Friday, June 9, 2017

Reflections on the Penn State Tragedy

In the wake of the Penn State tragedy which led to the untimely death of 19 year old sophomore Timothy Piazza, Twenty-One Debunked was initially quiet about it lest we be accused of cynically exploiting this tragedy.  But as time goes on, I have decided that as an activist and a Penn State alum myself, I cannot remain silent about it any longer.

First, I must say that the fraternity brothers who were present at the event in which Piazza was fatally injured should not be in any way absolved of responsibility for what happened.  It was bad enough that they gave (or more accurately, force-fed) him ludicrous amounts of alcohol in a short amount of time, enough to reach a BAC of 0.40 (!), apparently as a hazing ritual.   But when he fell down the stairs and sustained a nasty head injury and was barely responsive, they could have very likely saved his life by calling 911 or otherwise getting medical attention for him, but chose not to.  Instead, they basically treated him like a rag doll and subsequently let him "sleep it off".   Regardless of the drinking age and the age of the people involved, what the brothers did, and failed to do, was nothing less than reckless, selfish, and cowardly, and they should certainly never be allowed to get away with it.  So don't even think about putting any sort of words in our mouths.

But then a very ageist article was wrtitten to try to explain this tragedy away as a result of brain development or lack thereof.  And that's when we at Twenty-One Debunked really saw nothing but red.  The article was not only blatantly ageist, but completely missed the point by a long shot.  If the drinking age was 18, for example, this tragedy would have been far less likely to have happened.  There would be less reason for frats to even exist begin with, since 18-20 year old students would readily have more reliable alternative sources for alcohol and parties, and most of all drinking would occur in safer environments in which people would be more far likely to call 911 or otherwise get help for injuries or overdoses without fear of legal reprisals.  Even medical amnesty policies, which are good, are still no substitute for full legalization or at least decriminalization of "underage" drinking in general.  While lowering the drinking age is not a magic bullet, it will nonetheless go a long way towards reducing the problem of extreme and dangerous drinking on college campuses and towns, particularly among Greek organizations and athletes.  Additionally, we need to hold rogue individuals and organizations accountable for their behavior regardless of how powerful or privileged they are.

How many more must die or otherwise have their lives ruined for such an ignoble experiment as the 21 drinking age?   Are we as a society really so pharisaical that we don't even follow our own advice when we selectively say "if it saves one life, it's worth it"?   Because the logical conclusion of that line of reasoning is that the pro-21 crowd has some serious blood on their hands.

Sunday, June 4, 2017

Teen Drinking Drops in Germany Despite Low Drinking Age

The pro-21 crowd often likes to claim that the recent and secular trends towards less drinking among young people in the USA was largely a result of raising the drinking age to 21 and tightening up its enforcement. But the drinking age hike was at most a minor contributor to such trends, since similar trends can also be seen in several other countries that did NOT raise the drinking age to 21.

One such notable example of this is Germany, whose drinking age is 16 for beer and wine, and 18 for distilled spirits.  In fact, one can even drink at 14 in public when accompanied by a parent or guardian, and there is no age limit for drinking in private residences.   Such laws have essentially been in effect for as long as anyone can remember (with the notable exception of the Nazi era), so what were the results of maintaining them in recent decades?  From 1979 to 2016, the percentage of 12-17 year old Germans who drink at least weekly dropped from 25.4% to 10.0%, a relative drop of more than 60%.  For 18-25 year olds, the percentage dropped by nearly half during the same timeframe, and from 1973-2016 dropped from from two out of three (67.1%) to less than one out of three (30.7%).  These trends are comparable to if not faster than the corresponding figures for American youth.

In other words, consider this the final nail in the coffin for the specious claim that the 21 drinking age had anything more than a minor impact on overall teen or young adult drinking.

Saturday, June 3, 2017

The Dark Side of the Icelandic Model

Recently, we posted an article about the seemingly successful Youth in Iceland strategy for reducing teen substance abuse. To wit, since 1997, the consumption of alcohol, tobacco, cannabis, and other substances among 15-16 year olds has plummeted theremore so than any other nation, according to surveys.  And in fact, by 2016, Iceland was able to boast having the cleanest-living teens in the industrialized world, in contrast from being home to Europe's heaviest-drinking teens twenty years ago.

