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Underage Drinking in the United States

Sep. 1, 2016
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In the United States, underage drinking is a major public health concern. Underage drinking not only poses a threat to the young person indulging in this illegal activity, it also threatens the wellbeing of all those around them. According to the National Institute on Alcohol Abuse and Alcoholism, or NIAAA (2013), 5,000 people under the age of 21 die each year and more than 190,000 visit an emergency room for alcohol-related injuries. Underage drinking is rampant not only among high school-aged youth, but even some middle school-aged youth as well. Let’s examine the incidence of underage drinking in the United States, as well as the consequences and risks involved, and prevention.

What is underage drinking?

According to the NIAAA (2013),  underage drinking is “when anyone under the minimum legal drinking age of 21 drinks alcohol.” Nationally, the legal minimum age to drink alcohol is 21. Anyone under the age of 21 who drinks is not only breaking the law and putting themselves at risk of arrest, but they are putting themselves at risk to a number of physical, emotional, and social damages. 

Why do young people drink?

There is not always a clear-cut reason as to why young people drink. However, some of the most common risk factors for underage drinking include (Mayo Clinic, 2011): 

  • Desire to fit in with their peers (peer pressure)
  • A major transition (i.e. moving from middle school to high school)
  • Increased stress at home or at school
  • Family problems (i.e. conflict, parental alcohol abuse)
  • A history of behavioral problems or mental health issues

Young people are vulnerable to alcohol use for so many reasons. The stress of the physical and emotional effects of puberty can leave them susceptible and seeking a way to feel better about themselves. Since they may not be mature enough to fully grasp the seriousness of the situation, many young people can fall victim to the consequences of underage drinking.   

Incidences of Underage Drinking in the United States

Through a series of surveys, the Centers for Disease Control and Prevention or CDC (2012) uncovered some disturbing facts about underage drinking in the United States. In 2011, about 39% of high school students drank some amount of alcohol. Furthermore, 22% of high school students binge drank, 8% drove after drinking alcohol, and 24% rode with a driver who was under the influence of alcohol. The CDC (2012) further found that “33% of 8th graders and 70% of 12th graders had tried alcohol, and 13% of 8th graders and 40% of 12th graders drank during the past month.” 

Consequences and Risks of Underage Drinking

There are many emotional, physical, and social consequences and risk to underage drinking.

Alcoholism – People who begin drinking alcohol at an early age have an increased likelihood of
developing an alcohol dependency. According to the CDC (2012), “youth who start drinking before age 15 years are five times more likely to develop alcohol dependence or abuse later in life than those who begin drinking at or after age 21 years.”

Risky behavior – Young people who drink tend to exhibit risky behavior and impaired judgment, such as: having unprotected sex, drinking and driving, and participating in violence.

Brain development problems – “Research shows that brain development continues well into a
person’s twenties. Alcohol can affect this development, and contribute to a range of problems” (NIAAA, 2013). This can include memory loss and dysfunction in cognitive development. 

Being a victim of a violent crime – Young people who drink are at an increased risk of being a victim of a violent crime (i.e. rape, robbery, or assault).

Problems at school – Problems at school can include social, academic, and behavioral problems, such as fighting, suspension from extracurricular activities, and increased absence.

Legal problems – This can include anything from being arrested for driving under the influence to being arrested for assaulting someone while under the influence. 

Death – Alcohol-related deaths among young people include: car accidents, homicides, suicides, alcohol poisoning, and other injuries (falls, burns, and drowning).

Warning Signs of Underage Drinking

The transition from being a young person to becoming an adult can be confusing, frustrating, and difficult. Although a young person who drinks alcohol will exhibit signs of doing so, it is important to be able to know the difference between signs of alcohol use and signs of typical adolescent struggles. There may be some difficulty in knowing the difference, as many of the signs of underage drinking are very similar to the signs of growing up. However, the Substance Abuse and Mental Health Services Administration, or SAMHSA (2013), advises that a drinking problem is more likely the case if you notice several of the signs of underage drinking happening concurrently, suddenly, or if some of the signs are extreme in nature. Any adult who is around children or teenagers should be familiar with the warning signs of underage drinking. 

Changes in mood – irritability, outbursts, defensiveness

Change in friends – sudden, unexplained change in friends and a reluctance to let you know the reason why and/or to introduce you to the new group of friends. 

Apathy – less or no interest in appearance, lack of involvement in former interests and activities.

Physical or mental difficulties – memory lapses, slurred speech, coordination difficulties, poor concentration, bloodshot eyes. 

Problems in school – excessive lateness or absence, dramatically lower grades, school suspension or detention for behavioral issues.  

