Underage Drinking: A Research Brief
RESEARCH BRIEFS
A product of the Status
Offense Reform Center
(SORC), the Research Brief
series presents information on
key status offense behaviors,
focusing on their prevalence
and scope, as well as what we
know and don’t know based on
the available research.
What is a status offense?
Status offenses are behaviors
that are prohibited under law
only because of an individual’s
status as a minor, including
running away from home,
skipping school, violating a
curfew, drinking under age,
and acting “incorrigibly.” They
are problematic, but
noncriminal in nature.
What is SORC?
SORC provides policymakers
and practitioners with tools
and information to create
effective, community-based
responses for keeping young
people who engage in
noncriminal behavior out of
the juvenile justice system.
The Center is a project of the
Vera Institute of Justice and is
supported by the John D. and
Catherine T. MacArthur
Foundation’s Models for
Change Resource Center
Partnership.
Date of Publication: December 12, 2013
Author: Ashley Jackson
What is Underage Drinking?
The minimum drinking age is determined by states. However, to obtain
federal transportation funding, states must abide by the National Minimum
Drinking Age Act (NMDA) by setting their minimum legal drinking age at
21.1
The table below identifies the circumstances that youth under age 21 may
legally consume alcoholic beverages.2
Persons under 21 can consume alcohol…
Under parental supervision in general and/or on private
property
If the youth is married to someone who is over the age of
21
Under another family member’s supervision
If they are on private property
For religious purposes and ceremonies
If enrolled in culinary schools or other types of schools
Number of States
18 states
9 states
4 states
2 states
22 states
5 states
Why this Issue Matters?
Alcohol is the most common substance used among youth. In 2011,
almost four out of every 10 high school students reported having a drink
in the past month.3 Additionally, in 2012, 9.3 million young people under
age 21 reported drinking alcohol in the past month, six million of whom
met the criteria for binge drinking—that is, consuming five or more drinks
on the same occasion in the past 30 days. 4 In addition, 1.7 million met
the criteria for heavy drinking—consuming five or more drinks on the
same occasion on five or more days in the past month.5
Depending on the state, underage drinking is either a violation punishable
by a fine or a misdemeanor offense. In many states, youth who drink
underage may be referred to juvenile court on a delinquency case.6 In 11
states, these youth may be petitioned to juvenile court as status
offenders.7 In 2010, a total of 30,100 status offense cases entered
juvenile court as a result of liquor law violations.8 Although the Juvenile
Justice and Delinquency Prevention Act aims to limit the use of detention
for youth charged with status offenses, the proportion of detained status
offenders charged with liquor law violations increased from 19 percent in
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2001 to 24 percent in 2010, comprising one of the largest increases in
detention usage among all status offense cases.9
This brief provides an overview of what we know about underage drinking
and where gaps in the research still lie. It draws on more than 50 peerreviewed journal articles, government reports, and policy briefs looking at
the demographics of underage drinking, the reasons why young people
drink, and various intervention strategies.
What we Know
While many youth will experiment without consequence, for others,
drinking can lead to more serious problems, such as motor vehicle
accidents, accidental injuries, alcohol dependency, risky sexual behavior,
declines in academic performance, and alcohol poisoning.10 Drinking may
also signal other concerns, such as family crises or mental health
needs.11 Specifically, underage drinking has been linked with low self
esteem, depression, suicidal ideation, stress, and running away from
home.12
Who Engages in Underage Drinking. Research has shown differences in
the likelihood and frequency of alcohol consumption among young people
by age, gender, race, and income. In addition, there is evidence that
mental health needs and challenges in the home influence decisions to
engage in underage drinking.

