Alcohol is the most frequently-used – and abused – intoxicant in America, especially among young people. In fact, underage drinking accounts for 11% of all the alcohol consumed in the United States every year. Of distressing relevance, youths between the ages of 12 and 20 often engage in unsafe drinking behaviors with greater frequency than adult drinkers. Those dangerous drinking behaviors directly contribute to the over 4700 annual alcohol-related deaths occurring among US teenagers and young adults. To put that number in perspective, alcohol kills more young people than all other illegal drugs combined. In addition to the deaths, there are another 189,000 annual alcohol-related Emergency Room visits involving minors.

Underage Drinking in America By the Numbers

“The problem isn’t just too much to drink; it is the fact that alcohol addiction happens before our very eyes, even under the conditions of success. And we don’t recognize it. That’s what is scary. Our son was killing himself in our presence, over several years’ time, and we didn’t see it.” ~Chris and Toren Volkmann, From Binge to Blackout: A Mother and Son Struggle with Teen Drinking

While the nation focuses on the ongoing “opioid epidemic”, the excessive use of alcohol is still the biggest substance abuse problem among American young people. Here are some sobering statistics:

• There are nearly 11 million teenage drinkers in the United States.
• In 2010 alone, the economic burden of underage drinking reached $24 BILLION.
• According to the 2015 National Survey on Drug Use and Health, 1 in 5 American youths between 12 and 20 years of age regularly drink alcohol.
• But the 2015 Youth Risk Behavior Survey delves deeper, reporting that 1 in 3 high school students have used alcohol at least once.
• Within the past 30 days, 10% of US 8th graders have consumed alcohol.
• Among high school seniors, the drinking rate more than triples, to 35%.

How Big a Problem Is Underage Binge Drinking?

“Many kids these days talk casually about drinking or getting wasted, or binge drinking and blacking out. It’s like mentioning going to a latte stand, as commonplace as snacking on popcorn at a movie. Binge drinking is not only a social custom among youth, it is an epidemic.” ~Chris and Toren Volkmann, From Binge to Blackout: A Mother and Son Struggle with Teen Drinking

One of the most dangerous aspects of underage drinking is the tendency of young people to engage in risky binge drinking– the practice of consuming multiple drinks in one sitting – 5 or more for males and 4 or more for females. Binge drinking is not some uncommon, once-in-a-while drinking habit among American teenagers. On the contrary, it is almost completely the ONLY way they drink:

• 90% of the alcohol consumed by underage drinkers is via binge drinking.
• Per the Youth Risk Behavior Survey, 18% of high school students have engaged in binge drinking within the past 30 days.
• Even more worrisome, 5% of 8th graders and 17% of 12th-graders binge drank within the past two weeks.
• Despite this, only about 1% of parents believe that their teens binge-drink.

Teenage Binge Drinking – The Real Dangers

Binge drinking is hazardous for several reasons:

• Accidents – drunk-driving car crashes, falls, fires, drowning, etc. 8% of teens self-report driving after drinking alcohol, and an additional 20% say that they have accepted a ride from another person who had been drinking.
• Unsafe Sexual Behaviors – impaired consent, sexually-transmitted diseases, unplanned pregnancy, HIV/AIDS, etc.
• Sexual Assault – 80% of sexual assault cases involve the use of alcohol, either by the victim, the perpetrator, or both.
• Alcohol Poisoning –2200 Americans die every year after overdosing on alcohol.

Early Initiation and Alcohol Abuse

“Young people’s brains are still developing, and they may be more vulnerable to long-term effects on brain and educational achievement than adults – even if they drink within government-recommended upper limits for adults.” ~Dr. Sarah Jarvis, Medical Advisor to Drinkaware, an alcohol education nonprofit

One of the biggest potential future consequences of underage alcohol use is a magnified risk of alcohol abuse, dependence, and addiction. And teens who use alcohol before they turn 15 are SIX TIMES more likely to struggle with an AUD at some point than those who wait until age 21 or older. Why is this the case? The human brain continues to develop until the mid-twenties. This means that adolescents, teenagers, and young adults who drink are at greater vulnerability to the damaging and addicting effects of alcohol.

