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A new report says North Dakota leads the nation in the rate of binge and underage drinking. It's old news to state officials who have been on a mission to change it, with limited success.

The National Survey on Drug Use and Health, released Thursday by the federal Substance Abuse and Mental Health Services Administration, found 40 percent of North Dakotans ages 12 to 20 had at least one drink during the month before the survey was taken. The interviews were conducted in 2006 and 2007.

Researchers also found 32 percent of North Dakotans ages 12 and older said they had five or more drinks in one sitting during the month before the survey. The national average for binge drinking was 23 percent.

The results have changed little since 2005, when a similar survey found more than 31 percent of North Dakotans age 12 and older said they had five or more drinks in one sitting.

Drinking - even underage and to excess - is "culturally accepted" in North Dakota, authorities say, and many communities' social activities revolve around booze.

"This has been a tough nut to crack, no question about it," said Mikey Hoeven, North Dakota's first lady, who has been leading a campaign to prevent alcohol abuse since her husband was elected governor in 2000. "But I do see little glimpses of hope we're going in right direction."

Binge use is defined as having five or more drinks on the same occasion at least once in the last 30 days.

More than 58 percent of North Dakotans between the ages of 18 and 25 - the highest rate in the U.S. - reported binge drinking. Nearly 29 percent in the 26-and-older category said they had five or more drinks in one sitting, also leading the nation, the report said.

A survey last year of North Dakota communities found one-third of the adults thought teenage drinking was acceptable and should be legal, Attorney General Wayne Stenehjem said.

"It's shocking and it really points to the fact that we have a culture of acceptance," Stenehjem said. "It's illegal, it's dangerous and it needs to change."

Stenehjem said he has been criticized and called a worry wort by some, but he sees alcohol as a serious social problem.

The attorney general's office and the state Department of Human Services launched a brochure campaign in March to help prevent underage drinking and remind parents that providing booze to their children is against the law.

Some 36,000 brochures were mailed to parents of middle school and high school students, said Pamela Sagness, a Human Services prevention administrator. Posters and pamphlets aimed at teens also were placed in schools that outlined the consequences of drinking.

Day care centers and elementary schools received activity books aimed at making positive choices. Posters were sent to liquor stores and bars in the state reminding patrons that providing alcohol to people under 21 is illegal.

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"I don't know why they keep allocating money to this because I don't think it has any effect on anything," Nina VanPatton said. "I really think it's up to the parents."

VanPatton, 57, of Bismarck said she's been sober for 28 years. She said she did it for her daughter.

"I don't know any parent who wants their kid to drink," she said. "If drinking is an acceptable behavior for parents, then that's why kids do it. It's doing what you say, not what you preach."

Underage drinking is widely considered a rite of passage though it is illegal, Mikey Hoeven said.

"The good news is parents do have the power for modeling behavior and we need to use that power," Hoeven said. "Children live what they learn."

The study also found North Dakota was one of five states that showed increases in marijuana use among people ages 12 and older. But the state was among the lowest in the rate of illicit drug use other than marijuana.

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