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Alcohol's Effects on Health

Research-based information on drinking and its impact.

National Institute on Alcohol Abuse and Alcoholism (NIAAA)

Underage Drinking in the United States (ages 12 to 20)

Updated: 2024

Prevalence of Underage Alcohol Use, People Ages 12 to 20

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Underage drinking in the United States. In 2022, 956 drivers under age 21 were alcohol-impaired when involved in motor vehicle fatal crashes. Source: NHTSA FARS, 2024.

Prevalence of Lifetime Drinking

According to the 2023 National Survey on Drug Use and Health (NSDUH), 12.6 million people ages 12 to 20 (33.1% in this age group) reported that they have had at least one drink in their lives.1,2 This includes:

  • 6.1 million males ages 12 to 20 (31.1% in this age group)1,2
  • 6.5 million females ages 12 to 20 (35.3% in this age group)1,2
  • 68,000 American Indian or Alaska Native people ages 12 to 20 (23.6% in this age group)1,2
  • 563,000 Asian people ages 12 to 20 (23.7% in this age group)1,2
  • 1.4 million Black or African American people ages 12 to 20 (26.0% in this age group)1,2
  • 6.9 million White people ages 12 to 20 (37.0% in this age group)1,2
  • 495,000 people of two or more races ages 12 to 20 (36.5% in this age group)1,2
  • 3.2 million Hispanic or Latino people ages 12 to 20 (32.0% in this age group)1,2
  • Estimates for Native Hawaiian or other Pacific Islander people ages 12 to 20 were not presented because they were based on a relatively small number of respondents or had a large margin of error.1,2

Prevalence of Past-Year Drinking

According to the 2023 NSDUH, 10.6 million people ages 12 to 20 (27.9% in this age group) reported that they drank in the past year.1,2 This includes:

  • 5.1 million males ages 12 to 20 (26.0% in this age group)1,2
  • 5.5 million females ages 12 to 20 (29.8% in this age group)1,2
  • 51,000 American Indian or Alaska Native people ages 12 to 20 (17.7% in this age group)1,2
  • 474,000 Asian people ages 12 to 20 (20.0% in this age group)1,2
  • 1.1 million Black or African American people ages 12 to 20 (20.9% in this age group)1,2
  • 6.0 million White people ages 12 to 20 (31.7% in this age group)1,2
  • 414,000 people of two or more races ages 12 to 20 (30.5% in this age group)1,2
  • 2.6 million Hispanic or Latino people ages 12 to 20 (26.3% in this age group)1,2
  • Estimates for Native Hawaiian or other Pacific Islander people ages 12 to 20 were not presented because they were based on a relatively small number of respondents or had a large margin of error.1,2

Prevalence of Past-Month Drinking

According to the 2023 NSDUH, 5.6 million people ages 12 to 20 (14.6% in this age group) reported that they drank in the past month.1,2 This includes:

  • 2.7 million males ages 12 to 20 (13.7% in this age group)1,2
  • 2.9 million females ages 12 to 20 (15.6% in this age group)1,2
  • 17,000 American Indian or Alaska Native people ages 12 to 20 (5.8% in this age group)1,2
  • 180,000 Asian people ages 12 to 20 (7.6% in this age group)1,2
  • 558,000 Black or African American people ages 12 to 20 (10.6% in this age group)1,2
  • 3.4 million White people ages 12 to 20 (17.9% in this age group)1,2
  • 223,000 people of two or more races ages 12 to 20 (16.4% in this age group)1,2
  • 1.2 million Hispanic or Latino people ages 12 to 20 (12.5% in this age group)1,2
  • Estimates for Native Hawaiian or other Pacific Islander people ages 12 to 20 were not presented because they were based on a relatively small number of respondents or had a large margin of error.1,2

Prevalence of Past-Month Binge Drinking

According to the 2023 NSDUH, 3.3 million people ages 12 to 20 (8.6% in this age group) reported binge drinking in the past month (see glossary for definition of binge drinking).1,2 This includes:

  • 1.6 million males ages 12 to 20 (8.1% in this age group)1,2
  • 1.7 million females ages 12 to 20 (9.2% in this age group)1,2
  • 13,000 American Indian or Alaska Native people ages 12 to 20 (4.3% in this age group)1,2
  • 55,000 Asian people ages 12 to 20 (2.3% in this age group)1,2
  • 312,000 Black or African American people ages 12 to 20 (5.9% in this age group)1,2
  • 2.0 million White people ages 12 to 20 (10.7% in this age group)1,2
  • 127,000 people of two or more races ages 12 to 20 (9.4% in this age group)1,2
  • 759,000 Hispanic or Latino people ages 12 to 20 (7.7% in this age group)1,2
  • Estimates for Native Hawaiian or other Pacific Islander people ages 12 to 20 were not presented because they were based on a relatively small number of respondents or had a large margin of error.1,2

