Alcohol abuse is said to be most common in people aged between 15 and 24 years, according to Moreira 2009. However, this particular study of 7275 college students in England collected no comparative data from other age groups or countries.

Causes of alcohol abuse are complex and are likely the combination of many factors, from coping with stress to childhood development. The US Department of Health & Human Services identifies several factors influencing adolescent alcohol use, such as risk-taking, expectancies, sensitivity and tolerance, personality and psychiatric comorbidity, hereditary factors, and environmental aspects. Studies show that child maltreatment such as neglect, physical, and/or sexual abuse, as well as having parents with alcohol abuse problems, increases the likelihood of that child developing alcohol use disorders later in life. According to Shin, Edwards, Heeren, & Amodeo (2009), underage drinking is more prevalent among teens that experienced multiple types of childhood maltreatment regardless of parental alcohol abuse, putting them at a greater risk for alcohol use disorders. Genetic and environmental factors play a role in the development of alcohol use disorders, depending on age. The influence of genetic risk factors in developing alcohol use disorders increase with age ranging from 28% in adolescence and 58% in adults.

Medical organizations strongly discourage drinking alcohol during pregnancy. Alcohol passes easily from the mother's bloodstream through the placenta and into the bloodstream of the fetus, which interferes with brain and organ development. Alcohol can affect the fetus at any stage during pregnancy, but the level of risk depends on the amount and frequency of alcohol consumed. Regular heavy drinking and binge drinking (four or more drinks on any one occasion) pose the greatest risk for harm, but lesser amounts can cause problems as well. There is no known safe amount or safe time to drink during pregnancy.

Prenatal alcohol exposure can lead to fetal alcohol spectrum disorders (FASDs). The most severe form of FASD is fetal alcohol syndrome (FAS). Problems associated with FASD include facial anomalies, low birth weight, stunted growth, small head size, delayed or uncoordinated motor skills, hearing or vision problems, learning disabilities, behavior problems, and inappropriate social skills compared to same-age peers. Those affected are more likely to have trouble in school, legal problems, participate in high-risk behaviors, and develop substance use disorders themselves.

The impact of alcohol on weight-gain is contentious: some studies find no effect, others find decreased or increased effect on weight gain.

Alcohol use increases the risk of chronic gastritis (stomach inflammation); it is one cause of cirrhosis, hepatitis, and pancreatitis in both its chronic and acute forms.

A study published in the British Medical Journal on 10 July 2014 investigated the correlation between human variants of the ADH1B gene, which codes for the ADH1B enzyme (Alcohol dehydrogenase 1B), and cardiovascular health. The study concluded that carriers of one specific variant of this gene (A-allele of ADH1B rs1229984), which is associated with lower alcohol consumption, '...had a more favourable cardiovascular profile and a reduced risk of coronary heart disease than those without the genetic variant.' The study's authors extrapolated from this finding to suggest that '...reduction of alcohol consumption, even for light to moderate drinkers, is beneficial to health.'

This study contradicts previous findings on the causal relationship between light alcohol consumption and cardiovascular health, and has been criticized on its methodology by members of the International Scientific Forum on Alcohol Research, which stated in its analysis that '...[there are] questions about making generalized statements about the effects of alcohol on disease based on results from the analysis of a single nucleotide polymorphism of a gene.'

Moreover, the study fails to explain or discount previous findings that show a causal link between alcohol intake and cardiovascular health that can not be accounted for by genetic predisposition alone.

A study concluded, "Mild to moderate alcohol consumption is associated with a lower prevalence of the metabolic syndrome, with a favorable influence on lipids, waist circumference, and fasting insulin. This association was strongest among whites and among beer and wine drinkers." This is also true for Asians. A J-curve association between alcohol intake and metabolic syndrome was found: "The results of the present study suggest that the metabolic syndrome is negatively associated with light alcohol consumption (1–15 g alcohol/d) in Korean adults". However, "odds ratios for the metabolic syndrome and its components tended to increase with increasing alcohol consumption."

The cause of alcohol abuse is complex. Alcohol abuse is related to economic and biological origins and is associated with adverse health consequences. Peer pressure influences individuals to abuse alcohol; however, most of the influence of peers is due to inaccurate perceptions of the risks of alcohol abuse. According to Gelder, Mayou and Geddes (2005) easy accessibility of alcohol is one of the reasons people engage in alcohol abuse as this substance is easily obtained in shops. Another influencing factor among adolescents and college students are the perceptions of social norms for drinking; people will often drink more to keep up with their peers, as they believe their peers drink more than they actually do. They might also expect to drink more given the context (e.g. sporting event, fraternity party, etc.). This perception of norms results in higher alcohol consumption than is normal.

