Myths and Facts

The following list (under construction) is a list of myths and facts about the 21 drinking age and alcohol in general, with appropriate links/citations to our sources.


MYTH:  The 21 drinking age saves nearly 1,000 lives per year, and lowering the drinking age to 18 would lead to that much more increased carnage on the highways.

FACT:    That number is junk science, based on extrapolation from an outdated study from the 1980s.  About half of all studies done on the drinking age find no significant effect on traffic (or other) fatalities among teens and young adults (Wagenaar and Toomey, 2002).   In fact, here is a partial list of several studies that found either no significant effect, or even a perverse effect on fatalities.  All but the very last one are peer-reviewed as of 2011.

Naor and Nashold (1975)
Colon and Cutter (1983)
Colon (1984)
Males (1986)
Asch and Levy (1987)
Asch and Levy (1990)
Dee and Evans (2001)
Males (2008)
Miron and Tetelbaum (2009)
Grant (2011)
Dirscherl (2011)

So why do some other studies show a supposed (usually small) lifesaving effect?  For starters, many of those studies do not control for all key variables, leading to residual or unmeasured confounding.  Secondly, there may have been a transient effect in the first year or two of the new law that quickly wears off, especially among voluntary early-adopting states, that created a mirage of an enduring lifesaving effect (Miron and Tetelbaum, 2009).  Third, some studies (Males, Asch and Levy, Dee and Evans, and Dirscherl) suggest that raising the drinking age to 21 merely shifted traffic deaths from 18-20 year olds to 21-24 year olds, and perhaps even led to a net increase in deaths.  Finally, very few studies consider the effects on non-traffic deaths, such as alcohol poisoning, falls, violence, burns, and drownings.

Other things to note include the fact that alcohol-related traffic fatalities are lower in Canada, the UK, and Australia than the USA despite those countries having lower drinking ages. In fact, traffic fatalities there actually declined faster in those countries than they did in the USA during the most relevant time period of 1982-1993, both for young adults as well as the general population, despite not raising the drinking age to 21. And both there and here, the age group most likely to be involved in alcohol-related traffic fatalities is 21-24 year olds, not 18-20 year olds.

MYTH:  Drinking before 21 causes you to lose 10% of your brain power.

FACT:  Care to quantify that in gigahertz?  What exactly does "brain power" even mean?  Nowhere in the scientific literature can you find reference to "brain power" or any statement claiming that younger drinkers can lose a certain percentage of it.   The above statement, which can be found on the MADD website, represents a gross misinterpretation of sophisticated research. It dangerously oversimplifies the conclusions made by many neuroscientists who research the effects of alcohol on the adolescent brain. Their research, all performed on laboratory rats, clearly demonstrates a connection between alcohol abuse and detriments to the developing brain, especially in terms of memory storage and processing.   It does not make any assertions about percent loss of "brain power."  (Choose Responsibility, 2011)  Besides, the studies looked at alcohol abuse rather than moderate use, and excessive drinking is harmful to the brain (and other organs) at any age.

MYTH:  Alcohol is the Devil's water.  How dare you attempt to cause our children to stumble--Jesus says you deserve to have a millstone around your neck and be thrown into the sea!

FACT:  We shouldn't even dignify that with a response, but we will note that according to the best-accepted translations of the Bible, Jesus is reported to have turned water into wine.  Also, there are more positive references to alcohol in the Bible than negative ones, and nearly all negative ones are concerned with the abuse of alcohol rather than mere use.   Finally, we are talking about 18-20 year olds, who are adults, not children.  And it is highly unlikely that Jesus of Nazareth would have supported such an illberal and pharisaical law as the 21 drinking age.

MYTH:  The 21 drinking age actually keeps people under 21 from consuming alcohol.

FACT:  The drinking age has been an epic failure in preventing excessive alcohol use among people under 21.  Nearly 90% of the population will drink at least occasionally before reaching age 21, a number that has not changed very much since the 1970s and early 1980s when the drinking age was 18 in most states.  While it is true that fewer teens and young adults are drinking today, and are doing so less frequently, it appears that the more they do when they do.  To cite an alarming statistic from the neo-temperance Center on Alcohol Marketing and Youth, a whopping 96% of the alcohol drunk by 15-20 year-olds is consumed when the drinker is having five or more drinks at a time (Institute of Medicine, 2003).  Also, between 1993 and 2001, 18-20 year-olds showed the largest increase in the number of "binge" drinking episodes compared to other age groups (Wechsler, 2002).  In addition, alcohol poisoning deaths (a good indicator of trends in truly dangerous drinking) among 18-20 year olds have more than doubled since 1998.  The effects of Prohibition come to mind.

MYTH:  The 21 drinking age prevents young people from developing drinking problems later in life, including (but not limited to) alcohol-related deaths.

