Binge drinking. We all have heard the term used incessantly in the media, who usually claim it is getting worse. Our kids are out of control, they say, and we need to get tougher. Except, of course, when the issue of the 21 drinking age comes up--then it has gone way down, and the raising of the drinking age in the 1980s gets all (or nearly all) the credit. Predictable to say the least.
So which is it? It depends on your definition of "binge" drinking. The term originally meant a multi-day, very heavy drinking session in which the drinker neglects usual responsibilities and behaves recklessly--also known as a bender. Fortunately, very few people do this, both now and back in the day. But in 1994, Henry Wechsler of the Harvard University School of Public Health redefined the term to mean anytime someone drinks 5 or more drinks in the same evening, later modified to be 4 or more for a woman. This "5/4 definition" is the one most commonly used nowadays, with the gender-neutral 5+ definition a close second since the latter has been tracked by national surveys since 1975. And yes, it (defined this way) has gone down since its peak in 1979 for everyone except college students and non-college females. But that downward trend began several years before a significant number of states raised their drinking ages to 21, and also occurred in states that stayed 21 throughout.
But is it really an accurate index of harmful drinking? That question appears to have been answered fairly in a new study. Using self-reported alcohol-related injuries (major or minor) in the past 6 months as the dependent variable, researchers examined the effect of the number of drinks per drinking day, and the frequency of occasions having that number of drinks in the past month, among college students. This clearly makes more sense than lumping them all together, or looking only at total volume or frequency. Results were that risks increase rapidly after consuming 8+ drinks (males) or 5+ (females), on at least four days per month. Effects were further magnified among those who scored high on sensation-seeking. It was also found that the 5/4 definiton loses much of its predictive power when days of 8/5+ are removed from the equation. And remember, none of these models account for speed or context of drinking, or even distinguish drunk driving, and students often undercount their drinks as well (due in part to the ubiquitous "red party cups" and the popularity of hard liquor). But one benefit to this study is that body weight was controlled for, since the effect of a specific number of drinks varies widely across individuals.
Another recent study found that a 7/6+ cutoff was far more predictive of alcohol-related problems (relative to non-bingers) than a 5/4+ one. Those who met the 5/4+ cutoff but not the 7/6+ one averaged 5.4 drinks per occasion, while those who met the 7/6+ cutoff averaged a whopping 9.1 drinks. In terms of negative consequences, those males who typically drank 5-6 drinks (and 4-5 for females) generally did not fare significantly worse than the nonbingers, but the heavier 7/6+ group clearly did.
Clearly, the 5/4 definition is an arbitrary convention with little to no scientific basis. Kind of like, well, the 21 drinking age. An ideal definition would take into account context, speed, and BAC, set at rational thresholds. However, a quick, context-neutral, numerical definition is needed for survey purposes. While for the vast majority of the college-age population a 5/4+ threshold is a good negative test for acutely dangerous drinking, a 10/8+ threshold is a better sufficient test for the same, and intermediate between the two is an 8/6+ threshold. Thus, we at 21 Debunked propose two thresholds: 8/6+ drinks and 10/8+ drinks. It's probably best to jettison the word "binge" entirely--call the first threshold "heavy episodic drinking" or "high risk drinking," and the second one "extreme drinking." Unfortunately, these have not been measured very well over time, so to answer the first question, we don't know for sure.
But if we are to go with anecdotal data and statistical proxies for extreme drinking, we can probably safely that say such drinking has been on the rise, at least for college students. For example, another study found that between 1998 to 2005, there was a significant increase in alcohol-related nontraffic deaths among students, driven by a near tripling of alcohol poisoning deaths. (The actual statistics were simply those for 18-24 year olds multiplied by 30%, so this actually includes many non-students as well) That being said, we should note that the majority of college drinkers still drink responsibly, whether legally or illegally, and only a small minority drinks to these ludicrously high levels. However, the latter appears to be where the real problems lie, and where our efforts are best concentrated. But we still keep on barking up the wrong tree time and again.
It's also worth noting that in the first study mentioned, participants from 3 out of the 4 American universities surveyed had higher rates of alcohol-related injury than those from the one Canadian university, though the difference was not statistically significant. It is quite plausible that the 21 drinking age, by forcing drinking underground, exacerbates such problems. (Canada's drinking age is 18 or 19, depending on the province)
We at Twenty-One Debunked do not endorse any kind of drinking, underage or otherwise, and we do not mean to imply that drinking below a specific threshold is safe for everyone. To our knowledge, no such absolute threshold exists. But we do think that we need to get our priorities straight as a society when it comes to drinking. America's young people--our future--deserve nothing less.
Monday, September 21, 2009
Latest Bit of Scarelore--Is it True?
In a desperate attempt to hang on for dear life, knowing its days are numbered, the pro-21 crowd is recycling an old fear: that alcoholism rates would increase dramatically if the drinking age is lowered below 21. And they now have a study to "prove" it, or so they say.
The study pools data from both a 1992 survey and a 2002 survey, and finds that those who were exposed to a drinking age of less than 21 when they were ages 18-20 were about 1.3 times more likely to have an alcohol use disorder, and about 1.7 times more likely to have a substance use disorder other than alcohol, in the past year. Even (scratch that, especially) when the respondents were in their 40s and 50s. The researchers attempted to control for confounders, but we all know there can always be some that were missed. And we know that if you torture the data enough, it will confess to anything.
We at 21 Debunked think that the relationship between MLDA and later alcohol problems is likely spurious for the following reasons:
And why does Canada (MLDA 18 or 19 depending on province) not have a higher alcoholism rate than America? Demographically, they probably should! Ditto for most other countries with lower drinking ages, even the notoriously binge-drinking British and Australians? Some may say culture, but Canada's culture is not radically different than ours, and Britain's should, if anything, be more conducive to alcoholism than ours.
Another new study, this one done in Australia (with a legal drinking age of 18), explores the "age at first drink" effect on alcohol dependence from a new angle. Studying numerous twins, they find that there appears to be a gene-environment interaction among those who begin drinking before 15, especially before 13. Such very early drinking, or some environmental factor closely linked to it, appears to activate the bad genes. Though this could simply be a common vulnerability from other differences in environment rather than a truly causal effect of age. Or perhaps the context of drinking matters. The older one starts drinking, the more the environment matters, and the less genes do. But interestingly, and most importantly for the purposes of this discussion, the effect of age at first drink levels off after 18, with no significant difference between those who begin drinking at 18, 19, 20, or even 23. (Funny how this "leveling" effect occurs precisely at the age that corresponds to the MLDA. Coincidence? Hmmm.....)
This jibes well with a Canadian study done in 2000 that found that, while those who begin drinking between 11-14 have the highest risk for later alcohol dependence, even when taking time since first drink into account, there was no significant difference (in the long run) between those who began at 17-18 and those who began at 19 or later. For the latter group, the onset of dependence was merely delayed. Again, no conclusive proof of causation, but the authors concluded that prevention programs that succeed in delaying drinking to even 15-16 would likely produce substantial benefits. This is probably a better idea than trying to make the perfect the enemy of the good, like those who support the 21 drinking age never cease to do.
In other words, we need to see the forest for the trees. Something we as a society fail to do time and again.
