Background: Early adolescence is a key developmental period for the initiation of alcohol use, and consumption among adolescents is characterized by drinking in high quantities. At the same time, adolescence is characterized by rapid biological transformations including dramatic changes in the brain, particularly in the prefrontal cortex and the mesocorticolimbic dopamine system.

Methods: This article begins with an overview of the unique neural and behavioural characteristics of adolescent development that predispose these individuals to seek rewards and take risks such as initiation of drinking and high levels of alcohol intake. The authors then outline important factors associated with an increased risk for developing alcohol problems in later adolescence and young adulthood. Thereafter they address causality and the complex interplay of risk factors that lead to the development of alcohol use problems in late adolescence and young adults.

Conclusions: A few recommendations for the prevention of underage drinking are presented.

Keywords: adolescent; alcohol; brain development; dependence; risk factors.

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