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20 States with the Most Underage Drinking in the US

In this article, we are going to discuss the 20 states with the most underage drinking in the US. You can skip our detailed analysis of the economic cost of excessive drinking in America and the initiatives by a major brewing company to prevent underage drinking, and go directly to the 5 States with the Most Underage Drinking in the US.

Underage drinking is a serious public health issue in the United States, with alcohol being the most widely used substance of abuse among the country’s youth. According to the 2023 National Survey on Drug Use and Health, around one-third of America’s population aged between 12 and 20 reported that they have had at least one drink in their lives, while 14.6% of them reported having a drink in the past month. As a consequence, over 4,000 young people (below the age of 21) lose their lives from excessive alcohol use each year, making underage alcohol use an urgent nationwide concern.

READ ALSO: 20 States with the Most Bars per Capita in the US and 20 Countries with the Highest Alcohol Consumption per Capita in 2024.

The Economic Cost of Excessive Drinking: 

As we mentioned in our article – 20 Countries with the Most Alcohol Deaths – the economic costs of harm due to alcohol amount to $1,306 per adult or 2.6% of the global GDP. About 38.8% of these are incurred as direct costs, while the rest are due to losses in productivity.

According to the CDC, excessive drinking costs the United States around $249 billion annually, when combining healthcare expenditures, lost earnings and productivity, criminal justice implications, vehicle crashes, property damage, and more. The federal government picks up roughly $100 billion of the tab, largely through Medicare and Medicaid payments. Underage drinking alone cost the country $24 billion in 2010, the most recent year for which the data is available.

Several evidence-based strategies can help reduce excessive drinking, including increasing alcohol excise taxes, limiting alcohol outlet density, and commercial host liability.

Corporate Social Responsibility Initiatives: 

To help prevent underage drinking, NACS, the global trade association that represents the convenience and fuel retailing industry, and Conexxus, launched a groundbreaking digital identification solution in 2021 that enhances the current age-verification systems and protects user privacy. Named TruAge, the system makes it more accurate to verify an adult customer’s age when purchasing age-restricted products, while also making identity theft difficult. The system is already supported by some of the most recognized brands in the world and over 140 retail companies, representing 30,000-plus convenience store locations in the United States.

Among the early sponsors of TruAge was also the Molson Coors Beverage Company (NYSE:TAP), which became the first major global beer company to support the innovative solution. Jim Hughes, the then vice-president of convenience for Molson Coors, stated:

“Encouraging people to enjoy our products responsibly is at the cornerstone of our business. We are excited to be an early supporter of this technology that we believe will help reduce underage access to our products and can be expanded across all our major markets.”

The brewing giant also continues to support the Training for Intervention Procedures (TIPS) program, which trains bartenders and servers on how drinking can affect behavior, helping prevent underage access and alcohol abuse.

The Molson Coors Beverage Company (NYSE:TAP) produces a wide selection of beers in multiple price categories, going from core brands like Coors Light and Miller Light, premium brands like Madri and Blue Moon, right down to economy brands like Miller Higher Life, Keystone, and Icehouse. However, with beer being its core business and the US being its primary market, TAP also stands to lose quite a bit if the current trends toward spirits continue.

The net income of Molson Coors rose by around 24.7% in Q2 of 2024, driven by favorable prices and US shipment timing. Over the last year, the company has also greatly benefited from the boycott against Bud Light, one of the largest competitors of its core brands in the American market. However, analysts at Citi stated in April that gains by Molson Coors due to the Bud Light upset are coming to an end. It must also be kept in mind that TAP has consistently increased its revenue over the last 4 years, from $9.65 billion in 2020 to $11.7 billion in 2023, while the Bud Light controversy only happened last year. Knowing the risks it faces in the current beer market landscape, TAP is actively investing in its spirits portfolio and even acquired the cult favorite high-end Bourbon and rye whiskey brand, Blue Run Spirits, last year.

Molson Coors Beverage Company (NYSE:TAP) is also included in our list of the Best Alcohol Stocks To Own According to Hedge Funds.

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With that said, here are the States that Have the Most Underage Drinking in America.

Methodology:

To collect data for this article, we have referred to SAMHSA’s 2021-22 National Survey on Drug Use and Health, looking for the States with the Highest Rate of Underage Drinking in America. The following states have been ranked by their total percentage of residents aged 12-20 who reported drinking within the past 30 days before the survey.

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20. Washington

Prevalence of Underage Drinking: 16.47%

It is legal in the Evergreen State for a minor to drink alcohol under their parent or guardian’s permission and supervision. The law also allows viticulture students who are at least 18 years old to taste wine, but not drink it, under the supervision of the faculty.

19. Maine

Prevalence of Underage Drinking: 16.55%

According to the Maine Center for Disease Control and Prevention, alcohol is the most widely misused substance in the state by youths and adults. 667 Mainers died due to alcohol-related causes in 2021 – a 47% increase from 2019.

With a per capita alcohol consumption of 2.97 gallons, Maine is included among the Drunkest States in the US.

18. New Jersey

Prevalence of Underage Drinking: 16.6%

To control rowdy behavior on beaches and boardwalks, a New Jersey state senate panel approved a bill last year that would impose a $50 fine on people under 21 found with booze, and for police to notify parents or guardians of those under 18.

17. Virginia

Prevalence of Underage Drinking: 16.68%

Virginia’s Old Dominion University received a $10,000 grant from Virginia ABC this summer to fund a project that educates students on the risks associated with underage and high-risk drinking. In 2022, Virginia ABC reached gross revenues of $1.4 billion and contributed $622.8 million to the Commonwealth for designated state programs and services.

