Alcohol Use - Youth in Massachusetts

Massachusetts

Alcohol is the most commonly used substance among high school students in the United States. In 2024, there were an estimated 42,300 alcohol-related emergency department visits among children under the age of 18. Each year, approximately 4,000 youth under 21 die from excessive drinking in the U.S. 

Other adverse outcomes associated with underage drinking include:

• Delayed puberty.
• Depression, anxiety and other mental illnesses.
• Academic issues, such as increased absences and lower grades.
• Impaired judgment, which can lead to engaging in risky behaviors like violence, driving under the influence and unsafe sexual behavior.
• Legal consequences of actions taken while under the influence.
• Higher risk of developing an alcohol use disorder later in life.

Adolescence is a high-risk period for binge drinking. Most alcohol consumption among underage drinkers occurs in binge episodes. Underage drinkers consume an average of four to five drinks per drinking episode, nearly twice the amount of an average adult. Binge drinking is more likely to lead to alcohol poisoning and fatal accidents. It has been linked to decreased cognitive functioning among adolescents during a critical and vulnerable time in their neurodevelopment. Underage binge drinking also increases the risk of physical and sexual assault. In 2023, 84.3% of adolescents ages 15-17 years old reported getting their alcoholic beverage for free the last time they drank.

The economic burden of underage drinking in the U.S. totaled $56.9 billion in 2013, including direct and indirect costs.

The prevalence of alcohol use is higher among:

• Girls compared with boys.
• Non-Hispanic white and Hispanic youth compared with non-Hispanic Black youth.
• Lesbian, gay and bisexual students compared with students who identify as heterosexual, questioning or other.
• Youth ages 16-17 compared with those ages 12-13.

Strategies to prevent excessive drinking, including underage alcohol use, include:

• Increasing alcohol taxes.
• Regulating and restricting the number and concentration of alcohol stores. 
• Enforcing the law against selling alcohol to youth.
• Implementing dram shop liability laws, which hold liquor establishments legally responsible for harm caused by or to minors to whom they have sold alcohol.
• Reducing exposure to alcohol advertising.
• Screening for alcohol use by health practitioners.

Parents have a strong influence on a child’s attitude toward alcohol. In 2025, one survey found 50% of adolescents described their parents as the leading influence on their decision to drink or not. Communicating the dangers of alcohol to children and setting a good example can help young people make good decisions about alcohol. Parents should also set clear boundaries around alcohol use. The Substance Abuse and Mental Health Services Administration’s “Talk. They Hear You." campaign provides more resources and information to help parents, teachers and community members have conversations about and take action against underage drinking.

In 2007, the Office of the Surgeon General published the Call to Action to Prevent and Reduce Underage Drinking, as well as a shorter guide to community action using the approaches detailed in the full report. Additionally, the Community Guide maintains a list of evidence-based strategies to prevent and reduce excessive alcohol use among youth.

Healthy People 2030 has a goal to reduce the number of adolescents ages 12-17 who reported drinking alcohol in the past month.

Chung, Tammy, Kasey G. Creswell, Rachel Bachrach, Duncan B. Clark, and Christopher S. Martin. “Adolescent Binge Drinking.” Alcohol Research: Current Reviews 39, no. 1 (2018): 5–15. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6104966/.

Dees, William L., Jill K. Hiney, and Vinod K. Srivastava. “Alcohol and Puberty: Mechanisms of Delayed Development.” Alcohol Research: Current Reviews 38, no. 2 (2017): 277–82. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5513690/.

Hoots, Brooke E., Jingjing Li, Marci Feldman Hertz, Marissa B. Esser, Adriana Rico, Evelyn Y. Zavala, and Christopher M. Jones. “Alcohol and Other Substance Use Before and During the COVID-19 Pandemic Among High School Students — Youth Risk Behavior Survey, United States, 2021.” MMWR Supplements 72, no. 1 (April 28, 2023): 84–92. https://doi.org/10.15585/mmwr.su7201a10.

Lees, Briana, Lindsay R. Meredith, Anna E. Kirkland, Brittany E. Bryant, and Lindsay M. Squeglia. “Effect of Alcohol Use on the Adolescent Brain and Behavior.” Pharmacology Biochemistry and Behavior 192 (May 2020): 172906. https://doi.org/10.1016/j.pbb.2020.172906.

Substance Abuse and Mental Health Services Administration. Drug Abuse Warning Network (DAWN): National Estimates From Drug-Related Emergency Department Visits, 2024. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Administration, Center for Behavioral Health Statistics and Quality, 2025. https://www.samhsa.gov/data/sites/default/files/reports/rpt56252/dawn-national-estimates-2024.pdf.

U.S. Department of Health and Human Services. The Surgeon General’s Call to Action To Prevent and Reduce Underage Drinking. Rockville, MD: U.S. Department of Health and Human Services, Office of the Surgeon General, 2007. http://www.ncbi.nlm.nih.gov/books/NBK44360/.

U.S. Department of Health and Human Services. The Surgeon General’s Call to Action To Prevent and Reduce Underage Drinking: A Guide to Action for Communities. Rockville, MD: U.S. Department of Health and Human Services, Office of the Surgeon General, 2007.https://www.hhs.gov/sites/default/files/underage-drinking-community-guide.pdf.