By Diana Zuckerman, Ph.D., Padma Ravichandran, and Elly Field
Updated September 2013
Although the minimum drinking age is 21 years old, teenagers and young adults between the ages of 12 and 20 consume about 11% of the country’s alcohol in a given year—mostly by “binge drinking.” 1 Binge drinking is defined for men as drinking 5 or more drinks in a row (in 2 hours or less), and 4 or more drinks for women. Young adults between the ages of 18 and 24 consume the most alcohol on average when they binge drink (about 9 drinks in a two-hour period), but high school kids are also very likely to binge when they drink.2
While binge-drinking seems to be declining among teens, extreme binge-drinking (15 or more drinks in a row) is not. In 2005, 22% of high school students admitted to drinking 5 or more drinks in a row during “the last two weeks,” which was reduced to 18% in 2011.3 However, about 1 In 20 high school students drank more than 15 drinks in a row in 2011, the same as 2005.
Is this harmless fun? Or deadly? Every few years, there are “hazing” deaths like that of David Bogenberger, a freshman pledging to a fraternity at Northern Illinois University. He died after answering questions for two hours from upper class fraternity brothers in exchange for vodka.4 But, those individual tragedies aren’t the entire story.
Physical and Mental Health Effects
Kids that drink tend to do poorly in school, and it can harm growth, sexual development, and brain development. 5 Whether you drink too much alcohol or not, part of being young is not thinking about how what you do now can affect you later on. Unfortunately, excessive drinking in your teens and early adulthood can have an impact on your health many years later. Research shows that binge drinking while you’re young can worsen your memory and increase you risk for obesity and heart problems.
A 2008 study by researchers in Berkeley, California, found that young adults who started drinking alcohol early and heavily in adolescence were more likely to have more abdominal fat, to be overweight, and to have lower levels of the “good cholesterol,” all of which contribute to heart disease. 6
Long-term heavy drinking, which is defined for men as consuming more than 2 drinks per day every day, and more than one drink every day for women, weakens the heart muscle 7. This prevents the heart from effectively pumping blood to other organs. Binge drinking and long-term heavy drinking can also affect heart rhythms, causing the heart to beat irregularly or too fast. These strains on the heart can affect a person’s health in a number of ways. For instance, binge drinkers are almost 40% more likely to suffer from a stroke than people who don’t binge drink.8
Heavy drinking can also affect your abilities for the rest of your life. Long-term, heavy drinking can affect our neurons and slow the communication between neurotransmitters in the brain 8, but binge drinking when you’re a teenager may actually change the structure of the brain, damaging the tissue that messages pass through when moving from one area of the brain to another.9 These brain changes may impair a teenager’s memory and ability to learn.
A study published in 2013 that tracked college students in Brazil and Spain for two years had similar findings: the researchers found that those who binge drank had greater difficulty recalling information on memory tests—both immediately and 30 minutes later 10.
Besides the potential effects on health and memory, excessive drinking early in life is often a red flag for other problems. A study that followed almost 1,000 adolescents from high school through age 24 found that those who were problem drinkers when they were young grew into adults with drinking problems. They were also more likely to be depressed, anxious, antisocial, and have problems with other types of substance abuse.11 A study that followed college students into adulthood discovered that those who binge drank were significantly more likely to experience alcohol-related problems during college and 10 years after college.12 The researcher also found that the students who binge drank in college were less likely to continue their education and, if they did finish, were more likely to work in less prestigious and lower paying jobs.
Underage drinking not only affects the teenagers who do it, but everyone around them. One in three car crash deaths involve drivers with alcohol in their blood that is above the legal limit.13 A national survey found that 8% of high school students report they had driven a car after drinking alcohol, and 24% rode in a car with a driver who had been drinking alcohol. 
Underage drinking and binge drinking happen because we, as a society, allow it to. Adults may choose to look the other way, and teens and young adults often egg each other on. One study found that teenagers whose parents allowed them to drink engaged in riskier behavior than teenagers whose parents didn’t allow drinking. In addition, they generally experienced more negative consequences from their drinking.14 Even if their parents forbid drinking, teens have to contend with friends who drink and pressure them to join in. Research has shown that if you’re a young adult and your peers drink, you are more likely to drink as well.15
What should family members, teachers, and other adults do to help kids?
1) Understand the impact of peer pressure. It’s easier to talk to teenagers about the negative effects and risks of drinking when it appears you are only talking about their friends. See if he or she feels pressure to drink, and if so, discuss the possibility of finding new friends to make it easier to spend less time with peers who drink or avoid them when they are drinking. Also, help a teen practice ways of saying “no” or removing himself or herself from situations where she is expected to drink, without losing face or appearing judgmental.
