The period after high school is a transitional time. Many young adults have greater freedom and independence, and they take on more responsibility as they enter the next chapter of their lives. During this time, young adults may have an increased vulnerability for alcohol misuse and alcohol use disorder. 

Healthcare professionals play an important role in addressing alcohol misuse in their patients. There are a number of strategies that you can use in your practice and consider supporting in your community to prevent alcohol misuse among young adults.

Individual-level Strategies

Individual strategies aim to produce changes in a person’s attitudes or behaviors related to alcohol consumption, such as decreasing alcohol intake (e.g., frequency, quantity, or blood alcohol concentration) and/or alcohol-related risk-taking behaviors, thereby reducing harmful consequences.

Below is a list of evidence-based interventions that you may want to consider for your practice:

Brief motivational intervention (BMI): In-person—Individual

BMI combines a brief intervention with motivational interviewing. BMI emphasizes personal responsibility and self-efficacy of participants, offering them personalized feedback on their alcohol use, risks, expectancies, perceptions of social norms, and options for reducing problems and consequences.

Screening and behavioral treatments

Primary care clinicians conduct alcohol screening in adults and provide brief behavioral counseling interventions for the full range of unhealthy drinking behaviors, from alcohol misuse to alcohol use disorder.

Medications for alcohol use disorder

Three medications have been approved by the Food and Drug Administration to help people cut back or stop drinking and avoid relapse: naltrexone (in two forms, oral and extended-release injection), acamprosate, and disulfiram.

Environmental-level Strategies

Environmental strategies aim to change the alcohol use environment in the community, and thus can affect large subgroups such as those under age 21.

Enforce age-21 drinking age (e.g., compliance checks)

Local and state government support and implement strong enforcement of the existing age-21 minimum legal drinking age.

Restrict alcohol sponsorship and advertising

Local or state government establishes policies that restrict or prohibit alcohol sponsorship and/or advertising of alcoholic beverages, particularly where such sponsorship or advertising exposes young people to alcohol messages, such as at rock concerts or at athletic events.

Restrict happy hours/price promotions

Local or state government prohibits or restricts drink specials, such as the sale of two alcoholic beverages for the price of one, that encourage customers to drink more than they might otherwise.

Retain or enact restrictions on hours of alcohol sales

Local and state governments retain or enact policies limiting the hours during which alcohol may be sold legally.

Retain ban on Sunday sales (where applicable)

Local and state governments support existing bans on Sunday sales of alcohol for offsite consumption.

Establish minimum unit pricing

Local/state/federal government sets the minimum price at which alcohol is allowed to be sold in alcohol establishments.

Conduct “reward and reminder” or “mystery shopping visits”

Patrons who appear underage or intoxicated attempt to purchase alcohol. Servers/sellers are rewarded and/or congratulated for checking IDs and/or refusing alcohol service. Servers/sellers who sell alcohol receive education about the laws and training to improve compliance rather than punishment.

Retain age-21 drinking age

Local and state governments support continuation of the age-21 minimum legal drinking age due to its effectiveness in reducing underage drinking consequences.

Increase alcohol tax

A state or local government increases the tax on the sale of alcohol, thereby increasing the cost of alcohol and decreasing the affordability of drinking.

Enact dram shop liability laws: Sales to intoxicated

This type of dram shop liability law is enacted at the state level to hold the owner or server(s) at a bar, restaurant, or other location responsible for damages caused by an intoxicated person who was overserved alcohol at that location.

Enact dram shop liability laws: Sales to underage

This type of dram shop liability law is enacted at the state level to hold the owner or server(s) at a bar, restaurant, or other location responsible for damages caused by an underage drinker who was sold alcohol at that location.

Limit number/density of alcohol establishments

Local or state governments enact regulations that reduce the number of alcohol establishments or limit the number that may be established in a community or area, often through licensing or zoning laws.

Enact responsible beverage service training laws

Responsible beverage service training laws, enacted at the local or state level, mandate that all or some servers, managers, and/or license holders at alcohol establishments receive formal training on how to responsibly serve alcohol.

Enact social host provision laws

Social host provision laws are enacted by local or state governments to hold accountable adults who supply alcohol to those under age 21.

Retain state-run alcohol retail stores (where applicable)

Local and state governments support existing state control systems for wholesale and off-premises retail distribution whereby a state sets the prices of alcohol and gains profit/revenue directly rather than solely from taxation.

Enact false/fake ID laws

Local, state, and federal governments may enact laws to hold producers of fake IDs accountable for creating illegal identification products. These laws may also: (1) hold users of fake or false identification accountable for misrepresenting their age and/or identity, (2) make it illegal to loan or transfer an ID to an underage person, and (3) allow retailers to seize a fake ID from an underage person.

Please note: The material on this page is adapted from NIAAA's CollegeAIM website and booklet, which include information about interventions that are relevant to young adults who are not in college. CollegeAIM is unique in the breadth of research covered by its analysis and was designed to be updated periodically to capture recent research findings in peer-reviewed journals and to ensure that recommendations are revised accordingly.