and more than double that (31%) among 18-20-year-olds. While fewer teens are drinking alcohol than ever before, with nearly 88% abstaining in the past 30 days, the problem persists.
In 2023, 5.6 million youth aged 12 to 20 reported drinking beyond "just a few sips" in the past month, and 2.2% of 12th-grade students reported high-intensity drinking. Binge drinking is defined as a pattern of drinking that brings blood alcohol concentration (BAC) to 0.08% or higher. This typically corresponds to five or more drinks for males and four or more for females within a two-hour period. However, for youth, three drinks for girls and three to five drinks for boys within the same timeframe can result in the same BAC level.
Underage drinking has severe consequences and contributes to injuries, sexual assaults, alcohol overdoses, and deaths, including those from motor vehicle crashes. It also interferes with normal adolescent brain development, increasing the risk of developing AUD. Alcohol is the most widely used substance among American youth, and addressing this issue is a nationwide concern.
While statistics on AUD among teens are concerning, there is a positive trend in recent years. In 2024, the proportion of students reporting being drunk in the past 30 days reached an all-time low, with a 69% decline since 1991. Additionally, lifetime, annual, and past-month consumption, as well as binge drinking levels, are below pre-pandemic levels. These encouraging developments reflect the success of efforts to delay the onset of underage drinking and promote responsible alcohol decisions.
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Alcohol-related deaths
Alcohol is the most widely used substance among American youth, and it can cause enormous health and safety risks. Underage drinking is a serious public health problem in the United States, and it affects everyone, regardless of age or drinking status. The consequences of underage drinking can be severe and include aggressive behaviour, property damage, injuries, violence, and even death. Alcohol is a factor in the deaths of many people under the age of 21 in the United States each year. These deaths can result from motor vehicle crashes, homicides, alcohol overdoses, falls, burns, drowning, and suicides.
Car crashes are a leading cause of death for teens, and in 2023, almost a third of young drivers killed in fatal crashes had been drinking alcohol. Alcohol-impaired driving is a major issue, with about 34 people dying each day in drunk-driving crashes in the United States. In 2023, there were 12,429 alcohol-impaired driving traffic deaths, and these were all preventable. Alcohol impairs thinking, reasoning, and muscle coordination, all of which are essential for safe driving. As a person's blood alcohol concentration (BAC) increases, the risk of crashing also increases exponentially.
In addition to drunk-driving fatalities, alcohol contributes to other types of deaths among young people. About 4,000 young people under the age of 21 die from alcohol-related causes each year. This includes deaths from chronic conditions such as cancer, heart disease, liver disease, and alcohol use disorder, which develop from drinking alcohol over time. Binge drinking or drinking too much on one occasion can also lead to alcohol-related deaths, including drug overdoses, alcohol poisonings, and suicides.
To address the problem of underage drinking and alcohol-related deaths, early screening and intervention are crucial. Primary care providers and paediatricians can play a vital role in identifying alcohol use and providing opportunities for adolescents to ask questions and seek help. Additionally, policies that make it easier for people to choose to drink less can help prevent alcohol-related deaths. Overall, alcohol-related deaths among teens in America are a significant concern, and efforts are needed to reduce the harmful impact of alcohol on young people's lives.
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Underage drinking by race and ethnicity
Underage drinking is a serious public health problem in the United States, with alcohol being the most widely used substance among American youth. Alcohol use among adolescents differs by race and ethnicity.
According to the 2023 National Survey on Drug Use and Health (NSDUH), about 19.9% of youth aged 14 to 15 reported having at least one drink in their lifetime, and 5.6 million youth aged 12 to 20 reported drinking alcohol beyond "just a few sips" in the past month. The rate of alcohol consumption increases with age, with 1.2% among 12-13-year-olds, 6% among 14-15-year-olds, 13% at ages 16-17, and more than doubling to 31% among 18-20-year-olds.
When examining underage drinking by race and ethnicity, the following estimates were reported for individuals aged 12 to 20 in the United States:
- White individuals: 3.4 million to 6 million (17.9% to 31.7%)
- Black or African American individuals: 1.1 million to 1.4 million (20.9% to 26%)
- Hispanic or Latino individuals: 1.2 million to 2.6 million (12.5% to 26.3%)
- American Indian or Alaska Native individuals: 51,000 to 68,000 (17.7% to 23.6%)
- Asian individuals: 474,000 to 563,000 (20% to 23.7%)
- Individuals of two or more races: 223,000 to 495,000 (16.4% to 36.5%)
It is important to note that estimates for Native Hawaiian or Pacific Islander individuals were not included due to a small number of respondents or a large margin of error.