Alcohol abuse is also associated with acculturation, because social and cultural factors such as an ethnic group’s norms and attitudes can influence alcohol abuse.

About 12% of American adults have had an alcohol dependence problem at some time in their life. In the UK the NHS estimates that around 9% of men and 4% of UK women show signs of alcohol dependence.

Based on combined data from SAMHSA's 2004–2005 National Surveys on Drug Use & Health, the rate of past-year alcohol dependence or abuse among persons aged 12 or older varied by level of alcohol use: 44.7% of past month heavy drinkers, 18.5% binge drinkers, 3.8% past month non-binge drinkers, and 1.3% of those who did not drink alcohol in the past month met the criteria for alcohol dependence or abuse in the past year. Males had higher rates than females for all measures of drinking in the past month: any alcohol use (57.5% vs. 45%), binge drinking (30.8% vs. 15.1%), and heavy alcohol use (10.5% vs. 3.3%), and males were twice as likely as females to have met the criteria for alcohol dependence or abuse in the past year (10.5% vs. 5.1%).

Acute intoxication, such as binge drinking and alcoholism, are known potent risk factors for suicide. Binge drinking is also associated with an increased risk of unplanned sex, unprotected sex, unplanned pregnancies, and an increased risk of HIV infection. 10 percent of women and 19 percent of men have reported being assaulted as a result of alcohol. Males who drink more than 35 units of alcohol per week report being physically hurt as a result of alcohol, and 15 percent report physically hurting others as a result of their drinking. Almost 16 percent of binge drinkers report being taken advantage of sexually, and 8 percent report taking advantage of another person sexually as a result of alcohol within a 1-year period. Heavy drinkers cause approximately 183,000 rapes and sexual assaults, 197,000 robberies, 661,000 aggravated assaults, and 1.7 million simple assaults each year. Binge drinking has been associated with high odds of divorce, spousal abuse, and poor job performance. Binge drinking can cause adverse effects on the body including effects on blood homeostasis and its circadian variation, cardiac rhythm, ischaemic heart disease, blood pressure, white blood cell activity, female reproductive hormone levels as well as adverse effects on the fetus. There is also evidence from animal studies that binge drinking causes brain damage. Binge drinking has been associated with lower abdominal pain in women. Ketoacidosis can occur in individuals who chronically abuse alcohol and have a recent history of binge drinking. Alcohol affects brain development quite significantly especially during adolescence when the brain is still developing. The main lobes that are involved in decision making and complex thought processes are undergoing their final development phase during adolescence and binge drinking can negatively stunt the growth of these frontal lobes.

There are many health hazards that are caused from drinking. When students drink too much, the alcohol affects one's brain and ability to comprehend what is going on. One such problem is alcohol poisoning. After drinking too much, the alcohol and toxins in alcoholic drinks cause complications in one's brain and respiratory system. This causes mental and physical issues in one's body and could be very dangerous for one's health. Other hazardous health issues could arise from a drug called Rohypnol, nicknamed roofies. This is a toxic drug that could potentially be slipped into one’s drink which cause one to lose sight of what one thinks and does. This will also cause complications within one's body.

Alcohol is the most available, widely consumed, and widely abused recreational drug. Beer alone is the world's most widely consumed alcoholic beverage; it is the third-most popular drink overall, after water and tea. It is thought by some to be the oldest fermented beverage.

Binge drinking occurs when students drink large amounts of alcohol in a relatively short space of time in order to feel the full effects of alcohol consumption. The National Institute of Alcohol Abuse and Alcoholism defines binge drinking as a pattern of drinking that brings a person's blood alcohol concentration, also known as BAC, to 0.08 grams percent or above. This is usually seen when men consume five or more drinks, and when women consume four or more drinks in a two-hour time period.

Young adults who participate in binge drinking experience higher rates of physical and sexual assault, and unwanted, unplanned, and unprotected sexual activity. There are also links between heavy alcohol consumption and depression.

The motivations among young students have changed as well. In recent years, more students are drinking with the intended purpose of getting drunk.

