22 min read Medically Reviewed

Alcohol Use Disorder in Teens: Signs, Treatment & Recovery

By: Editorial Staff

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Secretive behavior, changing friendships, and falling grades can be early indicators of problematic drinking in teenagers. These changes may point to Alcohol Use Disorder (AUD), a treatable medical condition. This guide explains the symptoms, causes, and effective treatments available for your teen.

What is alcohol use disorder?

Alcohol use disorder (AUD) is a chronic brain disorder defined by a teen’s continued drinking despite harmful consequences. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR), a diagnosis is made based on 11 criteria, including loss of control over drinking, cravings, and risky use.

The condition exists on a spectrum from mild to severe, which helps clinicians and parents recognize that a teen doesn’t need to fit an outdated stereotype to be at serious risk.

“According to a 2023 national survey, about 1 in 7 men, 1 in 11 women, and 1 in 33 adolescents (aged 12‑17) meet the diagnostic criteria for AUD.”

— National Institute on Alcohol Abuse and Alcoholism (NIAAA), NIH

This means that in a typical high school classroom of 33 students, at least one teen is likely struggling with AUD. Early recognition and intervention are critical.

Signs of alcohol use disorder in teens

Recognizing the signs of AUD can be difficult, as some may overlap with typical adolescent moodiness. However, patterns of specific changes in behavior, physical health, and social habits can indicate a serious problem. The American Academy of Pediatrics recommends universal screening for substance use during routine checkups to catch these patterns early.

Behavioral changes to watch for

Secretive or dishonest behavior is a common indicator of potential issues. Pay attention to changes in your teen’s habits, friendships, and attitude, which can signal an underlying issue. These behaviors often include:

  • Increased secrecy: Hiding alcohol in their room, lying about where they are going, or being evasive about their activities.
  • New friend group: Suddenly spending time with a different crowd, especially one that is known for drinking or partying.
  • Loss of interest: Abandoning hobbies, sports, or other activities they once enjoyed in favor of opportunities to drink.
  • Solitary drinking: Teens who engage in drinking alone are at a much higher risk for developing severe alcohol-related problems.

Physical signs and symptoms

The physical toll of alcohol misuse can become apparent over time. While some signs are immediate, others develop over time due to prolonged, heavy use. You may observe physical signs, including:

  • Poor coordination: Noticeable issues with balance, slurred speech, or coordination during or after suspected drinking.
  • Frequent hangovers: Complaints of headaches, nausea, or fatigue, especially in the mornings after being out with friends.
  • Neglected appearance: A decline in personal hygiene or grooming habits that is out of character for your teen.
  • Alcohol on breath: The smell of alcohol on their breath or attempts to cover it up with gum or mints.

Academic and social warning signs

One of the first places parents or teachers notice a problem is in a teen’s academic and social life. Alcohol can disrupt concentration, motivation, and judgment. Look for these signs:

  • Declining grades: A sudden or gradual drop in school performance, missing assignments, or skipping classes.
  • Disciplinary issues: Getting into trouble at school, such as detention or suspension, are often related to rule-breaking or conflict.
  • Relationship problems: Increased arguments with family members or friends, broken relationships, or new conflicts with peers.
  • Risky behaviors: Alcohol misuse in teens is linked to higher rates of risk-taking, including unsafe sexual encounters.

How teen alcohol use differs from adult use

A teen’s brain is still developing, making it uniquely vulnerable to alcohol’s effects. Unlike the adult brain, the adolescent prefrontal cortex, which is responsible for judgment and impulse control, is not yet fully mature. This makes teens more prone to binge drinking and less able to recognize when they should stop.

Even moderate alcohol use can interfere with critical stages of brain development, potentially causing long-term damage to memory, learning, and emotional regulation. This heightened vulnerability is why teen alcohol use carries different and often more severe risks than adult use.

Why do teens develop alcohol problems?

It is natural for parents to ask “why” and even to blame themselves. Understanding the factors that contribute to AUD can help reduce this guilt and shift the focus toward solutions. The development of AUD is complex and involves a mix of biology, environment, and mental health.

Brain development and vulnerability

The adolescent brain is wired for novelty and reward, making teens more likely to experiment with substances like alcohol. At the same time, the brain systems that control impulses are still under construction. Pre-existing differences in brain regions related to judgment can make some teens biologically more susceptible to developing problematic drinking patterns.

