Youth and Underage Drinking: An Overview

Young people begin to take risks and experiment as they transition from childhood to adulthood. Without support and guidance, some young people may engage in behaviors that place them and others at risk – including using alcohol.

Highlights from SAMHSA’s National Household Survey on Drug Abuse ⁶

All youth, ages 12-17:

• 7.2 million drank at least once in the past year
  
• 2.7 million drank about once a month or more in the past year
  
• 1 million drank at least once a week or more in the past year
  
• Girls were as likely as boys their age to drink alcohol
  
• Hispanic youth were as likely as white non-Hispanic youth to be current drinkers
  
• Black non-Hispanic youth were the least likely of the racial/ethnic groups to be current drinkers
  
• 66 percent thought drinking 4 or 5 alcoholic drinks nearly every day was a great risk
  
• 47 percent thought drinking 4 or 5 alcoholic drinks once or twice a week was a great risk

All youth, ages 12-17: ⁷

• 13 percent had at least one serious problem related to drinking in the past year
  
• 6 percent had built up tolerance to the effects of alcohol
  
• 3 percent reported psychological problems related to their drinking
  
• 1 percent reported health problems related to their drinking

Youth, ages 12-17, who drank any alcohol in the past year:

• 39 percent had at least one serious problem related to drinking in the past year
  
• 18 percent had built up tolerance to the effects of alcohol
  
• 8 percent reported psychological problems related to their drinking
  
• 4 percent reported health problems related to their drinking

Youth, ages 12-17, who drank heavily (5 or more drinks on 5 or more occasions in the past month):

• 77 percent had at least one serious problem related to drinking in the past year
  
• 63 percent had built up tolerance to the effects of alcohol
  
• 20 percent reported psychological problems related to their drinking
  
• 12 percent reported health problems related to their drinking

Young adults, ages 18-20, who drank heavily (5 or more drinks on 5 or more occasions in the past month):

• 66 percent drove under the influence of alcohol in the past year
  
• 42 percent often drove or rode without wearing a seat belt

Young adults, ages 12-20, rates of alcohol use in 1998:

• Among youth ages 12-20, the rates of alcohol use were highest among those 18-20, among whites, male and among those living in the North Central region of the United States. The lowest rates of use were among blacks, females, and youth living in large metropolitan areas.
  
  
• The rates of current, binge, and heavy alcohol use did not change significantly between 1994-1998. Rates were 30.6 percent, 15.2 percent, and 6.9 percent, respectively, for current, binge, and heavy use.

Highlights from the National Survey Results on Drug Use from the Monitoring the Future Study⁸

8th graders:

• 25 percent reported drinking alcohol in the past month
  
• 8 percent reported being drunk
  
• 15 percent reported binge drinking in the 2 weeks prior to the survey
  
• 1 percent reported drinking every day

10th graders:

• 40 percent reported drinking alcohol in the past month
  
• 22 percent reported being drunk
  
• 25 percent reported binge drinking in the 2 weeks prior to the survey
  
• 2 percent reported drinking every day

12th graders:

• 53 percent reported drinking alcohol in the past month
  
• 34 percent reported being drunk
  
• 30 percent reported binge drinking in the 2 weeks prior to the survey
  
• 4 percent reported drinking every day

Adolescents' Beliefs About Alcohol

• Very young children – even preschoolers – can tell that alcohol has an effect on people that other beverages do not. In fact, children begin forming opinions about alcohol at an early age, and they tend to view it negatively.⁹
  
  
• Boys’ beliefs tend to be more favorable toward drinking than those of girls. Boys also tend to associate drinking with being more grown up – a perceived positive outcome of drinking.¹⁰<
  
  
• Adolescents ages 12 to 14 believe that the positive benefits of drinking (feeling good, fitting in with peers) are more likely to occur than the negative effects of drinking (feeling sick, causing serious health problems). White non-Hispanic children tend to hold more favorable beliefs about alcohol than African American children.¹¹
  
  
• Youth ages 12 to 14 who expect to gain greater social acceptance from drinking are more likely to begin to drink as well as to consume alcohol at faster rates.¹² White non-Hispanic children tended to be more concerned with their friends’ attitudes about alcohol than African American children.¹³
  
