Underage Drinking

The Facts About Underage Drinking

Underage drinking starts very early and can quickly become excessive. Alcohol abuse in minors can come with several dangerous health and social problems, including suicide, car accidents, violence, injuries, alcohol dependence, risky sexual behavior, brain impairment, academic issues, and drug abuse.

Unfortunately, most youths find alcohol easily. Despite the US drinking age starting at 21, many minors will find alcohol already within their home or find someone willing to supply them with alcohol. Some kids and young adults may even obtain a fake ID to purchase alcohol or gain entry to a bar or club.

Alcohol Trends in Underage Youth

According to the Substance Abuse and Mental Health Services Administration (SAMSHA), 15% began using alcohol before they were 13. Additionally, 2.3 million 12- to 17-year-olds used alcohol for the first time in 2019, averaging approximately 6,200 adolescents who began using alcohol daily.

SAMSHA reports that among adolescents ages 12 to 17, 2.3 million reported using alcohol in the past month, and 29,000 reported using alcohol daily.

The National Institute of Alcoholism and Alcohol Abuse (NIAAA) discovered that while underage youth drink less than adults overall, they consume much larger quantities than their adult counterparts in a single sitting. Drinking large amounts of alcohol in a short period is known as binge drinking.

In addition, the NIAAA reports that over 90% of all alcoholic drinks consumed by young people are ingested through binge drinking. Binge drinking can lead to blackouts, alcohol poisoning, and even death.

Data from 2019 show that underage females drink more than underage males, and underage drinking is highest among white youth.

Adolescents who drink are more likely to:

• Use drugs
• Develop Alchohol Use Disorder (AUD)
• Get bad grades
• Engage in risky sexual activity
• Make bad decisions
• Vandalize or damage property
• Experience health problems
• Suffer injury or death

How Do Young People Get Alcohol?

According to the Federal Trade Commission (FTC), 72% of teens who drink get alcohol without paying for it. Those who do pay for alcohol will typically give their money to an adult to purchase alcohol for them.

Most often, minors get alcohol through social hosting. Social hosting is when an adult of the legal drinking age provides alcohol for minors, often by hosting parties where alcohol use is heavy.

Another common way minors access alcohol is when parents or guardians keep alcohol in the house unmonitored. Whether in the top cupboard or an unlocked liquor cabinet, young people often sneak drinks from the supply in their own homes.

Common Risk Factors for Underage Alcohol Misuse

The causes of underage drinking can vary, from genetic factors and mental illness to problems at home or school. Identifying the leading causes or factors of alcohol abuse is essential to treating the issue. Let’s go over the most common motives for children to begin drinking and abusing alcohol.

Social Pressure

Social pressure is often one of the biggest influences leading to underage drinking. Shows, movies, music, and advertisements often show alcohol being consumed in a positive light or as a “cool” activity. Even if the media shows an unflattering picture of alcohol abuse, society tends to glamorize the damage of alcohol abuse.

Romanticization is when viewers or society idolize something harmful as being “cool” or “tragically beautiful.” These portrayals of mental illness or alcohol abuse in media typically misrepresent how destructive addiction can become. Society normalizes alcohol abuse, frequently marketing “adult beverages” with some sense of maturity and prestige.

Research shows that, as children age, they associate drinking alcohol with being more mature or growing up. Even if your child didn’t initially view alcohol consumption in a flattering light, one of their friends or peers at school likely has this opinion. According to NIAAA, when it comes to peer pressure and underage drinking, evidence suggests that the most reliable predictor of a youth’s drinking behavior is the drinking behavior of their friends.

Because young people’s brains are still developing critical functions like impulse control, it can be difficult for teens and young adults to stand up to peer pressure. Friend groups at school and parties outside of school are prime places a child or college student may be offered or pressured into drinking. If your child struggles to fit in or seeks validation from friends, they may be at a higher risk of giving in to peer pressure and consuming alcohol to gain acceptance.

Mental Illness

Research from NIAAA shows that children who begin to drink at a very early age (before age 12) often share similar personality characteristics that may make them more likely to start drinking. Young people who are disruptive, hyperactive, and aggressive—as well as those who are depressed, withdrawn, or anxious—may be at the greatest risk for alcohol problems.

According to the American Addiction Centers, Inc., alcohol addiction and mental disorders tend to co-occur more frequently than by chance. High anxiety, depression, and mood disorders in minors have all shown an increased risk of alcohol abuse.

Heavy alcohol use may become a coping mechanism for youth with psychiatric disorders. Additionally, adolescents who drink might delay the diagnosis of a mental health issue and may not receive proper treatment.

Relationship Issues

Children in abusive families or with toxic/abusive friends or romantic partners are at increased risk of turning to alcohol to cope with the stress and trauma. Young people may find relief or use drinking as an escape, which can lead to alcohol dependence.