This was done through a combination of things: 1) laws were changed to raise the age of majority from 16 to 18, raise the smoking age for tobacco to 18 and the drinking age to 20, and set a 10 pm curfew law for people under 16, 2) most parents pledging to basically close ranks and keep their kids on a fairly tight leash overall, at least by European standards, and 3) the government investing in providing sports and other recreational activities for young people to give them something to do as a healthy alternative to drugs or alcohol.   And while not explicitly considered a part of the strategy, Iceland's very high alcohol taxes no doubt played a role as well.  We at Twenty-One Debunked noted how this strategy was a mixed bag and would support it if (and only if) it could be done without the ageism/adultism, like Kaunas, Lithuania (and some other cities) supposedly was able to do.

But one thing we did not look at right away was what happens when Icelandic youth finally do come of age.  The surveys used to support the Icelandic Prevention Model are of 15-16 year olds, but curiously the model's supporters don't even mention any data for people just a few years older.  Surely there should be a positive spillover or at least a cohort effect that follows youth exposed to the strategy if the ageists' theories are correct, so such a glaring omission is very curious indeed.

We think we know why.  For adults, Iceland is in fact one of the drunkest and druggiest countries in the world.  This is particularly true for prescription pills:  they seem to lead the world (or at least Europe) in the use/abuse of opioid painkillers, sedatives, tranquilizers, and stimulants.  And such drugs, particularly opioids, have been on the rise lately even as they have fallen in many other countries.  And despite fairly strict drug laws, the use of illicit drugs, both cannabis as well as hard drugs, have also increased significantly recent years as well. Iceland also notably leads the world in antidepressant use, and is also on the increase, which can be true for a number of reasons.   Though their overall per-capita alcohol consumption is below the OECD average, it has nonetheless risen 35% since 1992 despite recent alcohol tax hikes, and when they do drink, they really drink themselves into oblivion--kinda like stereotypical American college freshmen.  Of course, Iceland was already kind of like that before the Youth in Iceland strategy began in 1998, as well as for cohorts that came of age before that, but the fact that such widespread substance use/abuse has held steady or increased for the cohorts of adults that were affected by the law changes shows just how hollow the whole thing really was.

Oh, and for those who think that America's so-called "hook-up culture" among young people is out of control, well, let's just say that you've never been to Iceland.  And not just for young people either.  Over there it seems that "f**k first, names later" is the norm, often literally, and they are usually under the influence of alcohol when they do it.  Not to knock casual sex per se, or to shame anyone for it, but it is nonetheless sobering to note that Iceland leads Europe in terms of STD's, or at least chlamydia in particular, a disease that has even been nicknamed the "Reykjavik Handshake".  So apparently many Icelanders are getting so wasted that they fail to use condoms as directed, if at all, when they hook up.

In other words, the otherwise-progressive Iceland has basically become Little America in that regard, and not necessarily in a good way either.  That is what happens when ageists in power focus only on young people while ignoring the pink elephant in the room--the behavior of their elders.  The contrast between "abstain from everything" adolescence and "anything goes" adulthood couldn't be any more stark, and simply raising age limits or revoking civil rights from young people merely kicks the proverbial can down the road.  It's the Law of Eristic Escalation in action:  imposition of order leads to escalation of chaos/disorder, particularly if the order in question imposed is arbitrary and/or coercive. Renowned sociologist and youth-rights activist Mike Males would surely have a field day with Iceland!

Monday, May 29, 2017

Have a Safe and Happy Memorial Day!

Today is Memorial Day, often known as the unofficial first day of summer and National BBQ Day.  But let's remember what it really is--a day to honor all of the men and women of our armed forces who made the ultimate sacrifice for our country.  And that of course includes all of those who died serving our country before they were legally old enough to drink.  Let us all take a moment of silence to honor them.

As for Candy Lightner, the ageist turncoat founder of MADD who had the chutzpah and hubris to go on national TV in 2008 and publicly insult our troops, may her name and memory be forever blotted out. 

And as always, arrive alive, don't drink and drive.  It's just not worth it, period.  And it's very simple to prevent.   If you plan to drive, don't drink, and if you plan to drink, don't drive.  It's not rocket science.

