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.