According to self-reported data, there are no gender differences in
youth’s likelihood of underage drinking. However, males are more
likely to end up in court for drinking than females and are also
more likely to drink heavily. In 2012, males and females aged 12
to 20 reported alcohol use at nearly identical rates (25 percent
versus 24 percent). However, in 2010, 61 percent of petitioned
status offense cases for liquor law violations were for males and
39 percent were for females.13 In addition, male youth are still
more likely than female youth to engage in binge (17 percent
versus 14 percent) and heavy (5 percent versus 3 percent)
drinking.14

As youth get older, the likelihood of drinking also increases.15 A
study comparing alcohol consumption by grade found that 12th
graders were more likely than younger students to report
underage drinking as well as drinking with parents at someone
else’s home.16 Court statistics bear this out—the rate of status
offense liquor law violation cases increases as youth get older.17
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
In a 2012 national survey on drug use and health American Indian
and Alaskan Native youth (30 percent) were more likely to engage
in binge drinking than other racial and ethnic groups, followed by
white youth (24 percent).18 In addition, between 1995 and 2010,
the rate of status offense cases for liquor law violations entering
the court system was highest among American Indian youth. In
fact, the rate for petitioned status offense cases for liquor law
violations among American Indian youth was more than nine times
the rate for black youth.19

Differences in income levels exist among youth who report heavy
alcohol use. A national survey on drug use and health found that
from 2002 to 2006 youth between the ages of 12 and 20 from
families with an annual income of less than $20,000 had the
highest rates of binge and heavy drinking.20 Youth from families
with an annual income of $75,000 or more had the second highest
rates of current, binge, and heavy use of alcohol.21
Why Young People Drink. Young people drink for a variety of reasons,
including experimentation, exposure to alcohol use by parents, and peer
pressure.

In a longitudinal analysis of expectant mothers, researchers found
that prenatal alcohol exposure was more likely to predict underage
drinking than a family history of alcoholism.22 Early childhood
exposure to parental alcohol consumption and abuse has also
been linked to underage drinking. Additional studies have also
found higher rates of current alcohol use, binge drinking, and
heavy drinking among youth 12 to 20 years of age who lived with
a parent who drank in the past year (18 percent) compared to a
parent who had not consumed alcohol in the past year (9
percent).23

Social pressures influence whether or not youth consume alcohol,
particularly among females. A study surveying more than 4,000
youth found that negative social influences, such as peer pressure
and associating with ―problem-behaving‖ friends, were positively
associated with underage drinking.24 Other studies have confirmed
that youth who drink together (or in peer clusters) are more likely
to engage in risky drinking behaviors, such as heavy drinking and
driving after consuming alcohol.25

Youth who experiment with alcohol are at a higher risk of
developing later patterns of problematic alcohol consumption.26
Although youth are experimenting with alcohol less today than in
prior years, research shows that reducing early experimentation
lessens the chances of future challenges with alcohol and more
serious substances.27
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Underage Drinking Interventions. A number of therapeutic approaches
have been found to be effective in addressing excessive or risky
underage drinking. The most commonly used include Motivational
Interviewing (MI), Brief Interventions (BI), Cognitive-Behavioral Therapy
(CBT), and Social Norms Theory.

Motivational Interviewing (MI) is a therapeutic approach typically
used to treat people struggling with both mental health and
substance abuse issues. To change client behavior, it addresses
the ambivalence between how he or she acts (engaging in
underage drinking) and his or her goals (to stop drinking).28 MI is
utilized in different settings, including hospitals, employee
assistance programs, and substance abuse treatment programs.
For a number of problems, including abuse of alcohol, marijuana,
tobacco, and other drugs, MI was found to reduce risky behavior
and enhance client engagement at a 10-20 percent higher rate
than was the case in the non-treatment group.29

Brief intervention (BI) employs elements of MI and is often used
with people not seeking formal substance abuse treatment. It
includes short counseling sessions lasting between five and 60
minutes, delivered over the course of six to eight weeks.30 Settings
where BI is utilized include primary care clinics, emergency
rooms, and schools.31 A 2001 study of BI and its use of MI found
reductions in alcohol consumption among youth.32

Cognitive-Behavioral Therapy (CBT) focuses on helping a person
identify the problem at hand and change the thoughts and
behaviors causing the problem. CBT is often practiced in schools,
criminal justice settings, treatment centers, and community-based
organizations.33 A large body of research supports the use of CBT
as an effective approach for youth abusing alcohol and marijuana,
with one study reporting a reduction of alcohol use from 23
percent pre-treatment to 14 percent at five month follow-up.34

Social Norms Theory, in addition to MI, CBT, and BI, is
recommended by the Office of Juvenile Justice and Delinquency
Prevention (OJJDP) as another effective approach to address
underage drinking and harm reduction.35 Social Norms Theory
maintains that behavior is influenced by incorrect perceptions of
how other people within our social networks think and operate.36
One study showed that middle school youth who received therapy
based on Social Norms Theory demonstrated ―high risk‖ drinking
at a rate that was more than 50 percent lower than youth in a
control group.37
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Gaps in the Research
While there has been some research exploring underage drinking,
additional research in the following areas could provide more insight
about why adolescents engage in this behavior and what approaches are
most effective in addressing it.

