Risky Behaviors/Injuries
Adolescents typically have an increased desire to experience new things, but experimenting with alcohol is not a good idea.
- Sorenson TJ, Rich MD, Deitermann A, Gotlieb R, Garcia N, Barta RJ, Schubert W. Likelihood of craniofacial injury and hospitalization with alcohol use while skateboarding and scootering. Craniomaxillofac Trauma Reconstr. 2023;16(1):34-8. PubMed PMID: 36824181
- Jennison KM. The short-term effects and unintended long-term consequences of binge drinking in college: a 10-year follow-up study. Am J Drug Alcohol Abuse. 2004 Aug:30(3):659-84. PubMed PMID: 15540499
- Chassin L, Pitts SC, Prost J. Binge drinking trajectories from adolescence to emerging adulthood in a high-risk sample: predictors and substance abuse outcomes. J Consult Clin Psychol. 2002 Feb;70(1):67-78. PubMed PMID: 11860058
Blackouts
- Alcohol-related blackouts are gaps in a person's memory for events that occurred while they were intoxicated. These gaps happen when someone drinks enough alcohol to temporarily block the transfer of memories from short-term to long-term storage—known as memory consolidation—in an area of the brain called the hippocampus.1
- There are two types of blackouts, which are defined by the severity of the memory impairment.
- The most common type is called a fragmentary blackout and is characterized by spotty memories for events, with “islands” of memories separated by missing periods of time in between. This type is sometimes referred to as a grayout or a brownout.
- Complete amnesia, often spanning hours, is known as an en bloc blackout. With this severe form of blackout, memories of events do not form and typically cannot be recovered. To the person experiencing the blackout, it is as if the events simply never occurred.
- Blackouts are quite common among adolescents. In one study, 1 in 5 older adolescents who drank alcohol in the previous 6 months reported an alcohol-induced memory blackout.2
- Research suggests that the earlier a teen starts drinking, the more likely they are to report experiencing blackouts years later, even if they decreased their drinking.3
- Blackouts are not necessarily a sign of alcohol use disorder (AUD), but experiencing even one is a reason for concern. Teens who have a blackout should think about their relationship with alcohol and consider talking to their doctor about their drinking.
For more information, see the National Institute on Alcohol Abuse and Alcoholism fact sheet Interrupted Memories: Alcohol-Induced Blackouts.
- White AM. What happened? Alcohol, memory blackouts, and the brain. Alcohol Res Health. 2003;27(2):186-96. PubMed PMID: 15303630
- Hingson R, Wenxing Z, Simons-Morton B, White A. Alcohol-induced blackouts as predictors of other drinking related harms among emerging young adults. Alcohol Clin Exp Res. 2016 Apr;40(4):776-84. PubMed PMID: 27012148
- Marino EN, Fromme K. Early onset drinking predicts greater level but not growth of alcohol-induced blackouts beyond the effect of binge drinking during emerging adulthood. Alcohol Clin Exp Res. 2016 Mar;40(3):599-605. PubMed PMID: 26853696
Alcohol Overdose
If you suspect someone is experiencing an alcohol overdose, get medical help immediately. Cold showers, hot coffee, food, or walking will NOT reverse the effects of alcohol overdose and could actually make things worse.
For more information, see the National Institute on Alcohol Abuse and Alcoholism fact sheet Understanding the Dangers of Alcohol Overdose.
Alcohol Use Disorder
- Alcohol use disorder (AUD) is a medical condition characterized by an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences. It encompasses the conditions that some people refer to as alcohol abuse, alcohol dependence, alcohol addiction, and the colloquial term “alcoholism.”
- Considered a brain disorder, AUD can be mild, moderate, or severe.
- Research shows that people who start drinking at an earlier age are at a higher risk for developing AUD later in life. For example, adults ages 26 and older who began drinking before age 15 are 4 times more likely to report having AUD in the past year compared to those who waited until age 21 or later to begin drinking.1
- It may be hard to imagine why people with AUD can’t just “use a little willpower” to stop drinking. But severe AUD creates an uncontrollable craving for alcohol. It can be as strong as the need for food and water. People may want to stop because they know that drinking harms their health and their loved ones. But quitting is extremely difficult.
- No matter how severe the problem may seem, most people with AUD can benefit from treatment with behavioral therapies, medications, or both.
- Research indicates that alcohol use during the teenage years can interfere with normal adolescent brain development and increase the risk of developing AUD.
- Research shows that genes are responsible for around 50% of the risk for AUD. Therefore, genes alone do not determine whether someone will develop AUD. Environmental factors play important roles in determining the outcomes, as with other conditions linked to a wide array of genes. For example, having a parent with a drinking problem increases a child's risk for developing an alcohol problem. About 10% of U.S. children ages 17 and younger live with a parent who has AUD.2
- The comparison of risk for an AUD between different ages at drinking onset is based on the prevalence ratio. The estimates are weighted by the person-level analysis weight and derived from the CBHSQ 2021 National Survey on Drug Use and Health (NSDUH-2021-DS0001) public-use data file. Age at drinking onset: age when first drank an alcohol beverage (a can or bottle of beer, a glass of wine or a wine cooler, a shot of liquor, or a mixed drink with liquor in it), not counting a sip or two from a drink. AUD: having met two or more of the 11 AUD diagnostic criteria in the past-year according to the American Psychiatric Association (APA) Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). https://www.datafiles.samhsa.gov/dataset/national-survey-drug-use-and-health-2021-nsduh-2021-ds0001. Accessed February 28, 2023.