Dr. Mary O’Connor, a Professor in the Department of Psychiatry and Biobehavioral Sciences at the University of California Los Angeles, said, “We know from both animal and human studies that alcohol affects brain development. The teenage brain is much more vulnerable to begin with and we now know that repeated drinking can lead to long term deficits in learning and memory.”

Is There a Double Standard When It Comes to Underage Drinking?

One of the biggest challenges of curbing underage alcohol use is the fact that drinking is not only a legal and socially-acceptable adult pastime, it is also extremely common. Statistics from the National Institute on Alcohol Abuse and Alcoholism revealed that more than 86% of US adults have used alcohol at some point.  More to the point, two out of every three adults are current drinkers, consuming an average of 4 drinks per week. But this acceptance of alcohol creates a perception problem – while most parents who drink would be justifiably horrified and concerned if their children was caught using an illicit drug like cocaine or heroin, they are much more nonchalant when they learn that their teen drinks alcohol.

“It’s no big deal.  I drank a little when I was their age.” “But it’s only a few beers…” “At least it’s not… (pills, meth, cocaine, etc.)”

Some parents will even go so far as allowing their children to consume alcohol under supervision, in an attempt to teach them how to drink responsibly. But studies have shown that approach to be wrong. Underage drinking, even with adult supervision, leads to future problems with alcohol.

Patrick Tolan, Director of Youth-Nex: The University of Virginia Center to Promote Effective Youth Development, said, “Parents need to make it clear that it’s not OK for kids to drink until they reach the legal drinking age – a line has to be drawn.”  

Alcoholism Is Just like Any Other Addiction

“Alcoholism is an addiction – it’s just one type of addiction. When you break out the specific things that someone who is suffering from alcoholism contends with…they are no different from any other type of addict.” ~ Dr. John Sharp, a faculty member with the medical schools at both UCLA and Harvard

Due to this misconception, many parents of alcohol-abusing teenagers are mistakenly relieved that their children are “only” drinking, because at least that means that they aren’t “drug addicts”. But what they don’t realize is, BOTH problems are two manifestations of the same disease – ADDICTION. Because both conditions profoundly affect the brain’s reward circuitry, substance abuse in any form “teaches” the user that alcohol and/or drug use is a positive behavior that is worth repeating. Put another way, a developing addiction motivates the person to keep drinking and using. And, as the disease progresses – from experimentation to regular use to abuse to dependence and eventually, to addiction, medically-diagnosable symptoms begin to manifest.

Drug Addiction and Alcoholism Are Caused by the Same Contributing Factors

“What’s the difference between alcoholism and addiction? WORDS…” ~ Dr. Reef Karim, host of the Discovery Channel’s Broken Minds

There are several factors that increase the likelihood of developing an addictive disorder:

• Genetics—Responsible for up to HALF of the risk of addiction
• Unstable or chaotic home environment
• Poor or ineffective parenting
• Lack of nurturing or attachment
• Overly-shy, aggressive, or inappropriate classroom behavior
• Poor classroom engagement
• Academic failure
• Insufficient coping skills
• Peer pressure
• Age of first use
• Personal drinking/drug use habits
• Abuse potential of the specific substance
• Personal or family history of mental illness such as depression, anxiety, or PTSD

However, while these risk factors increase the likelihood of future problems, they are independent of the specific substance of abuse.  This clearly demonstrates that problematic substance abuse is LESS about the drug of choice and MORE about the loss of control and the ensuing negative consequences.

The Alphabet of Alcohol Addiction

The American Society of Addiction Medicine describes an AUD as:

• An inability to Abstain from using –The person eventually loses the ability to control how often or how much they drink.
• A disruption in Behavioral control–The person loses control of their behavior when drinking.
• A powerful – and growing – Craving for alcohol –The person obsesses over acquiring and using alcohol, engaging in compulsive alcohol-seeking behaviors.
• A Diminished ability to recognize the consequences of their addicted actions – Typically, the person will vehemently deny that they even HAVE drinking problem. When confronted, they will minimize the damage their drinking is doing.
• A blunted or dulled Emotional response– Despite the negative consequences, the AUD will continue to worsen until the person is motivated – or compelled – to seek treatment. In the case of underage drinkers, this motivation/compulsion is nearly always external – parents, school, the court system, etc.

