Youth Drinking

Risk Factors and Consequences
Prevalence of Youth Drinking

Thirteen- to fifteen-year-olds are at high risk to begin drinking (3). According to results of an annual survey of students in 8th, 10th, and 12th grades, 26 percent of 8th graders, 40 percent of 10th graders, and 51 percent of 12th graders reported drinking alcohol within the past month (4). Binge drinking at least once during the 2 weeks before the survey was reported by 16 percent of 8th graders, 25 percent of 10th graders, and 30 percent of 12th graders.

Males report higher rates of daily drinking and binge drinking than females, but these differences are diminishing (3). White students report the highest levels of drinking, blacks report the lowest, and Hispanics fall between the two (3).

A survey focusing on the alcohol-related problems experienced by 4,390 high school seniors and dropouts found that within the preceding year, approximately 80 percent reported either getting "drunk," binge drinking, or drinking and driving. More than half said that drinking had caused them to feel sick, miss school or work, get arrested, or have a car crash (5).

Some adolescents who drink later abuse alcohol and may develop alcoholism.

Drinking and Adolescent Development

While drinking may be a singular problem behavior for some, research suggests that for others it may be an expression of general adolescent turmoil that includes other problem behaviors and that these behaviors are linked to unconventionality, impulsiveness, and sensation seeking (7-11).

Binge drinking, often beginning around age 13, tends to increase during adolescence, peak in young adulthood (ages 18-22), then gradually decrease. In a 1994 national survey, binge drinking was reported by 28 percent of high school seniors, 41 percent of 21- to 22-year-olds, but only 25 percent of 31- to 32-year-olds (3,12). Individuals who increase their binge drinking from age 18 to 24 and those who consistently binge drink at least once a week during this period may have problems attaining the goals typical of the transition from adolescence to young adulthood (e.g., marriage, educational attainment, employment, and financial independence) (13).

Drinking and Driving. Of the nearly 8,000 drivers ages 15-20 involved in fatal crashes in 1995, 20 percent had blood alcohol concentrations above zero (58). For more information about young drivers' increased crash risk and the factors that contribute to this risk, see Alcohol Alert No. 31: Drinking and Driving (59).

Sexual Behavior. Surveys of adolescents suggest that alcohol use is associated with risky sexual behavior and increased vulnerability to coercive sexual activity. Among adolescents surveyed in New Zealand, alcohol misuse was significantly associated with unprotected intercourse and sexual activity before age 16 (60). Forty-four percent of sexually active Massachusetts teenagers said they were more likely to have sexual intercourse if they had been drinking, and 17 percent said they were less likely to use condoms after drinking (61).

Risky Behavior and Victimization. Survey results from a nationally representative sample of 8th and 10th graders indicated that alcohol use was significantly associated with both risky behavior and victimization and that this relationship was strongest among the 8th-grade males, compared with other students (62).

Puberty and Bone Growth. High doses of alcohol have been found to delay puberty in female (63) and male rats (64), and large quantities of alcohol consumed by young rats can slow bone growth and result in weaker bones (65). However, the implications of these findings for young people are not clear.

Prevention of Adolescent Alcohol Use Youth Drinking: Risk Factors and Consequences--A Commentary by NIAAA Director Enoch Gordis, M.D.

Alcohol, the most widely used and abused drug among youth, causes serious and potentially life-threatening problems for this population. Although alcohol is sometimes referred to as a for youth because its use often precedes the use of other illicit substances, this terminology is counterproductive; youth drinking requires significant attention, not because of what it leads to but because of the extensive human and economic impact of alcohol use by this vulnerable population.

For some youth, alcohol use alone is the primary problem. For others, drinking may be only one of a constellation of high-risk behaviors. For these individuals, interventions designed to modify high-risk behavior likely would be more successful in preventing alcohol problems than those designed solely to prevent the initiation of drinking. Determining which influences are involved in specific youth drinking patterns will permit the design of more potent interventions. Finally, we need to develop a better understanding of the alcohol treatment needs of youth. Future questions for scientific attention include, what types of specialized diagnostic and assessment instruments are needed for youth; whether treatment in segregated, "youth only" programs is more effective than in general population programs; and, irrespective of the setting, what types of specific modalities are needed by youth to increase the long-term effectiveness of treatment.

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