  
• Adolescents ages 12 and 13 see other people, including their parents, as less disapproving of their engaging in drinking than do younger children.¹⁴
  
  
• Fifty-six percent of students in grades 5 through 12 say that alcohol advertising encourages them to drink.¹⁵
  
  
• In an annual survey of adolescents, 56 percent of 8th graders, 52 percent of 10th graders, and 43 percent of 12th graders believe that having five or more drinks once or twice each weekend is harmful. Survey results also show that 81 percent of 8th graders, 70 percent of 10th graders, and 65 percent of 12th graders, disapprove of this quantity and rate of alcohol consumption.¹⁶
  
  
• Seventy-five percent of 8th graders and 89 percent of 10th graders believe that alcohol is readily available to them for consumption.¹⁷
  
  
• Eighty percent of 12- to 17-year-olds surveyed think that alcohol negatively affects scholastic performance, and 81 percent believe it increases the likelihood of getting into trouble.¹⁸
  
  
• Twenty-two percent of youth under age 18 report drinking at least once a week.¹⁹

Risk Factors for Adolescent Alcohol Use

The reasons why adolescents use alcohol are complex but include curiosity, a need to fit in with friends, and a desire to relax and escape problems.²⁰ For some, additional factors may be involved.

Highlights from the National Institute on Alcohol Abuse and Alcoholism Alcohol Alert on Youth Drinking²¹ include the following risk factors:

• Genetic Factors: Children of alcoholic are significantly more likely to initiate drinking during adolescence and to develop alcohol use disorders, but the relative influences of environment and genetics have not been determined and vary among young people.



• Childhood Behavior: Research has shown that children who are very restless and impulsive at age 3 are twice as likely to be diagnosed with alcohol dependency at age 21. Aggressiveness in children as young as ages 5 to 10 has been found to predict alcohol and other drug use in adolescence.



• Psychiatric Disorders: Among 12- to 16-year-olds, regular alcohol use has been significantly associated with conduct disorder; in one study, adolescents who reported higher levels of drinking were more likely to have conduct disorder. Whether anxiety and depression lead to or are consequences of alcohol abuse is unresolved. In a study of college freshmen, a DSM-III diagnosis of alcohol abuse or dependence was twice as likely among those with anxiety disorder as those without this disorder. In another study, college students diagnosed with alcohol abuse were almost four times as likely as student without alcohol abuse to have a major depressive disorder. In most of these cases, depression preceded alcohol abuse. In a study of adolescents in residential treatment for alcohol and illicit drug dependence, 25 percent met the DSM-III criteria for depression – three times the rate reported for controls. In 43 percent of these cases, the onset of alcohol and/or illicit drug dependence preceded the depression; in 35 percent, the depression occurred first and in 22 percent, the disorders occurred simultaneously.



• Suicidal Behavior: Alcohol use among adolescents has been associated with considering, planning, attempting, and completing suicide. In one study, 37 percent of 8th grade females who drank heavily reported attempting suicide, compared with 11 percent who did not drink. Research does not indicate whether drinking causes suicidal behavior, only that the two behaviors are correlated.



• Parental and Peer Influences: Parents’ drinking behavior and favorable attitudes about drinking have been associated with adolescents’ initiating and continuing drinking. Early initiating of drinking has been identified as an important risk factor for later alcohol-related problems. Lack of parental support, monitoring, and communication also has been significantly related to frequency of drinking, heavy drinking, and drunkenness among adolescents. Peer drinking and acceptance also influences adolescent drinking behaviors.
• Expectancies: Positive expectations from alcohol use have been found to increase with age and to predict the onset of drinking among adolescents.

Additional Risk Factors include:²²

• Being a sibling of an adolescent who uses alcohol and illicit drugs
• Experiencing learning disorders or other academic problems
• Delinquency
• Teen Pregnancy

“Your Time – Their Future” is a campaign of the Center for Substance Abuse prevention of the Substance Abuse and Mental Health Services Administration. It urges adults to become actively involved in working with children, ages 7 to 14, to develop healthy and useful skills and interests. The campaign encourages adults to volunteer to spend more quality time with youngsters in need of guidance and mentor them toward productive and rewarding lives. Research has shown that such adult involvement can and does help children and young adolescents to resist the use of alcohol, tobacco, and illicit drugs which are dangerous and illegal.

