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Underage Drinking Risk Factors and Consequences
Verywell Mind's content is for informational and educational purposes only. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment.
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Buddy T is an anonymous writer and founding member of the Online Al-Anon Outreach Committee with decades of experience writing about alcoholism.
Medically reviewed by Steven Gans, MD on April 12, 2020
Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital.
Fortunately, underage drinking has actually been steadily declining for decades in the United States. However, it is still prevalent enough to be a major public health concern.
Underage drinking began a steep decline back in the 1980s when Congress passed the National Minimum Drinking Age Act, which required states to raise the age for legal purchase and possession of alcohol to 21 by October 1986 or lose 10% of their federal highway funds.
By 1988, all 50 states and the District of Columbia had adopted 21 as the minimum drinking age, setting off a steady decline in underage drinking rates among 8th, 10th and 12th-grade students that continues today.
However, according to the 2014 National Survey on Drug Use and Health (NSDUH), an estimated 8.65 million Americans age 12 to 20 reported that they were current drinkers, meaning they had at least one drink in the past 30 days.1
Males still binge drink and drink daily more than underage females, but the differences are diminishing. White students report the highest levels of drinking, Hispanics are next and Blacks report the lowest rates.
Of those students who have problems or who drop out, 80% report having gotten drunk in the past month, or reported binge drinking, or reported drinking and driving in the past 30 days.2
According to SAMSHA, teen drinking is defined in terms of non-drinkers, light, binge, and heavy drinkers.
For some students, drinking alcohol is their only behavioral problem, but for others, drinking goes along with other problem behaviors linked to unconventionality, impulsiveness, and sensation seeking, according to research.3
Adolescents age 12 to 17 who use alcohol are more likely to report behavioral issues, according to the Substance Abuse and Mental Health Services Administration (SAMHSA). Especially behavior that is aggressive, delinquent, or criminal.
Typically, binge drinking among students begins around age 13, increases during adolescence, peaks in young adulthood (ages 18-22), and then gradually decreases.3
However, studies have found that young people who increase their binge drinking between ages 18 and 24 or who consistently binge drink at least once a week during those years may having problems in the following areas:4
There are many reasons why some adolescents begin a pattern of alcohol abuse and develop alcohol use disorders while others do not. Here are some of the key risk factors.
Research has shown that genetic factors play a role in a person's vulnerability to developing alcohol problems.5
We know for certain that children of parents with an alcohol use disorder are significantly more likely to have a problem with drinking themselves compared to children of parents who do not have an alcohol use disorder. But, a family history of alcohol misuse is not the only determining factor.
Environmental influences also play a role in whether someone develops an alcohol use disorder and can vary widely from person to person.5 We also know that environmental influences can mitigate some of the genetic influences, leading those with genetic vulnerabilities to not develop issues with alcohol.
Studies have revealed that brain waves caused by a response to specific stimuli can provide measurable brain activity that can predict some risk of alcoholism. P300, a specific brain wave that occurs about 300 milliseconds following a stimulus of light or sound, is one of the brain waves used in these studies.6
Scientists were able to predict alcohol use in preadolescent boys four years later at the average age of 16 by measuring their P300 brain waves.7
Behavior patterns in early childhood have also be found to be predictors of later drinking problems. At age 3, children who were classified as "under controlled"—impulsive, restless, or distractible—were twice as likely to be diagnosed with alcohol use disorders at age 21 compared to 3-year-olds classified as "inhibited" or "well-adjusted."8
Children who exhibit aggressiveness as early as ages 5 to 10 years old are more likely to use alcohol and other drugs during adolescence.
Children who exhibit antisocial behavior are more likely to have alcohol-related problems during adolescence and severe alcohol use disorders in adulthood, research shows.6
Alcohol consumption and a variety of psychiatric disorders have been linked in adolescents and young adults in several research studies:9
Along with the factors listed above, there are a number of psychosocial factors that increase the risk of underage youth making a decision to begin early-onset alcohol consumption.
Parents are the single most important influence on their children's decision to become involved in substance use or not. Studies show that parents who drink or express favorable attitudes about drinking are linked to their children initiating alcohol consumption and continuing to drink.10
Children who are warned about the dangers of alcohol by their parents are less likely to start drinking underage. The same is true for children who report being close to their parents.