FACT:  No causal link between the legal drinking age experienced during youth and the subsequent development of drinking problems later in life has actually been proven.  A small number of preliminary studies using outdated American data have claimed to find a correlation, but correlation is not the same as causation.  In fact, globally speaking, this chart of age-standardized alcohol-related death rates seems to really put the lie to that specious claim.  Note in particular the difference between Canada and the USA, where Canada has a significantly lower alcohol-related death rate despite a drinking age of 18 or 19 depending on the province that has been in place since the 1970s.  (Of course, their healthcare system is also better than ours as well, and their alcohol taxes are higher too, but even so it seems that the drinking age is inconsequential if not perverse.)  And many other countries with lower drinking ages do as well.

MYTH:   But at least the 21 drinking age does a better job than an 18 drinking age of keeping alcohol out of the hands of kids under 18, right?

FACT:  According to the Montoring the Future survey, both 8th graders and 10th graders find alcohol easier to get than cigarettes, the latter of which have an age limit of 18 in nearly every state.  Similarly, the PRIDE survey of grades 6-12 find that alcohol is easier to get than cigarettes for grades 6-10, roughly equal in grade 11, and only in grade 12 (when many students are over 18) is the reverse true.  And remember that unlike alcohol, the age limit for cigarettes is much more poorly enforced, penalties are fairly lax, and cigarettes can be easily "bummed" from strangers on the street.

These facts dovetail nicely with Miron and Tetelbaum (2009), which found that high school seniors exposed to a drinking age of 18 were only very slightly more likely to report drinking in the MTF survey than those facing a higher age limit, after adjustment for confounders.  And the difference was small enough to be mostly or entirely due to reporting bias.  Even if the effect of raising the drinking age was real, it did not appear to be very beneficial:  the higher the drinking age, the higher the rate of traffic fatalities among drivers age 17 and under!  And among seniors, there was no significant (or even perceptible) correlation between self-reported (nonfatal) traffic crashes after drinking versus the legal drinking age.

MYTH:  Lowering the drinking age to 18 would lead to an increase in high school keggers.  Wouldn't 19 or 20 be better?

FACT:  There are already plenty of high school keggers right now with the drinking age at 21, and college drinking parties are frequently "crashed" by high school students in college towns.  And as we have noted above, whether the drinking age is 18, 19, 20 or 21 has relatively little effect on high school drinking.  Any concerns about a theoretical increase in such parties can be easily alleviated by keeping the purchase age for kegs, cases, and other large quantities of alcohol at 20 or 21 if and when the general drinking and purchase age is lowered to 18.

MYTH:  All we need to do is enforce the 21 drinking age better.  There is nothing wrong with the law that cannot be cured by increased enforcement.

FACT:  On the surface, it seems like a simple answer: "all we need to do to keep kids from drinking is enforce Legal Age 21." But, if it were possible to adequately enforce, we would have brought an end to underage drinking a long time ago. The 21 drinking age has been in place for nearly three decades nationwide and there remains a complete lack of consistency in how it is carried out and enforced, and enforcement is often arbitrary and capricious as a result. One study suggests that only two out of every 1,000 cases of underage drinking results in citation or arrest.(Wolfson et al., 1995) Such low rates of enforcement present inadequate deterrence to young people under 21 who choose to drink, such as the majority of 18-20 year olds.  Since then, enforcement has increased dramatically, but alcohol poisoning death rates have more than doubled among 18-20 year olds.  If the 21 drinking age really were enforceable, it is unbelievable that we would have the problem of reckless and irresponsible drinking by young people that we have in America today.

MYTH:  But aren't there studies that show that enforcement of the 21 drinking age (and closing the remaining loopholes) works wonders?

FACT:  In a word, no. This notion is grossly outdated, and based on a few studies using data from the early 1990s, a time when enforcement was fairly lax.  First of all, it is now enforced more than ever in American history, and more than other countries enforce their own (lower) drinking ages.  Most "loopholes", if you want to call them that, have effectively been closed in most states by numerous ancillary laws to prop up the 21 drinking age, such as dram shop, social host, zero tolerance, internal possession, use and lose, and many others.  Secondly, the fact that the alleged benefits occurred during a time of weak enforcement and many loopholes suggests that the such benefits were likely due to other factors than raising the drinking age.

