Formerly known as alcoholism, alcohol use disorder (AUD) can affect people of all ages.

According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), about 3.4% of US teenagers ages 12 to 17 have AUD. That’s about 894,000 adolescents.

Recognizing AUD in teenagers isn’t always easy, but it can be the first step in offering them the support they need.

What alcohol use disorder is (and isn’t)

AUD is a condition where a person is addicted to alcohol or unable to control their alcohol use. When someone drinks frequently, their body becomes dependent on alcohol.

Alcohol misuse is not the same as AUD. An example of alcohol misuse is binge drinking. Although binge drinking can have negative health consequences, not all people who binge drink are necessarily addicted to alcohol.

However, frequent alcohol misuse may eventually lead to AUD, according to the NIAAA.

Underage drinking doesn’t automatically mean your teen has AUD. Likewise, underage drinking isn’t the same as alcohol misuse.

With that said, some research suggests that people who drink alone as teenagers are likely to develop AUD as adults.

Additionally, the NIAAA notes that people who start drinking before age 15 are more than three times as likely to develop AUD as an adult than people who waited until age 21 to start drinking.

What alcohol use disorder looks like

Teenagers with AUD may exhibit the following:

frequent shifts in mood
increased anger and irritability
frequent tiredness and lethargy
loss of interest in usual hobbies and activities
loss of appetite
unexplained illnesses
unexplained tremors, shakes, nausea, or vomiting

You might also notice the following behaviors:

change in sleeping patterns
change in social circles
decrease in school performance
frequent, unexplained absences from school
neglecting personal hygiene
neglecting chores and other responsibilities
withdrawing socially

If a teenager you know displays the above signs, it doesn’t necessarily mean they have AUD. Other factors, including other physical and mental health conditions, could also cause these behaviors.

However, it’s still a good idea to reach out to them — regardless of the cause of their behavior, they may need guidance and support.

How alcohol use disorder develops

Certain factors may increase the risk of alcohol misuse or AUD, including:

being male
drinking at a young age
genetics
having relatives with the condition
mental health conditions, including mood disorders, personality disorders, or schizophrenia
a history of trauma
loneliness
stress

Regardless of the cause of someone’s AUD, it’s important that they receive the treatment and support they need to feel better.

What you can do to prevent it

The best way to prevent AUD is to stop unsafe drinking habits. If you’re the parent, guardian, or loved one of a teenager, there are a few ways to promote healthy attitudes around alcohol:

Model healthy choices: If your teen often sees people drinking excessively at social events or turning to wine every evening to destress, they might make the same choices. Show your teen that it’s possible to unwind, socialize, and have a good time without alcohol.
Be a nonjudgmental source of support: If your teen worries that you’ll judge or punish them for drinking, they may not turn to you when they need help with a matter relating to alcohol. Emphasize that you’re there to support them, not judge them.
Offer practical ways to help: Remind them to call you for help instead of getting stuck in an unsafe space or letting a friend drive drunk. This isn’t to encourage them to drink but to offer them a way out of a potentially dangerous situation.
Discuss AUD with compassion: Talk with your teen about AUD and share that people with addictions are not bad or weak but need support and help. Emphasize that, with the right treatment, addiction can be overcome.
Remind your teenager of the less-than-fun sides of alcohol: Emphasize that you’re not discouraging them from drinking to ruin their fun but because of the very real effects of alcohol use, which can range from hangovers and mood swings to diarrhea and alcohol poisoning.

If you’re worried about your teen using alcohol, it may be tempting to take an extremely strict approach or overemphasize the risks of alcohol use.

Consider taking a harm-reduction approach so that if they do drink, they do it safely.

Talk with them about safer drinking practices, like:

Only drinking small amounts at a time
Eating beforehand
Drinking water in between alcoholic drinks
Avoiding drunk driving
Avoiding potentially dangerous activities, like swimming, while drunk
Calling a trusted adult for help if they need it

If you think your teen may not feel comfortable talking with you, perhaps guide them toward another trusted adult, such as an aunt, uncle, family friend, or community leader, with whom they have a good relationship.

What you can do to help

Often, helping someone with AUD starts with a conversation. This talk may be a challenging but necessary first step in getting your teen the help they need.

Consider the following:

Timing is important. Wait until they’re sober, if possible. It’s also best to have a conversation when you’re both calm and not distracted or irritable.
Have the conversation in private, perhaps with other loved ones that your teen trusts.
Express concern, but in a nonjudgmental way. Talk about how alcohol may affect their physical and mental health, academic performance, and social relationships.
Understand their perspective. Learn more about why they drink.

Take the following practical steps:

Contact a healthcare professional, preferably someone specializing in addiction, for help: If your teen has been drinking heavily, they may need to detox in a medical setting.
Make an appointment to see a counselor who specializes in addiction: Individual and family counseling can help your teen understand their drinking and stay motivated on their path to sobriety.
Consider an inpatient facility or rehab: You can contact the Substance Abuse and Mental Health Services Administration’s (SAMHSA) National Helpline at 1-800-662-4357 or use SAMHSA’s online treatment finder to find a clinic that treats youths.
Remove alcohol from your home: It may be harder for your teen to stay sober if alcohol is easily accessible. Explain that this is not because you don’t trust them but because you want to make their journey as easy as possible.
Create opportunities for them to socialize and have fun where alcohol won’t be present: Consider hosting get-togethers to ensure there’s no alcohol. You could also suggest activities like movie nights, sports, exercise, or hobbies your teen enjoys.
Find support groups: 12-step programs and other support groups can be helpful for people who are coping with addiction. Many support groups also cater to the loved ones of people with addiction.
Play an active role in their recovery: This includes contacting their counselor and healthcare team and regularly checking in on your teen to offer encouragement, motivation, and a safe space to express their feelings.

Where to learn more and find support

Read about the mental health challenges facing teenagers at Healthline and Psych Central’s Youth In Focus series, which shares useful tips, resources, and support.

You can also find support here:

Alcoholics Anonymous and Al-Anon: Find a local support group and other resources.
NAMI: Call their toll-free helpline, available Monday through Friday from 10 a.m. to 6 p.m. Eastern Time (ET) at 800-950-NAMI. You can also text “NAMI” to 741741.
Substance Abuse and Mental Health Services Administration (SAMHSA): Call their National Helpline at 1-800-662-4357 or use their online treatment finder.
Talk. They Hear You.: Find resources from this SAMHSA campaign to reduce underage drinking.
Teen Line: Parents and teenagers can find resources here. Teenagers can call their helpline at 800-852-8336, 6 p.m. to 10 p.m. Pacific Time (PT) for support.
Teen Safe: Find a list of useful resources for teens and their parents.

Sian Ferguson is a freelance health and cannabis writer based in Cape Town, South Africa. She’s passionate about empowering readers to take care of their mental and physical health through science-based, empathetically delivered information.

Creswell KG, et al. (2022). Solitary alcohol use in adolescence predicts alcohol problems in adulthood: A 17-year longitudinal study in a large national sample of US high school students. https://www.sciencedirect.com/science/article/pii/S0376871622002897
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Nehring SM, et al. (2023). Alcohol use disorder. https://www.ncbi.nlm.nih.gov/books/NBK436003/
Understanding alcohol use disorder. (2023). https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/understanding-alcohol-use-disorder
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Yang P, et al. (2018). The risk factors of the alcohol use disorders—Through review of its comorbidities. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5958183/

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