Adolescent brain development and underage drinking in the United States: identifying risks of alcohol use in college populations

Harv Rev Psychiatry. 2012 Jul-Aug;20(4):189-200. doi: 10.3109/10673229.2012.714642.


Alcohol use typically is initiated during adolescence, a period that coincides with critical structural and functional maturation of the brain. Brain maturation and associated improvements in decision making continue into the third decade of life, reaching a plateau within the period referred to as emerging adulthood (18-24 years). This particular period covers that of traditionally aged college students, and includes the age (21 years) when alcohol consumption becomes legal in the United States. This review highlights neurobiological evidence indicating the vulnerabilities of the emerging-adult brain to the effects of alcohol. Factors increasing the risks associated with underage alcohol use include the age group's reduced sensitivity to alcohol sedation and increased sensitivity to alcohol-related disruptions in memory. On the individual level, factors increasing those risks are a positive family history of alcoholism, which has a demonstrated effect on brain structure and function, and emerging comorbid psychiatric conditions. These vulnerabilities-of the age group, in general, as well as of particular individuals-likely contribute to excessive and unsupervised drinking in college students. Discouraging alcohol consumption until neurobiological adulthood is reached is important for minimizing alcohol-related disruptions in brain development and decision-making capacity, and for reducing the negative behavioral consequences associated with underage alcohol use.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Adolescent
  • Age Factors
  • Alcohol Drinking / adverse effects*
  • Alcohol Drinking / epidemiology
  • Alcohol Drinking / physiopathology
  • Alcohol Drinking / psychology
  • Alcohol-Induced Disorders, Nervous System / epidemiology
  • Alcohol-Induced Disorders, Nervous System / physiopathology*
  • Alcohol-Induced Disorders, Nervous System / psychology
  • Alcoholism / epidemiology
  • Alcoholism / physiopathology
  • Alcoholism / psychology
  • Binge Drinking / epidemiology
  • Binge Drinking / physiopathology
  • Binge Drinking / psychology
  • Brain / drug effects*
  • Brain / physiopathology
  • Child
  • Cross-Sectional Studies
  • Decision Making / drug effects
  • Ethanol / toxicity*
  • Female
  • Humans
  • Male
  • Public Policy
  • Risk Factors
  • Students / psychology*
  • Students / statistics & numerical data
  • United States
  • Young Adult


  • Ethanol