As for the few studies that allegedly show that tougher enforcement increases the supposed benefits of the drinking age, i.e. those by Wagenaar et al., they do not seem to stand up to close scrutiny.  In 1993-1995, several Upper Midwestern communities were randomly assigned (or not assigned) to a community-level intervention whose purpose was to increase enforcement of the drinking age, particularly on the supply side.  This program was known as Communities Mobilizing for Change on Alcohol (CMCA), and the effects of which were studied as a randomized trial.  Though hailed as a success by the authors and others, there were serious issues that were glossed over.  For example, while the propensity of alcohol outlets to sell booze to those under 21 appeared to drop, and telephone surveys indicated a modest net reduction in self-reported drinking by 18-20 year olds (the most targeted age group), self-reported "binge" drinking (5+ drinks in a row) appeared to show a small net increase among that age group.  For high school seniors, the net effect on all measures was either virtually nil or had the "wrong" sign, implying that targeting 18-20 year olds does essentially nothing to protect high schoolers.  A second study by Wagenaar compared outcomes of the intervention on DUI arrests, disorderly conduct arrests, and traffic crashes (both single-vehicle nighttime and those reported alcohol-related).  Results:  a modest net reduction in DUI arrests for 18-20 year olds, but no significant change in any other measures, including crashes of either kind for 18-20 year olds or 15-17 year olds.  Thus it probably did not save any lives, and the overall results were really quite anemic (to say the least) given all that was invested in the program.  Other studies were done as well, but those studies suffered from far too much confounding to be conclusive.

Contrast this to the effects of tobacco enforcement of the purchase age of 18.  Though only a handful of studies have been done on the matter, nearly all of them suggest quite strongly that not only does tougher enforcement (specifically targeting vendors) succeed in reducing sales to minors, but also reduces smoking in those under 18.  Even Wagenaar himself essentially admits this fact in a study he co-authored.  Not only is the age limit lower for cigarettes than for alcohol, but most of the country still enforces the age limit for tobacco less vigorously than for alcohol as well.  However, since the 1970s, both teen and adult smoking have plummeted by half, declining more so than drinking has, even though no state has raised the smoking age to 21.  In fact, unlike booze, most states do not even prohibit possession or use of tobacco by minors, only purchase and sale.   The success story was primarily due to education, taxation, and advertising restrictions.

MYTH:  Drinking before the age of 21 is more dangerous since the brain (especially the prefrontal cortex, the seat of judgment and impulse control) doesn't stop developing until then.

FACT:  Actually, the brain (especially the prefrontal cortex) does not stop developing at 21, but continues to develop well into the 30s and 40s, and possibly even beyond that. Thus, those who claim the 21 drinking age exists to prevent people from drinking before their brain is fully developed would still be off by a few decades

The pro-21 crowd claims that there is no safe level of alcohol while the brain is still developing (given the above facts that would be truly disturbing indeed if it were true) and that even modest amounts of alcohol consumed by an 18-20 year old may cause permanent brain damage as a result, thus it should remain illegal. Nevermind that it is currently legal for an 18 year old to purchase and consume a known neurotoxin called nicotine. And the PTSD that too often results from going to war can't be all that great for a developing brain either, but there's no law against that. But rest assured, this after-the-fact attempt to justify the 21 drinking age fails to stand up to scrutiny. Nearly all the studies on which this specious claim is based are either done on rats (often with high dosing regimens) or are done on truly heavy drinking adolescents (often with alcohol-use disorders) who generally began drinking well before age 18. Sample sizes of many studies are quite small as well, and effect sizes are not usually particularly large either. Most human studies are cross-sectional rather than longitudinal, making determination of causation impossble, and almost no studies exist that compare those who began drinking before 21 vs. those who began drinking after. The lone exception is Demir et al. (2002), which controlled for the number of years of drinking and found no differences in terms of long-term cognitive impairments between alcoholics who began drinking before 20 and those who began after 20. And new research shows that even the middle aged brain is vulnerable to the long-term effects of excessive drinking.

The real moral of the story is that excessive drinking is harmful at any age, while there is zero hard evidence that alcohol is more dangerous to an 18 year old brain than it is to a 21 year old brain. For all ages, at least for those 18 and over, moderation appears to be the key.

MYTH:  You're just punting on the issue, leaving the under-resourced high-school principals and parents to deal with it. How dare you!

FACT:  No, the principals and parents who would rather stick their heads in the sand and leave college presidents and staff (as well as the police) to deal with it are the ones who are really punting. And right now numerous high schoolers still drink despite a drinking age of 21. Open your eyes. Right now, according to the Monitoring the Future and PRIDE surveys, it is easier for 6th-10th graders to get alcohol than it is to get cigarettes, a product whose purchase age is 18 (and often poorly enforced) in nearly all states.

Yes, high school drinking has sharply declined since 1979 according to the Monitoring the Future survey, but that trend began many years before a significant number of states raised the drinking age to 21, and also occurred in states that were 21 throughout with no age change. Canada saw a decrease as well, and they did not raise the drinking age to 21. For cigarettes, smoking rates among American high schoolers declined even faster than drinking rates. (It is worth noting, however, that there is no data in the MTF surveys for grades other than 12th grade for years earlier than 1991).

For people under 18, it SHOULD be the parents who deal with it, regardless of whether the drinking age is 18 or 21.

As for high schoolers having "liquid lunches" during school hours, it's not the 1970s anymore. Schools are often run like prisons, and students today are much more defanged and declawed than their parents were when they were in high school. Such behavior is now considered a red flag for a student having a serious drinking problem. Thus any such fears are largely anachronistic.

