Underage 'risky' drinking: motivations and outcomes

Lester Coleman and Suzanne Cater

An exploration of why some young people take part in 'risky' drinking and the effect on their health and wellbeing.

This report on 'risky' drinking (getting drunk in unsupervised locations, often out of doors) coincides with the publication of the government's first National Alcohol Harm Reduction Strategy for England. The report reviews recent trends in young people's alcohol use, and summarises the findings of existing work in this area, including an extensive questionnaire survey used to recruit young people for in-depth interview in this study.

These in-depth interviews with 64 young people, aged between 14 and 17, form the focus of the study. With extensive quotes from the young people themselves, the report reveals why young people take part in risky drinking, what their experiences have been and the role alcohol has played. The report also explores how these motivations and outcomes vary, for example by age and gender.

The authors conclude by addressing the implications for policy and practice, including ways of minimising harm and identifying groups at higher risk. They also discuss wider policy issues surrounding 'safer' drinking environments, alcohol advertising and school-based interventions.

Summary

Summary

Alcohol misuse among young people is a subject of great concern. This study, by Lester Coleman and Suzanne Cater of the Trust for the Study of Adolescence, looked at the reasons why underage young people (aged 14-17) get drunk, and explored the outcomes that occur. Only those young people reporting experiences of 'risky' drinking (or getting drunk in unsupervised, often outdoor settings) were interviewed. From a total of 64 in-depth interviews, the study found that:

  • Most of the young people reported positive reasons for getting drunk.
  • The most frequently cited motivation was increased confidence in social and sexual situations.
  • Other motivations included getting drunk to 'escape' and forget problems, to achieve a 'buzz', and for 'something to do'.
  • Getting drunk was widely seen as normal and acceptable. The young people reported the important influence of friends, ranging from actual peer pressure to the less overt, although more common, 'peer guidance'. They also reported the respect and image associated with getting drunk as a motivating factor.
  • The young people often reported harmful outcomes of being drunk, with health-related effects being the most commonly cited. These included regretted sexual experiences, injuries sustained through accidents and fighting, and instances of intoxication and drug-taking.
  • They also reported experiences that threatened their personal safety. These included walking home alone at night, daring behaviour and pranks, and dangerous driving.
  • Being in trouble with the police was occasionally reported, although the majority of incidents were minor and the result of being caught drunk outdoors.
  • The young people attributed 'risky' drinking to these harmful outcomes in a variety of ways. Accounts of alcohol leading to a loss of inhibitions, impaired judgement, and complete loss of control were reported. Furthermore, using alcohol as an excuse for socially unacceptable behaviour was apparent.
  • Those most prone to harmful outcomes were 14- and 15-year-olds who got drunk in unsupervised locations, especially outdoor settings, and those who reported getting drunk for the 'buzz'.

Introduction
Misuse of alcohol among young people is a subject of considerable concern. The study used in-depth interviews with a small sample of underage young people to explore the reasons why they get drunk, and the resulting outcomes.

Motivations - why do young people get drunk?
Most of the young people described their reasons for getting drunk in positive terms, emphasising the belief that getting drunk is a beneficial thing to do. The motivations cited fell under three broad themes: social facilitation, individual benefits and social norms and influences.

Social facilitation
The most commonly reported motivation for risky drinking was to increase confidence and enjoyment in a social situation. Getting drunk with other people was widely considered to be a bonding experience, making it easier to make friends and interact with peers. This motivation also included getting drunk to increase confidence in securing a sexual interaction. For example, many of the young people reported getting drunk to gain the courage to talk to someone they liked.

"... it gives you a lot more confidence. I mean, if you go into a club and see a good-looking boy and you're like, 'No I couldn't possibly,' get a couple of drinks down you, 'Well maybe. He may give me a chance and if he's had a couple of drinks,' ... when I'm on alcohol, I'm extremely confident." (Young woman, 17)

Individual benefits
Other motivations centred on individual benefits, including getting drunk to 'escape' and forget problems. This was perhaps the most worrying type of drinking, and was often done alone.

