Teen alcohol use is a serious concern for parents. Understanding the risk factors associated with teen alcohol abuse is crucial to providing effective prevention and early intervention if necessary.

Teen alcohol abuse is a serious concern for both parents and those who interact with teenagers because alcohol is the most accessible and widely used substance of abuse among teenagers.

According to the 2018 National Survey on Drug Use and Health (NSDUH), an estimated nine percent of American adolescents aged 12 to 17 were current drinkers, meaning they had at least one drink in the past 30 days. The major consequences of underage drinking include health and safety risks that can affect anyone regardless of age or drinking status. It is important to know that there are many reasons teens drink alcohol. Understanding the risk factors associated with teen alcohol abuse is crucial to providing effective prevention and early intervention if necessary.

Internal Risk Factors for Teen Alcohol Abuse

The causes of teen drinking can be divided into two categories, internal risk factors that are specific to an individual and external risk factors that depend on a teenager’s environment. Internal risk factors tend to be more difficult to control; however, recognizing internal risk factors for teen alcohol abuse can be the most important step of effective prevention.


Research has continually shown that certain genetic factors may play a role in how vulnerable a person is to developing substance use disorders. The term is known as predisposition and it is related to a person’s natural tendency to struggle with certain problems. The link between alcoholism and genetics is undeniable; however, research has shown that genes are responsible for about half of the risk for a person developing alcohol use disorder. This means that even if a teenager is predisposed to struggling with teenage alcoholism due to their genetics, other factors can play a role in preventing their abuse of alcohol.

While genetics can play a role, there are also other important factors affecting the difference between abstinence or alcoholism.

Behavior Patterns

Certain early childhood behaviors have been linked to predictors of alcohol use among teens. Impulsiveness, restlessness, aggressiveness and antisocial tendencies have been associated as behaviors signaling a teenager’s increased risk for alcohol use and alcohol use disorders. The relationship between alcohol and impulse control is important because a person that has strong control of their impulses will be more likely to reject alcohol when offered or stop their use of alcohol. The study of adolescence and brain development with regard to alcohol use can be very helpful in preventing alcohol use disorder. A trained psychologist or psychiatrist can provide appropriate professional judgment regarding specific behavior patterns and possible increased risk for teen alcohol abuse.

ADHD & Anxiety Disorders

Certain mental health disorders in teens have been associated with alcohol consumption and increased risk for alcohol use disorder. Attention deficit hyperactivity disorder (ADHD), weak social relationship skills and conduct disorder have all been linked to higher rates of alcohol abuse and dependence. Other psychiatric disorders, such as anxiety and depression, can lead to or can become consequences of alcohol abuse and dependence. It is important to address any concerns regarding teen alcohol use with a trained psychiatric professional in order to best understand the relationship between alcohol abuse and any specific diagnoses that your child may have.


Traumatic events and child abuse are risk factors for alcohol abuse as an adolescent and as an adult. The relationship between childhood trauma and alcoholism has resulted in higher rates of reported physical abuse, sexual abuse, violent victimization and witnessing of violence among adolescents in treatment for alcohol use disorder compared to other adolescents. Alcohol and trauma statistics show that about 13 percent of alcohol dependent adolescents have diagnosed posttraumatic stress disorder (PTSD).

Positive Perception of Alcohol

While there are a variety of reasons why a teenager may be at risk for alcohol abuse, the most universal risk factor is whether or not a teenager has a positive perception of alcohol. When answering the question “why do teenagers drink alcohol”, the most common reason is because they think that the perceived benefit of drinking alcohol is greater than the possible consequences or risks. This is possibly the only controllable internal risk factor for teen alcohol abuse because proactive education about the dangerous risks of alcohol abuse among teenagers can change a teenager’s perception of alcohol use.

It is critical for teenagers to get information about alcohol use and abuse from trusted sources such as parents, teachers, coaches and other strong role models. If teens do not receive strong and consistent messages about the dangers of adolescent alcohol use, they will not have any reason to turn down a drink when it is offered to them. The practice of teens drinking with parents sends inconsistent messages to teenagers about alcohol use and should be avoided. When a teenager is faced with instances that influence teen alcohol use, such as peer pressure from other teenagers who are making bad decisions, a clear perception of the dangers of alcohol use will guide them towards saying “no”.

The best prevention is proactive education that is clear and concise about the dangers of teen alcohol abuse. Arm your teen with the information and knowledge they need to help them make the right decision from the start.

External Risk Factors for Teen Alcohol Abuse

While internal risk factors are specific to an individual teen, external influences and causes of underage drinking depend greatly on a teenager’s environment. The adolescent years are important years for learning, understanding and forming a unique perspective of the world. If a teenager’s environment is constantly highlighting reasons for underage drinking, they will be far more likely to partake and will be more at risk for teen alcohol abuse. Knowing the possible external influences for teen alcohol abuse is very important to providing necessary prevention and intervention to change the message teenagers are receiving about alcohol use.

Media Advertising

Research studies continually show that there is significant influence from alcohol advertising to youth and the decision to drink alcohol during the adolescent years. With modern communication, the influence of underage drinking is not just from traditional forms of media, such as TV, movies or songs, but the influence of social media and advertising on social media can be very intense and constant. The relationship between a teenager’s intention to drink and their preference for alcohol and media advertising is undeniable.

