associated with even greater risks of traffic accidents for youth as compared to adults, and adolescent drivers are more likely than adults to get into accidents at lower BACs (Yi et al., 2001), likely because they have fewer years of driving experience (Hingson, Heeren, and Winter, 1994; Yi et al., 2001).

Alcohol is far from the “safe drug” parents often think. As BACs rise, alcohol overdose can occur, resulting in respiration failure, suffocation, coma, and, in some cases, death. Alcohol intoxication produces diminished inhibition, increased violent behavior, and poor judgment that can result in being in the wrong place at the wrong time, and these factors all contribute to young deaths and injuries due to alcohol-related aggressive behavior. Homicide is the second leading cause of death for those ages 10 to 20 (National Center for Health Statistics, 1999). Suicide is the third leading cause of death for youth (National Center for Health Statistics, 1999), and approximately 28 percent of suicides of those 9 to 15 years old can be directly attributed to or are related to alcohol use (Preuss et al., 2002; Reifman and Windle, 1995).

Young people under the influence of alcohol are at an increased likelihood of deciding to use other drugs (Brown, Tapert, Tate, and Abrantes, 2000b). Alcohol is often considered a gateway to the use of illegal substances. Youth who drink are significantly more likely to use other illicit drugs, compared to young nondrinkers (Kandel and Davies, 1996). A young person may decide to use an illicit substance after drinking because judgment is impaired, exposure to other substances is more likely, and susceptibility to peer influences is amplified. Once alcohol use has been initiated, the use of other intoxicants may no longer appear as risky to the teen.

Subacute effects of drinking may be experienced in the day or two following an episode of heavy drinking. For adolescents, these effects can include feeling dizzy when first standing up, nausea or vomiting, feeling depressed or irritable, tremor or shakes, racing heart, sweating, rapid breathing, insomnia, headaches, and muscle aches or weaknesses (Stewart and Brown, 1995; Tapert and Brown, 1999). Although relatively rare, youth who have developed a physical addiction to alcohol can experience withdrawal seizures in the first few days of abstinence.