While the majority of American teens do not drink alcohol, with 67% reporting that they have never consumed alcohol, the consequences of underage drinking can be severe and affect everyone. Underage drinking contributes to injuries, sexual assaults, alcohol overdoses, and deaths, including those from motor vehicle crashes. Additionally, it increases the risk of physical and sexual assault and is associated with the use of other substances.
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Peer influence on teen drinking
Alcohol is the most commonly abused drug by American teenagers and is considered a major public health concern in the US. Underage drinking contributes to a range of acute consequences, such as injuries, sexual assaults, alcohol overdoses, and deaths, including those from motor vehicle crashes. It can also interfere with normal adolescent brain development and increase the risk of developing alcohol use disorder (AUD). According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), 60% of adolescents admit to having had at least one alcoholic drink by the time they turn 18.
While parents, families, and teachers can play a significant role in shaping a teenager's attitude towards alcohol, peer influence or peer pressure is another major contributor to teen drinking. Adolescents spend a lot of time with their peers, and peer pressure can have a massive influence on their behaviors and actions. This pressure can be both overt and inadvertent. For example, direct peer pressure involves offering someone a drink or encouraging them to drink. On the other hand, indirect peer pressure can occur through social modeling, where a teenager may observe a group of popular students drinking alcohol and may participate in the same behavior to fit in with that social group. The perception that "everyone is doing it" can be a powerful influence on a teenager's decision to consume alcohol.
Social media also plays a significant role in peer influence. A study by CBS News found that teens who saw their peers "partying" on social media were more than three times as likely to try alcohol. This form of digital peer pressure can make teens feel like they are missing out if they do not partake. Additionally, advertising and marketing that portray drinking in a favorable light can also encourage underage drinking.
It is worth noting that the majority of American teens do not drink alcohol, and there has been a long-term decline in underage drinking over the past few decades. In 2024, 67% of American teens reported never consuming alcohol in their lifetime. This decline may be partly due to the COVID-19 pandemic, which resulted in unprecedented declines in underage alcohol consumption.
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Interventions and treatment options
Alcohol is the most widely used substance among American youth, and it can cause enormous health and safety risks. Screening youth for alcohol use is very important and can prevent problems down the line. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) has developed the guide "Alcohol Screening and Brief Intervention for Youth: A Practitioner's Guide" to aid healthcare providers with young people who have alcohol problems.
- Brief Interventions: Brief Interventions are short, one-on-one or small-group counselling sessions that are time-limited. The counsellor provides information about the individual's drinking pattern and potential risks. After receiving personalised feedback, the counsellor will help set goals.
- 12-step Facilitation Therapy: This is an engagement strategy used in counselling sessions to increase an individual's active involvement in 12-step-based mutual-support groups.
- Acceptance and Mindfulness-based Interventions: These interventions increase awareness and acceptance of present-moment experiences. Mindfulness-based skill-building strategies promote flexible responses to triggers that can prompt drinking.
- Medications: There are medications on the market approved to treat Alcohol Use Disorder (AUD). The newer types of these medications work by offsetting changes in the brain caused by AUD.
- Individual or Group Counselling: Youth can attend individual or group counselling sessions one or more times per week.
- Prescriptions: A primary care provider or psychiatrist can prescribe medications to help reduce alcohol cravings.
- Family Therapy: Family therapy can help build a supportive foundation for recovery.
Hotlines and Helplines
- SAMHSA's National Helpline: 1-800-662-HELP (4357) is a confidential, free, 24/7, 365-days-a-year helpline for individuals and family members facing mental and/or substance use disorders. It provides referrals to local treatment facilities, support groups, and community-based organisations.
- NIAAA Alcohol Treatment Navigator: Visit niaaa.nih.gov/health-professionals-communities to learn more.
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Frequently asked questions
According to the 2023 NSDUH, 757,000 youth aged 12-17 (2.9% of this age group) suffered from Alcohol Use Disorder (AUD) in the past year. This includes 270,000 boys (2.0% of boys in this age group) and 487,000 girls (3.8% of girls in this age group).
In 2023, 5.6 million youth aged 12-20 reported drinking alcohol in the past month. In 2024, this number decreased to 5.1 million males and females aged 12-20 (14.6% of this age group).
In 2024, 67% of American teens reported that they have never consumed alcohol. This is an increase from 2023, where 88% of America's youth had not consumed alcohol in the past 30 days.
Alcohol is the most commonly used drug by people under 21 in the United States. Underage drinking can cause a range of issues, including slower brain development, injuries, sexual assaults, alcohol overdoses, and deaths, including those from motor vehicle crashes.
The NIAAA and the American Academy of Pediatrics recommend that all youth be regularly screened for alcohol use by a primary care provider or other health practitioner. This allows for early identification and intervention, and provides an opportunity for adolescents to ask questions of a knowledgeable adult.
