In recent years, Maui County's young people have outpaced the rest of the state in the severity of underage drinking, according to the executive summary of Maui County's Strategic Underage Drinking Prevention Program.
The distinction means Maui's youth are more at risk of alcohol-related traffic fatalities, suicides, risky sexual behavior, physical and sexual assault, and the harm drinking can do to a young, developing brain, not to mention other organs, such as the liver.
The report specifically mentions the March 25, 2012, two-vehicle fatal crash on Kula Highway near Noholoa Street that took the lives of five youths and that officials said they believed may be linked to alcohol consumption.
According to the National Institutes of Health, underage drinking is a leading contributor to death from injuries, which are the main cause of death for people under age 21. Each year, approximately 5,000 people under the age of 21 die from causes related to underage drinking. These deaths include about 1,600 homicides and 300 suicides.
The Maui County report was completed in 2009 and updated in November 2012. County officials unveiled the report late last month.
The report's findings include:
* 10th-graders reported drinking dependence/abuse at a rate of 31.7 percent, 6.7 percentage points higher than the statewide rate of 25 percent.
* 21 percent of Maui students admitted using alcohol within the last 30 days, compared with 18 percent statewide.
* About 60 percent of youths in Maui County said they had been drunk or suffered the after-effects of alcohol at least once while at school, work or taking care of children.
* Approximately 70 percent of youths who have consumed alcohol in the past year reported being drunk when involved in activities that could increase their chances of being hurt.
* A higher percentage of Maui County youths reported experiencing multiple alcohol withdrawal and dependence symptoms (more than 20 percent in both categories) than their peers statewide (15 and 20 percent, respectively).
* A similar percentage of youths (more than 20 percent) in Maui County and statewide revealed that they wanted to give up drinking but were unable to quit.
* 40 percent of Maui County youths reported never having used alcohol, but a little more than 10 percent said they first used alcohol at age 10 or younger.
* Maui County binge drinking (the consumption of five or more drinks for males, four or more for females, per occasion) for the first time and getting drunk for the first time was reported highest for the age group 13 to 16 years old.
* About 98 percent of Maui County youth said they never bought alcohol at a store, bar or restaurant. However, about 20 percent of youth revealed that they had someone of legal age buy alcohol for them.
The report says that alcohol is readily available for youths, with most (80 percent) saying that they were offered alcohol by friends, while more than 50 percent said they were offered drinks by relatives.
"There is a definite connection between the perceived risk of harm and the underage use of alcohol in our county," the report says. "From parents, friends, the actual youth in question, all seem to feel that there is moderate-to-severe risk involved in underage drinking."
Despite presumably being more aware of the risks, the data indicate that those in the 15- to 17-year-old age group are still drinking more within the month than 12- to 14-year-olds.
Compared with their peers statewide, Maui's youths perceive less risk of getting in trouble with their parents and friends if they drink regularly, the report says.
"Youth in Maui County believe there is less disapproval of drinking among their peers than those statewide, with 71 percent showing disapproval of weekend drinking, compared with 74 percent statewide, and only half of Maui County youth see weekend drinking as a risky or dangerous behavior," the report says.
Youths are less concerned with law enforcement, it says.
Based on survey results for Maui County, "local youth made no mention of getting caught for underage purchase of alcohol, being stopped for drinking while driving or any similar consequence," the report says. "On the contrary, there was more concern about getting caught by parental figures.
"The implication is that underage drinking consumption and its consequences are not really thought of as relating to enforcement outside of the home. If youth are actually caught while under the influence, then it becomes an issue. However, the youth in Maui County do not seem to automatically put underage drinking and law enforcement in their minds."
As children become teenagers, their perception of alcohol use changes, the report says.
"In general, older children do not feel quite so strongly about alcohol use being 'wrong,' '' it says.
In Maui County, the mean age of a youth's first use of alcohol is 12.1 years old, a little less than the statewide mean age of 12.2 years old. Among Maui 12th-graders, 42.5 percent said they used alcohol within the last 30 days. The highest rate was on the Big Island, 49.8 percent.
The report says underage drinking is a wide-ranging problem.
"Because drinking alcohol lowers inhibitions, there are inevitably more juvenile cases involving vandalism, theft and assaults, in addition to a higher incidence of unprotected sex, teen pregnancy and spread of sexually transmitted diseases," it says. "Thus, in addition to the criminal justice arena, underage drinking burdens the social service and medical service systems in our community."
It is illegal for anyone under 21 years old to purchase, possess or consume alcohol, and it's illegal for adults to provide, sell or purchase alcohol to youths.
To address the problem of underage drinking, the state has created the Hawaii Strategic Prevention Framework State Incentive Grant. Funded through an agreement with the Center for Substance Abuse Prevention, states receive as much as $2.35 million annually for five years to:
* Prevent the onset and reduce the progression of substance abuse, including childhood and underage drinking.
* Reduce substance-abuse-related problems.
* Build prevention capacity at the state and community levels.
* Brian Perry can be reached at firstname.lastname@example.org.