16. Colorado

Prevalence of Underage Drinking: 16.96%

Coloradans drink more than the average American, with each person over 14 consuming about 645 drinks per year, compared to the national average of 536. In 2022, more than 1,500 people died from excessive drinking in Colorado, a slight decline from the previous year but still significantly higher than pre-pandemic levels.

15. Connecticut

Prevalence of Underage Drinking: 17%

To keep underage drinking in check, the Liquor Control Division in Connecticut conducted a series of sting operations last year, usually following a complaint filed with the police department or local government. The investigation revealed dozens of liquor stores that were selling to people under 21.

14. New York 

Prevalence of Underage Drinking: 17.1%

The New York State Department of Motor Vehicles (DMV), along with investigators from other departments, conducted a crackdown on various concert venues this summer to prevent underage drinking by checking for fake IDs.

13. Nebraska

Prevalence of Underage Drinking: 17.58%

Although Nebraska ranks among the States that Drink the Least Alcohol per Capita, about one in eight deaths of Nebraskans aged 20 to 64 in recent years can be attributed to alcohol use, according to figures from the CDC. Moreover, approximately 70% of all treatment center admissions in the Cornhusker State are due to alcohol use disorders.

12. Oregon

Prevalence of Underage Drinking: 17.9%

Due to the extremely low state taxes on beer and wine, Oregon is a drinker’s paradise. According to recent data from the Oregon Health Authority, around 8 Oregonians die every day due to alcohol, an increase of 30% over just three years.

11. Ohio

Prevalence of Underage Drinking: 18.18%

The average Ohioan drank 689 alcoholic drinks in 2021, an 11% decrease from 776 the previous year, according to a survey by DrugAbuse.com. A possible reason for this welcomed drop in drinking could be a change in routines for individuals, as restrictions eased in the pandemic’s second year and more people returned to out-of-home jobs.

10. Montana

Prevalence of Underage Drinking: 18.91%

Underage drinking is a serious problem in Montana, with 12.02% of the state’s youth reporting binge drinking in the past month. Youth alcohol-attributable deaths in the Treasure State are at 20.27 per 100,000 – the highest in the country.

9. District of Columbia

Prevalence of Underage Drinking: 19.18%

In 2021, the capital’s health department announced the launch of MyRecoveryDC, a public education campaign to help residents addicted to opioids, alcohol, and other drugs access the government’s comprehensive network of treatment and recovery services.

8. New Hampshire

Prevalence of Underage Drinking: 19.27%

Next up in our list of the States where Underage Drinking Occurs the Most is New Hampshire, which has relatively high alcohol sales per capita due in part to its state-operated liquor stores. Alcohol is the most commonly used substance by youth in New Hampshire, with 10% of them having started drinking before the age of 13.

7. Iowa

Prevalence of Underage Drinking: 19.82%

Keeping up with the national trend, Iowa witnessed a 13.2% increase in total liquor sales in 2021 when compared to the previous year, with Iowans spending more than $415.8 million on liquor. Unsurprisingly, alcohol-related deaths in the Hawkeye State also jumped to 923 in 2021, a 10.2% increase from 2020.

6. Minnesota

Prevalence of Underage Drinking: 19.88%

According to a 2022 study, excessive alcohol use cost Minnesota an estimated $7.85 billion in 2019, while underage drinking alone was responsible for over $747 million in costs to the state. Moreover, recent data from the CDC found that over 1,100 Minnesotans died in 2021 as a result of binge drinking.

5. North Dakota

Prevalence of Underage Drinking: 20.65%

Despite still being among the States with the Highest Rate of Teenage Drinking, North Dakota has made significant progress over the last two decades. In the 20 years between 2001 and 2021, alcohol use by the Peace Garden State’s high schoolers dropped from around 59% to just under 24%.

North Dakota is also counted among the States with the Highest Rates of Drunk Driving Deaths, with a staggering 47% of all motor vehicle-related deaths involving alcohol.

4. Rhode Island

Prevalence of Underage Drinking: 21.06%

Although small in size, the state of Rhode Island is quite big on alcohol. Nearly 1 of every 5 Rhode Island adults (19.7%) reports binge drinking at least once a month. The same goes for high-school students, at 18.3%. Both are higher than their respective national average.

A 2021 study found that almost 59% of Rhode Islanders aged 18 to 20 claim to have received alcohol from a friend or relative who is over the age of 21.

3. Wisconsin

Prevalence of Underage Drinking: 21.54%

Wisconsin is the State with the Highest Rate of Binge Drinking in America. Nearly 25% of the state’s high school students reported binge drinking within the past month. Excessive drinking costs the Badger State about $4 billion a year, or approximately $700 per resident. A major reason for the high alcohol consumption in Wisconsin could be its low liquor taxes, resulting in lower retail and wholesale prices.

2. Vermont

Prevalence of Underage Drinking: 22.29%

Vermont is the State with the Highest Rate of Underage Binge Drinking in the US, with 15.23% of its population aged 12-20 involved in binge drinking within the past month, consuming four or more alcoholic beverages in a single session.

With an annual per-head ethanol consumption of 3.13 gallons, Vermont is ranked among the States that Consume the Most Alcohol per Capita.

1. Massachusetts

Prevalence of Underage Drinking: 23.23%

Alcohol abuse costs Massachusetts at least $5.6 billion annually, while causing thousands of deaths and illnesses, according to a new analysis from Boston University researchers. Underage drinking alone cost the citizens of the Bay State $1.4 billion in 2010, yet revenues from alcohol-specific taxes fall far short of repaying these costs.

With an underage drinking prevalence of 23.23%, Massachusetts is the State with the Highest Rate of Underage Drinking in the US.

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Disclosure: None. 20 States with the Most Underage Drinking in the US is originally published on Insider Monkey.

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