Prevalence of Past-Month Heavy Alcohol Use

According to the 2023 NSDUH, 663,000 people ages 12 to 20 (1.7% in this age group) reported heavy alcohol use in the past month (see glossary for definition of heavy alcohol use).1,2 This includes:

  • 321,000 males ages 12 to 20 (1.6% in this age group)1,2
  • 342,000 females ages 12 to 20 (1.9% in this age group)1,2
  • 5,000 American Indian or Alaska Native people ages 12 to 20 (1.8% in this age group)1,2
  • 5,000 Asian people ages 12 to 20 (0.2% in this age group)1,2
  • 32,000 Black or African American people ages 12 to 20 (0.6% in this age group)1,2
  • 414,000 White people ages 12 to 20 (2.2% in this age group)1,2
  • 63,000 people of two or more races ages 12 to 20 (4.7% in this age group)1,2
  • 142,000 Hispanic or Latino people ages 12 to 20 (1.4% in this age group)1,2
  • Estimates for Native Hawaiian or other Pacific Islander people ages 12 to 20 were not presented because they were based on a relatively small number of respondents or had a large margin of error.1,2

Prevalence of High-Intensity Drinking

According to the 2023 Monitoring the Future survey, 2.2% of students in 12th grade reported high-intensity drinking.3

Consequences of Underage Alcohol Use

  • Research indicates that alcohol use during the teenage years can interfere with normal adolescent brain development and increase the risk of developing alcohol use disorder. In addition, underage drinking contributes to a range of acute consequences, such as injuries, sexual assaults, alcohol overdoses, and deaths—including those from motor vehicle crashes.4
  • Alcohol is a factor in the deaths of thousands of people younger than age 21 in the United States each year. This includes:
    • 1,345 from motor vehicle crashes involving an alcohol-impaired driver5
    • 998 from homicides6
    • 177 from alcohol overdose, falls, burns, and drowning6
    • 649 from suicides6
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), many (but not all) NSDUH estimates from 2023 are comparable with 2022 and updated 2021 estimates. However, 2021–2023 estimates are not comparable with 2020 or prior years' estimates. Please see the 2023 NSDUH Frequently Asked Questions and Section 2.3.4 of the 2023 Methodological Summary and Definitions Report for more details.
According to the Centers for Disease Control and Prevention (CDC), due to scientific updates to Alcohol-Related Disease Impact (ARDI), estimates of alcohol-attributable deaths or years of potential life lost generated in the current version of ARDI should not be compared with estimates that were generated using the ARDI default reports or analyses in the ARDI Custom Data Portal prior to February 29, 2024.

References

  1. SAMHSA, Center for Behavioral Health Statistics and Quality. 2023 National Survey on Drug Use and Health. Table 2.44A—Alcohol use in lifetime, past year, and past month and binge alcohol and heavy alcohol use in past month: among people aged 12 to 20; by demographic characteristics, numbers in thousands, 2022 and 2023. [cited 2024 Aug 9]. Available from: https://www.samhsa.gov/data/report/2023-nsduh-detailed-tables
  2. SAMHSA, Center for Behavioral Health Statistics and Quality. 2023 National Survey on Drug Use and Health. Table 2.44B—Alcohol use in lifetime, past year, and past month and binge alcohol and heavy alcohol use in past month: among people aged 12 to 20; by demographic characteristics, percentages, 2022 and 2023. [cited 2024 Aug 9]. Available from: https://www.samhsa.gov/data/report/2023-nsduh-detailed-tables
  3. Miech RA, Johnston LD, Patrick ME, O’Malley PM. Monitoring the Future: National Survey Results on Drug Use, 1975–2023: Overview and Detailed Results for Secondary School Students. Table 7-1b:  Frequency of Occasions of Heavy Drinking for 8th, 10th, and 12th grade students, 2023. Available from: https://monitoringthefuture.org/wp-content/uploads/2024/01/mtfoverview2024.pdf
  4. National Institute on Alcohol Abuse and Alcoholism (NIAAA). Get the facts about underage drinking [Internet]. Bethesda (MD): NIAAA; 2013 [updated 2023 Sept; cited 2023 Dec 8]. Available from: https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/underage-drinking
  5. Fatality and Injury Reporting System Tool [Internet]. Washington: National Highway Traffic Safety Administration [cited 2024 May 15]. Available from: https://cdan.dot.gov/query
  6. Centers for Disease Control and Prevention. Alcohol and Public Health: Alcohol-Related Disease Impact. [Table], Annual average for United States 2020–2021 alcohol-attributable deaths due to excessive alcohol use, under 21. [cited 2024 Mar 19]. Available from: https://nccd.cdc.gov/DPH_ARDI/Default/Report.aspx?T=AAM&P=F1F85724-AEC5-4421-BC88-3E8899866842&R=EACE3036-77C9-4893-9F93-17A5E1FEBE01&M=7F40785C-D481-440A-970F-50EFBD21B35B&F=AAMCauseGenderUnder21&D=H
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