It is crucial for parents to monitor social media use and the possible influence of media on their teenager. Advertising and social media do not have to be the enemy, research shows that alcohol warning advertisements and alcohol counter-advertising can reduce the urge to drink among young adults. Make sure that the ideals you are trying to teach your teenager are being positively reinforced by the advertising that is constantly bombarding your teenager in the media and on social media.

Parents & Family Members

Parent’s drinking behavior and attitude towards alcohol plays a large role in a teen’s decision to start drinking. A teenager growing up with alcohol readily accessible and parents allowing minors to drink reinforces negative decision-making. When surveyed, 53% of current underage drinkers reported that family and friends provided alcohol. Even though you may be setting a good example for your teenager, you need to make sure all family members and close friends are doing the same. Make sure you are providing clear signals about appropriate alcohol use. Adolescents who are warned about the dangers of alcohol by their parents are less likely to start drinking during their teenage years.

Peer Pressure

The teenage years are difficult to navigate socially and decision-making skills are still developing. This reality causes peer pressure to play a large role in the actions and decisions of many teenagers.

Research and statistics on peer pressure and alcohol use have continually connected peer pressure and alcohol abuse in finding that peer acceptance of drinking increases the likelihood of a teenager partaking in underage drinking. Teen drinking and peer pressure can lead to other risky decisions such as drunk driving, drug use, violence and sexual promiscuity. While negative peer pressure can result in risky decision-making, positive peer pressure can encourage good decision-making such as better academic performance. As a parent, it is very important to be aware of the positive and negative influences your teenager is receiving from their peers.

Preventing Teen Alcohol Abuse

The risks of underage drinking include negative health and developmental effects as well as increased risk for risky behavior or becoming a victim of acts of violence. Preventing underage drinking is essential to preventing alcohol and drug dependence in adulthood.

Some tips to keep in mind for how to prevent teen drinking:

  • Talk to your teen and maintain open and understanding communication
  • Provide clear and consistent warnings about the risks of underage drinking
  • Do not encourage the use of alcohol by allowing underage drinking or activities that promote underage drinking
  • Monitor your teenager’s use of social media
  • Encourage positive peer relationships and intervene when negative peer relationships are affecting your teenager’s actions
  • Address any concerns regarding teen alcohol use with your child’s doctor or healthcare provider

It is important for parents to be vigilant and knowledgeable. If you suspect your child is abusing alcohol, it is important to trust your instincts, closely monitor your child’s activities and understand that privacy does not become the priority over ensuring your child’s safety. Advice from your child’s doctor, a guidance counselor, or one of the addiction specialists at The Recovery Village, can help you assess the situation and determine any next steps that should be taken.

Help is always available and if you think your teen needs help, call The Recovery Village to speak with a representative about a comprehensive and personalized teen alcohol treatment plan that best meets the needs of your child.

a close up of a person wearing a necklace.
By – Kathleen Oroho Linskey, PharmD
Kathleen is a licensed pharmacist in New Jersey. She earned her Doctorate of Pharmacy from Rutgers University. Read more
a man smiling with a mountain in the background.
Editor – Daron Christopher
Daron Christopher is an experienced speechwriter, copywriter and communications consultant based in Washington, DC. Read more
a man in a suit and tie smiling.
Medically Reviewed By – Dr. Kevin Wandler, MD
Kevin Wandler holds multiple positions at Advanced Recovery Systems. In addition to being the founding and chief medical director at Advanced Recovery Systems, he is also the medical director at The Recovery Village Ridgefield and at The Recovery Village Palmer Lake. Read more

Centers for Disease Control and Prevention. “Fact Sheets- Underage Drinking.” Reviewed August 2, 2018. Accessed August 24, 2019.

Johns Hopkins Bloomberg School of Public Health. “Alcohol Advertising and Youth.” April 2007. Accessed August 24, 2019.

KidsHealth.org. “Alcohol.” September 2016. Accessed August 24, 2019.

National Institute on Alcohol Abuse and Alcoholism. “Alcohol Alert: Underage Drinking.” January 2006. Accessed August 24, 2019.

National Institute on Alcohol Abuse and Alcoholism. “Alcohol Alert Youth Drinking: Risk Factors and Consequences.” July 1997. Accessed August 24, 2019.

National Institute on Alcohol Abuse and Alcoholism. “Genetics of Alcohol Use Disorder.” November 4, 2008. Accessed August 24, 2019.

National Institute on Alcohol Abuse and Alcoholism. “Underage Drinking.” Updated February 2017. Accessed August 24, 2019.

Partnership for Drug-Free Kids. “Top 8 Reasons Why Teens Try Alcohol and Drugs.” February 13, 2017. Accessed August 24, 2019.

Partnership for Drug-Free Kids. “Underage Drinking: What You Should Know.” July 11, 2016. Accessed August 24, 2019.

Substance Abuse and Mental Health Services Administration. “2018 NSDUH Annual National Report.” August 2019. Accessed August 24, 2019.

VeryWellMing.com. “Underage Drinking Risk Factors and Consequences.” Updated July 7, 2019. Accessed August 24, 2019.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.