Theo Nash
Alcohol is the most common substance used by people under the age of 21 in the United States. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), alcohol is a significant factor in the deaths of people younger than 21 in the US each year. Alcohol-related deaths among this age group include car accidents, homicides, alcohol poisoning, falls, burns, drowning, and suicides. While there has been a long-term decline in alcohol consumption among American youth, with nearly 88% of teens not consuming alcohol in the past 30 days, underage drinking remains a persistent problem. In 2023, about 5.6 million Americans between the ages of 12 and 20 reported current alcohol consumption, representing nearly 15% of this age group. Alcohol use among adolescents can lead to various negative consequences, including health issues, accidents, violent behavior, and in some cases, death.
| Characteristics | Values |
|---|---|
| Number of underage deaths caused by excessive alcohol consumption in the US each year | 4,000 |
| Age range of the underage people who died | Under 21 |
| Causes of death | Motor vehicle crashes, homicides, alcohol overdoses, falls, burns, drowning, and suicides |
| Number of youth aged 14-15 who consumed alcohol at least once in their lifetime in 2023 | 19.9% |
| Number of youth aged 12-20 who consumed alcohol beyond "just a few sips" in the past month in 2023 | 5.6 million |
| Percentage of youth aged 12-20 who reported current alcohol consumption in 2023 | 15% |
| Rate of current alcohol consumption among youth in 2023 | 1.2% among 12-13 year olds, 6% among 14-15 year olds, 13% among 16-17 year olds, and 31% among 18-20 year olds |
| Number of high school students who reported binge drinking in the past month | 9% |
| Average number of annual deaths in California attributable to excessive alcohol use | 15,443 |
| Average number of annual deaths in Indiana attributable to excessive alcohol use | 2,960 |
| Average number of annual deaths in Kansas attributable to excessive alcohol use | 1,146 |
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What You'll Learn
Underage drinking costs: $24 billion in 2010
Underage drinking is a nationwide concern in the United States, with about 19.9% of youth aged 14 to 15 reporting having consumed alcohol in 2023. Adolescent alcohol consumption varies across different racial and ethnic groups, with White and Hispanic youth twice as likely to drink as Black youth by the age of 18. Underage drinking poses a range of risks and negative consequences, including violent behaviour, injuries, and death. Alcohol is a significant factor in the deaths of people younger than age 21 in the United States each year, with about 4,000 young people dying from excessive alcohol use annually. These deaths are often caused by motor vehicle crashes, homicides, alcohol overdoses, falls, burns, drowning, and suicides.
The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines binge drinking as a pattern of drinking that brings blood alcohol concentration (BAC) to 0.08% or higher. Binge drinking is a common problem among adolescents, with 9% of high school students reporting binge drinking in the past month. Alcohol use and binge drinking among high school students have generally decreased in recent decades, but it remains a serious issue. Underage drinking cost the United States a significant amount of money, estimated at $24 billion in 2010, with inflation and increased healthcare and public safety costs likely driving up these figures in subsequent years.
The economic impact of underage drinking is substantial, with the cost of excessive alcohol consumption in the United States rising over time. In 2006, the cost was estimated at $223.5 billion, and by 2010, it had increased to nearly $250 billion. Despite a severe economic recession in the late 2000s, the cost of excessive drinking continued to rise, outpacing the annual inflation rate. Lost productivity accounted for the majority of these costs, followed by healthcare expenses and other factors. Binge drinking, in particular, contributed to a significant portion of the total costs.
The prevention of underage drinking is a complex challenge that requires a multi-faceted approach. Individual-level interventions aim to change the way youth think about alcohol to resist peer pressure. School-based programs provide students with the knowledge and skills to make informed decisions, while family-based interventions empower parents to set clear rules and improve communication about alcohol. Community-based interventions, coordinated by local coalitions, work to mitigate risk factors for alcohol misuse, and policy-level interventions advocate for systemic change.