Youth development. More in-depth research is needed to
understand how the developmental stages of youth impact
drinking patterns. The National Institute on Alcohol Abuse and
Alcoholism encourages clinicians and researchers to further
explore the relationship between youth development and alcohol
use to more effectively address underage drinking.38

Demographics. Very little is currently known about if and how the
outcomes of underage drinking interventions vary by race, gender,
and socioeconomic status.

Settings. More needs to be known about the settings in which
youth are most likely to drink, how treatment interventions and
outcomes differ in tribal, rural, urban, and suburban settings, and
how programs can be individually tailored.

Pre-adolescent youth. While rates of petitioned status offense
liquor law violations increase with age, researchers argue that
more research is needed on younger children (nine to 14 years
old) who drink and are at risk of developing substance abuse
challenges later in adolescence.39

Mental health. More research is needed that explores connections
between underage drinking and other mental health needs and
challenges, outside of depression.

The effects of court intervention. Finally, there is little research on
the impact of the court process on underage drinking – that is,
does a status offense referral to court and subsequent juvenile
justice involvement improve or exacerbate underage drinking?
Research is needed to compare the effects of adjudication and
alternative programs, such as community or school-based
interventions, on underage drinking.
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Endnotes
1
Mary Pat Treuthart, ―Lowering the Bar: Rethinking Underage Drinking,‖ NYU Journal of Legislation and Public Policy, 1 no. 9
(2006). http://www.nyujlpp.org/wp-content/uploads/2012/11/Mary-Pat-Treuthart-Lowering-the-Bar.pdf.
2
Ibid.
3
Centers for Disease Control and Prevention, Youth Risk Behavior Surveillance—United States, 2011 (Atlanta, GA: CDC,
2011), http://www.cdc.gov/mmwr/pdf/ss/ss6104.pdf .
4
Substance Abuse and Mental Health Services Administration (SAMHSA), Results from the 2012 National Survey on Drug
Use and Health: Summary of National Findings (Rockville, MD: SAMHSA, 2013),
http://www.samhsa.gov/data/NSDUH/2012SummNatFindDetTables/NationalFindings/NSDUHresults2012.htm.
5
Ibid.
6
Office of Juvenile Justice and Delinquency Prevention, ―Statistical Briefing Book: Glossary,‖
http://www.ojjdp.gov/ojstatbb/glossary.html (accessed October 18, 2013).
7
Office of Juvenile Justice and Delinquency Prevention, ―Statistical Briefing Book: Jurisdictional Boundaries,‖
http://www.ojjdp.gov/ojstatbb/structure_process/qa04121.asp?qaDate=2012 (accessed September 5, 2013).
8
Charles Puzzanchera and Sarah Hockenberry, Juvenile Court Statistics 2010 (Pittsburgh, PA: National Center for Juvenile
Justice, 2013), http://www.ncjj.org/pdf/jcsreports/jcs2010.pdf.
9
The Juvenile Justice and Delinquency Prevention Act (JJDPA) states that youth charged with a status offense shall not be
placed in secure detention or correctional facilities. However, youth who violate a valid court order may be detained.
http://www.ojjdp.gov/about/jjdpa2002titlev.pdf. Detention statistics provided in Charles Puzzanchera and Sarah Hockenberry,
2013.
10
U.S. Department of Health and Human Services (HHS), Report to Congress on the Prevention and Reduction of Underage
Drinking (Washington, DC: HHS, 2012), http://store.samhsa.gov/shin/content//PEP12-RTCUAD/report_to_congress_2012.pdf.