The study pools data from both a 1992 survey and a 2002 survey, and finds that those who were exposed to a drinking age of less than 21 when they were ages 18-20 were about 1.3 times more likely to have an alcohol use disorder, and about 1.7 times more likely to have a substance use disorder other than alcohol, in the past year. Even (scratch that, especially) when the respondents were in their 40s and 50s. The researchers attempted to control for confounders, but we all know there can always be some that were missed. And we know that if you torture the data enough, it will confess to anything.
We at 21 Debunked think that the relationship between MLDA and later alcohol problems is likely spurious for the following reasons:
- At least part of the relationship seems to be mediated by self-selective cross-state migration (i.e. budding alcohol abusers moving to states with more lenient laws). But there was no data on state of residence at age 18, only birth state and current state.
- The relationship was apparently NOT mediated by earlier age of drinking onset, as would be expected if the relationship was truly causal. Also, there was no significant effect on drinking before 18, so we can rule out the often claimed "spillover effect" on younger kids.
- Drug addiction (especially hard drugs) was affected more strongly than alcohol addiction for whatever reason, the opposite of what would be expected assuming causality.
- No distinction was made between a drinking age of 18, 19, or 20, which may have a misleading impact on the results. Though this could bias the results in either direction.
- The effect on past-year alcohol use disorders was strongest among respondents in their 40s and 50s, and weakest (and statistically insignificant) among those in their 20s, the opposite of what would be expected from a causal relationship. Both drinking age exposed groups start out fairly close, disorders decline at the same rate at first, and divergence does not occur until around age 35.
- Regressions did not control for state-specific trends, religion, or completely for ethnicity. Whites were treated as a monolithic group (despite wide variation in drinking cultures), and no distinction was made for Native Americans (who tend to have higher alcoholism rates).
- Unemployment and education were controlled for, but not poverty.
- The odds ratio for the relationship between MLDA <21 and later alcohol use disorders was an anemic 1.33. In epidemiology, odds ratios and (relative risks) below 2.0 are difficult to interpret and are often due to residual or unmeasured confounding, bias, or even chance. This caveat is especially true for retrospective and non-longitudinal survey studies such as this one. For example, the New England Journal of Medicine would likely consider this association "weak" and thus unfit for publication in most circumstances.
- And there's always the usual recall bias, as well as good old-fashioned denial. They don't call it a "pink elephant in the room" for nothing.
And why does Canada (MLDA 18 or 19 depending on province) not have a higher alcoholism rate than America? Demographically, they probably should! Ditto for most other countries with lower drinking ages, even the notoriously binge-drinking British and Australians? Some may say culture, but Canada's culture is not radically different than ours, and Britain's should, if anything, be more conducive to alcoholism than ours.
Another new study, this one done in Australia (with a legal drinking age of 18), explores the "age at first drink" effect on alcohol dependence from a new angle. Studying numerous twins, they find that there appears to be a gene-environment interaction among those who begin drinking before 15, especially before 13. Such very early drinking, or some environmental factor closely linked to it, appears to activate the bad genes. Though this could simply be a common vulnerability from other differences in environment rather than a truly causal effect of age. Or perhaps the context of drinking matters. The older one starts drinking, the more the environment matters, and the less genes do. But interestingly, and most importantly for the purposes of this discussion, the effect of age at first drink levels off after 18, with no significant difference between those who begin drinking at 18, 19, 20, or even 23. (Funny how this "leveling" effect occurs precisely at the age that corresponds to the MLDA. Coincidence? Hmmm.....)
This jibes well with a Canadian study done in 2000 that found that, while those who begin drinking between 11-14 have the highest risk for later alcohol dependence, even when taking time since first drink into account, there was no significant difference (in the long run) between those who began at 17-18 and those who began at 19 or later. For the latter group, the onset of dependence was merely delayed. Again, no conclusive proof of causation, but the authors concluded that prevention programs that succeed in delaying drinking to even 15-16 would likely produce substantial benefits. This is probably a better idea than trying to make the perfect the enemy of the good, like those who support the 21 drinking age never cease to do.
In other words, we need to see the forest for the trees. Something we as a society fail to do time and again.
Friday, September 18, 2009
Blast from the Past
One of the fears about lowering the drinking age is that traffic fatalities will rise. Usually, the pro-21 crowd either points to studies of the 1980s, when drinking ages were raised, or the 1970s, when drinking ages were lowered. Having already debunked the studies of the post-1976 period, using studies such as Miron and Tetelbaum (2009), here we look at a period with relatively scant data: 1970-1975, when 30 states lowered the drinking age.
Claim: There was an immediate and persistent increase in (presumably alcohol-related) fatalities among 18-20 year olds when the drinking ages were lowered (generally to 18).
First of all, we don't really know if that statement is even true to begin with, and we probably never will. Only a few decent-quality studies examined the years 1970-1975, the years in which the drinking ages were lowered. The Fatality Analysis Reporting System (FARS), which gives detailed reports about traffic fatalities, was not even created until 1975, and state-level data were not available through that system until 1976. So any conclusions drawn from state-level data for 18-20 year olds before 1976 is questionable at best. For studies of nonfatal crashes, this caveat applies a fortiori. And any "alcohol-related fatality" data before 1982 is unreliable since FARS did not make this distinction until that year, which is understandable since a state that tested even 50% of fatal crash drivers for alcohol was considered stellar back then. Garbage in, garbage out.
From 1970-1975, any alleged increase in fatalities was imperceptible in the aggregate data. Using data from the National Safety Council, Miron and Tetelbaum (2009) showed that national 15-24 year old fatalities peaked in 1969, then declined sharply until 1975. From 1976-1980, fatalities rose somwhat, and declined from then on. The same was true for 18-20 year olds after 1976, when that group was separated out by FARS and the two groups have been highly correlated since. But the increase in the late 70s also occurred in states like California, which kept their drinking age at 21 throughout, so the 1976-1980 increase was unlikely to be a result of lowering the drinking age a few years prior.
So all state-level data for 18-20 year olds before 1976 must be gleaned from sources other than FARS, and some states had data problems for this period. And here's the grain of truth of it all. It is true that some states that lowered their drinking ages (and some that did not) saw increases in reported 18-20 year old fatalities from 1970-1975. But other states that lowered their drinking ages saw either no significant change or sharp decreases in such deaths in the table below:
Claim: There was an immediate and persistent increase in (presumably alcohol-related) fatalities among 18-20 year olds when the drinking ages were lowered (generally to 18).
First of all, we don't really know if that statement is even true to begin with, and we probably never will. Only a few decent-quality studies examined the years 1970-1975, the years in which the drinking ages were lowered. The Fatality Analysis Reporting System (FARS), which gives detailed reports about traffic fatalities, was not even created until 1975, and state-level data were not available through that system until 1976. So any conclusions drawn from state-level data for 18-20 year olds before 1976 is questionable at best. For studies of nonfatal crashes, this caveat applies a fortiori. And any "alcohol-related fatality" data before 1982 is unreliable since FARS did not make this distinction until that year, which is understandable since a state that tested even 50% of fatal crash drivers for alcohol was considered stellar back then. Garbage in, garbage out.
From 1970-1975, any alleged increase in fatalities was imperceptible in the aggregate data. Using data from the National Safety Council, Miron and Tetelbaum (2009) showed that national 15-24 year old fatalities peaked in 1969, then declined sharply until 1975. From 1976-1980, fatalities rose somwhat, and declined from then on. The same was true for 18-20 year olds after 1976, when that group was separated out by FARS and the two groups have been highly correlated since. But the increase in the late 70s also occurred in states like California, which kept their drinking age at 21 throughout, so the 1976-1980 increase was unlikely to be a result of lowering the drinking age a few years prior.