A study supported by NIAAA reported that adolescents who experienced neglect and physical abuse had 1.3 times higher odds of reporting binge drinking than adolescents with no maltreatment.

Role Models

Children learn behaviors first from watching their parents. If parents drink excessively in front of their children, it can set a precedent that drinking alcohol is encouraged. If a parent is struggling with alcohol abuse themselves, the child will see those behaviors and learn from them.

According to NIAAA, parents who drink more and view drinking favorably are likelier to have children who drink more. In addition, studies have shown that children who date older or adult partners are more likely to use alcohol when underage. Pressure to drink within a romantic relationship is common, especially if one person holds more power or influence than the other.

Lack of Parental Boundaries

Research has found that higher levels of parental alcohol use are associated with children as young as preschool age using alcohol earlier. As stated before, 72% of teens who drink get alcohol without paying for it, most often via social hosting.

Parents or adults of the legal drinking age are usually the ones who supply minors with alcohol. Some parents want to seem like “cool parents.” Other parents may wish to raise their children differently than their own upbringing (i.e., strict parents, sheltered from social events, etc.).

On the other hand, many parents justify social hosting by stating they would rather their child drink under their supervision instead of drinking with friends and possibly engaging in dangerous behavior.

The belief that children will drink no matter what or that drinking with a parent is safer is a myth. Not all children will drink, and parents can use specific strategies to help their kids understand how dangerous drinking is, even at a young age.

Warning Signs of Underage Alcohol Use

While underage drinking is associated with common warning signs, every child is different. Many of these warning signs could also indicate issues with something else, such as other substances, mental illness, or the growing pains of puberty.

It’s essential to be discerning when you start noticing these signs in your child and consider other causes before immediately confronting them about alcohol. Approaching the situation with aggression or accusation will likely only make the situation worse, regardless of whether alcohol abuse is occurring or if these behavioral problems are related to something else.

Problems in School

Many young people who abuse alcohol will have issues at school, both in grades and behavior. Common problems may include poor attendance, poor grades, and/or recent disciplinary action. Some students may begin acting rebellious, aggressive, or withdrawn in class.

If you suspect alcohol could be causing these issues, speaking with your child’s teachers for more information may be helpful. Teachers or school staff can help you determine if alcohol use is the reason behind their issues in school or if something else may be causing the change.

Mood Changes

Mood changes are one of the most prominent indications that alcohol abuse is taking place. Children may display more anger, irritability, and rebellious behavior at home.

Remembering these traits are common in many other conditions and situations is important. Do not jump to conclusions based only on these mood or behavioral issues, as it could indicate something else.

Loss of Interest in Activities and Appearance

As alcohol use becomes more frequent, adolescents may lose interest in activities they once loved to devote more time to drinking or obtaining alcohol. Withdrawal from sports or clubs is common.

Changes in appearance can be indicators as well. Teens may stop caring about their appearance and hygiene, such as infrequent showering, brushing their teeth less, and wearing dirty clothes. Teens may also display coordination issues or slurred speech.

Memory and Concentration Problems

Research has shown that young people’s brains continue to develop into their 20s. A person’s brain is still undeveloped and susceptible to substances capable of altering or even damaging the brain.

According to research from NIAAA, alcohol can alter development, potentially affecting brain structure and function. Alcohol use can cause cognitive or learning problems and/or increase vulnerability for alcohol use disorder, especially when people start drinking at a young age and drink heavily.

Common symptoms of alcohol use disorder include:

• Difficulty focusing
• Memory problems
• Loss of coordination
• Low energy levels

New Friend Circle

A new group of friends isn’t always problematic, but if they are pressuring your child to do things they usually don’t do, this indicates potential issues. Regardless of whether other warning signs have surfaced before or after a new friend circle, it’s essential to be aware of these new friends’ influence.

Research supported by NIAAA found that drinking is less consistently related to existing friendships and is more strongly associated with forming new friendships.

Additional research by the NIAAA uncovered the following data from high school students by the time they reached 12th grade:

• Nearly 50% report frequently drinking with others to get drunk
• About 75% report that one or more friends drink until drunk routinely
• Over 80% report drinking to have a good time with friends

If you suspect your child’s new friend group may be the wrong crowd and engage in unsafe behavior, intervening is always advisable. The potential exists even if your child doesn’t feel pressured or influenced to drink.

Consequences of Underage Drinking

Underage drinking comes with numerous, sometimes life-altering, consequences. Many factors can make drinking for children especially dangerous, from a lack of tolerance causing life-threatening health conditions to the long-term risks of developing alcohol use disorder.

Additionally, alcohol use can severely affect children’s brain development, causing many psychiatric and learning issues that may follow them into adulthood. With underage drinking, the risks are high, and most don’t need to drink heavily to put themselves at extreme risk of severe consequences.