Friday, May 12, 2017

What We Can Learn from the Latest Monitoring the Future Survey

The 2016 Monitoring the Future (MTF) survey results are in, and they may be a bit surprising to ageists as well as prohibitionists of all stripes:

  • The use of alcohol and tobacco are both at record lows for 8th, 10th, and 12th graders.
  • "Binge" drinking (5+ drinks in one session) is also at a record low, and even "extreme binge drinking" (10+ drinks in one session) is the lowest it has been since 2005 when participants were first asked this question.
  • The use of any illicit drug other than cannabis has also reached a historic low.
  • The use of most specific illicit drugs have dropped significantly in recent years, many of which to record lows.
  • The notorious opioid epidemic, while currently out of control among adults, does NOT appear to be much of a problem for teenagers, as the use of both heroin and prescription opioids have actually dropped dramatically in the past several years among all grades surveyed.
  • In fact, past-year use of heroin in particular reached an all-time record low in 2016 for all grades surveyed.
  • Use of designer drugs such as "bath salts" and synthetic cannabis are also at their lowest point since they first came on the radar of researchers.
  • And in spite of cannabis being legalized in several states recently, its use has nonetheless dropped significantly among 8th and 10th graders since the most recent peak in 2011, and stabilized (in fact dropped slightly) among 12th graders since then as well.  Note that there is also no evidence of a "gateway" effect of legalization either, as some had feared.
But don't expect the fearmongering mainstream media to tell you any of that, of course.  Certainly no one in the "teen panic" industry or the anti-legalization lobby would tout such statistics no matter how true, as that would contradict their agendas.  Put that in your pipe and smoke it!

Another thing that can be gleaned from the MTF surveys is a different sort of natural experiment for what full legalization of cannabis would look like in practice, using synthetic cannabis (Spice, K2, etc.) as a sort of counterfactual.  In 2011, when natural cannabis was illegal for recreational use in all 50 states (Alaska was then in legal limbo in regards to possession), it was also the first year that synthetic cannabis was asked about in the survey.  At the time, synthetic cannabis was readily available at head shops and even gas stations and convenience stores across the nation, and if there was even any age limit at all it was generally no higher than 18 and was generally not vigorously enforced.  And one of its biggest selling points was that not only was it legal, but it would also not show up in drug tests.  And it was widely regarded to be safe at the time, before its very real dangers became more obvious later on (and was later banned or restricted).  So one would think that, at least briefly, it would have become more popular than the real thing, right?

Wrong.  According to the 2011 MTF survey, young people apparently still preferred the real thing, legal niceties aside.   Fully three times as many 12th graders reported using natural cannabis at least once in the past year in 2011 as used the synthetic knockoffs that year.  And while 8th and 10th graders were not asked about synthetic cannabis until the following year, the 2012 results also show a similar two to threefold difference in favor of natural cannabis.  Thus, on balance, it strongly suggests that natural cannabis use among young people would not increase significanly even if it was legal and readily available at the local 7-Eleven for anyone over 18, right next to the cigarettes and beer, a policy which Twenty-One Debunked currently advocates.  And it also strongly suggests that young people who are so inclined can largely be trusted to make the safer choice as well in that regard.

So what are we waiting for?

Saturday, May 6, 2017

180/180: How to Clean Up Chicago (Or Any Other City) in 180 Days or Less

With all of the talk about Chicago's crime wave (despite most crime being at or close to the lowest in decades nationwide), the national opioid epidemic, and the corresponding calls (mostly from the right-wing) to get "tough on crime" as well as to further reinvigorate the War on (people who use a few particular) Drugs, we at Twenty-One Debunked have decided to discuss an idea that our webmaster has been working on for almost a year now, that may one day become a full-length book.  In a similar vein as When Brute Force Fails:  How to Have Less Crime and Less Punishment by UCLA researcher Mark Kleiman, we have put together an evidence-based strategy called "180/180" (i.e. turning the crime and drug problem around 180 degrees in 180 days) that we feel jibes better with our movement.   While we borrow many ideas from Kleiman, we also reject a few of his ideas and have added several of our own as well, drawing from the vast experience of various cities, towns, and countries around the world.