"... sometimes I drink to get away from things ... you feel better at the time, but then you, after a while, you ... well it never resolves anything. It's just a thing you do 'cos you want to feel better. Start feeling worse and then the next morning you feel worse and then your problems just increase if anything." (Young woman, 15)

Other young people reported getting drunk for the 'buzz', and to achieve a different feeling to when sober.

"It's just always funny. It's like you don't really know what you're doing most of the time and that's what I find really funny, that's why I like doing it. 'Cos you don't know, like when you wake up, you don't know what you've done." (Young man, 14)

Another important motivating factor was getting drunk for 'something to do', indicating that there could be a gap in the provision of activities targeted at this 14- to 17-year-old age group.

"I will get bladdered. Sometimes it's just boredom, 'cos where we live there's plenty to do ... but for our age, it's nothing ... it's cheaper to buy the alcohol than it is to go in the activities." (Young man, 17)

Social norms and influences
Almost all the young people saw getting drunk as completely normal, and did not see it as a problem. They commonly reported the influence of friends as a leading motivation, with such influence ranging from 'peer pressure' to 'peer guidance'. Peer pressure was the only motivation considered as negative, i.e. where young people perceived a pressure to get drunk. However, instances of peer pressure were very rare in the study. Reports of peer guidance were much more common, as illustrated by the following example:

"I suppose if none of my friends went out and got drunk I probably wouldn't either. I suppose they do influence you subconsciously, like you think you're an individual person, but just because everybody does it you do tend to do it." (Young woman, 16)

In addition, young people occasionally reported that they got drunk to achieve an image of being older and more rebellious.

"You're seen as sort of, if you're underage you're seen as slightly sort of, dangerous and bad, and naughty and stuff, which can be good." (Young woman, 17)

Outcomes - what have young people experienced when drunk?
All the young people interviewed were very keen to discuss their experiences of being drunk. Typically, these experiences related to their behaviour either during or immediately following a session of risky drinking. The outcomes were categorised under three themes: health outcomes, safety outcomes and legal outcomes.

Health outcomes
Of all the outcomes noted, negative impacts on health were the most common. The young people frequently reported sexual experiences they had regretted. The magnitude of these sexual behaviours varied considerably. For most, it was 'pulling' a person and later regretting it. Some also reported sexual intercourse they subsequently regretted, following a risky drinking session. Regret was also apparent where contraception had not been used. Most young people were clear that it would not have happened had they been sober.

"I've done not having safe sex and that, when I was drunk. It was like New Year's Eve and I wished I never did that. I would never have done it if I was sober." (Young man, 17)

A high proportion of the young people reported sustaining injuries as a result of their risky drinking. Although most of the injuries described were fairly minor, a few individuals had experienced being hurt more seriously. In all instances, the young people were certain that being drunk contributed to this outcome. Most of the injuries were incurred while the young people were drunk outdoors, illustrating how these unsupervised environments contributed to such incidents. For some, there was a strong sense that getting hurt or sustaining an injury was an inevitable consequence of risky drinking. However, the prospects of ongoing injury did not seem serious enough to deter future drinking.

"When you get drunk you've always hurt yourself somewhere, there's no stopping that. You always hurt yourself, if it's something small like just running into a bush of prickles and cutting yourself all over, or something big like falling out of a tree or something. It will always happen." (Young man, 16)

All the young people reported feeling at least some ill effects of being drunk, in terms of hangover or nausea. Some commented on how being sick was an additional inevitable outcome of drinking. Of more serious concern, a minor proportion of the sample reported some experience of severe intoxication and collapse, followed by involuntary vomiting.

"I got really drunk ... I was drinking all like bare spirits. And I got really, really drunk and ended up like being sick and couldn't walk or anything. They left me, they like put me in my mum's bed and left me, and they come home and I had been sick everywhere." (Young woman, 14)

Although many of the young people did not report any drug use at all, some had experience of using drugs. The link between risky drinking and drug use was complex and varied. For some, drinking led to a loss of control and lowering of resistance towards peer influence and pressure.

