Binge drinking: yes, parents should be concerned.

The legal drinking age in the U.S. is 21, but as most parents know, that age hasn't stopped kids from drinking. Teens use fake IDs to buy booze, go to friends' houses where alcohol is readily available, or even have parents who let them drink at home. It may not come as a surprise, then, to know that in 2003 nearly 45% of high school students had had an alcoholic drink.

While underage drinking may be illegal and is strongly discouraged, of more concern is binge drinking, when teens have more than five drinks within a few hours. A teen that has had one or two drinks may become tipsy, but a teen that has had more drinks than she can count on one hand in one evening puts herself at higher risk for other behaviors. Just how serious a problem is underage drinking particularly binge drinking--in the U.S., and what implications do these practices have on our youth?

Dr. Jacqueline W. Miller of the Centers for Disease Control and Prevention's Alcohol Team and her colleagues published a study in a January 2007 issue of Pediatrics that evaluated data from the 2003 Youth Risk Behavior Survey (YRBS) to determine the prevalence of teen drinking and binge drinking, and the relationship between drinking and other health risk behaviors.

More than 15,000 high school students who were representative of public and private high school students nationwide completed the YRSB, which was designed to monitor health risk behaviors such as unintentional injury or violence, tobacco use, alcohol and other drug use, sexual behavior that results in pregnancy or sexually transmitted disease, unhealthy dietary behavior and physical inactivity. Of the approximately 7,000 high school students who reported having had at least one drink in the previous 30 days before the survey, 16.1% reported that they currently drink but don't binge drink, and 28.8% reported that they drink and binge drink.

Further results revealed that, among drinkers, 67.4% of boys and 61.1% of girls reported binge drinking. The prevalence of binge drinking among drinkers increased with age, though not with grade; interestingly, as a group, 11th graders reported slightly higher prevalence of binge drinking than 12th graders. The highest rate of binge drinking was among white, male, boys in twelfth grade (75.5%). The lowest rates of binge drinking among those who currently drank were among black or African American students (41.5%).

Not surprisingly, students who reported drinking or binge drinking also reported engaging in other health risk behaviors, including riding with a driver who had been drinking, being sexually active, drinking or using drugs before having sex, getting pregnant or getting someone else pregnant, having smoked or done drugs, or been in a physical fight. When comparing nondrinkers, drinkers and binge drinkers, the odds of the latter two groups engaging in certain risk behaviors increased considerably. (The chart at the end of the article highlights a few of the results.)

In addition to engaging in more risky behaviors, students who binge drank reported earning worse grades in school than the other two groups. Almost 20% of binge drinkers said they earned mostly As, while almost 50% said they earned mostly Ds and Fs. The results were the inverse for nondrinkers: approximately 65% of nondrinkers said they earned As while more than 30% said they earned Ds and Fs. Interestingly, school performance did not vary among those who drank but didn't binge drink.