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More young people use alcohol than any other drug, including tobacco or marijuana.

Substance Abuse and Mental Health Services Administration. (2011).Report to Congress on the Prevention and Reduction of Underage Drinking. From

http://store.samhsa.gov/product/Report-to-Congress-on-the-Prevention-and-Reduction-of-Underage-Drinking/SMA11-4645

(accessed March 26, 2012).

Prevalence

In 2010, an Estimated 10 Million 12- to 20-Year-Olds Reported Drinking

• More than one out of every four 12- to 20-year-olds reported drinking alcohol.

Of this number: • 17% were binge drinkers (consuming five or more

drinks at one time in the last 2 weeks); and • 5.1% were heavy drinkers (binge drinking on at least 5

days out of the past month).

Substance Abuse and Mental Health Services Administration. (2011).Results from the 2010 National Survey on Drug Use and Health: Summary of National Findings. From

http://www.samhsa.gov/data/NSDUH/2k10Results/Web/PDFW/2k10Results.pdf (accessed March 26, 2012).

Alcohol Use Begins Early and Increases Rapidly With Age

Peak period of first use of alcohol: 7th–10th grades:

• 10% of 9- to 10-year-olds have already started drinking; and

• More than 20% of underage drinkers begin before they are 13 years old.

Substance Abuse and Mental Health Services Administration. (2011).Report to Congress on the Prevention and Reduction of Underage Drinking. From

http://store.samhsa.gov/product/Report-to-Congress-on-the-Prevention-and-Reduction-of-Underage-Drinking/SMA11-4645 (accessed March 26, 2012).

Initiated Alcohol Use

• An estimated 2,842 young people ages 12 to 14 initiated alcohol use per day in 2009.

• More than 1 million youth under age 15 initiate alcohol use each year.

Substance Abuse and Mental Health Services Administration. (2011).Report to Congress on the Prevention and Reduction of Underage Drinking. From

http://store.samhsa.gov/product/Report-to-Congress-on-the-Prevention-and-Reduction-of-Underage-Drinking/SMA11-4645

(accessed March 26, 2012).

Most Likely Place Where Underage Alcohol Use Occurs?

• Your home or the home of your child’s friend:– Of 12- to 20-year-olds who were current drinkers

in 2010, 30.3% drank in their own home; and – More than half (53.4%) drank in someone else’s

home.

Substance Abuse and Mental Health Services Administration. (August 28, 2008).Underage alcohol use: Where do young people drink? The NSDUH Report. From

http://oas.samhsa.gov/2k8/location/underage.htm (accessed March 26, 2012).

Alcohol Use by College Students Often Begins in High School

• Among 12th graders:

– 40% are current drinkers; and – 89% say that it is fairly easy or very easy to get

alcohol.

Johnston, L. D., O’Malley, P. M., Bachman, J. G., &Schulenberg, J. E. (2012). Monitoring the Future

National Results on Adolescent Drug Use: Overview ofKey Findings, 2011.

Those who begin drinking alcohol before the age of 15 are 6.6 times more likely than those

who start at age 21 and older to develop alcohol problems.

Substance Abuse and Mental Health Services Administration. (2011).Results from the 2010 National Survey on Drug Use and Health: Summary of National Findings . From

http://www.samhsa.gov/data/NSDUH/2k10Results/Web/PDFW/2k10Results.pdf (accessed March 26, 2012).

Alcohol Use by Full-Time College Students, Ages 18 to 22

• Common and• Excessive:

– 63.3% are current drinkers;– 42.2% are binge drinkers; and– 15.6% are heavy drinkers.

Johnston, L. D., O’Malley, P. M., Bachman, J. G., &Schulenberg, J. E. (2012). Monitoring the Future

National Results on Adolescent Drug Use: Overview ofKey Findings, 2011.

In 2010, of 12- to 20-Year-Olds Who Drank Alcohol:

• 30.6%, or almost one in three, paid for it themselves; • 26.4%, or more than one in four, got it free from a

nonrelative age 21 or older; • 14.6% got it free from another underage person; • 5.9% got it free from a parent or guardian; and • 8.5% received it free from another relative age 21 or

older.Substance Abuse and Mental Health Services Administration. (November 20, 2008).