MYTH:  The fact that the 21 law is widely disobeyed is no reason to change it.  In fact, that only proves that 18-20 year olds lack the maturity to handle alcohol.  Let's not appease them.  What's next, legalizing murder because some people still kill each other?

FACT:  Those who make such a fatuous argument are probably the same people who would have supported continuing Prohibition in 1933.  By that same logic, no one of any age is mature enough to handle alcohol because the majority of Americans of ALL ages disobeyed Prohibition.  Ineffective and unrealistic laws like Prohibition and the 21 drinking age show the limits of the role of government in a free society.  And laws that are clearly not working and/or are unjust absolutely must be changed in the name of justice as well as pragmatism.  Laws like that undermine the rule of law by breeding disrespect for the law and make a mockery of our legal system.  The analogy with murder also fails in that drinking alcohol per se by consenting adults is a victimless crime, while murder clearly is not.  (Alcohol-related crimes with victims such as DUI, drunk violence, etc. are already illegal and will remain such regardless of the drinking age.)  Also, the vast majority of citizens do follow the ban on murder, while as many as 90% of Americans will drink at least somewhat before reaching their 21st birthday.

MYTH:  The stakes are much higher for young drinkers today than in the 1980s, so we should keep the drinking age at 21 to keep them safe.

FACT:  The only way the stakes are higher now than in the 1980s is due to the 21 law.  It directly and indirectly makes drinking by 18-20 year olds more dangerous than it has to be.  Thus, that is no justification to keep the drinking age at 21, and it hardly keeps young people "safe" by any stretch of the imagination.

Overall, America is actually a far safer place now than it was in the 1980s.  Crime is down, violence is down, traffic deaths are way down, other accidental deaths are also down, teen pregnancy is at a record low, and even the AIDS epidemic (which began in the 1980s) appears to have been tamed to some extent.  And before anyone credits the 21 drinking age with these great improvements, remember that these trends were true for the 12 states that did not change their drinking ages (remaining 21 since the 1930s) as well as several other countries that kept their drinking ages at 18.

MYTH:  While other measures such as cracking down on DUI, raising the beer tax, improving alcohol education and treatment, etc. are good ideas, they are no substitute for keeping the 21 drinking age, which is one more tool we still need in our toolbox.  The more tools, the better.

FACT:  This "toolbox" argument ignores the fact that some "tools" actually work at cross-purposes with one another, and thus negate each other's effectiveness.  Some tools are in fact carry too many adverse side effects while others work just as well with fewer side effects.  For example, you don't swat a fly with a sledgehammer.  Other tools simply don't work at all for the particular task at hand, and are simply an added burden to carry.  And then there's the old adage about one bad apple spoiling the entire bunch.  Perhaps that's why Canada and several other countries have seen similar or faster declines in traffic deaths as the USA since 1982 despite NOT raising the drinking age to 21.

MYTH:   A lower drinking age may work fine in other countries, but America is too undisciplined/irresponsible/spoiled/diverse/multicultural/(insert favorite adjective here) to allow 18-20 year olds to drink. And our society is far too fractured as well.

FACT:   By that pseudo-logic, NO ONE in America of ANY age should be allowed to drink, period! And if Americans can't be trusted with alcohol, can they really be trusted with anything? In any case, in the interest of justice, we ought to allow 18-20 year olds, who are legal adults in essentially all other aspects, to have at least the same rights that those over 21 currently enjoy.

Diversity is a red-herring to this issue. If anything, a higher concentration of non-whites likely reduces overall alcohol abuse, even among whites. One can also observe that a high concentration of Anglo-Celtics in a country tends to increase alcohol abuse. Diversity is irrelevant to the drinking age.  As for ours being a fractured society, we certainly are, and more so than most developed countries. But arbitrarily dividing the adult population with an unrealistically high drinking age, and denying young people their civil rights only exacerbates any such fracturedness.

MYTH:  Unlike Europe, we do not have the public transport infrastructure needed to handle all of those 18-20 year old drinkers if the drinking age is lowered to 18.  Thus, the drinking age should remain at 21.

FACT:  Tell that to Canada, Australia, and several other car cultures with drinking ages of 18 who apparently still haven't gotten the memo.  These non-European countries do NOT have better public transportation than the USA does (and can even be quite lousy in many places), and yet they still have lower alcohol-related traffic death rates than the USA.  In fact, they saw a similar or even faster decrease in such deaths since 1982 compared with the USA despite NOT raising the drinking age to 21.  So they must be doing something right.  And that's one more nail in the coffin of the myth that the 21 drinking age actually saves lives.

Also, a better question to ask is why we don't have the public transport infrastructure needed to handle all of those drinkers over 21, who are responsible for nearly 90% of all alcohol-related traffic deaths in the USA.

