10 Teen Alcohol Abuse: Awareness, Action, Change

This chapter is based on the Social Ecological Model.

Alcohol abuse is not just an adult problem. In 2022, over 29 million Americans over the age of twelve were reported to have an alcohol use disorder (AUD) (Substance Abuse and Mental Health Services Administration [SAMHSA], 2023). This ongoing health issue affects an individual’s brain function and behaviors, which makes it challenging to control alcohol consumption despite negative consequences. Long-term alcohol use can lead to poor decision-making, mental health disorders, and increased risks of injury, liver disease, and other health complications (Rehm, 2011).

Depending on the signs a person shows, AUD can range from mild to severe. Common signs include difficulty controlling alcohol consumption, problems cutting back, and spending excessive time drinking or recovering (Cleveland Clinic, 2024). AUD can disrupt daily activities, leading to forgotten responsibilities, poor relationships, and withdrawal from social or work activities (Koob et al., 2025). Many continue drinking despite negative consequences and engage in dangerous behaviors like drinking and driving (Mayo Clinic Staff, 2022).

In most cases, AUD begins developing in the teen years and becomes common for people ages 20 to 30 (Mayo Clinic Staff, 2022). Key risk factors include prolonged drinking, binge drinking, and starting at a young age (National Institute on Alcohol Abuse and Alcoholism, 2025). Family history, especially if a parent or close relative has alcohol problems, can increase susceptibility (Reed, 2025). Mental health issues (e.g., depression or anxiety) and social influences (e.g., friends or partners who drink regularly) may cause a person to turn to alcohol (Mayo Clinic Staff, 2022). Furthermore, media portrayal of drinking and peer pressure significantly influence young people (Atkinson et al., 2011). However, when individuals recognize these signs, build healthy relationships with respectful peers and family, engage with a supportive community, and advocate for stronger government policies, they can help reduce these risks.

Individual

Many personal factors can increase a teen’s risk of developing AUD, such as an individual’s personality, mental health, social skills, and self-esteem. Teens who are impulsive or take risks are more likely to drink heavily, as well as those with anxiety, depression, or past trauma (Rada et al., 2024; Puddephatt et al., 2022). In addition, poor stress management and low confidence in handling challenges can also lead to drinking (Dawson et al., 2005; DiBello et al., 2020). Furthermore, teens who struggle to control their emotions may turn to alcohol to manage negative feelings (Zaorska et al., 2023).

One helpful resource for recognizing alcohol problems is the Centers for Disease Control and Prevention’s (CDC) Alcohol Use Disorder quiz. This quiz helps teens and adults understand their drinking habits and whether they need support (CDC, 2025). In addition, teens can build healthy coping skills by participating in programs like Alcoholics Anonymous (AA). AA meetings offer accessible resources to support individuals who are seeking help for their alcohol dependence (Kelly et al., 2020). These programs help to increase an individual’s mental well-being, strengthen interpersonal skills, improve stress management, and support the transition to a sober and alcohol-free lifestyle (Kelly et al., 2009).

Relationships

Although it is ultimately the individual’s decision, their social circle and relationships can easily be the deciding factor in causing or preventing alcohol abuse. Friends can influence teen drinking, as peer pressure and being around individuals who drink can increase a teen’s likelihood of misusing alcohol (Beckmeyer & Weybright, 2018). However, choosing supportive friends who are alcohol-free can help prevent misuse (Beckmeyer & Weybright, 2018).

Parenting strategies also play a large role in the likelihood of a child developing an alcohol misuse disorder (Harmony Ridge Recovery Center, 2023). Research has shown that the best form of parenting style to prevent alcohol abuse in kids is authoritative parenting (Harmony Ridge Recovery Center, 2023). This style of parenting encourages youth to be openly communicative, allowing parents to offer insightful advice regarding alcohol consumption in a nonjudgmental way (Harmony Ridge Recovery Center, 2023). On the other hand, if a child is raised by parents who have adopted an authoritarian style, they may be more likely to drink as a way to escape (Harmony Ridge Recovery Center, 2023). Parents having honest conversations with their children regarding social circles and setting boundaries have better alcohol outcomes (Anzilotti, 2020).

Community

Schools can promote early intervention programs that foster a secure place to learn and talk about alcohol abuse in order to encourage resilience. Educational-driven programs, such as Drug Abuse Resistance Education (D.A.R.E.), teach children in schools to withstand peer pressure and understand alcohol’s harmful effects (D.A.R.E., n.d.). After-school activities can serve as a great protective factor when accessible (Peterson, 2018). Excel Beyond the Bell youth program offers academic support, transportation to and from school, and warm, nourishing meals at no cost (Excel Beyond the Bell, n.d.). Vermont students who participated in up to 19 hours of extracurricular activities per week were less likely to use drugs, including alcohol (Morehouse, 2021).

Colleges also have a role to prevent alcohol abuse in teens’ lives by incorporating educational programs such as AlcoholEdu (Vector Solutions, 2025). AlcoholEdu aims to teach incoming college students about the dangers of alcohol misuse, supporting non-drinking options, and how to help as a bystander (Vector Solutions, 2025). The personalized content helps students recognize their drinking habits based on whether or how much they drink (Vector Solutions, 2025).

Cultural and social factors within neighborhoods and communities influence teens to drink. For instance, communities where alcohol use is common and easily accessible may accidentally encourage higher consumption rates (Sudhinaraset et al., 2016). However, strong enforcement of alcohol regulations and community-led programs can combat teen alcohol use. For example, the Drug-Free Communities (DFC) Support Program, run by the CDC and the Office of National Drug Control Policy, helps schools, parents, and local groups work together to prevent youth substance use (CDC, n.d.). Students Against Destructive Decisions (SADD) encourages teens to make healthy choices through group discussions with classmates and awareness events (SADD, n.d.). Communities can use these programs, along with stricter alcohol rules and better education, to improve teen safety.

Societal

Public policies enforced by society can lower alcohol misuse in teenagers. The National Minimum Drinking Age (MLDA) Act of 1984, one of the most well-known efforts, set the minimum drinking age to 21 and saved more than 1,000 teenage lives each year (Toomey et al., 1996). By restricting alcohol access during late adolescence, teens who can’t drink have a decreased risk for alcohol problems into mid-adulthood (Plunk et al., 2016). However, some teenagers still manage to obtain alcohol by using false identification, which contributes to the beginning of early alcohol use (Arria et al., 2014).

In order to prevent teenagers from purchasing alcohol, society must take the initiative to make alcohol less available. Communities can accomplish this by decreasing the number of establishments that sell alcohol and increasing the distance between them (CDC, 2024). Additionally, the government can increase the price of beverages by raising taxes on them, which would likely discourage younger adults from buying (CDC, 2024). In addition, MLDA laws have been primarily focused on punishing youth for illegally purchasing alcohol rather than starting at the source (Toomey et al., 1996). To minimize abuse, establishments should enforce training on how to check identification cards properly. Local law enforcement should also check sellers for identification compliance and encourage advertised warning signs of selling strictly to those 21 years of age and older (Toomey et al., 1996).

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