So all state-level data for 18-20 year olds before 1976 must be gleaned from sources other than FARS, and some states had data problems for this period. And here's the grain of truth of it all. It is true that some states that lowered their drinking ages (and some that did not) saw increases in reported 18-20 year old fatalities from 1970-1975. But other states that lowered their drinking ages saw either no significant change or sharp decreases in such deaths in the table below:
| State | Drinking Age Change (1970-1975) | % Change in 18-20 total auto fatalities per capita (1970-1975) |
| Alabama* | Lowered, 21 to 19, 1975 | -26% |
| Alaska* | Lowered, 21 to 19, 1970 | no data |
| Arizona* | Lowered, 21 to 19, 1972 | -29% |
| Arkansas | 21 (no change) | -22% |
| California | 21 (no change) | -14% |
| Colorado | 18 (no change) | -10% |
| Connecticut* | Lowered, 21 to 18, 1972 | +11% |
| Delaware* | Lowered, 21 to 20, 1972 | +2.3% |
| DC | 18 (no change) | no data |
| Florida* | Lowered, 21 to 18, 1973 | -28% |
| Georgia* | Lowered, 21 to 18, 1972 | -26% |
| Hawaii* | Lowered, 20 to 18, 1972 | no data |
| Idaho* | Lowered, 20 to 19, 1972 | -29% |
| Illinois* | Lowered, 21 to 19, 1973 | -18% |
| Indiana | 21 (no change) | -19% |
| Iowa* | Lowered, 21 to 19, 1972, then 18, 1973 | -31% |
| Kansas | 18 (no change) | -49% |
| Kentucky | 21 (no change) | -31% |
| Louisiana | 18 (no change) | -26% |
| Maine* | Lowered, 20 to 18, 1972 | -14% |
| Maryland* | Lowered, 21 to 18, 1974 | -8.6% |
| Massachusetts* | Lowered, 21 to 18, 1973 | 0% |
| Michigan* | Lowered, 21 to 18, 1972 | -6.4% |
| Minnesota* | Lowered, 21 to 18, 1973 | 0% |
| Missouri | 21 (no change) | -20% |
| Mississippi | 18 (no change) | -46% |
| Montana* | Lowered, 21 to 19, 1971, then 18, 1972 | +19% |
| North Carolina | 18 (no change) | -10% |
| North Dakota | 21 (no change) | +5.2% |
| Nebraska* | Lowered, 20 to 19, 1972 | +7.8% |
| Nevada | 21 (no change) | -61% |
| New Hampshire* | Lowered, 21 to 18, 1973 | -59% |
| New Jersey* | Lowered, 21 to 18, 1973 | +2.9% |
| New Mexico | 21 (no change) | -14% |
| New York | 18 (no change) | -9.7% |
| Ohio | 18 (no change) | -35% |
| Oklahoma | 21 (not lowered to 18 until 1976) | -14% |
| Oregon | 21 (no change) | -13% |
| Pennsylvania | 21 (no change) | -7.1% |
| Rhode Island* | Lowered, 21 to 18, 1972 | +67% |
| South Carolina | 18 (no change) | -25% |
| South Dakota* | Lowered, 19 to 18, 1972 | -31% |
| Tennessee* | Lowered, 21 to 18, 1971 | -1.6% |
| Texas* | Lowered, 21 to 18, 1973 | +2.0% |
| Utah | 21 (no change) | -49% |
| Vermont* | Lowered, 21 to 18, 1971 | +161% |
| Virginia* | Lowered, 21 to 18, 1974 | -17% |
| Washington | 21 (no change) | -7.1% |
| Wisconsin** | 18 (no change for on-premise beer)** | -7.1% |
| West Virginia | 18 (no change for beer) | +1.9% |
| Wyoming* | Lowered, 21 to 19, 1973 | +1.0% |
(Taken from Cook and Tauchen (1984), Appendix A. Calculations ours. All data involves purchase age for beer unless otherwise noted. Dates taken from Wikipedia)
Thus, the state-level data are completely patternless, at least in terms of drinking age. Clearly, other factors were involved, such as gas prices (now known to have an effect), the economy, or even the weather. Only a handful of states (mostly with relatively small populations and hence much volatility in the numbers) in the table show significant increases, including one (North Dakota) that kept a constant 21 MLDA since the 1930s. The rest either saw sharp decreases or no significant change. This was in spite of the fact that, nationwide, the average driver in 1975 traveled more vehicle miles than in 1970. And before the advent of FARS, any increases are not clear as to whether they reflect true fatality increases or simply changes in how fatal crashes were reported. Nor does this table tell us whether those increases were contemporaneous with the age-lowering (done mostly in 1972-1973) since only two years, 1970 and 1975, were compared due to data availability. For example, Vermont's rather large increase, apparently, was not contemporaneous (See Douglass and Filkins, 1974).
Thus, the state-level data are completely patternless, at least in terms of drinking age. Clearly, other factors were involved, such as gas prices (now known to have an effect), the economy, or even the weather. Only a handful of states (mostly with relatively small populations and hence much volatility in the numbers) in the table show significant increases, including one (North Dakota) that kept a constant 21 MLDA since the 1930s. The rest either saw sharp decreases or no significant change. This was in spite of the fact that, nationwide, the average driver in 1975 traveled more vehicle miles than in 1970. And before the advent of FARS, any increases are not clear as to whether they reflect true fatality increases or simply changes in how fatal crashes were reported. Nor does this table tell us whether those increases were contemporaneous with the age-lowering (done mostly in 1972-1973) since only two years, 1970 and 1975, were compared due to data availability. For example, Vermont's rather large increase, apparently, was not contemporaneous (See Douglass and Filkins, 1974).
A quick, albeit imperfect, way to estimate the effect of a policy change ceteris paribus is a method called "difference-in-differences," or DD for short. Here, we do a DD analysis comparing change vs. no change states:
Median difference, "change" states (1975 vs. 1970): -6.8%
Median difference, "no-change" states: -16.5%
Net difference-in-differences: +9.75%
This implies that, while both groups declined overall, the no-change states declined at a significantly faster rate than the states that lowered their drinking ages. And the latter group can be said to have more deaths at first glance. However, there are two radical outliers (VT and RI) that dramatically skew the results. Furthermore, Delaware is the only state that lowered the age from 21 to 20 and no further, and Wisconsin would better be included with the no-change states since 18 year olds were allowed to drink beer in bars both before and after. Thus, we omit the two outliers and Delaware entirely, and instead place WI with the no-change in our adjusted DD analysis:
Adjusted median difference, "change" states: -11.3%
Adjusted median difference, "no-change" states: -14.0%
Net difference-in-differences: +2.7%
Wow, that really makes a difference in the results. The net DD drops from nearly +10% to less than +3%. The latter "effect size" is small enough to be due to chance alone. Indeed, we also observe in the table that several of the states with significant increases are also states with some of the smallest 18-20 year old populations. Such states are prone to spurious shocks due to the volatility of smaller numbers of fatalities. Thus, we see that when we eliminate all the states with populations less than or equal to that of Montana, along with making the aforementioned adjustments, the drinking age effect disappears entirely:
Adjusted median difference, "change" states: -14.0%
Adjusted median difference, "no change" states: -14.0%
Net difference-in-differences: 0%
Regardless of what happened (or didn't happen) in the 1970s, it is essentially irrelevant today. Back then, drinking ages were lowered against a backdrop of falling real alcohol prices, higher adult per capita alcohol consumption than today, permissive and toothless DUI laws, social acceptability of drunk driving, no seat belt laws, ignorance about the risks of alcohol, and a generally cavalier attitude toward safety. The term "air bag" meant a person who talked too much. The term "designated driver" was not even in our vocabulary until the 1980s. Drunk driving was not just tolerated back then, it was expected of you if you were the least drunk person in the group (to drive everyone else home). Needless to say, things are very different today. So it's comparing apples and oranges. And any fear relating to the 1970s is therefore academic. Consider it debunked.
