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Monday, August 27, 2018

Finally, a Mainstream Social Science Article that Doesn't Trash Young People

A new article by Jeffrey Jensen Arnett is one of the very few mainstream articles that truly tell it like it is in regards to young people today.  Looking at trends in various risk behavior (e.g. alcohol, tobacco, and other drug use, crime and violence, traffic fatalities, teen pregnancy, unprotected sex, etc.) the author found what renowned sociologist and youth-rights activist Mike Males has been saying all along:  young people aged 13-18 today are actually better behaved overall that previous generations were at that age, at least going back to 1990.  But don't expect the ageist mainstream media to let mere facts get in the way of a good moral-panic story, of course.

Most interestingly, the authors attempts to delve into the causes of such positive trends since 1990.  Two such general explanations--public policy changes and changes in parenting practices/styles--were examined but were found quite lacking, in part due to data unavailability and in part due to no significant or even perceptible time-series correlation (sometimes even in the wrong direction).  The third explanation--the massive increase in smartphone and other media use among young people--is in fact the one that seems to carry the most weight.  Counterintuitive as it may be, such media use, for all of its faults, is quite a time sink that perhaps keeps young people too occupied to get into trouble as much as they otherwise would.

These trends have occurred despite the deteriorating behavior of the adults around them, and also seem to be more pronounced in the USA compared to other industrialized countries.  No explanation explains all of it, and some of it may simply be reversion to the mean or societal evolution.  But one should note that since 1990 there has been no further change in the drinking age since all states were already 21 by then, so there is no evidence that any trends since then were the result of that particular ageist abomination.

In fact, we actually have a very good yardstick (or perhaps meterstick) for what would have happened had the USA not raised the drinking age to 21 in the 1980s.  It's called Canada.  Again, there is no evidence that the 21 drinking age is responsible for such trends.  Zip.  Zilch.  Nada.  Sorry, try again, ageists.

So what else could it be?  Well, one likely candidate could be the retreat of an old villain--preschool lead poisoning from paint and gasoline--after its phaseout.  While the article does not mention it, the fact remains that young people today (except perhaps in Flint, Michigan) were exposed to far less lead (a known nasty neurotoxin) than previous generations were, especially the Baby Boomers.  And the phaseout of leaded gasoline began in 1976, so those born in and after that year reached adolescence in 1990 or later.  And the phaseout began and finished earlier in the USA and Canada than it did in most of Europe, the UK, and Australia, let alone the rest of the world.  In fact, only Japan phased it out significantly sooner than we did.  At the same time, the USA was also much slower in phasing out lead-based paint (1978, much later than the League of Nations did in 1922), and had significantly higher gasoline consumption per capita than the rest of the world, so the "double dose" of lead from gasoline and paint together in the mid-20th century was higher than most other countries, hence the reversion to the mean after 1990 or so.  So that explains at least largely why the trends since 1990 are more pronounced, or at least earlier, in the USA than most other industrialized countries.

Food for thought indeed.

The Public Health Crisis That Wasn't

One of our favorite journalists, Annie Lowrey, recently wrote an article titled, "America's Invisible Pot Addicts".  While she is clearly no friend of cannabis prohibition and in fact has repeatedly gone on the record supporting legalization, in this article the author addresses head-on the issue that many (but not all) legalization advocates have heretofore been loath to discuss at all:  cannabis addiction and its apparently growing trend in this country.

