June 2013

Drinking to Excess: Adolescents and Alcohol

More teens take their first drink of alcohol in June and July than in any other months.[1] As we head into summer, we look at key facts on adolescent alcohol use and what can be done to prevent and stop it.

Dark Side: Alcohol Black Outs

In one study, more than half of college students who drank alcohol reported blacking out at some point in their lives.[2] Many later learned they had participated in actions they didn’t remember, including vandalism, drunk driving, and unprotected sex. Learn more about preventing alcohol abuse on college campuses.

Alcohol’s Effects

Alcohol can affect adolescents’:

  • Brain development. Because adolescents’ brains are still developing, teen drinking can lead to changes in the brain’s make-up and function.[3],[4],[5]
  • Long-term health.  Adolescents who drink heavily are more likely to continue drinking heavily as adults, which can lead to certain types of cancers, liver disease, pancreatic illness, and stroke.[6]
  • Life-expectancy.  Between 2001 and 2005, at least 4,700 U.S. youth under the age of 21 died as a result of excessive alcohol use.[7]

Binge Drinking and Alcohol Poisoning

Many adolescents who die because of alcohol use were binge drinking and suffered alcohol poisoning.[8]  Although adolescent binge drinking has declined over the last two decades, it remains too high, with approximately one in five high school students reporting binge drinking in the last month.[9] Signs of alcohol poisoning include mental confusion, an inability to be roused, and vomiting. Learn more about a­­­lcohol poisoning.

Some Good News

Adolescent alcohol use has fallen substantially in the last two decades. In 1991, 54% of 8th graders, 72% of 10th graders, and 78% of 12th graders reported drinking alcohol in the previous year.  By 2011, these percentages fell to 27% of 8th graders, 50% of 10th graders, and 64% of 12th graders.[10]

Behind the Wheel

Teen drivers are three times more likely than more experienced drivers to be in a fatal crash.[11] Drinking any alcohol greatly increases this risk.

Specific policies can help reduce underage drinking and driving, including zero-tolerance laws, enforcing the minimum drinking age, and graduated driver licensing (GDL) systems. GDL systems, which phase novice drivers into full driving privileges over time, are in place in every state (though with different rules) and help new drivers get more experience under less risky conditions. Learn more about what works to prevent teen drinking and driving.

Family Matters

Parents and other caretakers can help adolescents avoid alcohol by consistently sending clear, accurate messages about the dangers of drinking.[12] It is important to:

  • Talk to your adolescent about alcohol.  Research shows that parents have an influence on their children’s behavior.  Even if you think your child is too young to feel pressured to drink alcohol, beginning the discussion early can prepare your child for future social situations involving alcohol.[13]
  • Foster an open relationship with your adolescent.  Scare tactics and authoritarian discipline practices may be ineffective strategies.  Instead, try to have ongoing, open-ended conversations with your child.  Let your child know you value their perspectives and opinions.[14]
  • Send clear messages to your adolescent about the specific dangers of teens drinking alcohol.  Share important, accurate information about alcohol use with your child, such as “alcohol is a powerful drug,” “alcohol can be dangerous,” and “underage drinking is illegal.”[15]  Establishing rules and expectations around alcohol that are clear and consistent is also important.[16]
  • Set a good example yourself. Drink alcohol in the manner you’d like to see your child drink when they are adults.[17] 
  • Consistently monitor your adolescent’s behavior.  Partner with other parents, teachers, and individuals in your community to help keep  track of your child’s activities and whereabouts.[18] Be especially vigilant during times that may be particularly stressful for your child, such as a move or a parental divorce.[19]

For additional tips and guidance, check out the new “Talk. They Hear You” campaign, designed to help parents and caregivers start talking to their children as early as nine years old about the dangers of alcohol.

What Works: Screening and Brief Interventions

Screening and brief interventions by healthcare providers (asking adolescent patients about alcohol use and advising them to reduce risky drinking) can result in lasting reductions in drinking levels and alcohol-related problems.[20] Along with screening youth, healthcare providers, schools, and other youth serving professionals can:

  • Refer teens in need of intervention to appropriate services, which may include integrated forms of intervention, such as treatment for other forms of substance abuse or for mental illness.[21]
  • Offer school-based programs for adolescents, as instructional programs can help reduce the incidence of adolescents riding with impaired drivers.[22]
  • Offer adolescents opportunities to become engaged in their school and community.  Youth who volunteer, play on a sports team, play a musical instrument, or participate in other academic or leadership activities may be less likely than those who do not to use alcohol.[23] 
  • Provide information and resources about adolescent alcohol use to parents and families to help empower them effectively communicate with their children about with alcohol use.[24]

Alcohol Use in Your State

Teen alcohol use varies across states, from 15% of high school students in Utah to 44% in Louisiana having had a drink in the last 30 days.  The national average was 39% in 2011, and the percentages were almost identical for boys (39%) and girls (38%).[25], [26] Find out more about student reports of alcohol use nationally and in your state with OAH’s searchable map. 