"I think it's really hard, 'cos if you're drunk and someone says, ''ere y'are, do some of this,' then you're just going to be like, 'oh go on then,' but when you're sober you might go, 'oh no'." (Young man, 15)

At the other extreme, young people seemed to make a conscious decision about wanting to try something new and different. Some explained that they were more likely to use drugs when they were drunk if they were bored with the effects of alcohol. They wanted to move on to a new, and perhaps better, feeling.

Safety outcomes
Risky drinking often led the young people to compromise their safety in a number of ways. This was often due to inability to accurately recognise a potentially risky situation. In most instances, young people said that these experiences would not occur when they were sober. Drunkenness appeared to lead to irrational judgements about the likelihood of danger in terms of getting home safely, dangerous pranks and dares (mostly outdoors), and occasionally getting into a car when the driver was drunk.

"I have walked home without getting a taxi when I'm drunk. My mum gets annoyed when I do that. I don't do it very often, but sometimes like say you've run out of money and the others were being a bit stingy ... sometimes if I'm low on cash I have been known to ... it doesn't scare me that much... I just thought 'it wouldn't happen to me,' which is stupid." (Young woman, 17)

Although these safety outcomes were potentially the most serious, and possibly life-threatening, they were rarely translated into actual harmful outcomes.

Legal outcomes
Most of the young people's accounts involved quite minor incidents (not involving arrest), such as having their alcohol tipped away by the police when caught drinking outdoors. However, a minority of interviewees described being involved in more serious incidents with the police when drunk, usually following acts of vandalism. Such instances often led to an arrest.

"I've been arrested for being drunk and disorderly. When there was like police driving past and we were caught and stuff like that." (Young man, 16)

How was risky drinking attributed to these harmful outcomes?
The young people attributed risky drinking to harmful health, safety and legal outcomes in a variety of ways, as follows:

  • in the context of sexual behaviour, seeing prospective partners as more attractive;
  • using alcohol as an 'excuse' for socially unacceptable behaviour;
  • increased confidence and lowering of inhibitions;
  • impaired judgement in accurately recognising and controlling a potentially risky situation, and an increased sense of unrealistic optimism;
  • complete loss of control, memory loss and 'black-out'.

These explanations represent a continuum of influence and are ordered with increasing significance. That is, complete loss of control and impaired judgment could represent the most causal relationship between risky drinking and the harmful outcomes reported (as opposed to the 'excuse' and lowering of inhibitions explanations).

Did young people's motivations and outcomes vary?
Some of the reported motivations and outcomes differed by age, gender, rural/urban residence, and supervised/unsupervised drinking location. Supervised drinking included drinking at home with parents or in licensed premises; unsupervised drinking included drinking at home with no parents present or in outdoor locations.

The most striking variation was the greater harms reported by the younger age groups. It seems that progressing to licensed establishments, closely correlated with increased age, offered a protective factor for a number of risky outcomes. It was apparent that young women had a greater ability to access the more supervised venues at an earlier age, offering them this protective effect in advance of young men. These slightly older groups also reported 'calming down' with their increased drinking experience.

Was there a relationship between motivations and outcomes?
Those who said that they drank primarily to achieve a 'buzz' generally reported more instances of harm. In contrast, those who got drunk to increase their confidence in a social group were the least likely to report harmful outcomes. It could be that the motivations and outcomes are affected by the transition to supervised locations that many young people experience with increased age and drinking experience.

Conclusion
This study has demonstrated that underage 'risky' drinking is a complex issue, with many motivating factors and varied outcomes. These findings will be of interest to researchers, policy-makers and practitioners. In identifying the leading motivations for risky drinking, the research has been useful in highlighting opportunities to reduce the harmful outcomes commonly reported. The insights into how alcohol is associated with these harmful outcomes will also be of use. Furthermore, specifying the groups and particular motivations most associated with these outcomes has shown areas where health promotion initiatives could be focused.

About the project
This study looked at the reasons why young people get drunk, and explored the resulting outcomes. In-depth interviews with 64 young people aged 14-17 were completed in the south-east of England. Only those young people reporting experiences of 'risky' drinking (or getting drunk in unsupervised, often outdoor settings) were interviewed.

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