Genetic and family risk factors

Genetics plays a significant role in a person’s risk for AUD. A family history of alcoholism increases a teen’s vulnerability. However, parenting practices are also highly influential. Parental monitoring, clear rules about alcohol, and a supportive home environment can significantly reduce the risk of teen alcohol misuse, even for those with a genetic predisposition.

Mental health connections

Many teens with AUD also struggle with a co-occurring mental health condition like anxiety or depression. They may turn to alcohol as a form of self-medication to cope with painful emotions. This connection is a crucial component for parents to understand.

To better understand this dynamic, it’s helpful to consider the perspective of Dr. Sarper Taskiran, a child and adolescent psychiatrist at the Child Mind Institute.

“The rule of thumb is that almost half of the kids with mental health disorders if they’re not treated, will end up having a substance use disorder.”

— Sarper Taskiran, MD, Child and Adolescent Psychiatrist, Child Mind Institute

This highlights the importance of addressing a teen’s mental health as a core component of treating their alcohol use.

Environmental and social influences

A teenager’s environment significantly influences their behavior. Exposure to alcohol through media, peer pressure, and community norms all play a part. Teens living in neighborhoods with a high density of alcohol outlets are more likely to drink. Family instability and high levels of stress at home can also contribute to a teen’s risk.

Getting your teen evaluated

If you suspect your teen has a problem with alcohol, the first step is a professional assessment. This process can feel intimidating, but it is designed to provide your family with a clear understanding of the situation and a roadmap for treatment.

What happens during a professional assessment

A comprehensive evaluation is the foundation for an effective treatment plan. It is conducted by a qualified professional, such as a psychiatrist, psychologist, or licensed addiction counselor. The process typically involves:

  • Parent interview: The clinician will ask you about your observations, your teen’s developmental history, family history of substance use, and your primary concerns.
  • Teen interview: The clinician will speak with your teen alone to understand their perspective, their pattern of alcohol use, and any underlying mental health symptoms.
  • Screening tools: Standardized questionnaires and validated screening tools are used to measure the severity of alcohol use and identify co-occurring conditions.
  • Medical review: In some cases, a physical exam or lab tests may be recommended to assess the impact of alcohol on your teen’s physical health.

Preparing for your teen’s first appointment

Your preparation can help make the first appointment as productive as possible. Taking a few proactive steps can help reduce anxiety for both you and your teen, ensuring the clinician receives the necessary information. You can prepare by:

  • Gathering observations: Write down specific examples of behaviors, incidents, and changes you have noticed, including dates if possible.
  • Listing questions: Prepare a list of questions you have about diagnosis, treatment options, confidentiality, and what to expect.
  • Including your teen: Discuss with your teen beforehand why you are seeking help. Frame it as a way to support them, not to punish them.
  • Bringing relevant records: If your teen has a history of mental health treatment or academic issues, bring any relevant reports or records.

Treatment options for teen alcohol use disorder

Choosing between treatment approaches when you want the best outcome for your teen creates natural uncertainty. There is no one-size-fits-all solution, and the most effective plans often combine several strategies tailored to your teen’s specific needs.

Therapy approaches that work for teens

Several evidence-based therapies have been proven effective for treating AUD in adolescents. These approaches focus on developing skills, modifying thought patterns, and fostering change.

Family-based treatment programs

Because family dynamics play a huge role in a teen’s recovery, family-based therapies are a cornerstone of effective treatment. These programs work with the entire family system to enhance communication, establish healthy boundaries, and foster a supportive home environment. Family interventions can reduce the chances of teen drinking, and the positive effects can last for years.

Inpatient vs. outpatient care

The appropriate level of care depends on the severity of your teen’s AUD and their overall health.

  • Outpatient care: Most teens can be treated effectively in an outpatient setting. This allows them to continue living at home and attending school while participating in therapy sessions one or more times per week.
  • Intensive Outpatient (IOP) / Partial Hospitalization (PHP): These programs offer more structured treatment, with therapy sessions several hours a day, several days a week, for teens who need more support than standard outpatient care.
  • Inpatient/Residential care: For teens with severe AUD, co-occurring mental health crises, or an unsafe home environment, a residential program provides 24/7 supervision and intensive therapy in a safe, structured setting.

