Friday, July 27, 2012

Update on Guam

Two years ago, we at Twenty-One Debunked were chagrined when Guam unfortunately raised the drinking age from 18 to 21.  While not all the necessary data are in yet, we have enough preliminary data to give some sort of an update on Guam since the drinking age was raised.

At least one Guam news website trumpets the July 2010 law change as a success.  For example, they note (correctly) that according to the 2011 Youth Risk Behavior Survey (YRBS), 13.6% of Guam's high school students engaged in "binge" drinking, compared to 19.2% in 2007, the last available year in the survey before the law change.  This drop by nearly a third sounds impressive until you consider the following facts:

  1. The decline in high school "binge" drinking actually began in 2001, from a high of 24.9%.  The drop from 2001 to 2007 was almost as large as the drop from 2007 to 2011.
  2. The figures also declined in the nation as a whole, from 29.9% in 2001 to 26.0% in 2011 to 21.9% in 2011.
  3. Due to the fact that the surveys were not done every year, we have no idea when the decline in Guam began to accelerate.
  4. For grades 9 and 10, the differences in "binge" drinking rates between the years 2007 and 2011 were not statstically significant, despite the fact that the differences were significant for the nation as a whole. 
  5. In fact, 9th and 10th graders in Guam actually saw increases in self-reported riding with a drinking driver, while the mainland saw decreases.  So much for the trickle-down theory.
  6. Guam's teen drinking and "binge" drinking rates have been consistently below the national average, even when their drinking age was 18.
  7. Compared with 2007, high school students in Guam saw increases in boozy sex as well as unprotected sex in 2011.
As for whether there were any effects on drunk driving arrests or crashes, it is too soon to tell since 2011 data are not yet available.  Even the 2010 data are problematic since the drinking age changed in midyear and there are not enough age-specific data yet for alcohol-related crashes and deaths.  We will keep you posted on this. 

The most recent Uniform Crime Report for Guam is for 2010.  In it we see that total DUI arrests dropped significantly from 2009 but nonetheless remain higher than 2008.  DUI arrests for 18-19 year olds were 42 in 2008, 52 in 2009, and 35 in 2010, which was a slight decrease from 2008.  (Data for 20 year olds in 2010 was lumped in with 21-24 year olds, so it could not be used.)  Juvenile crime (i.e. under 18) saw zero progress overall in 2010, and in fact nearly doubled from 2009.  Specific crimes that rose in 2010 among juveniles included not just DUI but also murder, rape, assault, robbery, vandalism, liquor law, and drug abuse violations among others.

One must also remember that in 2010 Guam had a major crackdown on drunk driving with tougher new penalties (after many years of a very lax policy), and also increased education and awareness about the alcohol problems on the island.  Also, the new drinking age of 21 appears to be more heavily enforced that the previous drinking age of 18, which was poorly enforced.  That's a lot of variables to consider.

Finally, we should note that if Miron and Tetelbaum's groundbreaking study of the 21 drinking age is any guide, any apparent benefits of Guam raising the drinking age to 21 should disappear beyond the first year or two of adoption.  And while tourism actually went up in 2011 (except for Japanese tourists after the tsunami) contrary to our predictions, it is still too soon to say that raising the drinking age to 21 had no adverse effect on tourism.  For example, the US military buildup on the island generated increased economic growth that could have potentially masked (or delayed) any declines in tourism that would have otherwise occurred.  The Fijian experience is instructive in that it took fully three years for Fiji to see that tourism was suffering due to the 2006 drinking age hike to 21, and then it was lowered back to 18 in 2009.

Friday, July 13, 2012

Is Alcohol Really a Gateway Drug?

While the "gateway drug" theory has historically been associated more with cannabis than any other substance, many of the theory's proponents have also fingered alcohol and tobacco as possible culprits in somehow inducing hapless youth to "graduate" to harder drugs and eventually become hopeless junkies, tweakers, and/or crackheads.  In this post we revisit the decades-old theory with a fairly new twist.

A new study of high school student survey data claims to find that alcohol, as opposed to cannabis or tobacco, is the real "gateway" drug.  The study found that of all of the numerous psychoactive substances asked about in the Monitoring the Future (MTF) survey, alcohol was the one that was the single most likely to predict (statistically) the use of the others with the greatest accuracy.  Ergo, if there is such a thing as a gateway drug, alcohol would most likely be it.