Claim: There was a major increase in high school drinking (and related problems) when the drinking age was lowered, as 18 year olds bought for their younger friends.
Again, correlation does not equal causation. It was true that in the 1970s, teen drinking increased, but that was a national trend that occurred in essentially every state, including those like California that kept the drinking age at 21. In fact, the secular trend predated the 1970s by many decades, and ironically enough began during Prohibition in the 1920s. It lasted until about 1979, then the trend reversed and teen drinking declined through the 1980s until the early 1990s. And the downward trend predated the raising of the drinking age, and again occurred in essentially every state.
The average age at first drink did decline nationwide, but that began in 1965 (or earlier), and continued to decline long after the drinking age was raised in the 1980s. And California, who had a 21 drinking age since 1933, saw the same trend overall as the rest of the country. So clearly other factors are at work, and the trends cannot be traced to changes in the drinking age.
Part of the increase in teen drinking could be that parents stuck their heads in the sand about alcohol, being relieved that "at least my kid isn't smoking pot." Or it could have resulted from a moral panic and a consequent deviancy amplification spiral. Or perhaps a bit of both, with the former preceding the latter.
Interestingly, a 1977 study found that high school seniors in states with a drinking age of 18 actually drank less and had fewer alcohol-related problems than those in states with a drinking age of 20 or 21. Why this is is not entirely clear, but the researchers hypothesize that "forbidden fruit" may very well entice those in the more restrictive states to drink. Or perhaps those seniors that are still 17 are more likely to wait until 18 to be legal since this is more realistic than waiting until 20 or 21.
Again, much of the fears from the 1970s are now academic, and are unlikely to be a problem if the drinking age was lowered today. The notion of teenagers having "liquid lunches" in high school is no longer socially acceptable--it is now considered a sign of a drinking problem. Those who are caught bringing booze to school are dealt with much more harshly than they were back then, campuses are often closed, and students are essentially defanged and declawed. And today's tough enforcement requires IDs to be shown when purchasing alcohol, reducing the chances of a 15-17 year old "passing" for 18. About the last remaining fear is high school keggers (which still occur even with a 21 drinking age), but any possible increase in these parties can (by definition) be prevented by keeping the purchase age at 21 (or 20) for bulk quantities like kegs and cases while lowering it to 18 for everything else.
One thing, however, is for sure: teenagers will get their hands on booze one way or another, and whether the drinking age is 18 or 21 is of little consequence to this fact. Where there's a will, there's a way. And where there's a swill, there's a sway. So consider this one debunked as well.
Regardless of what happened (or didn't happen) in the 1970s, it is essentially irrelevant today. Back then, drinking ages were lowered against a backdrop of falling real alcohol prices, higher adult per capita alcohol consumption than today, permissive and toothless DUI laws, social acceptability of drunk driving, no seat belt laws, ignorance about the risks of alcohol, and a generally cavalier attitude toward safety. The term "air bag" meant a person who talked too much. The term "designated driver" was not even in our vocabulary until the 1980s. Drunk driving was not just tolerated back then, it was expected of you if you were the least drunk person in the group (to drive everyone else home). Needless to say, things are very different today. So it's comparing apples and oranges. And any fear relating to the 1970s is therefore academic. Consider it debunked.
Claim: There was a major increase in high school drinking (and related problems) when the drinking age was lowered, as 18 year olds bought for their younger friends.
Again, correlation does not equal causation. It was true that in the 1970s, teen drinking increased, but that was a national trend that occurred in essentially every state, including those like California that kept the drinking age at 21. In fact, the secular trend predated the 1970s by many decades, and ironically enough began during Prohibition in the 1920s. It lasted until about 1979, then the trend reversed and teen drinking declined through the 1980s until the early 1990s. And the downward trend predated the raising of the drinking age, and again occurred in essentially every state.
The average age at first drink did decline nationwide, but that began in 1965 (or earlier), and continued to decline long after the drinking age was raised in the 1980s. And California, who had a 21 drinking age since 1933, saw the same trend overall as the rest of the country. So clearly other factors are at work, and the trends cannot be traced to changes in the drinking age.
Part of the increase in teen drinking could be that parents stuck their heads in the sand about alcohol, being relieved that "at least my kid isn't smoking pot." Or it could have resulted from a moral panic and a consequent deviancy amplification spiral. Or perhaps a bit of both, with the former preceding the latter.
Interestingly, a 1977 study found that high school seniors in states with a drinking age of 18 actually drank less and had fewer alcohol-related problems than those in states with a drinking age of 20 or 21. Why this is is not entirely clear, but the researchers hypothesize that "forbidden fruit" may very well entice those in the more restrictive states to drink. Or perhaps those seniors that are still 17 are more likely to wait until 18 to be legal since this is more realistic than waiting until 20 or 21.
Again, much of the fears from the 1970s are now academic, and are unlikely to be a problem if the drinking age was lowered today. The notion of teenagers having "liquid lunches" in high school is no longer socially acceptable--it is now considered a sign of a drinking problem. Those who are caught bringing booze to school are dealt with much more harshly than they were back then, campuses are often closed, and students are essentially defanged and declawed. And today's tough enforcement requires IDs to be shown when purchasing alcohol, reducing the chances of a 15-17 year old "passing" for 18. About the last remaining fear is high school keggers (which still occur even with a 21 drinking age), but any possible increase in these parties can (by definition) be prevented by keeping the purchase age at 21 (or 20) for bulk quantities like kegs and cases while lowering it to 18 for everything else.
One thing, however, is for sure: teenagers will get their hands on booze one way or another, and whether the drinking age is 18 or 21 is of little consequence to this fact. Where there's a will, there's a way. And where there's a swill, there's a sway. So consider this one debunked as well.
QED
Thursday, September 17, 2009
Daredevil Behavior and the Teenage Brain
Teenagers are often assumed to be risk-takers who engage in dangerous and idiotic activities. And that is often true. But compared to American adults, they are really not that bad.
It is often assumed that it is due to their "underdeveloped brains," which apparently continue to develop until at least age 25. This factoid is heard so often that it is taken as gospel. Indeed, numerous studies have revealed changes in the adolescent and young adult brain. So one must lead to the other, right?
But what if the supposed causation is not just inaccurate, but in fact is 100% wrong? Apparently, a new study of brain imaging suggests just that. They found that the more mature and "adult" the white matter of teen brains was, the more risk-taking behavior reported, the opposite of what was expected. Of course, the direction of causality is uncertain, but doesn't this blow a hole in the conventional wisdom?