The high levels of binge drinking among young people and the adverse consequences that include increased risk of alcoholism as an adult and liver disease make binge drinking a major public health issue. Recent research has found that young college binge drinkers who drink 4/5+ drinks on more than 3 occasions in the past 2 weeks are statistically 19 times more likely to develop alcoholism than non-binge drinkers, though the direction of causality remains unclear. This is particularly interesting as drinking for the sole purpose of getting drunk, remains a major health and social problem on college campuses across the United States. Heavy and regular binge drinking during adolescence is associated with an increased risk of alcoholism. Approximately 40 percent of alcoholics report heavy drinking during adolescence. Repeated episodes of excessive drinking, especially at an early age, are thought to cause a profound increase in the risk of developing an alcohol-related disorder (ICD-10, harmful use/dependence syndrome). Heavy drinking is also closely associated with depression. Those with severe depression have higher rates of alcohol abuse than those with low depression. College students who are depressed are more susceptible to use alcohol than college students who are not depressed. In a study conducted by Harvard University it was found that about 32% of students surveyed were diagnosable for alcohol abuse and about 6% were diagnosed as alcohol dependent. Binge drinking is also becoming an increasing problem in Australian adolescents, the Australian School Students Alcohol and Drug survey conducted by the National Cancer Council discovered that around 33 percent of students between Years 7 and 11 consumed alcohol in the week leading up to the survey, they also found that 10 percent of the students participated in binge drinking at a consumption level which is considered dangerous to adults. When the survey results were separated into age groups the findings were that 13 percent of 15-year-old's and 22 percent of 17-year-old's had alcohol consumption levels above the daily maximum suggested to adults and that 20 percent of 17-year-old's had a consumption level of alcohol considered risky to adults.

Other risk factors that influence the development of alcohol abuse or alcoholism include social and genetic factors. Several researchers have found that starting drinking before the age of 15 is associated with a fourfold increased risk for developing alcoholism compared to people that delay drinking until age 20 or later. It has been estimated by some that if the age at which people started drinking could be delayed to age 20, there would be a 50 percent reduction in the number of cases of alcohol use disorder. However, it is unclear whether this is a causal relationship, or a function of confounding familial (and other) factors associated with both age at first drink and propensity for alcoholism.

The main cause of death among adolescents as a result of binge drinking is road traffic accidents; a third of all fatal road traffic accidents among 15- to 20-year-olds are associated with drinking alcohol. Cyclists and pedestrians are likely to have less spatial awareness and concentration while travelling after binge drinking and, also, it is more common that adolescents that binge-drink drive drunk or are the passenger of a drunk driver. It has been found that 50 percent of all head injuries in adolescents in the US are associated with alcohol consumption. Violence and suicide combine to become the third-most-common cause of death associated with binge drinking among adolescents. The suicide risk in adolescents is more than 4 times higher among binge drinkers than non-binge drinking adolescents.

Earlier sexual activity, increased changing of sexual partners, higher rate of unwanted (teenage) pregnancy, higher rate of sexually transmitted diseases, infertility, and alcohol-related damage to the fetus during pregnancy is associated with binge drinking. Female binge drinkers are three times more likely to be victims of sexual assault; 50 percent of adolescent girls reporting sexual assault were under the influence of alcohol or another psychotropic substance at the time.

Adolescents who regularly participated in binge drinking for several years show a smaller hippocampus brain region, in particular those who began drinking in early adolescence. Heavy binge drinking is associated with neurocognitive deficits of frontal lobe processing and impaired working memory as well as delayed auditory and verbal memory deficits. Animal studies suggest that the neurodegenerative effects of alcohol abuse during adolescence can be permanent. Research in humans, which utilised sophisticated brain scanning technology suggests that in adolescent teenagers, drinking more than 4 or 5 drinks once or twice a month results in subtle damage to the teenagers developing brain tissue, in particular the white matter. However, this research is primarily cross-sectional and done with fairly small sample sizes, making causality less certain.

Several studies have been conducted to discover if there is a link between binge drinking in adolescent years and becoming a chronic alcohol consumer when they transition into adulthood. A particular study conducted by the National Longitudinal Survey of Youth found that harmful drinking during adolescent years was significantly associated with the continuance of dangerous levels of alcohol consumption into adulthood years.