If there is such a thing, that is.  And that's a pretty big "if" if you ask us.  For starters, the historical background of the gateway theory has a rather tainted pedigree.  The gateway theory as applied to cannabis turns out to be a virtually whole-cloth fabrication in the early 1950s by Harry Anslinger (the man responsible for cannabis being federally banned in 1937) who needed a justification for its continued ban and even harsher laws against it after the original Reefer Madness claims (murder, rape, insanity, and death) had been debunked by the La Guardia Committee Report in 1944.  So he flip-flopped and claimed that cannabis led its users to heroin addiction, which even he himself actually said was not the case in the 1930s.  But it turns out that a more general version of the theory is even older than that.  It can be traced back to at least 1910, when it was believed that indulging in smaller pleasures (such as eating spicy food) would lead one to crave larger pleasures (such as opium).  And that in turn would eventually lead one to the drunkard's grave.   Thus, the latest manifestation of the gateway theory, besides being recycled garbage, has actually come full circle (with alcohol at the start of the sequence rather than the end).  And nearly every major study of drugs and drug policy for the past century has been far more likely to refute the theory than to support it.

If not a causal relationship between alcohol (or cannabis) and later use of harder drugs, what explains the apparently strong association between the two?  One study by RAND in 2002 found that there was a more parsimonious explanation based on a mathematical model of:  1) the age at which each substance was typically first available to an individual, 2) individuals' propensity to use substances, which varies and is assumed to be normally distributed among the population, and 3) chance or random factors.  This explanation was equally accurate at predicting drug use progression compared with a model that assumed a causal relationship.  In the case of cannabis, another likely alternative explanation of the supposed gateway effect is the black market itself, as users are exposed to harder drugs through many of the same dealers who sell them their weed.  This was one of the reasons why the Netherlands adopted their policy of tolerance for cannabis (which can be purchased in "coffeshops" in many towns), and to this day the Dutch have significantly less of a problem with hard drugs than the USA and many other Western nations. 

Additionally, when young people are lied to about the dangers of alcohol and cannabis, they may eventually assume that all anti-drug messages are bunk and experiment accordingly.  Unfortunately, honest alcohol and drug education is not nearly as commonplace as it should be in this country.

So where does the issue of the 21 drinking age figure into all of this?  For starters, the authors of the study that links alcohol with subsequent use of other substances predictably claim that the longer alcohol use is delayed, the fewer problems there will be with not just alcohol abuse but the abuse of other substances as well, and they recommend zero tolerance for teen drinking.  This study would thus most likely be seen as vindication for the pro-21 crowd.  However, one can also look at the study's results a bit differently and see that the supposed gateway effect occurs despite (or perhaps even because of) the 21 drinking age.  For example, forcing alcohol underground makes it more likely to be used in the same environment as other substances, thus increasing young drinkers' exposure to the other substances.  The fact that "underage" drinkers are already breaking the law may encourage them to break other laws as well.   Also, at least some 18-20 year olds may find other substances easier to get than beer, and will thus be more likely to use them as substitutes.  In fact, a recent study found that when alcohol retreats, cannabis advances (and vice versa), and that is discussed in a previous post on this blog.  Therefore, one could say that the 21 drinking age acts as a "social gateway" to other drugs in a somewhat similar manner as cannabis prohibition, albeit much more modestly since there is not much of a real black market in alcohol (save for the modern-day speakeasies known as frat houses).  Indeed, it may not be a coincidence that American teens are more likely to use illicit drugs than their European counterparts despite being less likely to drink or smoke cigarettes.

In other words, we ought not to put too much stock in the rather dubious gateway theory, except to note how it could be one more way that the 21 drinking age yet again does more harm than good.

Monday, July 2, 2012

What the Obamacare Ruling Means

NOTE:  This post is on both the TSAP blog and the Twenty-One Debunked blog

The recent Supreme Court ruling on the Affordable Care Act ("Obamacare") was a mixed bag overall.  The individual mandate (which the TSAP does not support) was upheld, but as part of the government's taxing power rather than under the Commerce Clause.  While it is clearly a stretch to say it is constitutional because it is a tax (just think of poll taxes), and thus unfortunately provides a roadmap on how to make an end-run around some parts of the Constitution in the future, at least the Court recognized that the Feds do not have unlimited power under the Commerce Clause.  Thus, the ruling took some of the wind out of the sails of the dangerous Gonzalez v. Raich precedent in 2005.

One thing the Court did strike down was the primary mechanism for ensuring state compliance with the Medicaid expansion, namely the withholding of existing federal Medicaid funds as a penalty for noncompliance.  This was basically the same form of coercion used by the feds to force states to raise the drinking age to 21 in the 1980s, which was upheld by South Dakota v. Dole in 1987.  Since then, this power has been used to coerce the states to follow other mandates as well, and not just ones related to highways.  Thus if there is any silver lining to the Obamacare ruling, it is the fact that it may make it easier for states to lower the drinking age (and possibly even legalize cannabis) without federal interference.

As we have noted before, the TSAP supports a single-payer healthcare system similar to what Canada currently has, which is also what President Obama originally wanted as recently as 2008.  Anything less would be uncivilized.