Another study finds that, among 10-16 year olds, shortsightedness is not caused by impulsivity (lack of self-control), but rather by sensation-seeking. While 10-16 year olds did tend to think about the future less than adults do, and thus prefer immediate rewards to delayed ones, there was little change in shortsightedness after 16 (the study looked at 10-30 year olds). This is interesting since the parts of the brain that are related to sensation do not continue maturing after 16, but the parts responsible for self-control do. Still, shortsightedness changes little between the ages of 16 and 30.
The results of another study imply that, at least in terms of resistance to peer influences, 18 year olds are essentially just as competent as 23-30 year olds. This echoes older studies that found that results on tests that measure competence to stand trial seem to level off after age 16, similar to the way IQ typically does.
Another study found that the likely explanation of the relationship between age at first drink and subsequent drinking problems has to do with the quality of the parent-child relationship. In other words, the better the quality, the later drinking begins and the fewer drinking problems. Age at first drink may simply be a marker for later problems or lack thereof, since it appears to be a marker for the relationship quality. Still another study finds that child maltreatment is independently linked to adolescent "binge" drinking (5+ drinks/occasion), as was the pink elephant in the room (parental alcoholism).
What does all this have to do with the 21 drinking age? Plenty. Arguments supporting a drinking age higher than the age of majority do not appear to hold water upon closer examination.
It is often assumed that it is due to their "underdeveloped brains," which apparently continue to develop until at least age 25. This factoid is heard so often that it is taken as gospel. Indeed, numerous studies have revealed changes in the adolescent and young adult brain. So one must lead to the other, right?
But what if the supposed causation is not just inaccurate, but in fact is 100% wrong? Apparently, a new study of brain imaging suggests just that. They found that the more mature and "adult" the white matter of teen brains was, the more risk-taking behavior reported, the opposite of what was expected. Of course, the direction of causality is uncertain, but doesn't this blow a hole in the conventional wisdom?
Another study finds that, among 10-16 year olds, shortsightedness is not caused by impulsivity (lack of self-control), but rather by sensation-seeking. While 10-16 year olds did tend to think about the future less than adults do, and thus prefer immediate rewards to delayed ones, there was little change in shortsightedness after 16 (the study looked at 10-30 year olds). This is interesting since the parts of the brain that are related to sensation do not continue maturing after 16, but the parts responsible for self-control do. Still, shortsightedness changes little between the ages of 16 and 30.
The results of another study imply that, at least in terms of resistance to peer influences, 18 year olds are essentially just as competent as 23-30 year olds. This echoes older studies that found that results on tests that measure competence to stand trial seem to level off after age 16, similar to the way IQ typically does.
Another study found that the likely explanation of the relationship between age at first drink and subsequent drinking problems has to do with the quality of the parent-child relationship. In other words, the better the quality, the later drinking begins and the fewer drinking problems. Age at first drink may simply be a marker for later problems or lack thereof, since it appears to be a marker for the relationship quality. Still another study finds that child maltreatment is independently linked to adolescent "binge" drinking (5+ drinks/occasion), as was the pink elephant in the room (parental alcoholism).
What does all this have to do with the 21 drinking age? Plenty. Arguments supporting a drinking age higher than the age of majority do not appear to hold water upon closer examination.
Monday, August 31, 2009
The Tide is Turning
According to the latest Rasmussen poll, 30% of American adults believe that the drinking age should be lowered to 18, and 5% believe it should be lowered to 16. This combination, 35%, is a record high, and this is one of the few times in decades that we broke the 30% barrier. And only 51% believe it should remain at 21, a record low. Adults under 40 were fairly even on whether the drinking age should be 18 or 21 (last year it was about half of men and about a quarter of women under 40 who wanted the age to be 18), another sign of progress. (Now, if only we could get young people to vote more!)
Also, 50% of adults believe that drunk driving laws are too lenient, while only 8% think they're too tough. That's one thing we at 21 Debunked do agree with the majority on.
It appears we are fast approaching a critical mass, if we have not achieved one already. Remember that it does not always take a majority to prevail, as Samuel Adams so eloquently noted.
Forty years ago, it was 1969. Lots of great things happened in that fateful year (Woodstock, the moon landing, the first Earth Day, etc.), but most relevant to the debate is the fact that the first two states to lower the drinking age (the first time around) did so that year. From 1970-1976, 30 states would lower their drinking ages, chiefly in 1972-1973, after decades of it being 21 in most states (some were 18 since the 1930s or remained 21 throughout). This occurred because the voting age and age of majority were lowered, due to the hypocrisy that 18-20 year olds were dying in Vietnam but were not allowed to have full adult rights, leading to much protest from that age group. Sound familiar? There was a huge mass of young people at the time, whose numbers would decline to political impotence in the 1980s (when the drinking age was raised to 21) and rise again in the late 1990s and especially the 2000s. Forty years later, the children of the Baby Boomers have come of age. There are now at least as many young Millennials as there were young Boomers in 1969, and they are a force to be reckoned with as there is strength in numbers.
If the current groundswell continues, perhaps we can consider 2009 to be like the new 1969, and so on. Only now Vietnam is spelled "Iraq" (or perhaps "Afghanistan"). Thus, we may lay the events on a timeline and make a prediction that the first state or two to lower the drinking age will do so in 2009-2011. Those will be the "guinea pigs," and how the feds handle it in 2011 will be crucial to the movement's success--that will be the wild card. If a large number of states follow suit, that will likely occur in 2012-2013. If so, a few more may do so in 2014-2016, and hopefully the Millennials won't sell out like the Boomers did back in the day.
Of course, this is all just speculation, but it can happen. What better time than now?
Also, 50% of adults believe that drunk driving laws are too lenient, while only 8% think they're too tough. That's one thing we at 21 Debunked do agree with the majority on.
It appears we are fast approaching a critical mass, if we have not achieved one already. Remember that it does not always take a majority to prevail, as Samuel Adams so eloquently noted.
Forty years ago, it was 1969. Lots of great things happened in that fateful year (Woodstock, the moon landing, the first Earth Day, etc.), but most relevant to the debate is the fact that the first two states to lower the drinking age (the first time around) did so that year. From 1970-1976, 30 states would lower their drinking ages, chiefly in 1972-1973, after decades of it being 21 in most states (some were 18 since the 1930s or remained 21 throughout). This occurred because the voting age and age of majority were lowered, due to the hypocrisy that 18-20 year olds were dying in Vietnam but were not allowed to have full adult rights, leading to much protest from that age group. Sound familiar? There was a huge mass of young people at the time, whose numbers would decline to political impotence in the 1980s (when the drinking age was raised to 21) and rise again in the late 1990s and especially the 2000s. Forty years later, the children of the Baby Boomers have come of age. There are now at least as many young Millennials as there were young Boomers in 1969, and they are a force to be reckoned with as there is strength in numbers.
If the current groundswell continues, perhaps we can consider 2009 to be like the new 1969, and so on. Only now Vietnam is spelled "Iraq" (or perhaps "Afghanistan"). Thus, we may lay the events on a timeline and make a prediction that the first state or two to lower the drinking age will do so in 2009-2011. Those will be the "guinea pigs," and how the feds handle it in 2011 will be crucial to the movement's success--that will be the wild card. If a large number of states follow suit, that will likely occur in 2012-2013. If so, a few more may do so in 2014-2016, and hopefully the Millennials won't sell out like the Boomers did back in the day.
Of course, this is all just speculation, but it can happen. What better time than now?
