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.

Pregaming (also pre-drinking or pre-loading) is the process of getting drunk prior to going out socializing, typically done by college students and young adults in the United States and Europe, in a manner as cost-efficient as possible, with hard liquor and cheap beer consumed while in small groups.

Although pregaming is typically done before a night out, it can also precede other activities, like attending a college football game, large party, social function, or another activity where possession of alcohol may be limited or prohibited. The name "pregaming" spread from the drinking that took place during tailgating before football games to encompass similar drinking periods.

Other terms for the practice are pre-partying, prinking and (in Europe) prefunking.

A survey of over 6000 teenagers revealed (1):

- Teenagers and young adults typically get their alcohol from persons 21 or older. The second most common source for high school students is someone else under age 21, and the third most common source for 18- to 20-year-old adults is buying it from a store, bar or restaurant (despite the fact that such sales are against the law).

- In the 12th grade, boys were more likely than girls to buy alcohol from a store, bar or restaurant.

- The higher a teenager's weekly income, the more likely he/she will buy alcohol from a store, bar or restaurant.

- It is easy to get alcohol at a party and from siblings or others 21 or older.

How easy is it for youth to buy alcohol?

- When young females attempted to buy beer without an ID at liquor, grocery or convenience stores, 47–52% of the attempts, beer was sold (1, 2) and nearly 80% of all the stores sold beer to the buyers at least once in three attempts; nearly 25% sold beer all three times.(1)

- When young females attempted to buy beer without an ID at bars or restaurants, 50% of the attempts resulted in a sale to the buyer.(2)

- When young males and females attempted to buy beer without an ID at community festivals, 50% of the attempts resulted in a sale to the buyer.(3)

Pregaming has been associated with binge drinking and other dangerous activities, leading some universities to attempt to crack down on the practice. Government agencies at both the state and federal level have studied the problems created by pregaming.

The furtive nature of pregaming and bingeing can lead to massive quick consumption, acute alcohol poisoning, hospitalization, and death.

A 2012 study of more 250 Swiss students indicated that those who "pre-loaded" ended up consuming more total alcohol over the night (seven drinks rather than four) and engaged in riskier behavior. They had a 24% chance of reporting negative consequences from drinking (such as injury, unprotected sex, and unplanned drug use), compared to 18% chance for those who did not pre-drink.