11
Anton De Man, ―Predictors of Adolescent Running Away Behavior,‖ Social Behavior & Personality: An International Journal
28, no. 3 (2000): 261-268. http://www.sbp-journal.com/index.php/sbp/article/view/1025
12
Ibid.
13
Charles Puzzanchera and Sarah Hockenberry, 2013.
14
Substance Abuse and Mental Health Services Administration (SAMHSA), Results from the 2012 National Survey on Drug
Use and Health: Summary of National Findings (Rockville, MD: SAMHSA, 2013).
http://www.samhsa.gov/data/NSDUH/2012SummNatFindDetTables/NationalFindings/NSDUHresults2012.htm; Hua Zhong and
Jennifer Schwartz, ―Exploring Gender-Specific Trends in Underage Drinking Across Adolescent Age Groups and Measures of
Drinking: Is Girls’ Drinking Catching Up with Boys’?‖ Journal of Youth and Adolescence 39, no. 8 (2010): 911-926,
http://link.springer.com/article/10.1007%2Fs10964-009-9413-0.
15
Substance Abuse and Mental Health Services Administration (SAMHSA), Results from the 2012 National Survey on Drug
Use and Health: Summary of National Findings (Rockville, MD: SAMHSA, 2013),
http://www.samhsa.gov/data/NSDUH/2012SummNatFindDetTables/NationalFindings/NSDUHresults2012.htm .
16
Randall Mayer, Jean Forster, and David Murray, ―Social Settings and Situations of Underage Drinking, Journal for the Study
of Alcohol 59, no. 2 (1998): 207-215, http://www.ncbi.nlm.nih.gov/pubmed/9500308.
17
Charles Puzzanchera and Sarah Hockenberry, 2013.
18
Substance Abuse and Mental Health Services Administration (SAMHSA), 2013.
19
Charles Puzzanchera and Sarah Hockenberry, 2013.
20
Michael Pemberton, James Colliver, Tania Robbins, and Joseph Gfroerer, Underage Alcohol Use: Findings from the 20022006 National Surveys on Drug Use and Health, (Washington, DC: DHHS, 2008),
http://www.samhsa.gov/data/underage2k8/underage.pdf.
21
Ibid.
22
John Baer, Paul Sampson, Helen Barr, Paul Connor, and Ann Streissguth, ―A 21-Year Longitudinal Analysis of the Effects of
Prenatal Alcohol Exposure on Young Adult Drinking,‖ Archives of General Psychiatry 60, no. 4 (2003): 377–85,
http://www.ncbi.nlm.nih.gov/pubmed/12695315 ; John Baer, Helen Barr, Fred Bookstein, Paul Sampson, and Ann Streissguth,
―Prenatal Alcohol Exposure and Family History of Alcoholism in the Etiology of Adolescent Alcohol Problems,‖ Journal of
Studies on Alcohol 59, no. 5 (1998): 533–543, http://www.ncbi.nlm.nih.gov/pubmed/9718105 .
23
Michael Pemberton, James Colliver, Tania Robbins, and Joseph Gfroerer, Underage Alcohol Use: Findings from the 20022006 National Surveys on Drug Use and Health, (Washington, DC: DHHS, 2008),
http://www.samhsa.gov/data/underage2k8/underage.pdf; Amy Yule, Timothy Wilens, Mary Kate Martelon, Andrew Simon, and
Joseph Biederman, ―Does Exposure to Parental Substance Use Disorders Increase Substance Use Disorder Risk in
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Offspring? A 5-year follow-up study,‖ The American Journal on Addictions 22, no. 5 (2013): 460-465,
http://www.ncbi.nlm.nih.gov/pubmed/23952891.
24
Bruce Simons-Morton, Denise Haynie, Aria Crump, Patricia Eitel, and Keith Saylor, ―Peer and Parent Influences on Smoking
and Drinking among Early Adolescent, Health Education and Behavior 28, no. 1 (2001): 95-107,
http://heb.sagepub.com/content/28/1/95.short.
25
Beth Reboussin, Eun Young Song, and Mark Wolfson, ―Social Influences on the Clustering of Underage Risky Drinking and
its Consequences in Communities‖ Journal of Studies on Alcohol and Drugs 73, no. 6 (2012): 890-898,