Monday, August 24, 2009
Our Modest Proposal
While the first post outlines our purpose and views, and should be read, some folks may still be confused about details. Here is precisely what we at Twenty-One Debunked (a subsidiary of the True Spirit of America Party) propose, in concrete terms, to further the cause of justice and help reduce America's drinking problem:
**We do not consider implied consent laws to be against the constitution, and have no problem with stiff penalties for test refusals for drivers (but no one else).
- Lower the drinking age to 18, period. No compromises, except perhaps to have the age for kegs/cases/other very large quantities be 20 or 21.
- Raise the beer tax and liquor tax to its 1951 and 1991 inflation-adjusted values, respectively, and make the beer tax proportional to alcohol content. (No tax hike for microbrews.) Use the funds to pay for education, treatment, and DUI enforcement.
- Crack down hard on DUI, increase penalties, lower BAC limit to 0.05%. Have graduated (but stiff) penalties based on BAC, with serious jail time for high BAC offenders. Lose license forever on second offense above 0.08, regardless of age. No more excuses.
- Keep Zero Tolerance age at 21, and/or make it for anyone who has had a license for less than 5 years, regardless of age.
- Increase honest alcohol education, which should begin long before 18.
- Restrict alcohol advertising to no more than what is allowed for tobacco.
- Regulation of alcohol outlet density.
- Price floors on off-premises sales.
- Free or low-cost taxi service to and from bars and/or improved late night public transportation.
- Increased alcohol treatment.
- Make driver licenses tougher to get and easier to lose, and the road test much tougher.
- Make it a federal crime to drive drunk across state lines, punishable by many years in federal prison.
- Special restrictions on 18-20 year olds that do not apply to those over 21 (except perhaps on bulk quantities of alcohol) or any kind of strings attached, including "drinking licenses".
- Dram shop and social host laws of any kind.
- Loopholes that allow DUI offenders to get off easily (e.g. plea bargain for "reckless driving").
- Harsh criminal penalties for underage drinkers of any age.
- Blue laws.
- Public drunkenness laws based solely on BAC or the mere fact of drinking.*
- Laws that completely prohibit parents from giving their own children alcohol.
- Any laws that require that the Constitution be violated in order to adequately enforce them.**
**We do not consider implied consent laws to be against the constitution, and have no problem with stiff penalties for test refusals for drivers (but no one else).
Friday, August 14, 2009
Latest Brain Studies Demonstrate The Same Old Flaws
Potentially adding fuel to the fire of the drinking age debate is a new study of 18-20 year old first-year university students in Spain, that looked at the effects of so-called "binge" drinking on the brain. In this study, 95 students (42 "bingers", 53 controls) were given tests of attention and working memory, and their specific brain waves were monitored with electrodes. No statistically significant differences were observed between the two groups in terms of actual performance, but the electrophysiological test suggested that more attention was expended to complete a given task among the "binge" group, as well as other electrophysiological differences. This is a lot more nuanced and less certain than the media are implying, and hardly represents "dain bramage."
The biggest flaw in this study was the fact that there was no over-21 comparison group. So we simply cannot infer anything at all about age from this piece of research. Absolutely zilch. A better method would have been to have three groups: 15-17, 18-20, and 21-24 years of age. But no study that we know of meets this standard. This would help to settle the nagging question of whether or not it actually is worse to drink at 18 rather than 21. Or perhaps some people are afraid of the possibility that their rationale for keeping the drinking age at 21 would be debunked if such a comparison was done. As yet, there is essentially ZERO hard evidence that drinking at 18 is significantly worse than doing so at 21, ceteris paribus, but a plethora of evidence showing that excessive drinking is unhealthy at any age. To be fair, however, the purpose of the study was not to test the rationale for the drinking age, but rather the effects of alcohol on a particular segment of the population.
Other flaws included small sample size, and not enough information to determine whether the results are of any practical significance. The lack of behavioral performance differences between the two groups suggests that the answer is not very much, but still warrants more study before jumping to any conclusion either way. Subjects were only required to refrain from using alcohol or drugs for at least 12 hours, so acute and transient effects (such as hangover, which can last for up to 36 hours) cannot be ruled out. Also, this was a cross-sectional study, so we do not know whether or not the purported effects were acutally innate characteristics that predated (or even predisposed for) the "binge" drinking. Tobacco smoking was also not controlled for. In other words, this study is preliminary at best.
It is also interesting to note that the average age of onset of drinking in the "binge" group was 14, and 15 in the nonbinge group.
The reason this blog uses scare quotes on the word "binge" is by convention: we do not feel that the definiton used (6+ standard drinks on at least one occasion in the past month, at a pace of 3+ drinks per hour) was an adequate one. That was equivalent to about 4+ American drinks, and undercounting and underreporting can also confound the results as well. Given the small sample size, there could be a few students that drank much more than the others, and more than they led on, and skewed the results. Some could have been dishonest about alcohol use disorders, which were an exclusion criterion, and could also have skewed the results.
Another recent study, done on college students in Belgium, also found similar electrophysiological differences, but again no behavioral differences for some reason. In this study, there were no differences in alcohol consumption or electrophysiological results at baseline, but both changed significantly in the "binge" group when measured 9 months later, but not in the control group. However, we should keep in mind that the binge group averaged 12.5 units (about 9 American drinks) per binge session, and two such binge sessions per week, which is quite extreme. Number of (American) drinks per week averaged a whopping 35 units (25 American drinks) in the binge group, while the control group drank about one drink per week. And some participants drank as recently as three days before the tests as well, potentially conflating short and long term effects, though this was ostensibly controlled for. One good thing about this study, however, was that the sample size was significantly larger than the aforementioned one, and there was both a before test and and after test.
Still another study in 2007, this time of 21-25 year olds (you know, folks who are legally allowed to imbibe) who were self-identified heavy drinkers (more than 25 drinks per week), found that subtle brain changes are not exclusive to those under the magic age of 21. The heavy drinkers did not exhibit significant neuropsychological test differences, but PET scans showed subtle differences. Of course, this study did not gain nearly as much attention as the others previously mentioned.
Drinking ludicrous amounts of alcohol is dangerous, period. Regardless of age. That, if anything, should be the moral of the story. Keeping the drinking age at 21 only encourages such extremes, especially for college students.
We at 21 Debunked provide this for informational purposes only and do not in any way advocate drinking of any kind, underage or otherwise.
The biggest flaw in this study was the fact that there was no over-21 comparison group. So we simply cannot infer anything at all about age from this piece of research. Absolutely zilch. A better method would have been to have three groups: 15-17, 18-20, and 21-24 years of age. But no study that we know of meets this standard. This would help to settle the nagging question of whether or not it actually is worse to drink at 18 rather than 21. Or perhaps some people are afraid of the possibility that their rationale for keeping the drinking age at 21 would be debunked if such a comparison was done. As yet, there is essentially ZERO hard evidence that drinking at 18 is significantly worse than doing so at 21, ceteris paribus, but a plethora of evidence showing that excessive drinking is unhealthy at any age. To be fair, however, the purpose of the study was not to test the rationale for the drinking age, but rather the effects of alcohol on a particular segment of the population.