Overall, the impact of underage drinking in the United States is significant, with high associated costs and devastating consequences. Addressing this issue requires a comprehensive approach involving individuals, schools, families, communities, and policymakers to effectively reduce the harmful effects of alcohol consumption among minors.
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Alcohol poisoning and suicides
Alcohol is the most common drug used by people under the age of 21 in the United States. Alcohol-related deaths have increased among all age groups, including about 4,000 deaths each year among young people under 21. Alcohol is a significant factor in the deaths of people younger than 21 in the United States each year, including deaths from motor vehicle crashes, homicides, alcohol overdoses, falls, burns, drowning, and suicides.
Underage drinking poses a range of risks and negative consequences. Firstly, it causes many deaths and injuries. Drinking alcohol can lead to accidents, with about 188,000 people under 21 visiting emergency rooms for alcohol-related injuries in 2011 alone. Secondly, it impairs judgment, leading to poor decisions about taking risks, such as unsafe sexual behaviour, drinking and driving, and aggressive or violent behaviour. Thirdly, it increases the risk of physical and sexual assault, with underage binge drinking associated with a higher likelihood of being a victim or perpetrator of interpersonal violence.
Binge drinking, defined as a pattern of drinking that brings blood alcohol concentration (BAC) to 0.08% or higher, is the most common way that people drink alcohol excessively. Alcohol is estimated to cause about 20–30% of cases of oesophageal cancer, liver cancer, cirrhosis of the liver, homicide, epilepsy, and motor vehicle accidents. It is also a contributing factor to suicide, with alcohol abuse leading to increased suicidality through disinhibition, impulsiveness, and impaired judgment. Social withdrawal, the breakdown of social bonds, and social marginalization, which are common outcomes of untreated alcohol abuse, can further increase suicide risk.
Alcohol policies that reduce consumption, such as increasing excise taxes on beer and implementing drunk driving laws, have been shown to reduce youth suicides, particularly among young males. These policies can also have unintended benefits, such as reducing suicides by teenage females impacted by drunk driving laws. Overall, preventing underage drinking is a complex challenge that requires a multifaceted approach, including individual, school-based, family-based, community-based, and policy-level interventions.
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Binge drinking and its health risks
Binge drinking is a dangerous pattern of excessive alcohol consumption that can lead to severe health and safety risks, especially among underage individuals. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines binge drinking as a drinking pattern that raises blood alcohol concentration (BAC) to 0.08% or higher. This typically corresponds to consuming four or more drinks for women and five or more drinks for men in about two hours.
Underage drinking poses a range of risks and negative consequences. Firstly, it is a significant factor in the deaths of individuals under 21 in the United States each year. Alcohol-related deaths among this age group can result from motor vehicle crashes, homicides, alcohol overdoses, falls, burns, drowning, and suicides. Secondly, drinking alcohol impairs judgment and increases the risk of accidents, injuries, and violent or aggressive behaviour. Underage binge drinking is associated with a higher likelihood of being involved in interpersonal violence, either as a victim or perpetrator.
Additionally, binge drinking increases the risk of unsafe sexual behaviour, leading to a higher risk of sexually transmitted infections and unintended pregnancies. Binge drinking can also cause blackouts and contribute to the development of alcohol use disorder, which is more likely among those who start drinking at a younger age. Furthermore, excessive alcohol consumption can lead to long-term health issues such as high blood pressure, heart disease, liver disease, digestive problems, and a weakened immune system.
The availability of alcohol, mental health factors, and challenges in accessing healthcare have contributed to the increasing alcohol-related deaths among young people. Preventing underage drinking is complex and requires interventions at the individual, school, family, community, and policy levels. These interventions aim to change youth perceptions of alcohol, provide education, improve family communication, address risk factors, and implement effective policies to reduce alcohol misuse.
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Alcohol-related deaths by state
Alcohol is a significant factor in the deaths of people younger than age 21 in the United States each year, with about 4,000 young people (under 21) dying from excessive alcohol use annually. These deaths include motor vehicle crashes, homicides, alcohol overdoses, falls, burns, drowning, and suicides.