Twenty-One Debunked believes that 1) the drinking age should be lowered to 18, 2) cannabis should be fully legalized for everyone 18 and older and treated no more stringently than alcohol or tobacco, and 3) all other currently illegal substances should be treated for the most part according to the Portuguese model of decriminalization of users, since full legalization of such substances (while we don't necessarily oppose doing so) is unlikely to be politically feasible at this time and could have unforseen consequences if not implemented properly.  Additionally, the True Spirit of America Party also supports abolishing (or at least greatly reducing) material poverty (which is, along with structural racism and economic inequality, one of the major root causes of both crime and substance abuse) via a Universal Basic Income Guarantee as well as a Humprey-Hawkins style Job Guarantee program.  In the long run, all of these things are likely to reduce crime and/or substance abuse overall.  But in the meantime, with or without the aforementioned measures in place, enter the 180/180 strategy to really take a bite out of crime in the near-term:

  • Implement an all-ages curfew law for the first 90 days, albeit with exceptions for people traveling to or from work or school.  Similar to what Iceland did, except for all ages and for a limited period of time.  Set it at 9 pm Sunday-Thursday and 10 pm on Friday and Saturday in general (10 pm and midnight, respectively, in the summer when days are longer).  
  • Implement a "dry law" (no alcohol can be sold, period) for the first 30 days of the strategy.
  • Increase the number of police and the number of patrols conducted, while also being careful to maintain good relations overall between the police and the community.
  • Raise the taxes significantly on all alcoholic beverages and/or set a price floor on such drinks. 
  • Put a "sinking lid" on the number and density of alcohol outlets, especially liquor stores.
  • Make simple possession of cannabis (and perhaps other drugs) and "underage" drinking the lowest law-enforcement priority (LLEP), similar to the San Francisco Miracle of the 1990s.
  • Do a "low-arrest crackdown" on any hard-drug markets, as was done in High Point, NC.  Instead of the usual catch-as-catch-can, build a case against every drug dealer in town, with enough evidence to put them away for a long time.  Then call them all in for a meeting and give them an ultimatum: stop dealing now or go to prison.  The market will dry up very quickly, and likely remain as such for years.
  • Implement Hawaii's HOPE program (for hard drugs) and South Dakota's 24/7 program (for alcohol) for probationers and parolees. 
  • Implement the strategies of Operation Ceasefire, aka the Boston Miracle, as a proven way to defuse gang violence.
  • Conduct an evaluation of the effectiveness after 180 days.  If serious crime has not dropped by at least half during that time, re-start both the curfew and dry law again, repeating as needed.  Otherwise, do not bring either one back, but maintain the other components of the strategy.
If the reader found the first two components to be a bit jarring, that was in fact the goal.  It SHOULD be very jarring to anyone who believes in individual rights.  Only by applying them to all ages would such measures really have any significant benefit, and should be short-term since they basically function like a tourniquet--good for stopping the bleeding, but once the bleeding has stopped, leaving them in place would do more harm than good on balance.  And doing them frivolously would also do more harm than good, so reserve the curfew and dry law for places with exceptionally high levels of crime and/or hardcore drug abuse.  Otherwise, the other components of the strategy can stand alone, which we like to call "180/180 Lite".

Other, medium- to longer-term measures that ought to be included in a comprehensive strategy are:

  • Get the Lead Out, and Take a Bite Out of Crime.  Numerous studies have shown a strong relationship between preschool lead exposure and later involvement in crime and other social ills during adolescence and adulthood.  (And take fluoride out of our drinking water as well, which worsens the leaching and effect of lead and is also neurotoxic in its own right.)
  • Provide free birth control to anyone who wants it, and end the current assault on women's reproductive rights, yesterday.  (Fewer unwanted children will lead to fewer criminals in the long run, according to Freakonomics)
  • Send nurses to visit the homes of first-time mothers who are poor and/or young.  According to Kleiman, this may be the most cost-effective crime-fighting program ever devised.
  • Implement sensible gun control laws (while still respecting the Second Amendment), as well as putting a tax on bullets.
  • For cities with very high crime rates, consider combining the controversial Project Exile (i.e. tougher enforcement of federal gun laws) with the aforementioned Operation Ceasefire, as was the case in the strategy known as Project Safe Neighborhoods
  • Shift the school day (for middle and high school) to both start and end later.
  • Raise the minimum wage.  (Yes, studies do show a correlation)
  • Implement a "Housing First" approach to solving homelessness.
  • Invest more in education in general, from pre-K through post-grad.
  • Invest more in both mental health and substance abuse treatment programs, as well as substitution therapy (methadone, buprenorphine) for opioid addicts.
  • Provide more opportunities for alternative forms of recreation, like Iceland did.
  • If we find we must follow the "broken windows" theory, think James Q. Wilson (who invented it), NOT Rudy Giuliani.  Do NOT use racial profiling or police brutality, or anything else that violates anyone's civil or human rights, period.
  • And for crime in general, we must always keep in mind that swiftness and certainty of punishment works better than random severity.  Punishment is a cost, not a benefit.
And of course, all of these things have social benefits that go way beyond simply fighting crime as well.  The evidence is overwhelming, so what are we waiting for?

