The list of severe and often tragic consequences related to underage drinking is remarkable: fatal car crashes, rape, unwanted pregnancy, suicide, homicide, academic failure, vandalism, alcohol poisoning, alcoholism, and more.

It is no wonder the theme of Alcohol Awareness Month in April is "Save a Life--End Underage Drinking." The National Council on Alcoholism and Drug Dependence (NCADD) has been sponsoring this public awareness campaign since 1987, and virtually every year it makes underage drinking the main focus. And for good reason: Underage drinking is a critical public health issue in America. Drinking is associated with the leading causes of death among young people, including car crashes, unintentional injuries, murder, and suicide. A 16-year-old is more likely to die from a drinking-related problem than any other cause.

Consider a few telling statistics on youth and alcohol:

• About 6.8 million young people ages 12-20 were binge drinkers (consuming five or more drinks in a row on a single occasion) in the last month, and 2.1 million were heavy drinkers (binging at least five times in the month).
• About 8 percent of the nation's eighth-graders, 24 percent of tenth-graders, and 32 percent of twelfth-graders have been drunk during the last month.
• Total cost of alcohol use by youth is more than $58 billion per year.
• About two thirds of teens who drink report that they can buy their own alcoholic beverages.
• Teens 15 and older who drink are seven times likelier to have sexual intercourse than nondrinkers.
• Alcohol use is implicated in up to two thirds of sexual-assault and acquaintance-rape cases among teens and college students.

"As a society," says Stacia Murphy, NCADD's president, "we have to do a better job of persuading our citizens and our young people that alcohol use is a dead end, that they're playing Russian Roulette, not only with their own lives, but with the lives of friends, neighbors, and loved ones."

Murphy quashes the notion of alcohol use as a rite of passage for young people. Rather, it's "a passage for some young souls into a lifetime of broken promises, broken families, and broken lives," she says. "Alcohol is not a kid's drink, plain and simple. That's the reason teenage drinking is a violation of the 21 minimum legal drinking age."

Indeed, scientific evidence suggests that young people may be especially vulnerable to the ravages of alcohol use and abuse. Research over the past 15 years has helped us define addiction as a brain disease, one that results in fundamental, long-lasting changes in the biochemical makeup of the brain and its function. More recently, research from Yale University suggests that because the area of an adolescent's brain that controls impulsive behavior is not fully formed, it may put young people who experiment with alcohol and other drugs at greater risk for becoming addicted than nonusers.

A 1998 study by the National Institute on Alcohol Abuse and Alcoholism supports this finding. It found that the younger the age of drinking onset, the greater the chance that an individual at some point in life will develop an alcohol disorder. For instance, young people who began drinking before age 15 were four times more likely to develop alcohol dependence than those who began drinking at age 21. Overall, the risk for alcohol dependence decreases by 14 percent with each increasing year of age of drinking onset. Similarly, the prevalence of alcohol abuse declined as drinking age rose.

Experts in the addiction research and prevention fields agree that every day our youth choose not to drink improves their chances of avoiding long-term problems with alcohol abuse and preventing the tragic consequences of alcohol-related accidents. The bottom line: Young people and their brains simply can't handle alcohol.

Underage drinking is a complex problem that requires a sustained, cooperative effort of parents, schools, community leaders, and young people themselves. For more on NCADD's Alcohol Awareness Month and links to other prevention-oriented organizations, go to http://www.ncadd.org/ or call 212-269-7797.

--Published April 19, 2004