The Surprising Connection between Family Income and Underage Alcohol Use

Surprisingly, recent research suggests that teenage drinking is strongly influenced by how much money their parents make. England’s Health and Social Care Information Centre conducted research in 2015, with unexpected results

• 70% of teens from the “least-deprived” backgrounds have used alcohol at least once.
• Conversely, only around half of teens from the “most-deprived” backgrounds self-reported drinking.
• Over 60% of teens have consumed an entire alcoholic drink – not just a “sip” or “taste”.
• 15-year-olds from well-to-do families have a DOUBLED risk of regular drinking.
• Research from the Boys Town National Research Institute reveals that children growing up in middle-income households are 1.5 times more likely to start drinking by age 10 than those from lower-income homes.

Why might this be the case? According Dr. Suniya Luthar, an Arizona State University Psychology Professor, there may be several reasons:

• Greater disposable income
• Indifference or even approval from peers
• Wealthier parents may mistakenly feel somewhat insulated – that their children aren’t exposed to “bad” outside influences.

But after genetics, parents are the biggest influence on teen drinking.

How Your Behaviors Affect Your Children’s Drinking

“Both what parents say, and how they behave, have a strong impact on their teenagers’ drinking, drinking regularly, and drinking to excess.” ~ Claire Turner, Joseph Rowntree Foundation

Parental supervision and drinking habits are huge factors when it comes to underage alcohol use:

• Boys with alcoholic fathers have a 25% chance of developing an AUD.
• For comparison, children of non-alcoholics have an AUD risk as low as 7%.
• Of special relevance, over 18% of adolescents ages 12 through 17 whose fathers drink use alcohol or illicit drugs, even if their father does not have an AUD.
• 77% of mothers who drink more than one beer or glass of wine a day have children who use intoxicants.
• 82% of drinking parents raise children who also drink.
• Likewise, 72% of parents who don’t drink raise children who don’t drink.
• In a surprising finding, over 80% of parents who drink more than 10 cups of coffee a day have children who use intoxicants.
• However, only about a third of parents who don’t drink coffee have substance-using children.
• The likelihood of a teenager getting drunk is TWICE as high if they have seen their parents intoxicated.
• If they spend more than two evenings a week out with friends, the odds of a teenager drinking DOUBLE.
• If they spend every weekend out with friends, the odds QUADRUPLE.

Preventing Underage Drinking

Despite all the risk factors and negative influences, there are a number of protective factor that can help prevent underage alcohol use and abuse. Concerned parents can focus on:

• Building stronger family bonds—actively and regularly engaging with their children
• Fostering an interest in their children’s lives – who they are with, where they are, etc.
• Setting clear expectations –including consequences.
• Requiring academic ambition and success—checking homework is done, meeting with teachers, etc.
• Encouraging positive social engagement – extracurricular activities, sports, etc.
• Promoting pro-social involvement—church, community, volunteering, etc.
• Following social norms—Allowing NO underage drinking or drug use

What to Do If Your Teenager is Abusing Alcohol

When you consider the immediate risks – accidents, overdose, unsafe behaviors – and the long-term risks – dependence, addiction, brain damage – it becomes easily apparent how important it is to prevent underage drinking. It also means that if your child is already using – and most likely, ABUSING – alcohol, that it is even more imperative that you do everything you can to help them stop. You can take the normal parental route – stricter curfews, closer supervision, harsher consequences, etc. – but the best thing you can do for the health and future of your alcohol-abusing teenager is to get them specialized professional care that addresses their unique needs. Here’s the good news – with early intervention and evidence-based treatment, it is possible for your child to recover and live a sober and productive life.