In the June 2002 issue of the Journal of Adolescent Health, researchers from the University of California School of Public Health reported that middle school alcohol use is three times more common in children who start to drink while in elementary school than in those who do not. The authors concluded that alcohol interventions should begin no later than elementary school.

Despite recent hopeful reports from the NIH-funded Monitoring the Future Study, which documented a decline in alcohol use among adolescents in 2002, there is a growing realization that underage drinking exacts a terrible cost, that more must be done to protect our children, and that the general public must play a leading role in these efforts.

The costs are indeed great. Research shows that the cost of alcohol use by youth is an estimated $53 billion annually. This includes costs such as medical treatment, emergency services, lost work, property damage, and pain and suffering.1

Complicating the picture is a plethora of new alcohol beverages—lightly carbonated, slightly sweetened, and fruit-flavored—that have high “kid appeal.” Sales of these so-called “alcopops,” “malternatives,” and clear malts
are growing faster than sales of other
alcohol beverages.

Despite growing concern over underage drinking in some circles, lingering cultural attitudes often minimize the importance of alcohol misuse and help perpetuate the problem. For example, a young person’s first beer is commonly seen as a rite of passage in our culture. “We did it when we were young, and we turned out okay,” the reasoning goes. “What’s the big deal?”

What’s the Big Deal?

Why should we be concerned about underage drinking? Research provides us with many facts about the reality of this problem. The following are just a few:

• More than 20 percent of eighth graders and 44 percent of tenth graders have been drunk at least once.2
• Sixty-eight percent of eighth graders and 85 percent of tenth graders believe that alcohol is readily available
  to them.2
• Nearly seven percent of ninth graders reported driving one or more times while drinking.3
• Among 12- to 17-year-old current drinkers, 31 percent had extreme levels of psychological distress, and 39 percent exhibited serious behavioral problems.4

Serious Long-Term Effects

Underage drinking not only leads to problem drinking in later life—it also can have permanent physical effects.

“We have so much more information today than we had even five years ago,” notes Ting-Kai Lee, M.D., Director of the National Institute on Alcohol Abuse and Alcoholism (NIAAA). “Recent epidemiologic studies have shown that more than 40 percent of people who drink before age 13 will abuse alcohol or become alcohol dependent later in life. Imaging research has demonstrated noticeable changes in the brains of children who had begun heavy drinking by age 15. They develop fewer learning strategies and have poorer memory function than non-drinking children—not surprising, since early alcohol use affects areas in the frontal lobes of the brain responsible for higher order functions such as reasoning, problem solving, learning
verbal and spatial skills, and memory.”

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1 Costs of Underage Drinking, Updated Edition. Pacific Institute for Research and Evaluation. October 1999. (Prepared for the Office of Juvenile Justice and Delinquency Prevention.)

2 Johnston, L.D., O’Malley, P.M.,
Bachman, J.G. Monitoring the Future National Results on Adolescent Drug Use: Overview of Key Findings, 2002. National Institute on Drug Abuse. 2003.

3 Traffic Safety Facts 2000—Children. National Highway Traffic Safety Administration. US Department of Transportation. 2001.

4 The Relationship Between Mental Health and Substance Abuse Among Adolescents. Substance Abuse and Mental Health Services Administration (SAMHSA). 1999.

Contributor: John Bowersox, National Institute on Alcohol Abuse and Alcoholism.