Fact Sheet Index
Consequences of Underage Drinking
Excerpts from The Surgeon General's Call to Action To Prevent and Reduce Underage Drinking
All text in this fact sheet is excerpted directly from The Surgeon General's Call to Action To Prevent and Reduce Underage Drinking, a 2007 report from the Office of the Surgeon General (emphases added).
The short- and long-term consequences that arise from underage alcohol consumption are astonishing in their range and magnitude, affecting adolescents, the people around them, and society as a whole. Adolescence is a time of life characterized by robust physical health and low incidence of disease, yet overall morbidity and mortality rates increase 200 percent between middle childhood and late adolescence/early adulthood (Surgeon General's Call to Action, page 10).
This dramatic rise is attributable in large part to the increase in risk-taking, sensation-seeking, and erratic behavior that follows the onset of puberty and which contributes to violence, unintentional injuries, risky sexual behavior, homicide, and suicide1 (Call to Action, page 10).
Alcohol frequently plays a role in these adverse outcomes and the human tragedies they produce. Among the most prominent adverse consequences of underage alcohol use are those listed below.
Annually, about 5,000 people under age 21 die from alcohol-related injuries involving underage drinking. Approximately:
- 1,900 (38 percent) of the 5,000 deaths involve motor vehicle crashes,
- 1,600 (32 percent) result from homicides, and
- 300 (6 percent) result from suicides2 (Call to Action, page 10).
- Plays a significant role in risky sexual behavior, including unwanted, unintended, and unprotected sexual activity, and sex with multiple partners. Such behavior increases the risk for unplanned pregnancy and for contracting sexually transmitted diseases (STDs), including infection with HIV, the virus that causes AIDS3 (Call to Action, page 10).
- Increases the risk of physical and sexual assault4 (Call to Action, page 10).
- Is associated with academic failure5 (Call to Action, page 11).
- Is associated with illicit drug use6 (Call to Action, page 11).
- Is associated with tobacco use7 (Call to Action, page 11).
- Can cause a range of physical consequences, from hangovers to death from alcohol poisoning (Call to Action, page 11).
- Can cause alterations in the structure and function of the developing brain, which continues to mature into the mid- to late twenties, and may have consequences reaching far beyond adolescence8 (Call to Action, page 11).
- Creates secondhand effects that can put others at risk. Loud and unruly behavior, property destruction, unintentional injuries, violence, and even death because of underage alcohol use afflict innocent parties. For example, about 45 percent of people who die in crashes involving a drinking driver under the age of 21 are people other than the driver.9 Such secondhand effects often strike at random, making underage alcohol use truly everybody's problem (Call to Action, page 11).
- In conjunction with pregnancy, may result in fetal alcohol spectrum disorders, including fetal alcohol syndrome, which remains a leading cause of mental retardation10 (Call to Action, page 11).
- Is a risk factor for heavy drinking later in life,11 and continued heavy use of alcohol leads to increased risk across the lifespan for acute consequences and for medical problems such as cancers of the oral cavity, larynx, pharynx, and esophagus; liver cirrhosis; pancreatitis; and hemorrhagic stroke12 (Call to Action, pages 10-11).
There Is a High Prevalence of Alcohol Use Disorders Among the Young.
Early alcohol consumption by some young people will result in an alcohol use disorder-that is, they will meet diagnostic criteria for either alcohol abuse or dependence. . . . Figure 2 shows that the highest prevalence of alcohol dependence is among people ages 18-20 (Call to Action, page 4).
In other words, the description these young people provide of their drinking behavior meets the criteria for alcohol dependence set forth in the most recent editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM)-DSM-IV and DSM-IV-TR13 (Call to Action, page 4).
Early Onset of Drinking Can Be a Marker for Future Problems, Including Alcohol Dependence and Other Substance Abuse.
Approximately 40 percent of individuals who report drinking before age 15 also describe their behavior and drinking at some point in their lives in ways consistent with a diagnosis for alcohol dependence. This is four times as many as among those who do not drink before age 21.14 (Call to Action, page 12).
The Negative Consequences of Alcohol Use on College Campuses Are Widespread.
Alcohol consumption by underage college students is commonplace, although it varies from campus to campus and from person to person. Indeed, many college students, as well as some parents and administrators, accept alcohol use as a normal part of student life. Studies consistently indicate that about 80 percent of college students drink alcohol, about 40 percent engage in binge drinking,15 and about 20 percent engage in frequent episodic heavy consumption, which is bingeing three or more times over the past 2 weeks.16 The negative consequences of alcohol use on college campuses are particularly serious and pervasive (Call to Action, pages 12-13). For example:
- An estimated 1,700 college students between the ages of 18 and 24 die each year from alcohol-related unintentional injuries, including motor vehicle crashes17 (Call to Action, page 13).
- Approximately 600,000 students are unintentionally injured while under the influence of alcohol18 (Call to Action, page 13).
- Approximately 700,000 students are assaulted by other students who have been drinking19 (Call to Action, page 13).
- About 100,000 students are victims of alcohol-related sexual assault or date rape20 (Call to Action, page 13).
Underage Military Personnel Engage in Alcohol Use That Results in Negative Consequences.
Problems among underage military drinkers include: serious consequences (15.8 percent); alcohol-related productivity loss (19.5 percent); and as indicated by AUDIT scores,21 hazardous drinking (25.7 percent), harmful drinking (4.6 percent), or possible dependence (5.5 percent)22 (Call to Action, page 13).
Children of Alcoholics Are Especially Vulnerable to Alcohol Use Disorders.
Children of alcoholics (COAs) are between 4 and 10 times more likely to become alcoholics than children from families with no alcoholic adults23 and therefore require special consideration when addressing underage drinking. COAs are at elevated risk for earlier onset of drinking24 and earlier progression into drinking problems25 (Call to Action, pages 13-14).