http://www.ncbi.nlm.nih.gov/pubmed/23036206; Jessica Hamilton, Melody Noland, Richard Riggs, and David Mullineaux,
―Factors Related to Adolescent Drinking in Appalachia,‖ American Journal of Health Behavior 34, no. 2 (2010): 249-256,
http://www.ncbi.nlm.nih.gov/pubmed/19814604.
26
Vincent Guilamo-Ramos, Rob Turrisi, James Jaccard, Elizabeth Woods, and Bernardo Gonzalez, ―Progressing from Light
Experimentation to Heavy Episodic Drinking in Early and Middle Adolescence,‖ Journal on Studies of Alcohol and Drugs 65,
no. 4 (2004): 494-500, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2928558/.
27
Ralph Hingson, Jean-Pacal Assailly, and Allan Williams, ―Underage Drinking: Frequency, Consequences, and Interventions,‖
Traffic Injury Prevention 5, no. 3 (2004): 228-263, http://www.ncbi.nlm.nih.gov/pubmed/15276923; ―Tristan Kirby and Adam
Barry, ―Alcohol as a Gateway Drug: a Study of US 12th Graders,‖ Journal of School Health 82, no. 8 (2012),
http://www.ncbi.nlm.nih.gov/pubmed/22712674.
28
Stephen Rollnick and William Miller, ―What Is Motivational Interviewing?‖ Behavioural and Cognitive Psychotherapy 23, no.
4 (1995): 325-334, http://www.motivationalinterview.net/clinical/whatismi.html.
29
Brad Lundahl and Brian Burke, ―The Effectiveness and Applicability of Motivational Interviewing: A Practice-Friendly Review
of Four Meta-Analyses,‖ Journal of Clinical Psychology: In Session 65, no. 11 (2009): 1232-1245,
http://faculty.fortlewis.edu/burke_b/CriticalThinking/Readings/MI-Burke.pdf .
30
U.S. Department of Health and Human Services, ―Alcohol Alert: Underage Drinking,‖
http://pubs.niaaa.nih.gov/publications/AA66/AA66.htm (accessed June 1, 2013).
31
U.S. Department of Health and Human Services, ―Alcohol Alert: Underage Drinking,‖
http://pubs.niaaa.nih.gov/publications/AA67/AA67.pdf (accessed June 1, 2013).
32
John Baer, Daniel Kivlahan, Arthur Blume, Patrick McKnight, and G. Alan Marlatt, ―Brief Intervention for Heavy-Drinking
College Students: 4-Year Follow-up and Natural History, American Journal of Public Health 91, no. 8 (2001): 1310-1316,
http://www.ncbi.nlm.nih.gov/pubmed/11499124.
33
Development Services Group, Inc, U.S. Department of Justice, ―Cognitive Behavioral Therapy/Treatment Literature Review,‖
http://www.ojjdp.gov/dso/Cognitive%20Behavioral%20Treatment%20Literature%20Review.pdf (accessed July 5, 2013).
34
Holly Waldron and Yifrah Kaminer, ―On the Learning Curve: The Emerging Evidence Supporting Cognitive-Behavioral
Therapies for Adolescent Substance Abuse,‖ Addictions 99, no. 2 (2004): 93-105,
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1781376/ .
35
Development Services Group, Inc, U.S. Department of Justice, ―Underage Drinking Literature Review,‖
http://www.ojjdp.gov/dso/Underage%20Drinking%20Literature%20Review.pdf (accessed September 6, 2013).
36
Alan Berkowitz, ―An Overview of the Social Norms Approach,‖ Independent Consultant, 2004
http://www.alanberkowitz.com/articles/social_norms.pdf.
37
Ibid.
38
National Institutes of Health, National Institute on Alcohol Abuse and Alcoholism, ―Alcohol Alert: A Developmental
Perspective of Underage Alcohol Use,‖ http://pubs.niaaa.nih.gov/publications/AA78/AA78.htm (accessed June 27, 2013).
39
Enid Gruber, Ralph DiClemente, Martin Anderson, and Mark Lodico, ―Early Drinking Onset and Its Association with Alcohol
Use and Problem Behavior in Late Adolescence,‖ Preventative Medicine, 25 no. 3 (1996): 293-300,
http://www.ncbi.nlm.nih.gov/pubmed/8781007.
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