A lack of parental communication, support, and monitoring have been linked by researchers to the frequency of drinking, heavy drinking, and drunkenness among adolescents.11 Studies have also linked parental hostility, rejection, and harsh, inconsistent discipline to childhood drinking and alcohol-related problems.12
Adolescents are more likely to drink if their peers drink,13 but beyond that, even if their peers exhibit an acceptance of drinking it can influence a child's decision to initiate alcohol consumption.
Research shows that adolescents are more likely to begin drinking if they have developed a positive expectancy about drinking.6 These positive expectancies generally increase with age and can predict both the onset of drinking and problem drinking among young people.
Child abuse and other traumatic events are also risk factors for later alcohol problems among youth. Of those adolescents who end up in treatment for alcohol use disorders rates of physical abuse, sexual abuse, violent victimization, and witnessing violence are much higher than the general population of adolescents.
Compared to study controls, adolescents in alcohol treatment programs were:14
Those adolescents treated for alcohol abuse were 10 times more likely to have had PTSD while those treated for alcohol dependence were 13 times more likely.
Studies of the effects of alcohol advertising on children have found that alcohol ads can significantly increase positive expectancies about alcohol.15 Alcohol advertising targeted at adolescents has been found to influence alcohol brand preferences and increase the adolescent's intention to drink as adults.
In the late 1960s and early 1970s, in the Vietnam war era, many states dropped their legal drinking age to 18. The political thinking was, "if they are old enough to get drafted and fight for their country, they are old enough to drink."
The effect was almost immediate. Alcohol-related traffic fatalities increased dramatically. Highway deaths not only increased in the states where the drinking age was lower but also in the states that bordered those states.
That's when Congress stepped in and mandated nationwide legal drinking age of 21 by threatening to withhold federal highway funding to those states that did not increase the drinking age.
The higher legal drinking age immediately prompted a decrease in underage drinking and a decrease in drinking and driving as well as alcohol-related highway fatalities.
The legal drinking age no doubt had an effect in other areas where underage drinking can result in problems, including:
Underage drinking is linked not only to increased risky sexual behavior but also increased vulnerability to coerced sex.6 Adolescents who drink are more likely to have sex before age 16, more likely to have sex while they are drinking and less likely to practice safe sex after drinking.
Alcohol use among eighth and 10th graders have been found to increase both risky behavior and victimization.16 This is particularly true for eighth-grade students.
Here are some sobering statistics about crime, violence, and suicide based on self-reporting from teens who claimed they were heavy drinkers. In this comparison with adolescent non-drinkers these teens were:
If studies conducted with laboratory animals are an indication, heavy alcohol consumption in adolescents may delay puberty, slow bone growth, and result in weaker bones.17
There is also a strong relationship, based on adolescent self-reporting, between teen alcohol use and emotional and behavioral problems, including:
Several studies have found that early-onset drinking is linked to the risk of greater substance abuse problems later in life.6 The earlier a child begins to drink alcohol, the greater the problems they will face in adulthood, not only with substance abuse but with meeting important life goals such as education and careers.
Therefore, it is important for parents and for society to do everything possible to prevent the initiation of childhood drinking.
Laws and policies will only work so far, the real work begins in the home within the family.
Parents need to know that alcohol use can also be a warning sign or a cry for help that something is seriously wrong in a child's life. If parents, counselors, teachers, and other caring adults reach children early enough, they can intervene before troubling behaviors lead to serious emotional disturbances, including:
If your child is struggling with substance use or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.
For more mental health resources, see our National Helpline Database.
Learn the best ways to manage stress and negativity in your life.
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
U.S. Department of Health and Human Services. Substance Abuse and Mental Health Services Administration. Behavioral health trends in the United States: Results from the 2014 National Survey on Drug Use and Health. Updated September 2015.
Chung T, Creswell KG, Bachrach R, Clark DB, Martin CS. Adolescent Binge Drinking. Alcohol Res. 2018;39(1):5–15.
Meyers JL, Dick DM. Genetic and environmental risk factors for adolescent-onset substance use disorders. Child Adolesc Psychiatr Clin N Am. 2010;19(3):465–477. doi:10.1016/j.chc.2010.03.013
Adger H Jr, Saha S. Alcohol use disorders in adolescents. Pediatr Rev. 2013;34(3):103–114. doi:10.1542/pir.34-3-103
Caspi A, Moffitt TE, Newman DL, Silva PA. Behavioral observations at age 3 years predict adult psychiatric disorders. Longitudinal evidence from a birth cohort. Arch Gen Psychiatry. 1996;53(11):1033–1039. doi:10.1001/archpsyc.1996.01830110071009
National Institute on Alcohol Abuse and Alcoholism. Alcohol Alert. No.37. Updated July 1997.