MYTH:  Since it is impossible to eliminate the possibility of 18-20 year olds getting behind the wheel after drinking, they should not be allowed to drink at all since even very low BAC levels impair driving by people under 21 to a much greater degree than for those over 21, and thus pose an unacceptable risk to public safety.  

FACT:  This myth is actually two separate myths in one, though both have a grain of truth to them: 

First, let's tackle the premise.  While it is true that 16-20 year old drivers as a group do have dramatically increased relative risks of a fatal crash at all BAC levels (including < 0.05) relative to drivers over 21, nearly all studies that exhibited this finding did NOT separate those under 18 from those aged 18-20.  One exceptional study, Naor and Nashold (1975), found that "[t]here was no evidence that small blood alcohol concentrations [i.e. < 0.05] enhanced the likelihood of fatal accidents in youth [aged 18-20] more than in older persons [aged 21-44]."  A few other earlier studies (such as Carlson, 1972) that separated those under 18 from 18-20 year olds found that while driving at a low BAC carries a modestly higher relative risk for 18-20 year olds compared with 20-25 year olds, the difference is not nearly as dramatic as it is for drivers under 18.

Of course, no credible study disputes that driving with a BAC above 0.05 significantly increases risks for all ages, or that relative risks increase more rapidly with increasing BAC among younger drivers than for older drivers.  The most logical explanation is that novice drivers (and/or drinkers) regardless of age are more impaired by alcohol than more experienced ones, at all BAC levels.   Thus, a 21 year old novice is at least as dangerous as an 18 year old novice, but clearly there are more 18 year old novices than there are 21 year old novices.

Secondly, let's tackle the conclusion that 18-20 year olds should not be allowed to drink at all even if they do not get behind the wheel.  Even if the premise is completely true (which is questionable), it does NOT follow that we should ban 18-20 year olds from drinking period because they might get behind the wheel and then might cause a car crash.  In a free society we do not deprive legal adults of liberty solely on the supposition that they might abuse it.  By that pseudo-logic, no one of any age would be allowed to drink, ever!  While the premise does potentially justify zero-tolerance laws (i.e. a BAC limit of zero or close to zero) for young or novice drivers, as well as tougher DUI laws in general, it does NOT justify banning drinking per se since it is really not all that difficult for individuals to separate alcohol from driving.  If you plan on driving, don't drink, and if you plan on drinking, don't drive.  It's not rocket science.  But it seems that it is the neo-prohibitionists (ironically) who can't seem to separate the two in their minds.


MYTH:  One or two drinks will not affect my driving.  In fact, I think I drive better after a drink or two (or three).

FACT:  When driving or operating machinery, there is really no level of alcohol that is completely safe for everyone, other than zero.  The crash risk increases monotonically from about zero onwards, and increases exponentially with each drink.  Clearly, the more drinks you have, the more impaired you will be, but the safest option is not to drink at all if you plan to drive, and not to drive if you plan on drinking, period.  You may think you are fine to drive, but that does not mean that you actually are.  

MYTH:  Coffee, cold showers, and exercise will help sober someone up.

FACT:  None of these methods will work.  The blood alcohol concentration only diminishes at a set, slow, pace as the liver metabolizes the alcohol. Drinkers may feel more alert after drinking coffee or taking a cold shower, but the BAC will remain unchanged except for a certain metabolic rate per hour.  And none of these methods will make a drunk person safe to drive, period.

MYTH:  Drunk walking is more dangerous than drunk driving.

FACT:  Only someone who has repeatedly read Superfreakonomics would really believe that.  In this rather tepid and disappointing sequel to Freakonomics by Levitt and Dubner, the authors claim that, at least on a per-mile basis, a drunk person is eight times more likely to be killed while walking than driving the same distance.  However, there are a number of flaws to that claim.  First, they assume that the proportion of total miles traveled while drunk is the same for walking as it is for driving.  This is dubious because drunk driving is far less common nowadays, and many who would have driven drunk a generation ago now choose to walk instead.  Secondly, it is more realistic to compare the risk per hour of traveling time rather than per mile, since far more miles are traveled by car rather than on foot.  Thirdly, the relative risk for an alcohol-related pedestrian fatality does not rise to statistically significant levels until a BAC of about 0.15, while for driving deaths it begins to rise significantly at 0.05 or even lower.   To quote NHTSA in their Alcohol and Highway Safety 2001 report:

One interesting finding...was that the relative risk of involvement in a fatal pedestrian crash did not begin to rise until the pedestrians reached a BAC of .15 to .20. This is consistent with the hypothesis that safe walking is generally easier than safe driving, since the relative risk curve for fatal motor vehicle crashes starts to rise at a much lower BAC.