Underage alcohol use: Where do young people get alcohol? The NSDUH Report. From http://oas.samhsa.gov/2k8/underagegetalc/underagegetalc.htm

(accessed March 26, 2012).

College Student Treatment Admissions

46% of all substance abuse treatment admissions were primarily related to alcohol

disorders.

The DAWN Spotlight. (February 7, 2012). Nearly Half of College Student Treatment Admissions

Were for Primary Alcohol Abuse. From http://www.samhsa.gov/data/spotlight/Spotlight054College2012.pdf

(accessed March 26, 2012).

In 2009, 64,831 12- to 20-year-olds were admitted for alcohol treatment in the United

States, accounting for 8% of all treatment admissions for alcohol abuse.

Underage Drinking Enforcement Training Center. (N.D.). Underage Drinking Costs. From http://www.udetc.org/UnderageDrinkingCosts.asp (accessed March 26, 2012).

Consequences

Underage drinking contributes to a range of costly health and social problems, including traffic fatalities, suicide, physical and sexual

assaults, brain impairment, alcohol dependence, academic problems, and alcohol and drug

poisoning.

Substance Abuse and Mental Health Services Administration. (2011).Report to Congress on the Prevention and Reduction of Underage Drinking. From

http://store.samhsa.gov/product/Report-to-Congress-on-the-Prevention-and-Reduction-of-Underage-Drinking/SMA11-4645

(accessed March 26, 2012).

Between 1999 and 2008, Hospitalizations Among 18- to

24-year-olds Increased by:

• 25% for alcohol overdoses;• 56% for drug overdoses; and • 76% for combined alcohol/drug overdoses.

White, A. M., Hingson, R. W., Pan, I. J., & Yi, H. Y. (2011). Hospitalizations for alcohol and drug overdoses in young adults ages 18–24 in the United States, 1999–2008:

Results from the nationwide inpatient sample. Journal of Studies on Alcohol and Drugs, 72(5), 774–786.

During 2009, Underage Alcohol Use Contributed to an Estimated:

• 1,506 traffic fatalities and 36,963 nonfatal traffic injuries; • 1,844 homicides; • 949,400 nonfatal violent crimes such as rape, robbery,

and assault; • 1,811,300 property crimes, including burglary, larceny,

and car theft; and • 28,161 teen pregnancies and 937,972 teens having risky

sex.

Underage Drinking Enforcement Training Center. (N.D.). Underage drinking costs. From http://www.udetc.org/UnderageDrinkingCosts.asp (accessed March 26, 2012).

Students Between the Ages of 18 and 24

• 400,000 had unprotected sex. • More than 100,000 report having been too

intoxicated to know if they consented to having sex.

Hingson, R. W., Heeren, T., Zakocs, R. C., Kopstein, A., & Wechsler, H. (2002). Magnitude of alcohol-related mortality and morbidity among U.S. college students ages 18–24.

Journal of Studies on Alcohol 63(2),136–144. From http://www.collegedrinkingprevention.gov/StatsSummaries/snapshot.aspx(accessed March 26, 2012).

Alcohol Use by College Students, Ages 18 to 24, Can Be Deadly

Each year:• 1,825 die from unintentional injuries1;• 3,360,000 drive while intoxicated1; and• 4.0% seriously thought about suicide, and 1.2%

attempt suicide due to alcohol or drug use.2

1Hingson, R. W., Zha, W., & Weitzman, E. R. (2009).

Magnitude of and trends in alcohol-related mortality and morbidity among U.S. college students ages 18–24, 1998–2005.

Journal of Studies on Alcohol And Drugs, Supp. 16, 12–20.

2Core Institute, Southern Illinois University. (2011). Core Alcohol and Drud Survey Long Form—Form 194, Executive Summary.

Carbondale, IL. From http://core.siu.edu/pdfs/report09.pdf(accessed March 26, 2012).

STD in the Past Year• Likelihood of STD was related to the frequency of alcohol use

during the past month.• Similar patterns were found for males and females.• Among 18- to 25-year-olds, 1.4% of those who did not drink

alcohol in the past month had a past-year STD compared with:– 2.5% of those who drank but did not binge on alcohol in the past

month; – 2.4% of those who engaged in past-month binge alcohol use but not

heavy use; and – 3.1% of past-month heavy alcohol users.