Donovan JE, Molina BS. Childhood risk factors for early-onset drinking. J Stud Alcohol Drugs. 2011;72(5):741–751. doi:10.15288/jsad.2011.72.741
Chartier KG, Hesselbrock MN, Hesselbrock VM. Development and vulnerability factors in adolescent alcohol use. Child Adolesc Psychiatr Clin N Am. 2010;19(3):493–504. doi:10.1016/j.chc.2010.03.004
Handren LM, Donaldson CD, Crano WD. Adolescent Alcohol Use: Protective and Predictive Parent, Peer, and Self-Related Factors. Prev Sci. 2016;17(7):862–871. doi:10.1007/s11121-016-0695-7
Clark DB, Lesnick L, Hegedus AM. Traumas and other adverse life events in adolescents with alcohol abuse and dependence. J Am Acad Child Adolesc Psychiatry. 1997;36(12):1744–1751. doi:10.1097/00004583-199712000-00023
McClure AC, Tanski SE, Li Z, et al. Internet alcohol marketing and underage alcohol use. Pediatrics. 2016;137(2):e20152149. doi:10.1542/peds.2015-2149
Mikosch P. Alcohol and bone. Wien Med Wochenschr. 2014;164(1-2):15–24. doi:10.1007/s10354-013-0258-5
National Highway Traffic Safety Administration. Traffic Safety Facts 2008: Young Drivers. 2009.
Shults Ruth, Elder RW, Sleet DA, et al. Reviews of evidence regarding interventions to reduce alcohol-impaired driving. American Journal of Preventive Medicine. 2001;21(4):66-88.1. doi:10.1016/s0749-3797(01)00381-6
Substance Abuse and Mental Health Services Administration. Underage drinking.
Why Facts Don't Support Lowering the Drinking Age to 18
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How Zero Tolerance Laws Are Used for Drinking and Driving
Even Occasional Substance Use Can Have Lifelong Consequences for Teens
Drinking to Relieve Stress May Actually Compound the Problem
Do College Students Have a Higher Risk of Alcohol-Related Blackouts?
Evidence-Based Methods for Preventing Alcohol Disorders in Society
How Alcoholism Hits All of Our Pocketbooks
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Facts From the Surgeon General's Report on Alcohol, Drugs, and Health
Verywell Mind's content is for informational and educational purposes only. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment.
Ⓒ 2021 About, Inc. (Dotdash) — All rights reserved
Verywell Mind is part of the Dotdash publishing family.

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Women are taking to TikTok to share stories about having their drinks spiked.
A new trend on the beleaguered social media platform has people uploading videos to share horrifying experiences of having their drinks drugged.
“Last year 2 men bought my girlfriend & I drinks. I drank it, she didn’t,” TikTok user Stephanie Tavares wrote over a clip of herself in a college sweatshirt, dancing on her couch while lights flash in the room around her. The text then changes to, “This is me 5 mins later,” as the video changes to show Tavares falling over onto the ground, drink in hand.
“They followed us for a solid 15 minutes outside until our two other male friends joined us. It was a scary experience,” she added in the comments.
“This trend is funny, but this issue is serious!” the 26-year-old Montreal-based entrepreneur captioned the video, which has accumulated over 529,000 likes and concludes with the PSA: “Protect each other.”
While most responses to Tavares’ video have been positive, she told BuzzFeed News that a surprising amount of commenters blamed her for being drugged.
“[Because] I accepted a drink — that happened to be spiked — a bunch of people are telling me it’s my fault, that I should have known better, and to never accept a drink from a man,” Tavares told the outlet.
“Why tf would you accept a drink from a stranger,” reads one such comment.
Others quickly came to Tavares’ defense, though.
“ ’Why would you drink it’ WHY WOULD HE DRUG IT!?” says one, echoing a sentiment of many other comments.
Despite the victim-blaming pushback, however, Tavares added that she finds the trend of spreading awareness about drink-drugging to be extremely positive in helping keep people vigilant about the problem. And while the trend may seem light by nature of being on a quick-video platform like TikTok, “it’s an actual serious issue with dangerous consequences,” she said.
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