Health Problems

Recent research supported by NIAAA on adolescent brain development suggests that early heavy alcohol use may negatively impact the actual physical development of brain structure. Specifically, it can seriously affect the frontal and prefrontal lobes, the part of the brain responsible for essential functions such as planning, organization, and halting an impulse.

In addition to problems with brain development, alcohol use can worsen mental illness and even increase the odds of the child developing a mental illness.

According to the 2016 National Survey on Drug Use and Health, alcohol addiction and mental disorders tend to co-occur more frequently than by chance. The odds of developing a mood disorder are 3.6 times higher for someone dependent on alcohol than for someone not dependent on it.

Aside from the mental health concerns, underage drinking increases the risk of alcohol poisoning and unplanned pregnancy. Long-term alcohol use that begins in childhood can later lead to liver and heart disease, cancer, high blood pressure, and stroke.

Safety Concerns

Due to the immediate results of alcohol consumption, underage drinking often leads to impaired decision-making, risky behavior, and poor coordination. Many minors may engage in sexual behavior that leads to unwanted pregnancies and sexually transmitted diseases.

One of the biggest concerns many parents have is drunk driving.

According to the National Highway Traffic Safety Administration (2010), 5,051 drivers ages 16–20 were involved in fatal motor vehicle crashes. Of those, 19% had a blood alcohol concentration over the legal adult limit of 0.08. In addition, 80% of youth who frequently drank alcohol reported they had ridden with a driver who had been drinking.

Underage drinkers are likelier to binge drink, leading to poor choices or being unaware of dangerous situations. Alcohol can put children at risk for sexual assault, physical violence, homicide, and even suicide.

The NIAAA reports that each year, approximately 5,000 young people under the age of 21 die as a result of underage drinking; this includes about 1,900 deaths from motor vehicle crashes, 1,600 as a result of homicides, 300 from suicide, as well as hundreds from other injuries such as falls, burns, and drownings.

Academic Problems

Alcohol use can wreak havoc on a child’s academic achievement and good standing with teachers and staff. Research has shown that alcohol affects a child’s ability to concentrate, comprehend language and information, learn new information, and retain and recall information. These struggles can cause students to perform poorly in class and on standardized tests, affecting future college prospects.

According to research from the Centers for Disease Control and Prevention (CDC), there is a clear link between alcohol abuse and academic failure. Students using alcohol are more likely to miss school or skip classes more often, ultimately being expelled or dropping out of school entirely. As grades decline, many students may no longer meet GPA requirements for college and lose scholarships.

Prospective studies have documented that heavy alcohol use in adolescence is associated with lower enrollment in postsecondary education, reduced earnings, and heightened job instability in young adulthood.

Legal Problems

Underage drinking affects decision-making skills and impulse control, potentially leading to legal issues. Many underage drinkers may participate in vandalism, property damage, assault, and driving under the influence. While they will face trial as juveniles, crimes like these can follow offenders into adulthood and even begin a pattern of more crime if not addressed.

Minors charged with crimes related to alcohol can face arrest, steep fines, license suspensions, and time served in juvenile detention centers or jail. An alcohol conviction may be considered by college officials and employers, leading to issues later down the road.

How to Help Your Child with a Drinking Problem

Addressing your child’s alcohol abuse can be overwhelming and scary. As a parent or a guardian, it’s your instinct to protect your child from the world’s dangers, and sometimes the idea of treatment seems extreme.

While some parents may catch underage drinking early enough to intervene on their own, others may discover their child is drinking after the situation has become dire.

Many programs are available to assist you and your child despite how frightening this process can be. It’s important to remember you’re not alone in this and that many treatment options exist to address each child’s unique situation.

Treatment Programs

Addiction treatment for underage minors can differ significantly from treatment for adults, partly because children are less mature and often have fewer responsibilities than adults.

Unlike adults who usually begin treatment once dependence or life-challenging problems emerge, minors may be referred to treatment primarily because of trouble at school or after becoming involved with the justice system.

Typically, the first step is an assessment or pre-treatment screening. The pre-treatment screening determines the most effective treatment based on how severe the child’s alcohol use is. Other factors such as age, gender, psychiatric comorbidity, cognitive functioning, and legal mandates can affect the chosen treatment plan.

Most treatment options originally addressed the needs of adults, but many centers now offer programs specialized for minors.

Inpatient Rehab

Inpatient care is the most intensive option and typically involves living in the treatment facility for 30 to 90 days. Inpatient rehab is ideal for minors whose alcohol abuse is life-threatening or has reached dangerous levels that you, as a parent, cannot manage.

The benefits of inpatient care include:

• 24-hour medical supervision
• Group therapy
• One-on-one counseling
• No access to alcohol

While in residential care, your child will meet others their age experiencing the same struggles and can focus on their recovery without the distraction of regular school and any bad influences.