Medications for teen alcohol use disorder

While several medications are approved to treat AUD in adults, their use in adolescents is less common and not typically a first-line treatment. Medications like naltrexone may be considered in severe cases under the guidance of a psychiatrist, but therapy and family support remain the primary interventions for this age group.

Supporting your teen at home

Your role as a parent is crucial to your teen’s long-term recovery. Creating a stable, supportive, and structured home environment can make a significant difference. Parent-focused education and involvement are highly protective factors against teen drinking.

Creating a recovery-supportive environment

A teen’s environment can either support or undermine their recovery efforts. A home that promotes sobriety and wellness is essential. You can create this by:

  • Removing alcohol: Secure or remove all alcohol from the home to eliminate temptation and demonstrate your commitment to their recovery.
  • Modeling healthy behavior: Evaluate your own relationship with alcohol and model healthy coping mechanisms for stress.
  • Encouraging positive activities: Help your teen explore new hobbies, sober social activities, and healthy outlets for their time and energy.

Communication strategies that work

Open, honest, and non-judgmental communication can rebuild trust and strengthen your relationship. Programs that train parents and teens to talk openly about alcohol have been shown to reduce drinking and improve family bonds. Try these strategies:

  • Use “I” statements: Express your feelings and concerns without blaming your teen (e.g., “I feel worried when you come home late” instead of “You are so irresponsible”).
  • Practice active listening: Give your teen your full attention when they talk. Listen to understand their perspective, not just to respond or correct them.
  • Schedule regular check-ins: Set aside dedicated time each week to talk, free from distractions, to keep the lines of communication open.

Setting boundaries and consequences

Clear, consistent boundaries are a form of love and support. They provide the structure and predictability that teens need, especially during recovery. This structure is proven to reduce the risk of alcohol misuse.

  • Collaborate on rules: When possible, involve your teen in setting the rules and consequences. This gives them a sense of ownership and fairness.
  • Be consistent: Follow through on consequences every time. Inconsistency sends mixed messages and undermines your authority.
  • Focus on natural consequences: Connect consequences directly to the behavior (e.g., if they miss curfew, they lose car privileges for a week).

Preventing relapse together

Relapse can be a part of the recovery process. It is not a sign of failure but an indication that the current support plan may need to be adjusted.

  • Identify triggers: Work with your teen and their therapist to identify situations, people, or feelings that trigger the urge to drink.
  • Develop a coping plan: Create a plan for how your teen will manage triggers when they arise, such as calling a trusted adult or using a specific coping skill.
  • Stay connected to support: Ensure your teen stays engaged with their therapist, support groups, or other recovery resources. Structured online peer support groups can also be effective.

Navigating school and academic support

A teen’s recovery must extend into their school life. Working collaboratively with school staff can ensure your teen has the support they need to succeed academically while managing their recovery.

Working with school counselors and staff

School counselors, psychologists, and trusted teachers can be valuable allies. Open a line of communication with the school to create a supportive team for your teen. You can discuss what information to share while respecting your teen’s privacy.

Educational accommodations and support plans

If your teen’s AUD has significantly impacted their ability to learn, they may be eligible for formal accommodations.

  • 504 Plan: A 504 Plan provides accommodations to ensure a student with a disability (which can include AUD) has access to the learning environment. This could include extended time on tests or preferential seating.
  • Individualized Education Program (IEP): If a student requires specialized instruction to make academic progress, an IEP may be necessary. This is more common when AUD co-occurs with another learning or mental health disability.

Addressing academic recovery

Falling behind in school is a significant source of stress that can trigger relapse. Create a plan to address any academic gaps. This may involve hiring a tutor, working with teachers to complete missed assignments, or temporarily adjusting your teen’s course load. Celebrate academic effort and progress, not just grades.

When to call for crisis help

These situations create fear in any parent; that response shows your care for your teen’s wellbeing. Knowing how to recognize an emergency and what to do can be life-saving. Adolescent ER visits for overdoses and alcohol-related crises are rising, making parental preparedness essential.

Recognizing emergencies

Trust your instincts. Your sense that something significant is happening deserves immediate attention. Seek emergency help if your teen:

  • Expresses thoughts of harming themselves or others.
  • Becomes violent or uncontrollably aggressive.
  • Experiences a seizure.
  • Is unresponsive or cannot be woken up.

