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Almost 20 percent of all traffic crashes involving a driver under age 21 involve alcohol. Of course, not every crash involving alcohol is actually caused by alcohol. Counting only those crashes with a driver under age 21 that are attributable to alcohol, the costs total $18.2 billion per year (in 1998 dollars; see figure 2). In addition, a cost of $289 million is accrued in accidents involving pedestrians and cyclists under age 21.
It is estimated that incidents of interpersonal violence committed by individuals under age 21 account for approximately:
Numerous studies reveal that both perpetrators and victims of violence are often under the influence of alcohol at the time of the offense. A causal role of alcohol in violence is supported by experimental studies of biological effects and population studies that control for other factors. These findings are borne out in interviews with convicted offenders. In 1996, 36 percent of adult offenders indicated that they had been drinking when they committed their crimes. One study found that some types of youth homicide declined when States raised the minimum drinking age and that beer consumption levels predicted youth homicide rates.
The total cost of alcohol-attributable violent crime involving perpetrators under age 21 is $35.9 billion (see Figure 3).
The involvement of alcohol in cases of fatal drownings and burns has been well described in alcohol literature, although rates of involvement vary considerably. Alcohol involvement in drownings is high among youth, and the cost of alcohol-attributable drowning and near drowning for youth is $532 million. The cost of alcohol-attributable burns for youth is $315 million (see figures 4 and 5).
Of approximately 31,000 completed suicides that occurred in 1994, almost 3,000 (9 percent) involved individuals under age 21. In addition, close to 230,000 nonfatal suicide attempts took place, of which approximately 60,000 (26 percent) involved those under age 21. The association of alcohol with suicide has been established by numerous studies. It is estimated that 12 percent of male suicides and 8 percent of female suicides are attributable to alcohol.
The cost of alcohol-attributable suicide attempts (fatal and nonfatal) for youth is $1.51 million in 1998 dollars (see figure 6). Nonfatal attempts may result in additional costs due to psychological harm, which are excluded from the above estimates.
Prenatal alcohol exposure is known to be toxic to the developing fetus and is one of the leading causes of mental retardation. A recent Government study estimated that FAS costs society more than $944 million in 1992. The cost of FAS as a consequence of underage alcohol use is $493 million (see figure 7).
Heavy drinking can lead to alcohol poisoning. In 1994, there were 10 fatal and 40,000 nonfatal cases of alcohol poisoning among youth in the United States. The cost of youth alcohol poisonings was $340 million in 1994, calculated in 1998 dollars (see figure 8). Alcohol poisonings are likely to be heavily underreported because physician reports often omit the mention of alcohol in patient records to avoid family embarrassment.
In 1991, 9.4 percent of alcoholism-only and 16.2 percent of alcohol-and--other-drug treatment clients were under age 21.
Total costs of alcohol dependence for those under age 21 for the United States are estimated at $1.008 billion annually. Treatment costs for alcohol dependence syndrome average an estimated $16,000 per case. These costs are understated because they do not include productivity-related losses.