The age for legal purchase and consumption of alcohol in the U.S. is 21 years old – but everyone in the U.S. knows that a large majority of people start drinking – or try alcohol for the first time – during their teenage years.

Underage drinking in the adolescent population is a problem for many reasons.

First, studies show that the earlier a teen begins drinking, the more likely they are to develop an alcohol use disorder or develop problematic drinking habits later in life.

Second, alcohol consumption – especially chronic consumption at high levels – can cause damage to the major organs. Alcohol can damage the liver, heart, kidneys, and pancreas. Research also links excessive alcohol consumption to a higher risk of various forms of cancer.

Finally, research indicates that alcohol can cause problems in the developing adolescent brain. Alcohol can change both the physiological structure (size, volume, etc.) and practical function (how it works) of the brain.

Physiologically speaking, alcohol can have a negative impact on the following brain areas:

• Hippocampus: The hippocampus plays a major role in memory formation, movement, and spatial orientation.
• Amygdala: The amygdala is part of the limbic system, which governs our emotions, responses to external stimuli, and some behavior. The amygdala and limbic system are key players in the activation of our “fight or flight” reflex.
• Prefrontal Cortex: This is the executive function center of the brain. It regulates decision-making, planning, language, rational judgment, and impulse control.

Functionally speaking, alcohol can have an impact on:

• Memory formation
• Movement and spatial awareness
• Language learning
• Impulse control
• Decision making
• Risk assessment
• Problem-solving
• Overall cognitive function

These facts, when considered together, reaffirm the reasoning behind our legal drinking age: the behavioral consequences notwithstanding, the drinking age makes sense for health reasons alone.

Underage Drinking Statistics for 2018

Given the serious health risks associated with early initiation of alcohol use, the data on underage drinking in the U.S. is promising. It shows that alcohol use in teenagers is on the decline, and has been for quite some time.

Data from the National Survey on Drug Use and Health (NSDUH) show that over the past ten years:

• Current underage drinking – meaning adolescents who’ve had a drink in the past 30 days – is down for high schoolers:
  • 45% decrease for 8^th graders
  • 39% decrease for 10^th graders
  • 31% decrease for 12^th graders
• Lifetime underage drinking – meaning adolescents who’ve ever had a drink – is down for high schoolers:
  • 36% decrease for 8^th graders
  • 27% decrease for 10^th graders
  • 19% decrease for 12^th graders

Those numbers are encouraging. They’re part of a larger, longer trend that’s equally encouraging. Data shows the following decreases in current (past 30 days) adolescent alcohol consumption between 1991-2018:

• 67% decrease for 8^th graders
• 57% decrease for 10^th graders
• 44% decrease for 12^th graders

There’s one more reason to be optimistic about this general decline in underage drinking. Over the past several decades, research shows that underage drinking can increase the risk of accidental injury, sexual assault, and deaths from car crashes.

Knowledge, Awareness, and Making Choices

The National Survey on Drug Use and Health offers the best possible data about drug use and health in the U.S., but does not attempt to assign reasons or causes for the increase or decrease in reported rates of alcohol and drug use in our population. However, even a casual observer of trends in our society and culture around drug and alcohol awareness might note that in broad terms, we’ve become more open, accepting, and understanding about the facts of drug and alcohol use. Parents are more willing to discuss these issues openly with teens, and teens, in turn, appear more empowered to ask questions, seek information, and get the real facts about alcohol and drugs before they make a decision to experiment or not.

This general increase in knowledge and understanding may be the driving force behind this long-term – close to three decade – decrease in alcohol consumption in adolescents. Which drives home an important point: the more reliable information we have before making a decision, the more likely we are to make a good decision – or at least one based on facts.

In the case of alcohol consumption and adolescents, it appears that the more information they receive from adults about alcohol and its dangers to the mind and body, the more they choose to experiment with alcohol later in life – which bodes well for their long term health and well-being.