We have been trying to get "tough on crime" for decades now.  It's time to get SMART on crime instead.

Monday, April 24, 2017

Lowering the Drinking Age: It's Not Just for the Left Anymore

Twenty-One Debunked, a subsidiary of the True Spirit of America Party, is generally on the political left, or more accurately, at the intersection of progressivism and libertarianism.  Or as we prefer to call ourselves, "progressive libertarian".  Thus, we are certainly not a right-wing organization.

But did you know that one can easily make a conservative case as well for lowering the drinking age, or even abolishing it entirely?  That is what British author Wayland Ellis argues in his new provocatively-titled book:  Abolish the Drinking Age:  The Conservative Case Against Alcohol Regulation.   His old-school conservative argument centers on the idea that the 21 drinking age is in fact a form of paternalism, as is alcohol regulation more generally as well.  And that paternalism is actually not right-wing, but rather left-wing or even socialist.  (Progressivism and even socialism need not be paternalistic, of course, but I digress.)  He certainly does not believe that the federal government has any business dictating to the states what the drinking age should be, and indeed his position does in fact jibe with old-school Republicans (not to be confused with the radical right, neocons, theocons, etc. that now control the party).  As for letting the states decide, he realizes the political infeasibility of abolishing the drinking age overnight, and would be fine with first lowering the drinking age to 18, then 16, and so on as pragmatism shall dictate.  As for other alcohol regulations, he is generally against them, with the notable exception of taxation--like us, he believes alcohol taxes should in fact be raised significantly.  But otherwise, he feels regulation does more harm than good for the most part.

Twenty-One Debunked, on the other hand, argues from a progressive libertarian and youth-rights perspective, that the 21 drinking age violates the guarantee of equal protection of the law.  There is no good reason for the legal drinking to be any higher than the age of majority, period. And while we are not actually opposed to lowering the drinking age further (say, to 16, or abolishing it entirely) after it has been successfully lowered to 18, we no longer consider such a goal to be worthwhile at least for the near-term.  It would be a LONG time before it would be politically possible to do, and doing it too quickly could indeed have unintended consequences.  But lower it to 18 we must, yesterday.  As for other alcohol regulations, we (unlike Ellis) generally do not oppose them as long as they are reasonable and not ageist or otherwise discriminatory.

Anyone reading this needs to show this to their conservative friends and family.   As unpalatable as it may be to form a "big-tent" coalition with conservatives over the issue of lowering the drinking age, it will most likely be our only hope in succeeding.   Even if we have to hold our noses.  For the same reason, we need to rely not just on libertarian or individualistic arguments for lowering the drinking age, but also on communitarian arguments as well.  Even "law and order" arguments can work in our favor as well, in fact.

So what are we waiting for?

What's Up With Iceland?

Iceland, a country that Americans don't hear much about in the news is now the talk of the town, apparently.   At least among those who are interested in reducing youth substance abuse.  Since 1997, the consumption of alcohol, tobacco, cannabis, and other substances among 15-16 year olds has plummeted there, more so than any other nation, according to surveys.  And in fact, by 2016, Iceland was able to boast having the cleanest-living teens in the industrialized world, in contrast from being home to Europe's heaviest-drinking teens twenty years ago.  So how did they do it?

