High-intensity drinking by underage young adults in the United States

Aims: To estimate (1) the prevalence of underage binge drinking, high-intensity drinking and intoxication among young adults aged 19/20 years; (2) change in these behaviors across the transition out of high school and across historical time; and (3) associations between these behaviors and key covariates, including college status.

Design, setting, participants: Longitudinal data from the US nationally representative Monitoring the Future study included 1657 respondents first surveyed as 12th graders (modal age 18 years) in 2005-13 and again at modal age 19/20 years in 2006-14.

Measurements: Self-reported measures of alcohol use, demographics, college attendance and living situation.

Findings: Binge drinking (5+ drinks on one occasion) was reported by 24.2% [95% confidence interval (CI) = 22.0, 26.5] of young adults aged 19/20; 10.3% (CI = 8.7, 11.9) reported high-intensity drinking of 10+ drinks; 4.2% (CI = 3.1, 5.2) reported 15+ drinks. Usual moderate/high intoxication when drinking was reported by 33.1% (CI = 30.6, 35.6); 29.6% (CI = 27.2, 32.0) reported usual sustained intoxication of 3+ hours. Significant variability (P < 0.001) in these behaviors from ages 18 to 19/20 was observed. Significant decreases (P < 0.05) across historical time in 5+ and 10+ drinking were found. Four-year college students not residing with parents had significantly higher odds of moderate/high intoxication, binge drinking and high-intensity drinking compared with other groups (P < 0.001).

Conclusions: Young adult underage binge drinking (5+ drinks on one occasion), high-intensity drinking (10+ and 15+ drinks) and intoxication are relatively common in the United States, and show meaningful variability across the transition out of high school. Four-year college students and those who do not live with their parents are more likely to engage in high-intensity drinking than their peers.