Alcohol is one of the most widely used drug substances in the world.

TEEN DRINKING

Alcohol use is not only an adult problem. It's a teen problem too. Most American high school seniors have had an alcoholic drink within the past month. This is in spite of the fact that the legal drinking age is 21 years old in the United States.

About 15 percent of teens report using alcohol in the past month. About 8 percent of teens report binge drinking in the past month. Many of these are problem drinkers. This means that they:

• Get drunk
• Have accidents related to alcohol use
• Get into trouble with the law, family members, friends, school, or dates because of alcohol

THE EFFECTS OF ALCOHOL

Alcoholic drinks have different amounts of alcohol in them.

• Beer is about 5% alcohol, although some beers have more.
• Wine is usually 12% to 17% alcohol.
• Hard liquor is about 40% alcohol.

Alcohol gets into your bloodstream quickly.

The amount and type of food in your stomach can change how quickly this occurs. For example, high-carbohydrate and high-fat foods can make your body absorb alcohol more slowly.

Certain types of alcoholic drinks get into your bloodstream faster. Stronger drinks tend to be absorbed faster.

Alcohol slows your breathing rate, heart rate, and how well your brain functions. These effects may appear within 10 minutes and peak at around 40 to 60 minutes. Alcohol stays in your bloodstream until it is broken down by the liver. The amount of alcohol in your blood is called your blood alcohol level. If you drink alcohol faster than the liver can break it down, this level rises.

Your blood alcohol level is used to legally define whether or not you are drunk. The legal limit for blood alcohol is 0.08 in the United States. Below is a list of blood alcohol levels and the likely symptoms:

• 0.05 -- reduced inhibitions
• 0.10 -- slurred speech
• 0.20 -- euphoria and motor impairment
• 0.30 -- confusion
• 0.40 and over -- stupor, coma, breathing stops and death

You can have symptoms of being drunk at blood alcohol levels below the legal definition of being drunk. Also, people who drink alcohol frequently may not have symptoms until a higher blood alcohol level is reached.

HEALTH RISKS OF ALCOHOL

Alcohol consumption increases the risk of:

• Alcoholism
• Falls, drownings, and other accidents
• Head, neck, stomach, colon, breast, and other cancers
• Heart attack and stroke
• Motor vehicle accidents
• Risky sex behaviors, unplanned or unwanted pregnancy, and sexually transmitted infections (STIs)
• Suicide and homicide

Drinking during pregnancy can harm the developing baby. Severe birth defects or fetal alcohol syndrome are possible.

RESPONSIBLE DRINKING

If you drink alcohol, it is best to do so in moderation. Moderation means the drinking is not getting you intoxicated (or drunk) and you are drinking no more than 1 drink per day if you are a woman and no more than 2 if you are a man. A drink is defined as 12 ounces (oz) or 350 milliliters (mL) of beer, 5 oz or 150 mL of wine, or 1.5 oz or 45 (mL) of liquor.

Here are some ways to drink responsibly, provided you do not have a drinking problem, are of legal age to drink alcohol, and are not pregnant:

• Never drink alcohol and drive a car.
• If you are going to drink, have a designated driver, or plan an alternative way home, such as a taxi, rideshare, or bus.
• Do not drink on an empty stomach. Snack before and while drinking alcohol. 

If you are taking medicines, including over-the-counter medicines, check with your health care provider before drinking alcohol. Alcohol can make the effects of many medicines stronger. It can also interact with other medicines, making them ineffective, dangerous, or make you sick.

If alcohol misuse runs in your family, you may be at increased risk of developing this disease yourself. So, you may want to avoid drinking alcohol altogether.

CONTACT YOUR HEALTH CARE PROVIDER IF:

• You are concerned about your personal alcohol use or that of a family member
• You are interested in more information regarding alcohol use or support groups
• You are unable to reduce or stop your alcohol consumption, in spite of attempts to stop drinking

Other resources include:

• Local Alcoholics Anonymous or Al-Anon/Alateen groups
• Local hospitals
• Public or private mental health agencies
• School or work counselors
• Student or employee health centers

If you or someone you know is thinking about suicide, call or text 988 or chat 988lifeline.org. You can also call 1-800-273-8255 (1-800-273-TALK). The 988 Suicide and Crisis Lifeline provides free and confidential support 24/7, anytime day or night.

You can also call 911 or the local emergency number or go to the hospital emergency room. DO NOT delay.

If someone you know has attempted suicide, call 911 or the local emergency number right away. DO NOT leave the person alone, even after you have called for help.

Beer consumption; Wine consumption; Hard liquor consumption; Safe drinking; Teen drinking

American Psychiatric Association website. Substance-related and addictive disorders. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Text Revision (DSM-5-TR), Washington, DC: American Psychiatric Association Publishing; 2022.

National Institute on Alcohol Abuse and Alcoholism website. Alcohol's effects on health. www.niaaa.nih.gov/alcohols-effects-health. Accessed June 3, 2024.

National Institute on Alcohol Abuse and Alcoholism website. Understanding alcohol use disorder. www.niaaa.nih.gov/publications/brochures-and-fact-sheets/understanding-alcohol-use-disorder. Updated July 2024. Accessed August 27, 2024.

O'Connor PG. Alcohol use disorders. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 364.

Sherin K, Seikel S, Hale S. Alcohol use disorders. In: Rakel RE, Rakel DP, eds. Textbook of Family Medicine. 9th ed. Philadelphia, PA: Elsevier; 2016:chap 48.

US Preventive Services Task Force, Curry SJ, Krist AH, et al. Screening and behavioral counseling interventions to reduce unhealthy alcohol use in adolescents and adults: US Preventive Services Task Force recommendation statement. JAMA. 2018;320(18):1899-1909. PMID: 30422199 pubmed.ncbi.nlm.nih.gov/30422199/.

Updated by: Fred K. Berger, MD, addiction and forensic psychiatrist, Scripps Memorial Hospital, La Jolla, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. Editorial update 08/27/2024.