Alcohol-related deaths in the US increased among all age groups from 2020 to 2021, compared to just a few years earlier (2016–2017). This increase was more pronounced in non-metropolitan areas than in any other area. Small to medium-sized metropolitan areas also saw a significant rise in alcohol-related deaths from 2006 to 2019, while large metropolitan areas saw the fewest deaths and the smallest increase in the death rate during the same period. The death rate for large metropolitan areas was 9.2 deaths per 100,000 people, below the national average of 10.4. The highest death rates tend to be found in the western part of the US, with New Mexico having the highest death rate at 34.3 deaths per 100,000 people.
From 2015 to 2019, the leading causes of alcohol-attributable deaths due to chronic conditions in the US were liver diseases, cardiovascular diseases, and cancers of various types. In 2019, 30 states had alcohol-related death rates in the double digits, compared to just 10 states in 2006. American Indians/Alaskan Natives have the highest rates of alcohol-related deaths, followed by White/Caucasians. The death rate for all races jumped between 2006 and 2019, with the rate for American Indians/Alaskan Natives increasing from 30.8 to 50.5 deaths per 100,000 people. The death rate for Whites during the same period increased from 6.9 to 11.1 deaths per 100,000 people.
Overall, excessive alcohol use leads to approximately 178,000 deaths in the US each year, including about 120,000 male deaths and 59,000 female deaths. Alcohol is one of the leading preventable causes of death in the country.
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Strategies to prevent underage drinking
Alcohol is the most common substance used by people under the age of 21 in the United States. Alcohol-related deaths have increased among all age groups, including about 4,000 deaths each year among young people under 21. Alcohol is a significant factor in the deaths of people younger than 21 in the United States each year, including deaths from motor vehicle crashes, homicides, alcohol overdoses, falls, burns, drowning, and suicides. Underage drinking cost the United States $24 billion in 2010.
Individual-level interventions
This approach aims to change the way young people think about alcohol so that they are better able to resist the pressure to drink. It involves educating them about the effects of alcohol on their health and behaviour, as well as providing them with the skills to make informed decisions and resist peer pressure.
School-based interventions
These programs provide students with the knowledge, skills, motivation, and opportunities they need to avoid alcohol. This can include curricula targeted at preventing alcohol use, as well as extracurricular activities such as social or life skills training or alternative activities.
Family-based interventions
These interventions empower parents to set and enforce clear rules against drinking and improve communication between children and parents about alcohol. This includes educating parents about the risks of underage drinking and the importance of modelling responsible drinking behaviour for their children.
Community-based interventions
Communities can play a crucial role in preventing underage drinking by implementing and enforcing laws that prohibit alcohol sales to minors. This includes increasing alcohol prices and taxes, limiting the number of places selling alcohol, and enhancing the enforcement of laws prohibiting alcohol sales to minors. Communities can also address underage drinking parties and create enforcement mechanisms, such as requiring beer kegs to be registered at the time of retail sale, so that adult purchasers can be identified and penalized if they provide alcohol to minors.
Policy-level interventions
Policy strategies have included increasing the minimum legal drinking age, reducing the commercial and social access of adolescents to alcohol, and reducing the economic availability of alcohol. This includes enacting and enforcing laws that prohibit the sale of alcohol to minors, limiting alcohol advertising to young people, and raising awareness about the harms of alcohol use through national media campaigns.
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Frequently asked questions
About 4,000 young people under the age of 21 die from excessive alcohol use each year in the US.
These deaths include car accidents, homicides, alcohol poisoning, falls, burns, drowning, and suicides.
Binge drinking for males involves having 5 or more drinks in a 2-hour period, and 4 or more drinks for females in the same timeframe.
Underage drinking can cause injuries, violence, and deaths. It can also lead to poor decision-making, such as drinking and driving, and increase the risk of physical and sexual assault.
Various interventions have been found to be successful in preventing underage drinking, including individual-level, school-based, family-based, community-based, and policy-level interventions. These aim to change youth perceptions of alcohol, provide education, improve family communication, and implement policies to reduce alcohol misuse.
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