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Underage possession of alcohol is illegal in the United States, and the minimum legal drinking age is 21. The earlier that a young person starts to drink, the more likely they are to have alcohol-related problems as a teenager or adult. Drinking at a young age greatly increases the risk for many problems now and in adulthood.

Drinking alcohol can:

• Affect mood, thinking, and decision-making
• Affect grades and damage a young person's relationships
• Cause long-term harm to the brain and body
• Get a young person in legal trouble or lead to injuries or death for themselves or others
• Lead to alcohol use disorder (AUD)

AUD is a medical condition known for difficulty stopping or controlling alcohol use despite negative consequences. It is a spectrum disorder, which means it can range from mild to moderate to severe. It covers the conditions that some people refer to as alcohol abuse, alcohol dependence, or the colloquial term, alcoholism.

Too Dangerous

Here are some of the dangers of underage drinking:

Poor Judgment and Reckless Behavior

People may not recognize that critical decision-making abilities as well as coordination and motor skills are already diminished long before a person shows overt signs of intoxication.

Alcohol also decreases inhibitions and judgment and can lead to reckless decisions.

With more drinking, reaction times get slower, and behavior becomes poorly controlled and sometimes even aggressive—leading to fights and other types of violence. Continued drinking causes the slurred speech and loss of balance that are typically associated with being drunk.

Blackouts and Overdoses

Alcohol can also cause blackouts, which are gaps in a person’s memory for events that occurred while they were intoxicated. Drinking a lot of alcohol can also lead to a life-threatening alcohol overdose due to the shutting down of vital life functions.

Injuries and Death

Each year, according to the U.S. Centers for Disease Control and Prevention (CDC), an estimated 4,000 people under the age of 21 die from causes related to alcohol, such as car crashes, burns, falls, and other unintentional injuries.

Cognitive Problems

The brain is still developing throughout the teen years. Research shows that heavy drinking in the teen years can cause long-lasting harm to their learning, memory, and reasoning.

Alcohol Use Disorder

The younger someone is when they start drinking, the greater the chance they will develop alcohol-related problems at some point in their life. People ages 26 and older who began drinking before age 15 are 4 times as likely to report having alcohol use disorder (AUD) in the past year as those who waited until age 21 or later to begin drinking. The risk for females in this group is almost one and a half times that of males.

Who's At Risk?

Alcohol problems can sneak up on people who drink. But there are ways to tell if someone is more likely to develop alcohol-related problems.

Starting Young

The younger someone is when they start drinking, the higher the chances of having problems with alcohol later.

Having an Impulsive Temperament

Some people have the strong urge to act on impulse and to seek new experiences. They have a higher risk of starting to drink early and developing alcohol problems.

Having Friends Who Drink

The more friends a person has who drink, the more likely that person is to drink.

Having Close Family Members with Alcohol-Related Problems

This raises a person’s risk for alcohol problems, but it is not destiny. Steps can be taken to protect oneself from alcohol problems.

Having Behaviors or Experiences that Increase the Risk of Alcohol-Related Problems

Youth who experience early childhood trauma or who have behavioral issues and certain mental health conditions, such as anxiety, depression, attention deficit hyperactivity disorder, or other substance use, may be at a greater risk of developing alcohol problems as adolescents.

Middle schoolers who have already begun drinking are even more likely to have alcohol problems if they:

• Drink heavily
• Drink to get drunk
• Drink to cope with stress or other problems
• Feel less of an effect from alcohol than other people would
• Use other substances in addition to alcohol

Setting Healthy Expectations for Safe, Legal Alcohol Use in the Future

Some people think alcohol can help them to relax, socialize, or relieve stress. These people may drink or even misuse alcohol, which can cause a host of problems, even cancer—especially breast cancer.

Having a risk factor does not guarantee that someone will have a problem with alcohol. Some people will and some won't. Talk to middle school students about what they can do to lower their chances of developing alcohol problems. Here are two important points to cover:

1. It’s important that, if they ultimately choose to drink, they don't start until age 21—Not only is that age the law, research shows people who start drinking after age 21 have a lower chance chance of developing AUD compared with people who start younger.

2. Even for adults, any amount of drinking could be harmful. According to the Dietary Guidelines for Americans 2020-2025, adults of legal drinking age can choose not to drink or to limit intake to 2 drinks or less in a day for men and 1 drink or less in a day for women, when alcohol is consumed. 
   
   Developed by the U.S. Department of Health and Human Services and U.S. Department of Agriculture, the dietary guidelines provide advice on what to eat and drink to meet nutrient needs, promote health, and help prevent disease. 
   
   Finally, studies show no health benefits from moderate drinking, and drinking less is better for health than drinking more.

Reality Check

It’s important to teach middle schoolers that they have the right to resist peer pressure to drink. Encourage them to hang out with people who don’t drink, and to participate in community events, sports, or other activities that keep them alcohol free. Know what resources are available in your school so that you know where to turn to get help for a student.

And perhaps most important, never serve alcohol to your middle schooler or their friends. Research shows that underage students whose parents provide alcohol  are more likely to engage in heavier drinking, to drink more often, and to get into traffic crashes. Remember, too, that in almost every state it is illegal to provide alcohol to minors who are not family members.