Finally, there is a significant qualitative difference between the two in that while a drunk pedestrian is unlikely to endanger innocent people, a drunk driver is very likely to do so.  That's precisely why the latter is illegal while the former is generally not, though some states do have laws against public drunkenness (which are typically only enforced if the drunk pedestrian is noticeably causing a nuisance or hazard to others).  We may never be able to determine exactly how risky drunk walking is to the drunk individual, and we certainly know that the risk is not zero.  In fact, the NHTSA report suggests that it can be quite significant at very high doses of alcohol.  There is also a risk of falls when one is "falling-down drunk," which can lead to serious or even fatal injuries.  But all things considered, drunk walking is still a better option than drunk driving at any BAC level. 

Additionally, research has found that the best ways to reduce the number of drunk pedestrian casualties at the population level are basically the same strategies that would benefit all pedestrians drunk or sober, most notably reducing speed limits, and otherwise improving infrastructure to be more pedestrian-friendly in general.  Anything else, in our view, is an Orwellian slippery slope just waiting to happen.

MYTH:  Alcohol is an aphrodisiac that makes sex better.

FACT:  Like Shakespeare once said, alcohol "provokes desire but takes away the performance".  That is, while some drinkers may become a bit more aroused due reduced inhibitions, it actually reduces their ability to perform and their sensitivity to stimuli.  This negative effect is especially true at higher doses.  And some drinkers even become less aroused when under the influence.

MYTH:  More alcohol is better, at least as far as pleasure is concerned.

FACT:  That is simply not true, because alcohol follows what is known as a biphasic response curve.  In the first phase, alcohol provides an exciting and stimulating "buzz" or euphoria.  But have a few more drinks and you will enter the second phase, where the euphoria decreases and dysphoria (negative feelings) increases with each additional drink.  The peak of the curve, or point of diminishing returns, is a BAC of around 0.06.  From this point onward, drinking more will NOT increase feelings of pleasure or make you have a better time.  In fact, such pleasure will actually decrease, and after around 0.10-0.15, dysphoria predominates (i.e. your mood is worse than when sober). 

MYTH:  It is the alcohol itself that is responsible for all of its effects, both good and bad.

FACT:  Actually, the best research on the matter shows that many of the supposed effects (both good and bad) commonly attributed to alcohol are actually placebo effects.  One study found that people in a bar who drank just tonic water with no alcohol (but believed it contained alcohol) still recalled details with less accuracy and showed some visible signs of intoxication.  Another study using a balanced placebo design found that people who believed they had consumed alcohol (but actually did not) became more aggressive and sexually aroused, while those who believed they had not consumed alcohol (but actually did) became less aggressive.  Still another study found that people are more likely to delay gratification when intoxicated when rewarded for doing so, suggesting that alcohol does not necessarily lead to increased impulsivity. 

And much research shows that drinkers actually can control their behavior quite well when drunk, and are aware of their mistakes while under the influence.  It turns out that people who believe that alcohol disinhibits them tend to act disinhibited when intoxicated, while those who do not believe it does tend not to act that way.  Thus alcohol is never a valid excuse for otherwise unacceptable behavior, since it is not really the fault of the alcohol itself but the person consuming it.  And in cultures that recognize that fact, and don't attribute some magical disinhibiting power to booze, we find (unsurprisingly) that alcohol-related misbehavior (especially violence) is far less common than in cultures who tend to believe in these myths such as the USA and the UK.  Clearly, what people think is more important than what they drink.

Of course, that is not to deny that alcohol does have some very real pharmacological effects on the mind and body, and that it can be rather dangerous and even toxic in high enough doses.  But it is important to know which effects are real, and which effects are placebo effects.  Alcohol is the ultimate "active placebo", and the more we recognize this fact, the fewer problems we will have with this rather mundane and non-magic elixir that our culture obsesses over.

In short, alcohol is never an excuse for otherwise unacceptable behavior, period.

MYTH:  Different types of alcohol have different behavioral effects.  For example, gin makes you cry, bubbly makes you flirt, tequila makes you violent, etc.

FACT:  The truth is that alcohol is alcohol is alcohol, period.  There is really no hard evidence that different types of alcohol have different effects.  While some drinkers believe this myth and behave accordingly, that is the result of their beliefs, not the beverage itself.  In fact, when test subjects were given look-alike and taste-alike non-alcoholic beverages and were led to believe they were the real thing, they still acted accordingly.  Remember that many of alcohol's effects are actually placebo effects.  See the closely-related previous myth for further information.

There is perhaps a grain of truth to this myth, but it pertains only to how you will feel the morning after.  Some types of alcoholic beverages (whiskey, brandy, and especially red wine) tend to give worse hangovers than others (vodka or other clear spirits).  This is because of the congeners (impurities) that differ from one beverage to another, and these can pack quite a wollop.  But all forms of alcohol can give you a rather nasty hangover if you drink enough of it, since the primary reason for hangovers is acute withdrawal from the alcohol itself, as well as dehydration.

MYTH:  But I swear the booze made me do it!  You know how I get when I had a bit too much to drink.

