The death of Makamae Auli'i Ah Mook Sang from alcohol poisoning shocked many people in Hawai'i and generated questions about how this tragic incident could have happened.

Makamae's senseless death has brought to light the serious problems of underage drinking, binge drinking and adults providing alcohol to minors. While alcohol poisoning deaths are infrequent, Makamae's story is a chilling reminder that more needs to be done to educate both youth and adults about the dangers of underage drinking.

The public recognizes MADD Hawai'i as an organization dedicated to stopping drunk driving and supporting the victims of this violent crime. The third part of MADD's mission, adopted in 1999, is to prevent underage drinking. It may prove to be the most challenging aspect of MADD's work and it needs help from many sectors of the community.

The average age at which children take their first drink in Hawai'i is 12. The use of alcohol increases during the intermediate and high school years. According to a 2007 Youth Risk Behavior survey by the National Center for Chronic Disease Prevention and Health Promotion, 14.9 percent of Hawai'i public school students in grades 9 to 12 had five or more drinks of alcohol in a row at least once in the previous month.

It's an alarming statistic that indicates that approximately one out of every seven public high school students engages in binge drinking at least once a month.

In addition to the possibility of death from alcohol poisoning, there are a number of other serious consequences to underage drinking, including car crashes, other "accidents," homicide, suicide, sexual abuse, sexually transmitted diseases and school failure.

In 2003, the social host law was adopted in Hawai'i which creates civil liability for an adult who provides alcohol to a minor if that minor then kills or seriously injures another person. Adults can also be liable for knowingly allowing the consumption of alcohol by minors on premises under their control. In addition, the law states that it is a misdemeanor offense for adults to provide alcohol to minors under the age of 21. Misdemeanors are punishable by up to a year in jail and/or a fine of up to $1,000.

While the social host law focuses on deterring adults from providing alcohol to minors, another recently passed law penalizes the underage drinkers themselves. The "use and lose" law requires the court to issue a 180-day driver's license suspension to any person under 21 who illegally purchases, possesses or consumes alcohol. In addition, all violators are required to perform community service and undergo alcohol education and counseling.

The Social Host and Use and Lose laws act as intervention tools, but there are also preventive initiatives to combat the underage drinking problem in Hawaii. MADD Hawai'i offers two such programs in which youth affect their own communities: Youth in Action and UMADD, which involve high school and college students, respectively.

MADD's nationally recognized youth program, Youth In Action, trains students to participate in projects that engage the community and local law enforcement to help curb underage drinking. Projects focus on making environmental changes through working to restrict minors' access to alcohol, increasing youth awareness of the impact of alcohol advertising, and advocating for legislative bills that pertain to youth and alcohol. The UMADD program works directly with colleges and universities to change the college-drinking environment.

In addition to these two projects, MADD Hawai'i and other local organizations and agencies participate in a statewide coalition — The Hawai'i Partnership for the Prevention of Underage Drinking — to coordinate the community's plans and programs to tackle the pervasive problem of underage drinking.

It is unfortunate that the death of a 15-year-old girl has to be the catalyst for bringing attention to issues surrounding alcohol and youth. For Makamae's death not to be in vain, parents and other adults must accept the fact that alcohol can be a dangerous drug which, except in certain legal circumstances, should never be sold or provided to minors under the age of 21.

To receive more information about the prevention of underage drinking, call MADD Hawai'i at 532-6232 or visit www.MADD.org.