For starters, laws were changed.  The general age of majority was raised from 16 to 18, the smoking age was raised to 18, and the drinking age was raised to 20.  While possession and consumption are not illegal below that age over there, selling or furnishing alcohol or tobacco to people below that age is prohibited.  Advertising for both substances was banned, and the prices for both substances are very high due to taxation (e.g. alcohol in Iceland costs about double what it does in the USA on average). Also, a 10 pm curfew was implemented for 13-16 year olds, albeit relaxed to midnight in the summer.  (Of course, it should go without saying that we at Twenty-One Debunked would NOT support a drinking age any higher than 18, period, and from a youth-rights perspective we would NOT support age-based curfew laws either).

More importantly, though, were the other components of the Youth in Iceland strategy.  From the Mosaic article:

"Links between parents and school were strengthened through parental organisations which by law had to be established in every school, along with school councils with parent representatives. Parents were encouraged to attend talks on the importance of spending a quantity of time with their children rather than occasional “quality time”, on talking to their kids about their lives, on knowing who their kids were friends with, and on keeping their children home in the evenings."
Home and School, the national umbrella body for parental organisations, introduced agreements for parents to sign. The content varies depending on the age group, and individual organisations can decide what they want to include. For kids aged 13 and up, parents can pledge to follow all the recommendations, and also, for example, not to allow their kids to have unsupervised parties, not to buy alcohol for minors, and to keep an eye on the wellbeing of other children.
These agreements educate parents but also help to strengthen their authority in the home, argues Hrefna Sigurj√≥nsd√≥ttir, director of Home and School. “Then it becomes harder to use the oldest excuse in the book: ‘But everybody else can!’”
State funding was increased for organised sport, music, art, dance and other clubs, to give kids alternative ways to feel part of a group, and to feel good, rather than through using alcohol and drugs, and kids from low-income families received help to take part. In Reykjavik, for instance, where more than a third of the country’s population lives, a Leisure Card gives families 35,000 krona (£250) per year per child to pay for recreational activities."
So they seem to have an overall mixed bag from a youth-rights perspective, perhaps.  But that last bit about increasing state funding for recreational activities is what really seems to be the clincher for Iceland's success story.  Twenty-One Debunked certainly supports that aspect of the Youth in Iceland strategy.  And indeed that is precisely what one would predict from the famous yet underrated "Rat Park" studies.  To wit, boredom, stress, and especially lack of connection are the root causes of substance abuse and addiction.  Whether rats or people, give them fun stuff to do and opportunities to interact socially with one another, and they are less likely to want to numb themselves with alcohol or other drugs.  And that is true for all ages.

Note as well that Iceland, like all Nordic countries, has a very robust and generous social welfare state and social safety net. That clearly contributes to their relatively low level of poverty and desperation compared to the USA.  And they are generally one of the most progressive countries in the world in that regard.   And more so now than they were before the 2008 financial crisis.  So that might also have something to do with it as well.

Another gem from the same article, about when the less-controverisal aspects of the Icelandic model have been tried in some other places with a drinking age of 18 and no curfew laws, as Kaunas, Lithuania:

"Across Europe, rates of teen alcohol and drug use have generally improved over the past 20 years, though nowhere as dramatically as in Iceland, and the reasons for improvements are not necessarily linked to strategies that foster teen wellbeing. In the UK, for example, the fact that teens are now spending more time at home interacting online rather than in person could be one of the major reasons for the drop in alcohol consumption.
But Kaunas, in Lithuania, is one example of what can happen through active intervention. Since 2006, the city has administered the questionnaires five times, and schools, parents, healthcare organisations, churches, the police and social services have come together to try to improve kids’ wellbeing and curb substance use. For instance, parents get eight or nine free parenting sessions each year, and a new programme provides extra funding for public institutions and NGOs working in mental health promotion and stress management. In 2015, the city started offering free sports activities on Mondays, Wednesdays and Fridays, and there are plans to introduce a free ride service for low-income families, to help kids who don’t live close to the facilities to attend.
Between 2006 and 2014, the number of 15- and 16-year-olds in Kaunas who reported getting drunk in the past 30 days fell by about a quarter, and daily smoking fell by more than 30 per cent."

Thus, when viewed through a more nuanced lens than the mainstream media does, it becomes clear that Iceland's apparently miracle can indeed be achieved without raising the drinking age (or smoking age) any higher than 18, and without implementing youth curfew laws either.  Or any other forms of "social cleansing" for that matter, something the USA has a rather dark history of doing.