Other flaws included small sample size, and not enough information to determine whether the results are of any practical significance. The lack of behavioral performance differences between the two groups suggests that the answer is not very much, but still warrants more study before jumping to any conclusion either way. Subjects were only required to refrain from using alcohol or drugs for at least 12 hours, so acute and transient effects (such as hangover, which can last for up to 36 hours) cannot be ruled out. Also, this was a cross-sectional study, so we do not know whether or not the purported effects were acutally innate characteristics that predated (or even predisposed for) the "binge" drinking. Tobacco smoking was also not controlled for. In other words, this study is preliminary at best.
It is also interesting to note that the average age of onset of drinking in the "binge" group was 14, and 15 in the nonbinge group.
The reason this blog uses scare quotes on the word "binge" is by convention: we do not feel that the definiton used (6+ standard drinks on at least one occasion in the past month, at a pace of 3+ drinks per hour) was an adequate one. That was equivalent to about 4+ American drinks, and undercounting and underreporting can also confound the results as well. Given the small sample size, there could be a few students that drank much more than the others, and more than they led on, and skewed the results. Some could have been dishonest about alcohol use disorders, which were an exclusion criterion, and could also have skewed the results.
Another recent study, done on college students in Belgium, also found similar electrophysiological differences, but again no behavioral differences for some reason. In this study, there were no differences in alcohol consumption or electrophysiological results at baseline, but both changed significantly in the "binge" group when measured 9 months later, but not in the control group. However, we should keep in mind that the binge group averaged 12.5 units (about 9 American drinks) per binge session, and two such binge sessions per week, which is quite extreme. Number of (American) drinks per week averaged a whopping 35 units (25 American drinks) in the binge group, while the control group drank about one drink per week. And some participants drank as recently as three days before the tests as well, potentially conflating short and long term effects, though this was ostensibly controlled for. One good thing about this study, however, was that the sample size was significantly larger than the aforementioned one, and there was both a before test and and after test.
Still another study in 2007, this time of 21-25 year olds (you know, folks who are legally allowed to imbibe) who were self-identified heavy drinkers (more than 25 drinks per week), found that subtle brain changes are not exclusive to those under the magic age of 21. The heavy drinkers did not exhibit significant neuropsychological test differences, but PET scans showed subtle differences. Of course, this study did not gain nearly as much attention as the others previously mentioned.
Drinking ludicrous amounts of alcohol is dangerous, period. Regardless of age. That, if anything, should be the moral of the story. Keeping the drinking age at 21 only encourages such extremes, especially for college students.
We at 21 Debunked provide this for informational purposes only and do not in any way advocate drinking of any kind, underage or otherwise.
Tuesday, August 4, 2009
Looks promising for South Carolina (Updated)
Two recent lower (county level) court rulings have declared South Carolina's drinking age of 21 unconstitutional. The state's constitution says that “Every citizen who is eighteen years of age or older ... shall be ... endowed with full legal rights and responsibilities, provided that the General Assembly may restrict the sale of alcoholic beverages to persons until age twenty-one.” (emphasis added). Also cited was a SC Supreme Court decision in May 2008 that struck down a law banning handgun possession by 18-20 year olds. If these rulings are upheld on appeal, then the age for possession and consumption of alcohol would automatically revert to 18, like it was 25 years ago. But the age for sale would remain 21, unless the legislature decides to lower it. And the results of the court cases would only be binding in the affected counties unless the SC Supreme Court upholds the appeal as well.
However, the legislature could always change the state constitution, but only with voter approval.
While limited, this is clearly a step in the right direction. Domino effect you say? One can only hope.
UPDATE: We may have spoken too soon. On August 26, 2009, a circuit court upheld the drinking age of 21, unfortunately. The judge said it would create an "absurd result" to allow possession and consumption, but not sale, to 18-20 year olds. (But the SC constitution clearly says "sale" and nothing about possession or consumption). Honestly, the real absurdity is the fact that 18-20 year old legal adults are allowed to go to war, vote, get married, raise kids, and even (as of 2008) carry handguns in SC, but not drink--period. And we (the USA) stand alone among the developed world in maintaining this absurdity.
However, the latest ruling can still be appealed further if so desired, possibly all the way to the Supreme Court. It is too early to throw in the towel just yet.
The drinking age must be lowered, in the interest of justice. What better time than now?
However, the legislature could always change the state constitution, but only with voter approval.
While limited, this is clearly a step in the right direction. Domino effect you say? One can only hope.
UPDATE: We may have spoken too soon. On August 26, 2009, a circuit court upheld the drinking age of 21, unfortunately. The judge said it would create an "absurd result" to allow possession and consumption, but not sale, to 18-20 year olds. (But the SC constitution clearly says "sale" and nothing about possession or consumption). Honestly, the real absurdity is the fact that 18-20 year old legal adults are allowed to go to war, vote, get married, raise kids, and even (as of 2008) carry handguns in SC, but not drink--period. And we (the USA) stand alone among the developed world in maintaining this absurdity.
However, the latest ruling can still be appealed further if so desired, possibly all the way to the Supreme Court. It is too early to throw in the towel just yet.
The drinking age must be lowered, in the interest of justice. What better time than now?
Saturday, August 1, 2009
About-Face, About Time!
You know the 21 drinking age is on its last legs when one of its former supporters, substance abuse expert Dr. Morris Chafetz, has a sudden change of heart a quarter-century later. Remember that presidential commission in 1982? The one that gave 39 recommendations, #8 of which was to raise the drinking age to 21? Well, Dr. Chafetz was on that commission, and he now calls his decision to support Legal Age 21 "the single most regrettable decision" in his career.
Now THAT really says something! Especially given the length of his career. And he's no hippy-dippy or wild party animal either. Dr. Chafetz was the founding director of the NIAAA (pronounced "nee-ahh") beginning in 1970, a psychiatrist, and a renowned expert on alcohol.
He also notes, as 21 Debunked has, that the alcohol-related traffic fatality decline in the US was virtually identical to that in Canada, a country that did not raise the drinking age to 21. Even NHTSA admits this, and it is pretty tough to explain away. This fact alone puts a huge question mark over the specious claim the Legal Age 21 saves any lives at all. Additionally, he echoes the view that the 21 drinking age created unintended negative consequences, such as more deaths and injuries off the roads from clandestine, underground binge drinking (not unlike Prohibition).
As a result, we at 21 Debunked propose an honor for anyone who once fervently supported Legal Age 21 but has finally seen the light. Three cheers for the first ever recipient of the Chafetz award!
The tide, my friends, is turning as we speak. What better time than now?
Now THAT really says something! Especially given the length of his career. And he's no hippy-dippy or wild party animal either. Dr. Chafetz was the founding director of the NIAAA (pronounced "nee-ahh") beginning in 1970, a psychiatrist, and a renowned expert on alcohol.
He also notes, as 21 Debunked has, that the alcohol-related traffic fatality decline in the US was virtually identical to that in Canada, a country that did not raise the drinking age to 21. Even NHTSA admits this, and it is pretty tough to explain away. This fact alone puts a huge question mark over the specious claim the Legal Age 21 saves any lives at all. Additionally, he echoes the view that the 21 drinking age created unintended negative consequences, such as more deaths and injuries off the roads from clandestine, underground binge drinking (not unlike Prohibition).
As a result, we at 21 Debunked propose an honor for anyone who once fervently supported Legal Age 21 but has finally seen the light. Three cheers for the first ever recipient of the Chafetz award!
The tide, my friends, is turning as we speak. What better time than now?
Thursday, July 2, 2009
The Shell Game
A recent study found that "binge drinking"* has declined overall from 1979 to 2006 among young people, with one notable exception--college students. Oh yeah, and young females also.
