What are the effects of alcohol abuse on teens?

Scope of the Problem

Alcohol use and abuse among young people in the United States is pervasive and destructive. Despite a nationwide minimum legal drinking age of twenty-one years, 35 percent of American teenagers have had at least one drink by age fifteen years and 65 percent of Americans begin drinking alcohol by age eighteen years. The NIAAA reports that, on average, young people have about five drinks in a night, which many health experts consider to qualify as binge drinking. More specifically, the NIAAA also defines binge drinking as consuming enough alcohol within about two hours to bring blood alcohol levels (BAC) to 0.08 grams of hemoglobin per deciliter (g/dL). According to the NIAAA, approximately five thousand youths under the age of twenty-one die each year in the United States due to alcohol-related car crashes, homicides, suicides, alcohol poisoning, and other injuries. Nearly two thousand college-aged students aged eighteen to twenty-four die from alcohol-related injuries each year. According to the 2013 Youth Risk Behavior Surveillance System, in the thirty days before taking the survey, approximately 22 percent of Americans aged ten to twenty-four years had ridden in a car driven by someone who had been drinking alcohol. The US Centers for Disease Control and Prevention (CDC) reports that, in 2013,10 percent of teen drivers admitted to drunk driving within the past thirty days.

People who commence heavy or episodic binge drinking before age sixteen years are more than twice as likely as people who start drinking after age eighteen years to develop alcohol dependence. This statistic is often cited as justification for higher drinking ages and for more diligent enforcement of laws against underage drinking. There is some controversy whether this is a matter of cause and effect. Early heavy drinkers usually have parents or siblings who are alcoholics and may be genetically susceptible to alcoholism; also, they probably are subject to environmental influences favoring alcohol abuse.

Rates of both alcohol abuse and alcohol dependence decline steadily after age twenty-five years, a pattern that has been consistent for many decades despite changing social attitudes. Among drinkers with a normal trajectory, work and family responsibilities reduce the opportunities for, and acceptability of, frequent intoxication.

Rates of teen and young-adult alcohol abuse in northern Europe are similar to those in the United States, except that the average age of onset of heavy drinking is lower; this is in part due to lower minimum legal drinking ages. A survey of fifteen- to sixteen-year-olds in thirty-four European countries in 2007 showed more than 80 percent had drunk alcohol in the past year and 43 percent had been intoxicated or consumed more than five drinks on one occasion in the past thirty days. There is considerable variation from country to country, with abuse being less frequent in southern Europe.

In the United Kingdom and Ireland, which are two European nations with the highest binge drinking rates, drinking among young people is a serious national problem. Up until 1960, persons age sixteen to twenty-four years had the lowest per capita alcohol consumption of any adult group; since 1990, the situation has reversed. Some of this pattern (which is seen to a lesser extent in the United States) may be attributed to the rising age of workforce participation. Fewer sixteen- to eighteen-year-olds are employed full time, and an increasing proportion of eighteen- to twenty-four-year olds are students with more leisure time and fewer responsibilities than working counterparts. In general, high rates of unemployment that are not accompanied by extreme economic privation produce high levels of alcohol abuse. In England, 43 percent of all teenagers aged eleven to fifteen reported consuming at least one drink in 2012. In Ireland, 29 percent of young teenage girls (aged thirteen to fifteen) admitted to binge drinking within the last month.

Effects of Early Alcohol Use and Abuse

Alcohol abuse exacts a heavy toll among young people. According to the NIAAA, 1,825 college students between the ages of eighteen and twenty-four in the United States die due to alcohol-related injuries each year, 599,000 are injured because of drinking, over 690,000 are assaulted by a drunk individual, and 97,000 are the victims of alcohol-related sexual assault or date rape. Approximately one in four college students report adverse academic consequences due to drinking, such as missing classes, performing poorly on tests or exams, or receiving lower grades. Intoxication also increases the likelihood of risk-taking behaviors, such as not utilizing safe-sex practices during intercourse or committing property damage or vandalism.

The negative effects on a person’s life range from short-lived and inconsequential
to profound. Drinking leads to a massive loss of productivity, both in poor
academic performance and in the resources that college administrators and law
enforcement divert toward combating alcohol problems on campuses.

Statistics on alcohol use for persons eighteen to twenty-five years of age who are not enrolled in a college or university are not as comprehensive; in general, rates of binge drinking are lower but still significant. For both college and university students and people in the workforce, an early and persistent pattern of alcohol abuse tends to translate into poorer career prospects and family instability, even if the drinker never becomes alcohol dependent or if the drinker later successfully enters a recovery program.

Alcohol can serve as a gateway drug. A high proportion of younger heavy drinkers also use marijuana, and the culture surrounding binge drinking among young people for whom it is illegal provides opportunities for experimenting with more dangerous street drugs. Many methamphetamine addicts report that they began using the drug to counteract the effects of alcohol on the job.

Reducing Underage Drinking

Federal, state, and local governments devote a great deal of energy to combat
underage drinking through education and increased enforcement. Federal law in the
United States has mandated a minimum state drinking age of twenty-one years as a
condition of receiving federal highway funds since the passage of the
National Minimum Drinking Age Act of
1984. This law has reduced the availability of alcohol to
middle- and high-school students but has had little effect on levels of
consumption among college-aged students.

A comparison of the United States with European countries, where a drinking age of sixteen or eighteen years is typical, calls into question whether the approach in the United States is effective. In no European country is the level of binge drinking among eighteen- to twenty-one-year-olds higher than in the United States. It can be argued that turning any level of alcohol consumption into a criminal activity increases the chances of excessive use and alcohol-associated risky behaviors. According to the CDC, approximately 90 percent of the alcohol consumed by young people in the United States is consumed during a binge-drinking session.

Revenue considerations often complicate efforts to curtail alcohol abuse among
young people. Underage drinkers comprise a major market sector. Advertising
campaigns continue to target this demographic despite government regulation.
Flavored alcoholic beverages are of particular concern to regulators and to
opponents of alcohol use among youth. Also, in college and university towns, the
revenue stream generated by youth alcohol consumption tends to undermine efforts
at truly effective enforcement of liquor laws.

If statistics on traffic accidents are any indication, efforts made toward curbing underage drinking and reducing alcohol abuse among high school and college students do seem to have had a significant effect on driving behavior, but not on consumption. The CDC reports that the percentage of high-school students who drink and drive declined by 54 percent between 1991 and 2012. The agency also reported that graduated driver license programs, zero tolerance laws, and increased parental involvement help into increase teen safety when drinking.

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