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Despite minimum-purchase-age laws, young people regularly drink alcohol. This study estimated the magnitude and costs of problems resulting from underage drinking by category—traffic crashes, violence, property crime, suicide, burns, drownings, fetal alcohol syndrome, high-risk sex, poisonings, psychoses, and dependency treatment—and compared those costs with associated alcohol sales. Previous studies did not break out costs of alcohol problems by age.

For each category of alcohol-related problems, we estimated fatal and nonfatal cases attributable to underage alcohol use. We multiplied alcohol-attributable cases by estimated costs per case to obtain total costs for each problem.

Underage drinking accounted for at least 16% of alcohol sales in 2001. It led to 3,170 deaths and 2.6 million other harmful events. The estimated 61.9billionbill(relativeSE=18.5%)included 5.4 billion in …