During this period of nearly three decades, men and women experienced converging trends in reported "binge" drinking:
Males
Age 15-17: -50%
Age 18-20: -20%
Age 21-23: -10%
Females
Age 15-17: unchanged
Age 18-20: unchanged
Age 21-23: +40%
while college students and nonstudents the same age experienced diverging trends:
College:
Age 18-20, males: unchanged
Age 18-20, females: unchanged
Age 21-23, males: unchanged
Age 21-23, females: +40%
Non-college:
Age 18-20, males: -30%
Age 18-20, females: unchanged
Age 21-23, males: -10%
Age 21-23, females: +20%
The authors took this as evidence that raising the drinking age to 21 was successful. But there are two problems with that theory. One is that they are assuming that correlation was causal without controlling for other variables, while in reality the downward trend predated the raising of the drinking age to 21. It was a secular trend, albeit one with some groups bucking it. And a higher drinking age may also increase underreporting as well. The other flaw is that it even if it were partly due to the drinking age being raised, it appears to have been a rather hollow victory upon closer examination. Females seeing no change or even an increase? Ditto for 21-23 year olds? Zero progress among collegians? If that's success, I'd hate to see what failure looks like.
Using an overly broad definition of "binge" drinking, like the one used above (5 drinks in an evening at least once in the past month)* may mask trends in truly dangerous drinking. Another study found that between 1998 to 2005, there was an increase in alcohol-related deaths, self-reported "binge" drinking, and self-reported driving after drinking among college-age 18-24 year olds (but in most cases a peak was reached in 2001-2002). Deaths were driven by a near tripling in the number of alcohol poisoning fatalities. That's a good index of extreme drinking, well above the 5 drinks threshold. But because the increase in self-reported "binge" drinking and driving after drinking was primarily among 21-24 year olds, while 18-20 year olds stayed roughly the same, some people have taken that as a sign of success. Again, this is specious reasoning. It seems that the 21 drinking age (and increased enforcement thereof) simply shifted such behavior a few years into the future, not at all unlike the drunk driving studies mentioned on this blog.
And remember, from 1993-2001 when "binge" drinking was (modestly) increasing for all age groups, 18-20 year olds ironically saw the largest increase of all (+56% in the number of "binge" episodes per person per year) before ostensibly declining again. So part of the increase in 21-24 year old binge drinking could in fact be a cohort effect a few years later. But for 18-20 year olds, it remains elevated in spite of (or perhaps even because of) tougher 21 law enforcement over time. It is also worth noting that the number of episodes per person per year increased faster than the proportion of "binge" drinkers in the population.
Further evidence of failure is that, according to MADD, about half (48%) of the of the alcohol consumed by college students (at four-year schools) is consumed by students under 21. This is even more striking when you consider that only 37% of four-year collegians are under 21.
In other words, at best, a drinking age of 21 appears to merely delay binge drinking, drunk driving, and alcohol-related injuries and deaths. At worst, it may even prolong such behavior. In other words, a shell game.
*A convention on this blog is to always use scare quotes when referring to "binge drinking" defined as an arbitrary number of drinks in an evening. Definitions very as there is no international consensus on what qualifies as a "binge," but the most common definition is 5 or more drinks in the same occasion (evening), or 4 for a woman in some definitions, regardless of drinking speed, weight, etc. When no scare quotes are used, we are talking about truly heavy, rapid, high-intensity drinking--often involving serious chugging or slamming many shots in a short period of time--which involves an unacceptably high risk of harm for anyone of any age. Our definition implies very high intoxication, at least 0.15 BAC if not 0.20+. That is where the lion's share of real problems occur. Fortunately, the vast majority of Americans, even college students, do not do this, regardless of what the media says.
During this period of nearly three decades, men and women experienced converging trends in reported "binge" drinking:
Males
Age 15-17: -50%
Age 18-20: -20%
Age 21-23: -10%
Females
Age 15-17: unchanged
Age 18-20: unchanged
Age 21-23: +40%
while college students and nonstudents the same age experienced diverging trends:
College:
Age 18-20, males: unchanged
Age 18-20, females: unchanged
Age 21-23, males: unchanged
Age 21-23, females: +40%
Non-college:
Age 18-20, males: -30%
Age 18-20, females: unchanged
Age 21-23, males: -10%
Age 21-23, females: +20%
The authors took this as evidence that raising the drinking age to 21 was successful. But there are two problems with that theory. One is that they are assuming that correlation was causal without controlling for other variables, while in reality the downward trend predated the raising of the drinking age to 21. It was a secular trend, albeit one with some groups bucking it. And a higher drinking age may also increase underreporting as well. The other flaw is that it even if it were partly due to the drinking age being raised, it appears to have been a rather hollow victory upon closer examination. Females seeing no change or even an increase? Ditto for 21-23 year olds? Zero progress among collegians? If that's success, I'd hate to see what failure looks like.
Using an overly broad definition of "binge" drinking, like the one used above (5 drinks in an evening at least once in the past month)* may mask trends in truly dangerous drinking. Another study found that between 1998 to 2005, there was an increase in alcohol-related deaths, self-reported "binge" drinking, and self-reported driving after drinking among college-age 18-24 year olds (but in most cases a peak was reached in 2001-2002). Deaths were driven by a near tripling in the number of alcohol poisoning fatalities. That's a good index of extreme drinking, well above the 5 drinks threshold. But because the increase in self-reported "binge" drinking and driving after drinking was primarily among 21-24 year olds, while 18-20 year olds stayed roughly the same, some people have taken that as a sign of success. Again, this is specious reasoning. It seems that the 21 drinking age (and increased enforcement thereof) simply shifted such behavior a few years into the future, not at all unlike the drunk driving studies mentioned on this blog.
And remember, from 1993-2001 when "binge" drinking was (modestly) increasing for all age groups, 18-20 year olds ironically saw the largest increase of all (+56% in the number of "binge" episodes per person per year) before ostensibly declining again. So part of the increase in 21-24 year old binge drinking could in fact be a cohort effect a few years later. But for 18-20 year olds, it remains elevated in spite of (or perhaps even because of) tougher 21 law enforcement over time. It is also worth noting that the number of episodes per person per year increased faster than the proportion of "binge" drinkers in the population.
Further evidence of failure is that, according to MADD, about half (48%) of the of the alcohol consumed by college students (at four-year schools) is consumed by students under 21. This is even more striking when you consider that only 37% of four-year collegians are under 21.
In other words, at best, a drinking age of 21 appears to merely delay binge drinking, drunk driving, and alcohol-related injuries and deaths. At worst, it may even prolong such behavior. In other words, a shell game.
*A convention on this blog is to always use scare quotes when referring to "binge drinking" defined as an arbitrary number of drinks in an evening. Definitions very as there is no international consensus on what qualifies as a "binge," but the most common definition is 5 or more drinks in the same occasion (evening), or 4 for a woman in some definitions, regardless of drinking speed, weight, etc. When no scare quotes are used, we are talking about truly heavy, rapid, high-intensity drinking--often involving serious chugging or slamming many shots in a short period of time--which involves an unacceptably high risk of harm for anyone of any age. Our definition implies very high intoxication, at least 0.15 BAC if not 0.20+. That is where the lion's share of real problems occur. Fortunately, the vast majority of Americans, even college students, do not do this, regardless of what the media says.
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