Alcohol poisoning: What parents must know

Binge drinking can lead to alcohol poisoning, a medical emergency that can be fatal. Signs include confusion, vomiting, slow or irregular breathing, pale or bluish discoloration of the skin, and loss of consciousness. Teens admitted for alcohol poisoning often have dangerously high blood alcohol levels. If you suspect alcohol poisoning, call 911 immediately. Do not leave them alone or assume they will “sleep it off.”

If you are reading this and feel unsafe or are worried you might hurt yourself, please know that help is available right now. You can call or text 988 anytime to connect with someone who can support you. You are not alone.

Creating a family safety plan

A safety plan is a proactive tool that outlines what to do in the event of a crisis. It should be created when things are calm and involve input from your teen and their therapist. The plan should include warning signs, coping strategies, contact information for trusted adults and professionals, and clear steps to take in the event of an emergency. Structured family counseling after a crisis can help in developing these plans.

Crisis resources and immediate support

In any mental health or substance use crisis, immediate help is available. Do not hesitate to use these resources.

  • 988 Suicide & Crisis Lifeline: Call or text 988 to connect with a trained crisis counselor 24/7. This service is free and confidential.
  • Crisis Text Line: Text ‘HOME’ to 741741 to connect with a crisis counselor.
  • 911 or Local Emergency Room: For any immediate medical emergency or safety threat, call 911 or go to the nearest emergency room.

Impact of teen alcohol use on family and siblings

Teen AUD is not an individual problem; it is a family disease. The stress, fear, and disruption affect every member of the household, including parents and siblings. Recognizing this impact is the first step toward healing for the entire family.

How teen alcohol problems affect the whole family

The ripple effects of a teen’s AUD are significant. Families often experience intense stress, financial strain from treatment costs, and a communication breakdown. The entire family system can become organized around the teen’s substance use, leading to anxiety and exhaustion for caregivers.

Supporting other children in the home

Siblings are often the forgotten victims. They may feel a mix of anger, fear, and neglect as parental attention is focused on the child who is struggling. An older sibling’s drinking pattern strongly predicts a younger sibling’s risk. It is vital to:

  • Maintain routines: Keep up with routines and special time for other children as much as possible.
  • Create open communication: Allow them to express their feelings without judgment. Let them know it’s okay to be angry or scared.
  • Provide information: Explain what is happening in age-appropriate terms to reduce confusion and fear.

Managing family stress and guilt

Parents often carry a heavy burden of guilt, wondering what they did wrong. This guilt can be paralyzing. High family conflict and low parental monitoring are linked to increased teen drinking, but it’s essential to focus on moving forward rather than dwelling on the past. Finding support for yourself is not selfish; it is essential for your family’s well-being.

Family therapy and support groups

You do not have to go through this alone. Professional support can provide tools and relief for the entire family.

  • Family therapy: A therapist can help your family improve communication, resolve conflict, and learn to work together to support recovery.
  • Parent support groups: Connecting with other parents who are facing similar challenges can reduce feelings of isolation and provide practical advice.
  • Al-Anon/Alateen: These free, peer-led support groups offer guidance and hope for families and friends of individuals with alcoholism.

How teen alcohol problems differ from depression and anxiety

Symptoms of AUD, depression, and anxiety often overlap, making it difficult for parents to distinguish between them. A teenager might be irritable, withdrawn, and struggling in school due to any of these conditions. Integrated treatment that addresses both substance use and mental health is often necessary.

Overlapping symptoms and co-occurring conditions

It’s common for a teen with AUD also to have an underlying mental health disorder. The symptoms can be interconnected:

  • Social withdrawal: Can be a sign of depression or a result of hiding alcohol use.
  • Irritability and anger: Can be a symptom of anxiety, depression, or withdrawal from alcohol.
  • Sleep problems: Insomnia or excessive sleeping can be caused by all three conditions.

When mental health issues come first

In many cases, an anxiety or mood disorder precedes the development of AUD. A teen may start using alcohol to manage social anxiety, numb feelings of sadness, or quiet racing thoughts. In these situations, treating the underlying mental health condition is essential for achieving lasting recovery from alcohol misuse.

Integrated treatment approaches

The most effective treatment addresses co-occurring conditions simultaneously. An integrated approach involves a team of professionals who collaborate to treat both the AUD and the mental health disorder. This ensures that one condition is not overlooked while treating the other, giving your teen the best chance for a full recovery.

Sources

Author: Editorial Staff
SEPTEMBER 2, 2025

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