Not only is underage drinking against the law, but there are also many consequences to underage drinking impacting the health and safety of North Dakota youth. Individuals who begin drinking before age 15 are four times more likely than individuals who start drinking at the age of 21 to meet the criteria for alcohol use disorder at some point in their lives (Center for Adolescent Health).

There are factors that increase the likelihood of substance-related consequences and consumption - called intervening variables. Research has identified several of these intervening variables which increase the likelihood of underage drinking and related consequences. It is through impacting intervening variables that positive population-level changes are seen. 

Intervening variables are factors identified through research as having an influence on substance misuse and related consequences. They include, but are not limited to, risk and protective factors (Center for Strategic Prevention Support, 2022). It is through impacting intervening variables that positive population-level changes are seen. Research has identified several intervening variables which increase the likelihood of binge drinking and related consequences which are: 


Economic/Retail Pricing

The price of purchasing alcohol influences how much is consumed. The higher the price, the less it is consumed.

Retail Availability

Alcohol is a product that requires a retail market. The easier it is to obtain alcohol through that market, the greater the consumption. Research shows that access restrictions are related to lower consumption rates and decreases in associated problems.

Social Availability

This refers to obtaining alcohol from unlicensed sources such as friends, family, or at a party. Research indicates underage youth primarily receive their alcohol through these sources.


Alcohol consumption is influenced by enforcement in two ways; actual enforcement and the perception that the laws are being enforced. At first, the perception of enforcement is enough to make an impact in reducing problems associated with alcohol. With time, actual enforcement becomes essential because people must experience consequences to make an impactful difference.

Community Norms

This represents the general attitudes that govern the acceptability of a behavior within the community. Norms are often reflected in public policy, laws, and regulations, but not all norms coincide with legal restrictions. For instance, the legal age to drink is 21; however, there are norms that can govern whether underage drinking is acceptable under adult supervision. More permissive alcohol consumption norms are associated with greater alcohol consumption and higher rates of associated problems.

Promotion of Alcohol

Retail outlets attempt to increase alcohol sales through the promotion of their products. Promotion of alcohol increases the attractiveness of drinking. Deals and discounts are a way to attain new consumers and retain existing ones. Additionally, ads, billboards, commercials, logos and other types of promotion create increased exposure to alcohol and are associated with increased consumption.

Individual Factors

Individuals have a variety of characteristics which make the misuse of alcohol more likely and less likely. These factors include genetic predispositions, mental and behavioral health issues, early exposure to alcohol, and experiencing extreme poverty. These individual factors also include attitudes, beliefs and perceptions that have been shown to be related to substance use.


Evidence-Based Strategies Targeting Underage Drinking

Accordion Section Title
Does your community have a Lack of Enforcement or Consequences for underage drinking?
Accordion Section Title
Is the Low Price of alcohol making it easy for youth to purchase/consume?

Screening, Brief Intervention, and Referral to Treatment (SBIRT)

Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based practice used to identify, reduce, and prevent problematic use, abuse, and dependence on alcohol and illicit drugs. This public health approach is often conducted in medical settings, hospitals, clinics, emergency departments, and workplace wellness programs.


Learn More


We can help!

We provide assistance to individuals and communities across North Dakota interested in implementing effective prevention.