In the U.S., alcohol is the most commonly used substance of abuse among young people, creating a serious public health problem.1 Individuals ages 12-20 account for 11% of all the alcohol consumed in the States, and more than 90% of that is consumed by binge drinking.1
Current drinking culture can make it difficult for parents and students to fully understand the severity and potential consequences of alcohol abuse. Teens may drink because of peer pressure, experimentation, stress, or other reasons. This risky behavior can lead to an alcohol use disorder (AUD) and other dangers.1
Early drinking can lead to property damage, injury, violence, and death. There are many ways this nationwide concern can be addressed, including through open communication and educating youth on the risks associated with alcohol use both in the short and long terms.1
What is Considered Binge Drinking?
According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), binge drinking is defined as a drinking pattern that results in blood alcohol concentration (BAC) levels of 0.08 g/dL and above. For adult men, that’s usually around 5 drinks in a couple hours, and for adult women, it’s generally about 4.2
NIAAA states that research indicates that young people can reach that level with fewer drinks, so it has additional guidelines for what is considered binge drinking in youths, broken down by gender and age1:
- 9 to 13 years old: Around 3 drinks
- 14 to 15 years old: Around 4 drinks
- 16 to 17 years old: Around 5 drinks
- 9 to 17 years old: Around 3 drinks
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), binge drinking is defined as 4 or more drinks on the same occasion for women (5 or more for men) at least one day in the prior month. Binge drinking five or more days during the past month is considered heavy alcohol use by SAMHSA.2
Statistics on Underage Binge Drinking
The Youth Risk Behavior Survey is conducted by the Centers for Disease Control and Prevention (CDC) among samples of ninth- through twelfth-graders. The 2017 results showed that:3
- 5% consumed their first alcoholic drink (beyond a few sips) before age 13.
- 4% had alcohol on at least 1 day in their life.
- 8% of girls reported alcohol use in the prior 30 days.
- 6% of boys reported alcohol use in the prior 30 days.
In the 30 days prior to the survey:3
- 29.8% drank alcohol on at least 1 day.
- 13.5% had binge drank (4 or more drinks in a couple hours for girls, 5 or more for boys).
- 4% consumed 10 or more drinks in a row, within a couple of hours.
- 5% of those who drank in the past 30 days usually got alcohol from someone giving it to them.
- 5.5% of those who drove a vehicle in the past 30 days drove after drinking alcohol.
- 16.5% rode with a driver who had been drinking alcohol.
According to SAMHSA’s 2017 National Survey on Drug Use and Health:4
- An estimated 4.5 million 12- to 20-year-olds binge drank at least once in the past month.
- An estimated 0.9 million 12- to 20-year-olds binge drank on 5 or more days over the past month.
What is an Alcohol Use Disorder?
Although alcohol use disorder (AUD) can only be diagnosed by a licensed health care provider, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has outlined diagnostic criteria that may indicate a person is struggling with an alcohol use disorder.5 If a person has experienced two or more of these criteria within the last 12 months, it may point to a pattern of problematic alcohol use:5
- Inability to cut down or control alcohol consumption despite persistent desire and/or attempts to quit.
- A craving or a strong desire to use alcohol.
- Often consuming more alcohol than intended or drinking for a longer time than intended.
- Continued drinking in spite of repeated or ongoing issues with interpersonal relationships caused or exacerbated by alcohol.
- A lot of time is spent doing activities that involve drinking alcohol, getting alcohol, or recovering from its effects.
- Alcohol use leads to giving up or decreasing important occupational, social, or recreational activities.
- Experiencing symptoms of withdrawal when abstaining from alcohol, or using alcohol or another substance to reduce or prevent withdrawal.
- Having problems fulfilling important responsibilities at home, work, or school due to regular drinking.
- Continued use of alcohol in situations where it is physically hazardous (e.g., driving).
- Tolerance (more alcohol is needed to achieve intoxication or other desired effect).
- Continued drinking even when knowing that it is likely causing or worsening a physical or psychological problem
Is Binge Drinking Alcoholism?
While binge drinking does not necessarily mean an individual has an alcohol use disorder, a 2002 study found that adolescents who engaged in binge-drinking had a higher risk of alcohol and drug and abuse and dependence than those who did not binge drink.7
For adults, more than 4 drinks a day (or more than 14 in a week) for men and more than 3 drinks a day (or more than 7 in a week) for women is considered at-risk drinking. Around 25% of those who go beyond these limits already have an alcohol use disorder, and anyone who binge drinks would, by definition, exceed these limits.8
What are the Dangers of Underage Drinking?