Sources

¹ Center for Substance Abuse Prevention, Prevention Primer: An encyclopedia of alcohol, tobacco, and other drug prevention terms, Rockville, MD: Department of Health and Human Services, 1993.

² National Institute on Drug Abuse, National Survey Results on Drug Use from The Monitoring the Future Study, 1975-1997, Volume I: Secondary School Students, Rockville, MD: Department of Health and Human Services, 1998.

³ Ibid.

⁴ Wechsler, H. et al., “Changes in Binge Drinking and Related Problems Among American College Students Between 1993 and 1997: Results of the Harvard School of Public health College Alcohol Study,” Journal of American College Health, 1998.

⁵ Substance Abuse and Mental health Services Administration, Summary Findings from the 1998 National Household Survey on Drug Abuse, Rockville, MD: U.S. Department of Health and Human Services, 1999.

⁶ Substance Abuse and Mental health Services Administration, National Household Survey on Drug Abuse Population Estimates 1998, Rockville, MD: U.S. Department of Health and Human Services, 1999.

⁷ Substance Abuse and Mental Health Services Administration, National Household Survey on Drug Abuse Main Findings 1997 (Table 9.3), Rockville, MD: DHHS, 1999.

⁸ National Institute on Drug Abuse, National Survey Results on Drug Use from The Monitoring the Future Study, 1975-1997, Volume I: Secondary School Students, Rockville, MD: Department of Health and Human Services, 1998.

⁹ Gillmore, M.R., et al., “Children’s beliefs about drinking,” American Journal of Drug and Alcohol Abuse, Volume 24 (1), 1998.

¹⁰ Ibid.

¹¹ Ibid.

¹² Chassin, Laurie and Christian DeLucia, “Drinking during adolescence.” Life-Stage Issues, Volume 20 (3), 1996.

¹³ Gillmore, M.R., et al., “Children’s beliefs about drinking,” American Journal of Drug and Alcohol Abuse, Volume 24 (1), 1998.

¹⁴ Ibid.

¹⁵ The Scholastic/CNN Newsroom Survey on Student Attitudes about Drug and Substance Abuse, 1990.

¹⁶ National Institute on Drug Abuse, National Survey Results on Drug Use from the Monitoring the Future Study, 1975-1997, Volume I: Secondary School Students, Rockville, MD: Department of Health and Human Services, 1998.

¹⁷ Ibid.

¹⁸ National Center on Addiction and Substance Abuse, 1996 Survey of American Attitudes and Substance Abuse, Columbia University, N.Y., 1996.

¹⁹ Ibid.

²⁰ American Academy of Pediatrics, Alcohol: Your Child and Drugs, Washington, DC: 1999.

²¹ National Institute on Alcohol Abuse and Alcoholism, Youth Drinking: Risk Factors and Consequences, Alcohol Alert No. 37, July 1997.

²² Alcohol, Drug Abuse, and Mental Health Administration, Office for Substance Abuse Prevention, Preventing Adolescent Drug Abuse: From Theory to Practice, OSAP Prevention Monograph-8, Rockville, MD: Department of Health and Human Services, 1991.

SAMHSA, a public health agency in the Department of Health and Human Services, is the Federal Government’s lead agency for improving the quality and availability of substance abuse prevention, addiction treatment, and mental health services in the United States. Further information about SAMHSA is available on the Internet at www.samhsa.gov.
  

** Peer pressure begins early. One-third of 4th graders and more than half of 6th graders say they have been pressured by friends to drink alcohol.¹

** On average, young people begin drinking at about age 13,² but some start even younger. By the time they are high school seniors, more than 80 percent have used alcohol and approximately 64 percent have been drunk. ³ When adolescents move on to college, they bring their drinking habits with them: more than 40 percent of college students are binge drinkers.⁴

** In 1998, 10.4 million current drinkers were under legal age (age 12-20). Of these, 5.1 million were binge drinkers, including 2.3 million heavy drinkers.⁵