2) Never ignore teenage drinking hoping it will go away. Often it is a symptom of more serious problems that the teen is experiencing now or will develop in the coming years.11
Bottom Line: What you need to know as a teen or parent
If you are a teen, pay close attention to your friends’ drinking and talk to them about the risks. Avoid situations where you will be under pressure to drink or ride in a car with a driver who has been drinking. If you are worried that discussing your friends’ drinking with your parents will make them dislike your friends or limit your social time with them, find another adult you trust to discuss strategies for saying “no” and avoiding risky situations. You can also visit these websites for suggestions on how to deal with peer pressure and plan ahead to minimize risky situations:
For parents: Talk with your teens about how to approach various scenarios in which they might feel pressured to drink or ride in the car with a driver who has consumed alcohol. Tell your teen that you’ll pick him up or pay for his taxi, no questions asked, if he or his ride has made the mistake of drinking. The mistake and the decision to behave differently next time can be addressed the following day. For more information on how to keep your teenager from drinking and driving, visit: http://m.cdc.gov/en/VitalSigns/teen-drinking-and-driving .
Lastly, if you need help for your son or daughter’s drinking, there is a toll-free number you can call: 1-800-662-HELP (4357). This is a service of the Substance Abuse and Mental Health Services Administration (SAMHSA), which is part of the U.S. Department of Health and Human Services (HHS). You will get a recorded message in English or Spanish giving you the option 1) to speak to someone about treatment or request educational materials, or 2) to get a referral to a treatment place in your state. If you don’t want to call and prefer to look for help online, visit this SAMHSA site: http://findtreatment.samhsa.gov/
- Office of Juvenile Justice and Delinquency Prevention. Drinking in America: Myths, Realities, and Prevention Policy Washington, DC: U.S. Department of Justice, Office of Justice Programs, Office of Juvenile Justice and Delinquency Prevention, 2005. ▲
- Centers for Disease Control and Prevention. Youth Risk Behavior Surveillance- United States, 2011. MMWR 2012:61(4). ▲
- Patrick ME, Schulenberg JE, Martz ME, Maggs JL, O’malley PM, Johnston LD. Extreme binge drinking among 12th-grade students in the United States: prevalence and predictors. JAMA Pediatr. 2013. ▲
- Walberg M & St. Clair S. Frat members charged in freshman’s hazing death. Chicago Tribune. December 18, 2012. Accessed September 17, 2013. Available at: http://articles.chicagotribune.com/2012-12-18/news/chi-charges-filed-in-niu-hazing-death-20121217_1_fraternity-david-bogenberger-dekalb-county-authorities ▲
- Centers for Disease Control and Prevention. Alcohol and Public Health Fact Sheets: Underage Drinking. Accessed September 17, 2013. Available at: http://www.cdc.gov/alcohol/quickstats/underage_drinking.htm ▲
- Fan, AZ, Russell, M, Stranges, S, Dorn, J, Trevisan, M. Association of lifetime alcohol drinking trajectories with cardiometabolic risk. J Clin Endocrinol Metab. 2008;93(1): 154-161. ▲
- Centers for Disease Control and Prevention. Alcohol and Public Health: Frequently Asked Questions. Accessed September 16, 2013. Available at: http://www.cdc.gov/alcohol/faqs.htm#heavyDrinking ▲
- National Institute of Health, National Institute on Alcohol Abuse and Alcoholism. (2012). Beyond hangovers: understanding alcohol’s impact on your health. NIH Publication No. 10-7604. ▲
- McQueeny, T, et al. Altered white matter integrity in adolescent binge drinkers. Alcoholism: Clinical and Experimental Research. 2009; 33(7):1278-1785. ▲
- Mota, N, et al. Binge drinking trajectory and neuropsychological functioning among university students: A longitudinal study. Drug and Alcohol Dependence. 2013. Available at: http://dx.doi.org/10.1016/j.drugalcdep.2013.05.024 ▲
- Rohde, P., Lewinsohn, PM., Kahler, CW., Seely JR, Brown, RA. Natural course of alcohol use disorders from adolescence to young adulthood. Journal of the American Academy of Child and Adolescent Psychiatry. 2001; 40(1): 83-90. ▲
- Jennison, KM. The short-term effects and unintended consequences of binge drinking in college: a 10-year follow-up study. The American Journal of Drug and Alcohol Abuse. 2004;30(3): 659-684. ▲
- Centers for Disease Control and Prevention. Impaired Driving Fact Sheet. Available at: http://www.cdc.gov/motorvehiclesafety/impaired_driving/impaired-drv_factsheet.html ▲
- Abar, C., Abar, B., Turrisi, R. The impact of parental modeling and permissibility on alcohol use and experienced negative drinking consequences in college. Addictive Behaviors. 2009; 34(6): 542-547. ▲
- Andrews, JJ, Tildesley, E, Hops, H, Li, F. The influence of peers on young adult substance use. Health Psychology. 2002; 21(4):349-357. ▲