 It's time for the USA to stop "chasing the dragon" of failed drug and alcohol policies, pun intended, because try as we may, we all know that we're never gonna catch it.

Friday, March 17, 2017

What Happened in NYC After Raising the Smoking Age to 21?

In 2014, New York City became the first major city in the USA to raise the tobacco purchase age to 21.  Prior to that, it was 18, much like the rest of the country.   The law was passed by Mayor Bloomberg at the end of 2013, and it went into effect in May 2014.

Since then, two states (California and Hawaii) have also raised it to 21 (both in 2016) and several counties and towns/cities as well from 2013-2017, though a few localities had also done so earlier as well.  When Needham, MA did so in 2005-2008, there was much praise from the pro-21 crowd when surveys showed that teen smoking rates had dropped much faster in Needham than in its surrounding communities (which were 18) from 2006-2010.  So it is very curious indeed that no one seems to be talking about what happened in NYC since they raised their smoking age.

We think we know why.  At first glance, it does appear to have had some effect.  According to the CDC's Youth Risk Behavior Survey (YRBS), teen smoking rates did in fact drop from 2013 to 2015 in NYC: 

2005   11.2%
2007   8.5%
2009   8.4%
2011   8.5%
2013   8.2%
2015   5.8%

Those are the percentages of combined 9-12 grade students who reported any current cigarette smoking in the past 30 days.  Looks impressive at first:  a relative 29% drop from 2013 to 2015.  But take a look at the same data for the nation as a whole, for comparison:

2005   23.0%
2007   20.0%
2009   19.5%
2011   18.1%
2013   15.7%
2015   10.8%

As you can see, the nation as a whole also saw a similar (if even faster) drop in teen smoking at the same time, with a relative 31% decrease from 2013 to 2015, despite no change in the smoking age in most places.  And the teen smoking rate in NYC was already much lower before the law change, having dropped more dramatically than the rest of the USA prior to 2007 and then remaining at a low level since. 

How about San Francisco, another major city that raised its age limit to 21?

2005   10.9%
2007   8.0%
2009   10.4%
2011   10.7%
2013   7.5%
2015   5.4%

They also saw a similar size drop from 2013-2015, to the tune of 28% (vs. 29% in NYC and 31% in the USA overall).  Just one problem though.  San Francisco did not raise their smoking age until 2016, so these data show that the drop in the smoking rate happened while it was still 18, before the age limit was raised.  Thus, it would actually be part of the no-change control group, not the experimental group.  And if you include the decrease since 2011, San Francisco in fact saw more progress than NYC.

Thus, we can conclude that the decrease in teen smoking in NYC following the hike in the purchase age was most likely NOT causally linked to it, and would most likely have occurred regardless given the above counterfactual data.  Kinda like we at Twenty-One Debunked initially predicted back in 2013 after first learning of the law change being proposed.  So if that wasn't the cause, what was?  Well, we know that nationwide, as well as in NYC, the secular trend for the past four decades (except a brief increase from 1992-1997) has been downward for both teen and adult smoking.  This was due to a general combination of education/awareness, taxation, regulation, and advertising restrictions, and the resulting cultural changes.  And in very recent years, electronic cigarettes have gained popularity as an alternative to combustible cigarettes, and in fact overtaking the latter and becoming at least twice as popular among high-schoolers by 2015.  Note that this was also true in NYC despite the 21 age limit applying to e-cigarettes as well.

Bottom line:  it looks like the supposed benefits of raising the smoking age to 21 were, shall we say, all smoke and mirrors.  The supposed success of Needham, MA was likely a statistical fluke and/or a result of endogeneity, much like the "early adopter" effects of the first few states to raise the drinking age to 21 creating that particular mirage in the 1980s.  Or perhaps increased enforcement in general relative to neighboring towns did the trick regardless of the age limit, like it did in Woodridge, IL and several other communities the 1990s.  And even if such benefits of the 21 age limit were real, we at Twenty-One Debunked would still not support an age limit any higher than 18, on principle alone.  Old enough to fight and vote = old enough to drink and smoke.  'Nuff said.

Sunday, February 12, 2017

What Should the Blood Limits for THC Be?