FACT:  This lame excuse is really just the modern-day version of "the devil made me do it".  Much research shows that drinkers actually can control their behavior quite well when drunk. It turns out that people who believe that alcohol disinhibits them tend to act disinhibited when intoxicated, while those who do not believe it does tend not to act that way.  Bad behavior while drunk is the fault of the person, not the alcohol.  Those who claim otherwise are either looking for a convenient excuse to misbehave and/or have been seriously fooled by one of the worst cultural myths about alcohol.  While there is some evidence that naturally aggressive people can indeed become somewhat more aggressive under the influence of high doses of alcohol in certain situations, it does NOT change the fact that such drinkers are still in control of their behavior and are still fully accountable for their own actions.  Alcohol may intensify one's personality (i.e. an asshole when sober becomes more of an asshole when drunk) to some extent, but generally the worst it does is enhance what was already there all along.

One notable exception is a phenomenon known as pathological intoxication (mania a potu), an extremely rare psychotic reaction to alcohol which formed the basis for the 1990 film Final Analysis.  Listed in the DSM-IV as "acute idiosyncratic intoxication", this unusual reaction occurs when an otherwise sane and healthy person becomes psychotic (loses touch with reality) and aggressive for several hours following small doses of alcohol.  A person who has experienced it once will most likely experience it again nearly every time they drink even small quantities.  In addition, some people with pre-existing psychotic disorders such as schizophrenia may experience dangerous and unpredictable effects from drinking, particularly at higher doses.  And chronic, severe alcohol abuse can over time produce an alcohol-related psychosis that did not exist before.  Clearly, there are some individuals who really should avoid alcohol like the plague.  But these folks are essentially the exceptions that prove the rule.

Again, alcohol is never an excuse for otherwise unacceptable behavior, period.  More to the point, if you know how you get when you drink too much, why on earth do you continue to do so?

Which brings us to the next myth...

MYTH:  Alcoholism is a chronic, progressive disease for which there is no cure other than total abstinence and strict adherence to a 12-step program.  Once an alcoholic, always an alcoholic.

FACT:  The truth is that alcoholism (referred to as alcohol dependence in the DSM-IV) is actually the result of habitual choice, not a "disease" in the strict medical sense of the term.  Though alcohol dependence (like many other addictions) is undoubtedly a very serious problem, statistics show that many alcoholics are able to quit drinking or return to moderation on their own, or at least show some improvement.  Some even recover spontaneously or simply "mature out" of heavy drinking.  Of course there are many for whom this is not true, but that hardly implies that it is typically a progressive and incurable disease.

Furthermore, there is good evidence that the "hijacked-brain theory" of addiction in general is just plain wrong for the most part, and is not supported by science.  A much better model of how addiction works is the dynamic tension model, which postulates that the prefrontal cortex (the "new brain" or seat of reason), the limbic system (the "old brain" or location of the pleasure centers), and the environment are all dynamic entities which change over time.  Addiction is simply the result of how these three entities interact with one another.  And recovery (defined as no longer meeting the DSM-IV criteria of dependence) need not always require total abstinence; about half of recovered alcoholics are able to achieve a non-abstinent recovery via controlled drinking.  While some 12-step advocates would claim that such folks only succeeded because they were never "true alcoholics" to begin with, that is merely a form of the "No True Scotsman" fallacy as well as circular reasoning.

MYTH:  The horror stories about alcohol causing permanent brain damage are true.

FACT:  Such horror stories are actually mostly false, though there is a grain of truth to them.  While it is well known that long-term heavy drinkers experience some degree of brain shrinkage and cognitive deficits, the neurons (gray matter) are generally not killed, with the exception of some in the parietal lobe that are used for spatial processing.  Overall, alcohol-related brain damage is generally limited to the white matter (the connections between neurons), and is typically reversible with abstinence or moderation for the most part.  And most cognitive abilities will eventually return to normal, though some take longer than others.  Notable exceptions include wetbrain (Wernicke-Korsakoff Syndrome, which is actually caused by a thiamine (vitamin B1) deficiency and not the alcohol itself) and hepatic encephalopathy (caused by liver failure, since the liver can no longer screen out toxins).  In those cases, the resulting brain damage can be severe and often permanent.  But as long as one does not have a thiamine deficiency or liver failure, these exceptions will not occur even in the heaviest drinkers. 

MYTH:  A shot of whiskey or vodka contains more alcohol than a can of beer.

FACT:  One can of beer (12 oz, 5% ABV), one glass of table wine (5 oz, 12% ABV), and one shot of hard liquor (1.5 oz, 40% ABV) all contain the same amount of alcohol.  This is called alcohol equivalence.  Alcohol is alcohol is alcohol, period.  One caveat is that beverages within each category may vary on the percentage of alcohol (i.e. not all beers are 5% and not all liquor is 80 proof), so you will need to adjust your serving sizes up or down accordingly to maintain alcohol equivalence.  Another caveat is that some people pour stronger than others when making mixed drinks.