Problems at home – rebellion against rules, fighting with family members. 

Physical evidence of alcohol – finding alcohol among the young person’s possessions (i.e. in his or her room or backpack) or smelling alcohol on their breath. 


The first line of defense in combating underage drinking is prevention. Prevention starts at home – parents and family should talk to their child or teen about the consequences of underage drinking. Although no one wants to believe that their child or teen can fall victim to underage drinking, avoiding the subject does not mean that it will not happen. Being proactive means to stop the problem before it has a chance to start. When talking to teens about underage drinking, it is important to find out what the teen’s stance is on the topic. Find out what they think about underage drinking, what they believe the consequences are (if any), then give them the actual facts on this matter. Chances are there is a lot of information that they thought they knew, but it was actually just hearsay (from other young people who know as little as them about the issue). 

The Mayo Clinic (2011) also recommends discussing the reasons why they should not drink, ways to handle peer pressure, and also to discuss your own drinking habits. The child or teen may want to know if you drank as a teenager – be prepared to explain why you chose not to drink, or if you did, explain the consequences of your decision.  Last, be prepared to explain why responsible drinking is acceptable as an adult, but not as a child or teenager. 

Prevention is not only the responsibility of the parent or family, but it is the responsibility of society as well. Educating young people on the dangers of underage drinking, implementing and enforcing tougher laws regarding underage drinking and drunk driving, and reducing youth exposure to alcohol advertising are some of the community-based initiatives that can help to reduce underage drinking. 


The legal drinking age in the United States has not always been 21. For much of the early 20th century, the legal drinking age fluctuated between 18 and 21, with the age varying by state. However, in 1984, the federal government ordered all 50 states to either comply with a minimum drinking age act that required adults to be at least 21 years of age in order to drink, or suffer a 10% cut of annual federal highway funding (Daniloff, 2010). Although the wide majority of the country seems to be accepting of this law, there have been several attempts over the past 30 years to change the minimum age limit on drinking from 21 to 18, and to leave the decision up to the state rather than the federal government.

In 2004, former Middlebury College president John McCardell became a leader of sorts in the crusade to lower the legal minimum drinking age in the U.S. to 18 (Daniloff, 2010). Mr. McCardell theorizes that lowering the minimum drinking age and increasing awareness about responsible drinking will decrease binge and irresponsible drinking among youth. Furthermore, he believes that keeping the minimum age limit of 21 has not decreased underage drinking, but has simply driven underage drinking underground and encouraged binge drinking. 

Mr. McCardell is not alone in his theories and beliefs about underage drinking. In 2007, he founded a non-profit organization called Choose Responsibly (Daniloff, 2010). Choose Responsibly’s mission is to lower the minimum drinking age to 18, as well as educate young people about the dangers of excessive and reckless alcohol consumption. The organization has a community of supporters, donors, and volunteers who share in Mr. McCardell’s point of view. 


Underage drinking is a serious and widespread problem in the United States. Every year, thousands of people die and hundreds of thousands more are injured in alcohol-related accidents. The physical, social, and emotional consequences of underage drinking are quite serious and sometimes even fatal. Prevention is the responsibility of everyone, as underage drinking can directly and indirectly impact our entire society. Adults, peers, law enforcement, government officials, family and friends all have a social responsibility in protecting our youth from the dangers of underage drinking through prevention and education. Recognizing the signs of underage drinking is important to getting underage drinkers the mental, emotional, social, and physical support that they need. 

In my opinion, knowing when and how much to drink has less to do with age and more to do with maturity – there are adults well over the age of 21 who still do not know their limit, do not drink responsibly, and find themselves in trouble whenever they drink. With that being said, we cannot expect children to always know what is best for them – they often lack the maturity to do so. Leaving such an important, potentially life-altering decision in the hands of our youth is a risk not only to them, but to everyone around them. Perhaps lowering the minimum drinking age would decrease irresponsible drinking among youth, or perhaps not – would it be better to gamble with the lives of our youth, or to err on the safe side?


Centers for Disease Control and Prevention (2012). Fact sheets – Underage drinking. Retrieved

Daniloff, C. (2010, October 21). Drinking: 18 vs. 21. Boston University Today. Retrieved from

Mayo Clinic (2011). Underage drinking: Talking to your teen about alcohol. Tween and teen
 health. Retrieved from

National Institute on Alcohol Abuse and Alcoholism (2013). Underage drinking. Retrieved from

Substance Abuse and Mental health Services Administration (2013). Underage drinking.

 Retrieved from

Cover Image by Jodeci Zimmerman