Now that cannabis is legal in eight states for recreational use, and numerous other states for medical use, the issue of how to handle driving under the influence of cannabis (DUIC) is currently being hotly and heavily debated.  Many states, both where cannabis is legal and where it is illegal, currently set an arbitrary non-zero number for their blood-THC limit, while others set the limit at zero (i.e. zero-tolerance), while still others do not set any specific per se limit despite driving while impaired being illegal.  And as of 2017, there remains zero evidence that any of these laws actually save any lives on the highways or otherwise.

Recently, the state of Oregon, where cannabis is legal, has effectively stopped enforcing their legal per se limit for THC, citing a lack of scientific evidence to justify such a policy.  To wit, the Oregon Liquor Control Commission’s report on the matter also supports the idea that cannabis is far less impairing than alcohol:

The rate of drivers tested by Drug Recognition Experts who are positive for THC intoxication rose between 2013 and 2014, but did not increase following legalization [in 2015]. Fatal accidents data is highly variable year-to-year, making trend analysis difficult. But in Oregon in 2015 there were only three more traffic fatalities involving a driver testing positive for THC compared to 2004. Moreover, the rate of THC-related fatal accidents is also considerably lower than such accidents involving alcohol intoxication. Finally, while overall traffic fatalities and alcohol-related fatalities spiked in 2015, THC-related fatalities did not."

Even the AAA now concedes that, while being high on weed can cause driving impairment, it is significantly less impairing than alcohol and is in fact comparable to driving with a “noisy child in the back of the car,” and only half as dangerous as talking on a hands-free cellphone (which is legal in all states).  That said, we should also note that different drivers may be affected differently, and novice users and/or novice drivers may be a lot more impaired than more experienced users and/or drivers.  And combining cannabis with alcohol is known to be significantly more dangerous in terms of driving impairment than either one alone as well.  But there is currently no scientific evidence strong enough to justify a zero-tolerance or per se limit for THC, as its pharmacokinetics are far too complex to correlate blood THC levels with actual driving impairment.  For example, frequent users (including medical users) can test positive several days after the last time they used it, even if they are not impaired in the least, and thus get unjustly snared in the same dragnet as those who are actually impaired from toking up an hour or two ago.

Twenty-One Debunked does not recommend that anyone drive under the influence of cannabis.  But our laws must reflect reality nonetheless.  Thus, we make the following recommendations:

  • Follow Colorado's lead and set a prima facie limit for THC instead of a per se limit.  That distinction is crucial, as that would not mean automatic guilt, but a rebuttable presumption of guilt for going over the limit, which can still be challenged in court to prove non-impairment.
  • Set the limit at no lower than Colorado's 5 ng/mL, as that level, though imperfect, provides the clearest separation between impaired and non-impaired driving according to the best research.  Zero tolerance = zero intelligence.
  • Do not test for inactive metabolites, except perhaps to confirm recency of use.
  • Increase the use of field sobriety tests and drug-recognition experts, and use saliva tests to check for recent cannabis use before drawing any blood.
  • Work on developing better methods of determining actual impairment, but do NOT use that as an excuse or delaying tactic for keeping cannabis illegal.
  • Consider allowing a "medical necessity" defense for medical users.
  • Make the penalties for DUIC alone significantly lower than for alcohol and other drugs, but in combination with other substances, or if anyone is injured or killed, throw the book at 'em!
  • For illicit drugs other than cannabis, a per se limit would in fact be appropriate.
  • Get much tougher on bad and reckless drivers in general, as well as distracted driving.
  • And in keeping with the overall mission of Twenty-One Debunked, set the age limit for cannabis at 18 and do not treat drivers aged 18-20 any differently than drivers over 21 with respect to cannabis.
In other words, facts > feelings, even in the "post-truth" era.

We should also note that the rather modest increase in traffic deaths in 2015 and 2016 nationwide, and in 2014 in some states as well, does NOT seem to be caused by recent cannabis legalization in several states.  Increases occurred in both legalized and non-legalized states, as did some decreases, and there was no clear pattern in that regard.  A much more plausible explanation is the massive drop in gas prices from late 2014 to 2016, which is known to increase traffic fatalities (all else being equal), along with the improving economy as well as "reversion to the mean" following an all-time record low per VMT in 2013-2014.  Ergo, QED.