Substance Abuse and Mental Health Services Administration, Office of AppliedStudies. (March 30, 2007). The NSDUH Report: Sexually Transmitted Diseases

and Substance Use. Rockville, MD. From http://oas.samhsa.gov/2k7/STD/STD.pdf(accessed March 26, 2012).

Alcohol Use

• People infected with HIV are nearly twice as likely to use alcohol as people in the general population.

• Up to 50% of adults with HIV infection have a history of alcohol problems.3,4

3Lefevre, F., O’Leary, B., Moran, M., Mossar, M., Yarnold, P. R., Martin, G. J., et al. (1995).Alcohol consumption among HIV-infected patients. Journal of General Internal Medicine, 10(8), 458–460.

From PMID: 7472704 (accessed March 26, 2012).4Samet, J. H., Phillips, S. J., Horton, N. J., Traphagen, E. T., & Freedberg, K. A. (2004). Detecting alcohol problems in HIV-infected

patients: Use of the CAGE questionnaire. AIDS Research and Human Retroviruses, 20(2), 151–155. From PMID: 15018702 (accessed March 26, 2012).

Cost to U.S. Citizens

Underage drinking costs an estimated $62.0 billion in 2010 for related: • Medical care;• Work loss; and • Associated pain and suffering.

Underage Drinking Enforcement Training Center. (N.D.). Underage drinking costs. From http://www.udetc.org/UnderageDrinkingCosts.asp (accessed March 26, 2012).

Trends

Concern

According to the Pacific Institute for Research and Evaluation:• 92% of the alcohol consumed by 12- to 14-year-olds

is through binge drinking.

Substance Abuse and Mental Health Services Administration. (2011).Report to Congress on the Prevention and Reduction of Underage Drinking. From

http://store.samhsa.gov/product/Report-to-Congress-on-the-Prevention-and-Reduction-of-Underage-Drinking/SMA11-4645(accessed March 26, 2012).

Alcohol Use by Girls Is Up

• Adolescent females now exhibit rates of drinking, binge drinking, and drunkenness similar to rates for adolescent males.

• Certain consequences of alcohol use (e.g., unintended pregnancy, sexually transmitted diseases, and interpersonal violence) may be expected to increase as a result.

Substance Abuse and Mental Health Services Administration. (2011).Report to Congress on the Prevention and Reduction of Underage Drinking. From

http://store.samhsa.gov/product/Report-to-Congress-on-the-Prevention-and-Reduction-of-Underage-Drinking/SMA11-4645 (accessed March 26, 2012).

Distilled Spirits Are:

• Becoming more popular among adolescents. • Challenging beer as the beverage most likely

to be consumed by underage drinkers.• Frequently involved in binge drinking.

Substance Abuse and Mental Health Services Administration. (2011).Report to Congress on the Prevention and Reduction of Underage Drinking. From

http://store.samhsa.gov/product/Report-to-Congress-on-the-Prevention-and-Reduction-of-Underage-Drinking/SMA11-4645

(accessed March 26, 2012).

Communities Can Prevent Underage Alcohol Use!

• Responsible beverage service • Happy hour restrictions• Controls on alcohol outlet location and density • Restricted sales of alcohol at public events • Other types of environmental prevention

Environmental Prevention

SAMHSA 2012 Town Hall Meetings on Underage Drinking Prevention

• Theme: Getting to Outcomes • Types of environmental prevention:

– Responsible beverage service; – Alcohol compliance checks; – Happy hour restrictions; – Controls on alcohol outlet location and density; – Sobriety and traffic safety checkpoints; – Graduated driver licensing laws; – Social host liability laws; – Restricted sales of alcohol at public events; and – Increased taxes on sales of alcohol.

Responsible Beverage Service

• Is designed to reduce sales to minors and intoxicated adults.• Targets both on- and off-premises alcohol retailers.• Eliminates lax enforcement of minimum legal drinking age

laws by merchants. • Trains servers to increase familiarity with State and local

restrictions on:– Alcohol service;– Failure to recognize false identification; and – Continued service to intoxicated patrons.

