In addition to the personal risks to the adolescent, the societal and economic costs of alcohol and other substance use disorders in the United States also are substantial. Alcohol is used by more young people in the United States than tobacco or illicit drugs.1 Although it is illegal to drink alcohol before the age of 21 years in all states, in 2007, 26% of high-school students reported episodic heavy or binge drinking and 11% of high-school students reported driving a car or other vehicle during the past 30 days when they had been drinking alcohol. In addition, 29% of students reported riding in a car or other vehicle during the past 30 days driven by someone who had been drinking alcohol.5 In 2005, there were more than 145,000 emergency rooms visits by youths aged 12 to 20 years for injuries and other conditions linked to alcohol.6