Get Help

Call the Substance Abuse and Mental Health Services Administration’s (SAMHSA’s) substance abuse treatment helpline at 1-800-662-HELP for confidential, free service, along with referrals to local treatment facilities, support groups, and community-based organizations. You can also find a local treatment facility with SAMHSA’s Substance Abuse Treatment Facility Locator. Find more resources on helping adolescents who may be struggling with alcohol.


1  Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. (2012). The NSDUH Report:Monthly Variation in Substance Use Initiation among Adolescents. Rockville, MD. Available here.

2  White, A. M., Jamieson-Drake, D. W., & Swartzwelder, H. S. (2002). Prevalence and correlates of alcohol-induced blackouts among college students: Results of an e-mail survey. Journal of American College Health, 51(3), 117-131.

3  De Bellis MD, Clark DB, Beers SR, et al. Hippocampal volume in adolescent-onset alcohol use disorders. The American Journal of Psychiatry. 2000; 157(5):737-744.

4  Ehlers CL, Criado JR. Adolescent ethanol exposure: Does it produce long lasting electorphysiological effects? Alcohol. 2010;44(1):27-37.

5  Thoma RJ, Monnig MA, Lysne PA, et al. Adolescent substance abuse: the effects of alcohol and marijuana on neuropsychological performance. Alcoholism: Clinical and Experimental Research. 2011;35(1):39-46.

6  U.S. Department of Health and Human Services. (2007).  The Surgeon General’s call to action to prevent and reduce underage drinking. Rockville, MD: Office of the Surgeon General.

7  Centers for Disease Control and Prevention. (2008). Alcohol Related Disease Impact (ARDI) application, 2008Available here

8  Many surveys define binge drinking as consuming five drinks or more at a time.  However, males and females metabolize alcohol differently.  For this reason, the National Institute on Alcohol Abuse and Alcoholism defines binge drinking as having five drinks in one sitting for men, and four drinks in one sitting for women.

9  Centers for Disease Control and Prevention. (2012). 1991-2011High SchoolYouth Risk Behavior Survey Data. Available here.

10  Johnston, L. D., O’Malley, P. M., Bachman, J. G., Schulenberg, J. E.  (2012).   Monitoring the Future, national results on adolescent drug use: Overview of key findings, 2011.  Ann Arbor: Institute for Social Research, the University of Michigan. Available here.

11  Centers for Disease Control and Prevention. (2012). Vital Signs: Teen Drinking and Driving – A Dangerous Mix. Available here.

12  National Institute on Alcohol Abuse and Alcoholism. (2009). Make a difference: Talk to your child about alcohol. Bethesda, MD: National Institutes of Health. Available here.

13  Ibid.

14  Ibid.

15  Ibid.

16  National Institute on Alcohol Abuse and Alcoholism. (2010). Parenting to prevent childhood alcohol use. Bethesda, MD: National Institutes of Health. Available here.

17  U.S. Department of Health and Human Services. (2007).  The Surgeon General’s call to action to prevent and reduce underage drinking. What it means to you: A guide to action for families. Rockville, MD: Office of the Surgeon General. Available here.

18  National Institute on Alcohol Abuse and Alcoholism. (2010). Parenting to prevent childhood alcohol use. Bethesda, MD: National Institutes of Health. Available here.

19  U.S. Department of Health and Human Services. (2007). The Surgeon General’s call to action to prevent and reduce underage drinking. Rockville, MD: Office of the Surgeon General.

20  National Institute on Alcohol Abuse and Alcoholism. (2013). NIH study finds missed opportunities for underage alcohol screening. Bethesda, MD: National Institutes of Health. Available here.

21  U.S. Department of Health and Human Services. (2007). The Surgeon General’s call to action to prevent and reduce underage drinking. Rockville, MD: Office of the Surgeon General.

22  Guide to Community Preventive Services. Improving adolescent health. Available here.

23  U.S. Department of Health and Human Services. (2007). The Surgeon General’s call to action to prevent and reduce underage drinking. Rockville, MD: Office of the Surgeon General.

24  Ibid.

25  Centers for Disease Control and Prevention. (2012). 1991-2011High SchoolYouth Risk Behavior Survey Data. Available here.

26  Based on high school students reporting at least one drink of alcohol on at least 1 day during the 30 days before the survey in 2011.

Last updated: March 10, 2016