For youth, underage initiation of drinking may have harmful effects on cognitive development. The brain continues to mature into a person's early 20s, and in the long term, heavy alcohol use in the teenage years can cause lasting cognitive deficits and alter the course of brain development.6
Other dangers associated with underage drinking include impaired judgment (which can lead to violent behavior, drinking and driving, and more), increased risk of carrying out or suffering from physical or sexual assault, injuries, increased risk of later alcohol problems, death, and other problems (such as trouble with the law or other drug use). The CDC estimates that alcohol plays a role in the deaths of 4,358 individuals under age 21 each year on average.1
Does My Teen Have A Drinking Problem?
Although teens consume alcohol less often than adults, they generally drink more per occasion.6 If you feel that your teen may be using alcohol, you should talk with a healthcare provider,9 they can provide guidance specific to your situation.
There are some warning signs you can look for that could point to potential underage alcohol use, including:1
- Mood changes (e.g., anger, irritability).
- Decreased energy levels.
- Behavioral and/or academic issues in school.
- Decreased interest in activities and/or in appearance.
- Coordination problems.
- Issues concentrating and/or with memory.
- Finding alcohol in their belongings.
- Smelling alcohol on their breath.
- Switching friend groups.
- Speech slurring.
Preventing Underage Drinking
Parents and/or close family members can help play a role in their teen’s choices about alcohol. The following advice is drawn from a prevention guide published by NIAAA that is targeted to parents and caregivers of 10- to 14-year-olds. Parents have greater influence on their child’s values and choices regarding alcohol before they start drinking.
Talking to your child about alcohol use can be difficult, and they may try to dodge the topic. But underage alcohol use is dangerous, and research shows that parents have a large amount of influence on their teen’s actions. Take time to consider which issues you want to discuss, how your child may react, and how you can respond to them.9
Before talking with your child, here are some things to consider:9
- Choose a time to talk when you both have some “down time,” and are calm.
- Don’t lecture, make it an ongoing conversation.
- Ask them their views on alcohol and what they know about its effects.
- Be a listener. You may want to drive the conversation, but let them have an opportunity share their thoughts so that they feel heard and respected.
- Take the time to familiarize yourself with common misconceptions about alcohol so you can share facts with them that they may not know.
- Help them understand that even young people can develop an alcohol use disorder.
- Offer good reasons not to drink (e.g., it may lead to embarrassing or dangerous situations, hinders brain development, familial history of alcoholism), but avoid scare tactics.
- Help them develop plans for how to respond to peer pressure in a way that will work for them.
- Clearly convey ways that you are willing to support them (e.g., they can call you to pick them up and they will not get in trouble).
Parents can also make smart choices to help their teens avoid alcohol by:9
- Not making alcohol available and keeping track of their own supply.
- Getting to know their children’s friends and encouraging healthy friendships.
- Having regular conversations about life in general and developing a solid relationship with their child.
- Keeping track of their teen’s plans and activities.
- Connecting with other parents, which can help them keep an eye on their child and ensure that gatherings will be supervised and not involve alcohol.
- Supervising all parties to make sure there is no alcohol.
- Encouraging teens to participate in healthy and fun activities that do not involve alcohol (e.g., sports, music).
- Being a good example with their own alcohol use (e.g., drinking in moderation, not using alcohol as a coping mechanism, not glamorizing alcohol use).
Remember, this should be a continuing conversation, and you can make a difference.
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. National Institute on Alcohol Abuse and Alcoholism (NIAAA). (2017). Underage drinking.
. National Institute on Alcohol Abuse and Alcoholism (NIAA). (2019). Drinking Levels Defined.
. Robert R. Redfield, Anne Schuchat, MD, Leslie Dauphin, PhD, et al. Centers for Disease Control & Prevention. (2018). Youth Risk Behavior Survey. MMWR Surveillance Summaries, 67(8).
. Jonaki Bose, Sarra L. Hedden, Rachel N. Lipari, Eunice Park-Lee. Substance Abuse & Mental Health Administration. (2018). Key Substance Use and Mental Health Indicators in the United States: Results from the 2017 National Survey on Drug Use and Health.
. Diagnostic and Statistical Manual of Mental Disorders: DSM-5. (5th ed.). (2013). Washington, D.C.: American Psychiatric Association. 490-491.
. Federal Trade Commission Consumer Information. (2013). Dangers of Teen Drinking.
. Chassin, L., Pitts, S. C., & Prost, J. (2002). Binge drinking trajectories from adolescence to emerging adulthood in a high-risk sample: predictors and substance abuse outcomes. Journal of consulting and clinical psychology, 70(1), 67.
. National Institute on Alcohol Abuse and Alcoholism (NIAAA). (n.d.). What's "at-risk" or "heavy" drinking?
. National Institute on Alcohol Abuse and Alcoholism (NIAAA). Talk to your child about Alcohol. Make A Difference. 10-11.