- Lipari RN, Van Horn SL. The CBHSQ report: children living with parents who have a substance use disorder. Rockville (MD): SAMHSA, Center for Behavioral Health Statistics and Quality; 2017 Aug 24 [cited 2020 Dec 8]. Available from: https://samhsa.gov/data/sites/default/files/report_3223/ShortReport-3223.html
Brain and Mental Health
- Although a person’s brain generally reaches its maximum size by age 10, the second decade of life brings widespread changes in the organization and functioning of the brain. Changes in brain circuits continue until at least the mid-20s.
- Alcohol misuse during adolescence might cause negative long-term effects because of physical changes in the brain during development.
- Alcohol misuse during adolescence is also associated with reduced size of the frontal lobe (involved in planning and decision-making), hippocampus (involved in memory), amygdala (involved in fear-sensing), and corpus callosum (involved in the communication between the two sides of the brain).1
- A growing body of evidence suggests that the earlier people start drinking alcohol, the more likely they are to experience a measurable negative impact on cognitive functions, memory, and school performance over time—perhaps even into adulthood.2,3
- In some people, a history of adolescent alcohol misuse could increase the likelihood of developing alcohol use disorder, and is associated with mental health disorders such as anxiety and depression during adolescence and later in life.4,5
- The good news is that the ability of the brain to change during adolescence can also help the brain recover from some alcohol-induced consequences.
- Alcohol use and sleep problems in adolescence are linked to an increased risk of depression, which can be made even worse by environmental stressors.6
- As with adults, alcohol plays a role in suicide involving underage people who drink.7
- Infante MA, Eberson SC, Zhang Y, Brumback T, Brown SA, Colrain IM, Baker FC, Clark DB, De Bellis MD, Goldston D, Nagel BJ, Nooner KB, Zhao Q, Pohl KM, Sullivan EV, Pfefferbaum A, Tapert SF, Thompson WK. Adolescent binge drinking is associated with accelerated decline of gray matter volume. Cereb Cortex. 2022 Jun;1;32(12:2611-20. PubMed PMID: 34729592
- White AM, Hingson R. A primer on alcohol and adolescent brain development: implications for prevention. In: Sloboda Z, Petras H, Robertson E, Hingson R, editors. Prevention of substance use: advances in prevention science. Switzerland: Springer Cham; 2019, p. 3-18. Available from: doi.org/10.1007/978-3-030-00627-3_1
- White AM. What happened? Alcohol, memory blackouts, and the brain. Alcohol Res Health. 2003;27(2):186-96. PubMed PMID: 15303630
- Ning K, Gondek D, Patalay P, Ploubidis GB. The association between early life mental health and alcohol use behaviors in adulthood: a systematic review. PloS One. 2020 Feb;15(2):e0228667 PubMed PMID: 32069303
- Chassin L, Pitts SC, Prost J. Binge drinking trajectories from adolescence to emerging adulthood in a high-risk sample: predictors and substance abuse outcomes. J Consult Clin Psychol. 2002 Feb;70(1):67-78. PubMed PMID: 11860058
- Alzueta E, Podhajsky S, Zhao Q, Tapert SF, Thompson WK, de Zambotti M, Yuksel D, Kiss O, Wang R, Volpe L, Prouty D, Colrain IM, Clark DB, Goldston DB, Nooner KB, De Bellis MD, Brown SA, Nagel BJ, Pfefferbaum A, Sullivan EV, et al. Risk for depression tripled during the COVID-19 pandemic in emerging adults followed for the last 8 years. Psychol Med. 2023 Apr: 53(5):2156-63. PubMed PMID: 34726149
- Harding FM, Hingson RW, Klitzner M, Mosher JF, Brown J, Vincent RM, Dahl E, Cannon CL. Underage drinking: a review of trends and prevention strategies. Am J Prev Med. 2016 Oct;51(4 Suppl 2): S148-57. PubMed PMID: 27476384
Diseases and Health Conditions
- World Health Organization (WHO). Global status report on alcohol and health 2018. Geneva, Switzerland: WHO, 2018 [cited 2021 Jun 25]. Available from: https://www.who.int/publications/i/item/9789241565639
- Shield KD, Soerjomataram I, Rehm J. Alcohol use and breast cancer: a critical review. Alcohol Clin Exp Res. 2016 Jun;40(6):1155-81, 2016. PubMed PMID: 27130687
- Li CI, Chlebowski RT, Freiberg M, Johnson KC, Kuller L, Lane D, Lessin L, O’Sullivan MJ, Wactawski-Wende J, Yasmeen S, Prentice R. Alcohol consumption and risk of postmenopausal breast cancer by subtype: the Women's Health Initiative Observational Study. J Natl Cancer Inst. 2010 Sep;102(18):1422-31. PubMed PMID: 20733117
- Allen NE, Beral V, Casabonne D, Wan Kan S, Reeves GK, Brown A, Green J, Million Women Study Collaborators. Moderate alcohol intake and cancer incidence in women. J Natl Cancer Inst. 2009 Mar;101(5):296-305. PubMed PMID: 19244173
For more information about alcohol's effects on the body, please see the NIAAA Interactive Body.
Other sections:
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Need immediate help for mental health and/or substance use problems?
Call the SAMHSA National Helpline at 1-800-662-HELP (4357), or call or text 988 to reach the 988 Suicide & Crisis Helpline