During my teenage years in the 1970s, the legal age to purchase alcohol in my state was 18. It was hardly rare that some of my friends and classmates drank before their 18th birthday, but clearly there was a rite of passage mentality around turning 18 and using alcohol.

My supervisor and co-workers at my after-school job began planning a night out for me as my birthday approached. My dad came along. Nothing too wild, but the expectation was clear.

For many people, early experiences using alcohol involve binge drinking. That is, we don’t have a drink or two as we visit with friends or family. We drink until we are intoxicated. Binge drinking is typically defined as four or more drinks at one time for girls or women, and five or more drinks at one time for boys or men. Clearly, consuming that much alcohol makes you legally intoxicated.

It seems self-evident that binge drinking can be a problem by itself. People who are intoxicated risk motor vehicle accidents or other accidents, such as falls, that lead to injury or death. As a central nervous system depressant, alcohol slows down your breathing, heart rate and brain function. Too much alcohol in a limited amount of time can kill you.

Binge drinking is often the first step toward alcohol abuse or alcohol dependence. Alcohol abuse is defined as continued use of alcohol even when it causes serious disruption in your work, school, family and friends.

Alcohol dependence involves physiological tolerance to alcohol, withdrawal when use of alcohol stops or obsessive use of alcohol. People who binge drink are at higher risk for abuse and dependence.

Two disturbing findings have emerged recently in terms of our national struggle with alcohol abuse. First, the average age when people become alcohol-dependent is their early 20s. However, the average age when people first receive some type of treatment is in their early 30s. The National Institutes of Health term this a “lost decade” and highlight the importance of getting people into treatment earlier.

Even more disturbing, the age at which alcohol problems begin is alarming. Recent national surveys suggest that one in 10 sixth-graders have had an episode of binge drinking. In a class of 20 sixth-graders, that means that, statistically, two students have already been drunk.

One in three high school students report at least one episode of binge drinking in the last month. Are we truly aware that issues of alcohol use should be front and center for our children in middle school and high school?

There are many changes that would help limit the negative impact of alcohol abuse. But, uncomfortable as it may be, perhaps we can start with our own attitudes. What do you think about yourself or your children and binge drinking? Is binge drinking just part of being young? Or, might we go at this a little more thoughtfully?

Psychologist Dr. David Prescott is the director of psychology services and clinical research at The Acadia Hospital. He writes a monthly column as part of Acadia’s Because Your Mental Health Matters Campaign.