MYTH:  Four or five drinks in the same evening is "binge drinking".

FACT:  Until 1993, the term "binge drinking" typically referred to going on a "bender", which is a multi-day drinking session in which the drinker remains seriously intoxicated and drops out of normal activities and behaves recklessly.  However, Henry Wechsler of the Harvard School of Public Health redefined "binge drinking" as five or more drinks in the same evening, which was later changed to five or more drinks for males and four or more for females.  These amounts of drinking may or may not lead to intoxication, and one may remain relatively sober if these drinks are spread out over a long evening.  And there is a world of difference between 5 beers spread out over 5 hours, versus pounding 5 shots in 5 minutes.

The real problem is the relatively small minority of drinkers that engage in "extreme" or "high-intensity" drinking, often at more than twice the 5/4+ definition threshold.  Such a dangerous drinking style is associated with far worse (and sometimes catastrophic) consequences in general, including alcohol poisoning, serious injuries, and alcohol use disorders.

MYTH:  The majority of today's teenagers and young adults are out-of-control "binge" drinkers.

FACT:  Nothing could be further from the truth.  In fact, drinking by middle and high school students has dropped to a record low.  From 1980 to 2010, past-month drinking by high school seniors has dropped from 72% to 41%, and so-called "binge" drinking (5 or more drinks in the same evening at least once in the past two weeks) has dropped from 41% to 23% during the same period.  Even among college students, the majority are not "binge drinkers" by that definition, and the vast majority do not engage in "extreme" drinking (10 or more drinks per occasion for males, 8 for females) or are otherwise as out of control as the media likes to claim.  While truly dangerous drinking continues to be a problem for all ages, it is mainly confined to a small minority of drinkers, as has always been the case.

MYTH:  Alcohol education doesn't work.

FACT:  The best evidence shows that it actually does, and does so significantly.  In fact, it probably just did!  One leading pioneer is Hobart and William Smith Colleges, whose award-winning Alcohol Education Project has shown great results.  More information about their program can be found here.

MYTH:  Twenty-One Debunked is somehow affiliated with the alcohol industry and/or gets some sort of funding from them, which is a conflict of interest.

FACT:  Neither Twenty-One Debunked nor the TSAP are in any way affiliated with the alcohol industry.  And we don't get a dime from them either, nor would we ever accept anything from them.  Integrity is far too important to trade for cash.  When was the last time the industry, or any of its front groups, came out in favor of increased alcohol taxes, let alone even modest advertising restrictions? This myth doesn't even pass the straight face test.

MYTH:  Actually, Prohibition was a success.  Alcohol consumption went down, and many lives were saved.  And women and children were the primary beneficiaries.  Too bad it had to end thanks to selfish men in power.

FACT:  No, actually it was an EPIC FAIL by just about any rational and intellectually honest measure.  As the famous social critic H.L. Mencken said in 1924:

Five years of Prohibition have had, at least, this one benign effect: they have completely disposed of all the favourite arguments of the Prohibitionists. None of the great boons and usufructs that were to follow the passage of the Eighteenth Amendment has come to pass. There is not less drunkenness in the Republic, but more. There is not less crime, but more. There is not less insanity, but more. The cost of government is not smaller, but vastly greater. Respect for law has not increased, but diminished.

And it only got worse from then on.  So bad in fact that by 1933, more than 70% of women turned against it.  That really says something, given how more than 70% of women supported it in 1919-1920.  A real about-face indeed.

It is true that many scholars believe that alcohol consumption (along with drunk and disorderly arrests, cirrhosis deaths, and possibly even drunk driving fatalities) declined significantly during the first two years, but they note that it was already declining for several years before 1920, and after 1922 it began rising again. Moonshining became an art form. Bootleggers and speakeasies were the order of the day. In fact, they grew so much that there were eventually double the number of speakeasies than there were saloons before Prohibition! Thus, the effective "outlet density" doubled as a result of Prohibition.

But unlike saloons, illegal speakeasies were decidedly co-ed, and women began drinking like never before. Speakeasies were not exactly safe either, as one was inevitably in the company of rather dodgy characters far away from the presence of any police or security. Someone could easily slip you a Mickey Finn and take full advantage of you, or simply massive amounts of booze would have had the same effect. You also had to worry about the potency and even purity of the hooch being sold, as it was often adulterated or contaminated with toxic substances. Not surprisingly, alcohol poisoning cases increased nearly fourfold from 1920 to 1925. Crime rates also skyrocketed, reaching a peak in 1933, and alcohol was controlled by organized crime. In fact, Prohibition was the main reason the Mafia got as powerful as they did. Society became corrupted as otherwise law-abiding citizens were now criminals, and even the police took kickbacks from the organized crime elements of the day.

Thus, since alcohol became far more dangerous that it had to be, death rates and hospitalizations from drinking went way up during the 1920s.  If that's success, we would hate to see what failure looks like.