Outpatient Treatment

An outpatient treatment program might be better if your child’s alcohol abuse is not as severe. There are two standard options for outpatient rehab: a Partial Hospitalization Program (PHP) or an Intensive Outpatient Program (IOP).

A Partial Hospitalization Program (PHP) allows your child to come home every day after treatment while still providing essential care in inpatient rehab programs.

PHP includes:

• Medical detoxification, if necessary
• Group therapy
• One-on-one counseling
• Education services

Alternatively, an Intensive Outpatient Program (IOP) is most common for minors with mild to moderate alcohol addiction. Your child will visit the treatment center a few days each week for a personalized treatment plan for a minimum of 10 hours. Their treatment plan may include behavioral therapy, group therapy, medication management, and life skills education.

IOP includes:

• Group therapy
• One-on-one counseling
• Education services

IOP does not offer medical detoxification services, unlike inpatient rehab and some PHPs. If your child needs medical detox services, you can get a referral for a detox center before an IOP treatment begins.

Medical Detox

Inpatient or partial hospitalization will typically include medical detoxification. Quitting alcohol use is notorious for its dangerous withdrawal symptoms. However, it is not common for adolescents to require medical detoxification.

However, a minor may experience some withdrawal symptoms. If you’re concerned withdrawal may occur, or if it has occurred in the past, you can bring this up during your child’s treatment assessment.

Therapy

Therapy is the most common treatment for youths abusing alcohol. Available therapy options are typically single-shot programs that encourage self-help and getting to the root of what is causing their alcohol-seeking behavior.

Therapy is generally the best treatment for minors who have not yet developed dependence or major, chronic alcohol use problems (i.e., heavy drinking).

The most common type of addiction treatment therapy is Cognitive Behavioral Therapy (CBT), but others may include:

• Dialectical Behavior Therapy (DBT)
• Interpersonal Therapy
• Psychodynamic Therapy
• Supportive Therapy
• Family Therapy

How to Talk to Your Kids About Alcohol

Whether your child is drinking or not, having conversations about the risks associated with drinking alcohol can be incredibly effective. Many parents can feel intimidated or overwhelmed when discussing alcohol use, but it doesn’t have to be an uncomfortable affair.

There are several ways to have these conversations and ensure they don’t feel “preachy” or summon an eye roll from your child.

The most critical purpose of conversations about alcohol is to build an open, trusting relationship with your child. It’s never too late to begin discussing alcohol and other drugs. If your child feels they can come to you with serious issues and talk about them in a judgment-free place, the better chance you have of preventing future substance abuse.

Pick a Good Time

It may be your instinct to warn your child of all the dangers in the middle of a heated moment, but this is not always the best approach. Even if you catch your child drinking and this triggers an argument, it’s unlikely they will absorb your warnings while they are emotional.

Wait until you have both calmed down, and then have the discussion. You are more likely to get through to your child if you come from a place of calm concern and love, rather than yelling and screaming.

Get on the Same Page

As a parent, you may have a lot of negative, no-tolerance views on underage drinking, but handling it with high emotions won’t help. Children often do not respond well to a parent who doesn’t listen to and consider their perspective. Being authoritarian is more likely to push them away and encourage them to be secretive.

Instead, listen to your child’s issues and perspectives without judgment. Listening will encourage them to trust you and be more honest instead of hiding behavior for fear of getting in trouble.

Additionally, if your child feels you’re hearing them out, they are more likely to listen. You can still be firm in your beliefs and opinions about underage drinking and set ground rules, but this approach encourages mutual respect and honesty.

Treat It Like a Conversation, Not a Lecture

Research has shown that many little talks are more effective than having one “big talk.” Smaller, more frequent discussions can take the pressure off the situation and make things less intimidating for both parties. It’s often better to treat them more like conversations than big sit-downs, like the dreaded “birds and the bees” discussion.

As your child ages, the conversation will likely change—what you say to a 9-year-old about alcohol is different from what you say to a 15-year-old. With that in mind, have these conversations frequently about various aspects of alcohol. One large “info dump” can be overwhelming, and your child likely won’t absorb all the information immediately.

Be Solution-Oriented

Your child should understand they are not alone in the recovery journey and that their family will support them through the process. Instead of focusing on punishments or restrictions, try to meet your child halfway. Listen to what they have to say and focus on recovery options.

That’s not to say you shouldn’t discuss the negative consequences of underage drinking—definitely talk about the risks with your child. But ultimately, focusing on the benefits of a life free from alcohol can be incredibly productive and healing.

Get the Help Your Child Needs to Quit Drinking Alcohol

SAMHSA’s National Helpline (1-800-662-4357) is a treatment referral and information service. It’s free to use, completely confidential, and available 24/7, 365 days a year. SAMHSA provides support and resources for addicts and families facing mental and/or substance use disorders.