Alcohol Compliance Checks

• Deter alcohol outlets from selling alcohol to underage youth.

• Involve law enforcement officials, who supervise undercover youth attempting to purchase alcohol:– Penalties are imposed on the alcohol outlet if the

attempt is successful.• Are most effective when: – Frequent;– Well publicized; and– Well designed.

Happy Hour Restrictions

• Alcohol promotions may encourage underage drinking by making alcohol more affordable and appealing.

• Happy hour restrictions are aimed at reducing the tragic consequences of overconsumption by limiting: – Drink promotions, such as reduced pricing during specific

days or times; – Free beverages or unlimited beverages at a set price and

time; – Increased drink volume; and – Drinks offered as prizes.

Controls on Alcohol Outlet Location and Density

• Applying regulatory authority, implemented through licensing or zoning processes, can reduce or limit the number of alcohol outlets in a given area.

• Reducing the density of alcohol outlets can result in fewer drinking-related problems, including violence, crime, alcohol-involved traffic crashes, and injuries.

Centers for Disease Control and Prevention. (N.D.). Preventing excessive alcohol consumption:

Regulation of alcohol outlet density. Guide to Community Preventive Services. From http://www.thecommunityguide.org/alcohol/outletdensity.html (accessed March 26, 2012).

Sobriety and Traffic Safety Checkpoints

• “… traffic stops where law enforcement officers systematically select drivers to assess their level of alcohol impairment. The goal of these interventions is to deter alcohol-impaired driving by increasing drivers’ perceived risk of arrest.”5

• Checkpoints, when combined with a vigorous awareness campaign, tend to decrease alcohol-related traffic crashes and fatalities among youth.

5Centers for Disease Control and Prevention. (N.D.). Research update: Sobriety checkpoints are effective in reducing alcohol-related crashes. From

http://www.cdc.gov/MotorVehicleSafety/Impaired_Driving/checkpoint.html(accessed March 26, 2012).

National Highway Traffic Safety Administration. (April 2006). Low-Staffing Sobriety Checkpoints. From http://www.nhtsa.gov/people/injury/enforce/LowStaffing_Checkpoints/ (accessed March 26, 2012).

Graduated Driver Licensing Laws

• Are laws designed to gradually introduce new young drivers to different driving circumstances:– Transporting passengers; or – Driving at night.

• Allow beginners to gain experience driving as they move from a highly supervised permit to a supervised license with restrictions and then to a full-privileged driver’s license.

• Help prevent conditions under which young people may be at increased risk of alcohol-related traffic injuries or death:– May limit youth driving between midnight and 3 a.m., during

which time 55% of drivers involved in fatal crashes were alcohol impaired.

Social Host Liability Laws• These laws try to prevent youth from obtaining alcohol from older

adults (e.g., parents, siblings, and friends).• Noncommercial servers of alcohol (homeowners or parents) are held

liable in the event that they provide alcohol to a minor or an obviously inebriated individual whose alcohol use later contributes to injury or death to a third party.

• Extent of these laws varies from State to State; however, research has shown that these laws are associated with reductions in heavy drinking and with drinking and driving.

• One study found that social host liability laws reduced the drunk driving fatality rate among 18- to 20-year-olds by 9%.

• These laws encourage adults to think twice before purchasing alcohol for youth or allowing underage youth to drink in their homes.

Restricted Sales of Alcohol at Public Events

• Implementation of policies, voluntary or mandated by local legislation, which control the availability and use of alcohol at concerts, street fairs, sporting games, tailgate parties, and other public venues.

• Tighter controls on alcohol availability have been shown to reduce underage drinking by protecting youth from access to alcohol at public events.

• These controls may also reduce alcohol-related problems, such as traffic crashes, vandalism, fighting, and other public disturbances.

Increased Taxes on Sales of Alcohol

• Price affects how much people will consume.• Price affects the number of alcohol-related

problems people will cause or experience.• Consumption can be discouraged by increasing

taxes on alcohol.• Research indicates that raising the alcohol

excise tax results in benefits, such as reduced medical costs, that substantially outweigh the costs of implementing a tax increase.

Prevent Underage Drinking in Your Community!

Anyone can help; all are needed. 2012 Town Hall Meetings