Treatments for alcohol dependence can be separated into two groups, those directed towards severely alcohol-dependent people, and those focused for those at risk of becoming dependent on alcohol. Treatment for alcohol dependence often involves utilizing relapse prevention, support groups, psychotherapy, and setting short-term goals. The Twelve-Step Program is also a popular process used by those wishing to recover from alcohol dependence.

Marquis states how "Adolescent alcohol

use is not an acceptable rite of passage but a serious threat to adolescent

development and health, as the statistics related to adolescent impairment,

injury, and death attest." Research shows how an adolescent

makes the decision to consume alcohol because they are influenced by various

factors. "These factors include normal maturational changes that all

adolescents experience; genetic, psychological and social factors specific to

each adolescent and the various social and cultural environments that surround

adolescent, including their families, schools and communities". It is also

shown that early onset of alcohol intake can lead to high levels of alcohol use

in adulthood.

Alcoholism throughout adolescents is increasing yearly for a number of different reasons. These reasons include:

- Availability of alcohol

- Peer pressure

- Role model

- Television

- Anxiety or stress

The combination of self-starvation and alcohol abuse can lead to an array of physical and psychological consequences. For example, drinking in a state of malnutrition can predispose individuals to a higher rate of blackouts, alcohol poisoning, alcohol-related injury, violence, or illness. Drinking on an empty stomach allows ethanol to reach the blood system at a swifter pace and raises one's blood alcohol content with an often dangerous speed. This can render the drinker more vulnerable to alcohol-related brain damage. In addition, alcohol abuse can have a detrimental impact on hydration and the body's retention of minerals and nutrients, further exacerbating the consequences of malnutrition and denigrating an individual's cognitive faculties. This can ultimately have a negative impact on academic performance.

These harmful consequences can be more easily induced in women, as women are oftentimes less capable of metabolizing alcohol than men. On CBS News, Carrie Wilkins, PhD, of the Center for Motivation and Change (a private practice group based in New York City) describes how women are more vulnerable to particular toxic side effects of alcohol consumption.

Drunkorexia can lead to short term and long term cognitive problems including difficulty concentrating and difficulty making decisions. It also increases the risk of developing more serious eating disorders or alcohol abuse problems. As binge drinking is involved there is a greater risk for violence, risky sexual behavior, alcohol poisoning, substance abuse and chronic disease later in life.

Drunkorexia consists of 3 major aspects: alcohol use/abuse, food intake restriction, and excessive physical activity. It is commonly summarised in the following activities:

- Counting daily calorie intake (commonly known as "calorie counting") to ensure no weight will be gained when consuming alcohol.

- Missing or skipping meals to conserve calories for consumption of alcoholic beverages.

- Over exercising to counterweigh for calories consumed from alcoholic beverages.

- Consuming an extreme amount of alcohol to vomit previously digested food.

A legal minimum age for the buying or consuming of alcohol is in place in many of the world's countries, typically with the intent to protect the young from alcohol-related harm. This age varies between countries; for example, the minimum legal drinking age for Australia is 18, whereas the MLDA in the United States is 21.

Although the incidence of underage drinking is still significant, government, university and national statistics have confirmed that alcohol use and binge drinking among high school students has declined steadily over the past three decades, and continues to decline annually. According to a United States Substance Abuse and Mental Health Services Administration study involving 30,000 youths aged 12 to 20 years old, between 2002 and 2013 the percentage of underage drinkers declined from 28.8% to 22.7%. Underage binge drinkers decreased 19.3% to 14.2%. A December 2014 study performed by the University of Michigan also found that 75% of senior high school students disapproved of drinking excessively on the weekends. Alcohol still proved to be the favored substance of abuse among American youths however, with tobacco and illicit drugs following in rank.

Alcohol consumption by youth in the United States of America is an umbrella term for alcohol consumption by individuals under the age of 21 in the country.

Although the minimum legal age to purchase alcohol is 21 in all states (see National Minimum Drinking Age Act), the legal details vary greatly. While a few states completely ban alcohol usage for people under 21, the majority have exceptions that permit consumption.

