Underage Drinking

SAMHSA provides information on the dangers of underage drinking and offers tips on how to prevent this threat to adolescent development and health.


Alcohol is the most widely misused substance among America’s youth. Consumption of alcohol by anyone under the age of 21, also known as underage drinking, remains a considerable public health challenge. Adolescent alcohol use is not an acceptable rite of passage, but a serious threat to adolescent development and health. Medical research shows that the developing adolescent brain may be particularly susceptible to long-term negative consequences of alcohol use. In 2014, more than 1.6 million people between the ages of 12 and 20 reported driving under the influence of alcohol in the past year. This accounts for almost 4.4% of people between these ages.

In March 2007, the Acting Surgeon General of the United States issued a Call to Action to Prevent and Reduce Underage Drinking. In that report, the Surgeon General addressed the need for a comprehensive approach to prevention that includes support from parents, families, schools, colleges, communities, the health care system, and all levels of government.

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Underage drinking is a significant, but often overlooked, problem in the United States. More teens use alcohol than tobacco or other drugs.

Although adolescents and young adults drink less often than adults, they tend to drink more than adults, frequently drinking as many as 5 or more drinks on a single occasion. Rates of binge and heavy alcohol use among people under the age of 21 declined from 2002 and 2014, according to SAMHSA’s 2014 National Survey on Drug Use and Health; however, over 5 million youth between the ages of 12 and 20 reported being binge drinkers, and 1.3 million reported being heavy drinkers.

The results showed 77% of current underage drinkers reported drinking while with a group, while 6.3% reported drinking alone. The remaining youth reported they drank with one other person the last time they drank.

For young people between the ages of 12 and 20, the reported rates of alcohol use in the past month in 2014 were:

  • 13.5% of Asian Americans
  • 17.3% of African-Americans
  • 21.1% of people reporting two or more races
  • 21.2% of Hispanics
  • 21.9% of American Indians/Alaska Natives
  • 26% of whites

Reports of underage alcohol use were highest in the Northeast (28.3%) and lowest in the South (22.3%). Rates in the Midwest and West were both around 24.5%.

Risk Factors

Although adolescence brings increased risk for alcohol use, some factors put teens at higher risk for abusing alcohol. These include high levels of impulsiveness, novelty seeking, and aggressive behavior; having conduct or behavior problems; and a tendency not to consider the possible negative consequences of one’s actions.

Underage drinking:

  • Is responsible for more than 4,300 annual deaths among underage youth
  • Is linked to 189,000 emergency rooms visits by people under age 21 for injuries and other conditions
  • Contributes to the likelihood of risky sexual behavior, including unwanted, unintended, and unprotected sexual activity, and sex with multiple partners
  • Increases the risk of encountering legal problems, such as being arrested for drunk driving or physically hurting someone while drunk
  • Increases the risk of physical and sexual assault
  • Increases the risk for suicide and homicide
  • Increases the risk of memory problems
  • Increases the risk of using and misusing other drugs
  • Increases the risk of changes in brain development that may have life-long effects
  • Is a risk factor for heavy drinking later in life, which can lead to other medical problems (youth who start drinking before age 15 are almost 5 times more likely to develop alcohol dependence or abuse later in life than those who begin drinking at or after age 21)

Addressing underage drinking has historically been a top priority for SAMHSA. SAMHSA’s Strategic Initiatives, as outlined in 2011, underscored the importance of public awareness and health education to address and prevent underage drinking. As SAMHSA looks to the future, it remains committed to engaging with parents and other caregivers, schools, communities, and youth in a coordinated national effort to prevent underage drinking.

Underage Drinking Campaign

Mandated by the Sober Truth on Preventing Underage Drinking Act (STOP Act) of 2006, SAMHSA’s underage drinking prevention campaign—“Talk. They Hear You.”—helps parents and caregivers start talking to their children early—as early as 9 years old—about the dangers of alcohol. The goals of the campaign are to:

  1. Increase parents’ awareness of the prevalence and risk of underage drinking
  2. Equip parents with the knowledge, skills, and confidence to prevent underage drinking
  3. Increase parents’ actions to prevent underage drinking

Over the past few years, thousands of communities across the United States have held events to educate people about the dangers of underage drinking and to involve people in proven prevention strategies. The impact of this continuing initiative is presented in the report 2012 Town Hall Meetings to Prevent Underage Drinking: Moving Communities Beyond Awareness to Action. In April 2014, SAMHSA launched its 2014 Town Hall Meetings to prevent underage drinking.

Last Updated: 10/27/2015