Underage drinking has become an activity primarily done behind closed doors. Typically, underage drinkers hide their alcohol consumption by drinking quickly before they go out, which is often referred to as pregaming or pre-partying. Brittany Levine explained in her article "Pre-Gaming" in USA Today that "of all drinking events involving pre-partying, 80% involved additional drinking afterward." Those who oppose a complete ban on underage drinking argue that it is important that minors be introduced to alcohol in a controlled environment, so that supervision and guidance might occur instead of experimentation. Some parents are willing to provide alcohol for their children if they drink it in a controlled environment. Furnishing alcohol to one's own children is permitted in 31 states, while it's illegal to do so for other people's children in all fifty states. Social host ordinances have been enacted in a number of jurisdictions to attempt to limit the parties where adults may permit minors to drink. Social host laws or ordinances have proliferated in the last ten years because it has been too difficult for law enforcement to prove which adults furnished or served alcohol to minors in their own home, so it permits them to cite or arrest the adult who has control of the premises.

One out of 67 women who drink alcohol during pregnancy will have a child with a birth defect. The five countries with the highest prevalence of alcohol use during pregnancy were Ireland (about 60%), Belarus (47%), Denmark (46%), the UK (41%) and the Russian Federation (37%). The lowest prevalence is in those nations whose religious beliefs govern their alcohol consumption. Birth defects caused by alcohol consumption may be up to 1% in many places. This may mean that FASD may be higher than anencephaly, Down syndrome, spina bifida and trisomy 18. Globally, one in 10 women drink alcohol during pregnancy. Out of this population, 20% binge drink and have four or more alcoholic drinks per single occasion.

"Binge drinking is the direct cause of FAS or FASD. These findings are alarming because half of the pregnancies in developed countries and over 80% in developing countries are unplanned. That means that many women don’t realize they are pregnant during the early stages and that they continue drinking when pregnant."

Extensive epidemiological studies have demonstrated the cardioprotective effect of alcohol consumption. However the mechanism by which this occurs is not fully understood. Research has suggested several possible mechanisms, including the following.

There is a lack of medical consensus about whether moderate consumption of beer, wine, or distilled spirits has a stronger association with heart disease. Studies suggest that each is effective, with none having a clear advantage. Most researchers now believe that the most important ingredient is the alcohol itself.

The American Heart Association has reported that "More than a dozen prospective studies have demonstrated a consistent, strong, dose-response relation between increasing alcohol consumption and decreasing incidence of CHD (coronary heart disease). The data are similar in men and women in a number of different geographic and ethnic groups. Consumption of one or two drinks per day is associated with a reduction in risk of approximately 30% to 50%".

Heart disease is the largest cause of mortality in the United States and many other countries. Therefore, some physicians have suggested that patients be informed of the potential health benefits of drinking alcohol in moderation, especially if they abstain and alcohol is not contraindicated. Others, however, argue against the practice in fear that it might lead to heavy or abusive alcohol consumption. Heavy drinking is associated with a number of health and safety problems.

Passive drinking, like passive smoking, refers to the damage done to others as a result of drinking alcoholic beverages. These include the unborn fetus and children of parents who drink excessively, drunk drivers, accidents, domestic violence and alcohol-related sexual assaults

On 2 February 2010 Eurocare, the European Alcohol Policy Alliance, organised a seminar on “The Social Cost of Alcohol : Passive drinking”. On 21 May 2010 the World Health Organization reached a consensus at the World Health Assembly on a resolution to confront the harmful use of alcohol.

The International Agency for Research on Cancer of the World Health Organization has classified alcohol as a Group 1 carcinogen.

Alcohol dependence is not prerequisite to blackouts (either en bloc or fragmentary). Students in one study who reported blackouts were demographically similar to other drinking students. Importantly, however, students reporting blackouts drank more, and had other symptoms of alcoholic drinking, even though they did not fall into the alcoholic range on the Michigan Alcoholism Screening Test (MAST). Half of the students reported having had a blackout during their drinking careers, which closely followed other research findings.

In another study 25% of healthy college students reported being familiar with alcoholic blackouts. 51% of the students reported that they had had at least one blackout. Blackouts were reported during activities such as spending money (27%), sexual conduct (24%), fighting (16%), vandalism (16%), unprotected intercourse (6%), and driving a car (3%). So a significant number of students were engaged in a range of possibly hazardous activities during blackouts.

Of 545 individuals in another study, 161 (29.5%) reported driving drunk, 139 (25.5%) reported a regretted sexual situation, 67 (12.3%) reported unprotected sex, 60 (11%) reported having damaged property, 55 (10.1%) reported getting into a physical fight, and 29 (5.3%) reported injuring someone while under the influence of alcohol in the past 6 months.