As she quotes various self-styled experts on the matter, we seem to get several different answers on the size of the problem and especially how to handle it.  But some facts are undeniable regardless of who says them:
  • Some people can indeed become dependent on cannabis, to one degree or another.  And while cannabis is significantly less addictive than alcohol, tobacco, hard drugs, prescription painkillers and sedatives, and even caffeine, it can still become quite habit-forming when used too frequently and heavily.
  • While cannabis addiction is usually not as severe as most other addictions, it can be for some people.  Cannabis may be relatively harmless for most of its users, but that does not make it completely safe for everyone.  Some may find that it can have quite a dark side when seriously abused.
  • Since the early to mid-1990s and especially since the early 2000s, rates of "cannabis use disorder" (abuse, dependence, or both) as defined by DSM-IV criteria have increased markedly, as have the percentage of daily or near-daily (DND) users of cannabis (about half of whom are dependent).
  • While some of those who technically meet DSM-IV criteria for abuse or dependence are pseudoaddicts or an artifact of social stigma and prohibition, others are indeed genuine addicts, and the exact proportion is not entirely clear.
  • Likewise, many DND users are truly medical or quasi-medical users, but many are clearly not.
  • These trends in heavy and/or dependent use began long before recreational legalization and even before medical legalization in most states, and there is no unambiguously prospective link between legalization and such trends.
  • These trends have occurred primarily among adults rather than teenagers.
  • Regardless, none of the above facts constitute a real public health crisis at this time, and all of this truly pales in comparison to the opioid epidemic as well as the "pink elephant in the room" that is America's alcohol problem.
So yes, Virginia, there really is a "there", there, but contrary to what some commentators may fear, it is unlikely that legalization is really anything to fear in terms of making it worse.  After all, prohibition clearly couldn't stop it from rising over the past quarter-century.  And us legalization advocates would do wise to stop the denials and face the problem head-on, without fear that it would weaken our movement one bit.  Do not fall into the trap of ceding the moral high ground to the anti- side.  At the same time, we must also tackle head-on the "tyranny of the weaker brother" that really has no place in a free society.

The message really needs to be that spending the majority of one's waking hours under the influence of any psychoactive substance is probably not a wise idea, unless of course one truly needs it for medical reasons.   Saying that cannabis is the safer choice is NOT the same as saying that it is absolutely safe for everyone.  Besides, when you are stoned all the time, it basically loses its fun eventually, and isn't the whole point of recreational use by definition to have fun in the first place?  As Dr. Andrew Weil notes, if it stops being fun or effective, the worst thing one can do is smoke even more weed or seek out stronger strains.  And if you're at the point where you can't even enjoy video games without being stoned, that is definitely a warning sign that you need to at least take a break or cut back significantly, if not quit completely.

It is utterly important to first name and define the problem before discussing it further, to avoid inadvertently reinforcing the lies and half-truths on either side of the debate. We are talking about problematic, chronic, heavy, very heavy, and ultra-heavy use of cannabis here, at ANY age.  We are NOT talking about casual use, use per se by people below some arbitrarily high age limit, or about the roundly debunked "gateway theory" either.   Toking up, say,  once a week (or less) is really NOT the problem here, it's more like toking up every day or nearly so, especially multiple times a day, and/or in very large quantities, that is the real problem.  And while slopes may be slipperier than they appear as one approaches heavier and heavier use, the vast majority of cannabis users still do NOT become chronic heavy users.  And among those who do, it doesn't usually last very long, though for some it unfortunately does.

Likewise, while there currently is no hard scientific evidence (and not for lack of trying to find it) that using cannabis at 18 is really any worse in practice than using it at 21, 25, or even 30 for that matter, there is nevertheless some evidence that using before 18 and especially before 15 may indeed be riskier overall, both in terms of potential harm as well as addiction potential.  It is quite nuanced and the studies still need to be fleshed out, for sure.  But we should note that the aforementioned chronic, heavy users that represent the real problem typically started toking before 15 and/or transitioned to heavy use before 18 as a rule.  And many, if not most, of those users have also used alcohol and/or tobacco at an early age as well, again especially before 15.

As for public policy within the framework of legalization, Lowrey notes that probably one of the best--if not the best--measures that policymakers can take is to raise the taxes on cannabis.  That would, by definition, hit the heaviest users the hardest, while casual users would barely even notice the resulting price hike.  Of course, it would be best to keep the taxes very low at first in order to destroy the black market, and then gradually but sharply raise them beginning a year or two after legal recreational sales begin in a given state.  Lowrey also notes other ideas as well, such as capping THC levels in products, dispensing public health information, and restricting advertising, which are likely good ideas.  But excise taxes, especially if they are proportional to THC content (and perhaps inversely proportional to CBD content as well), would probably have the largest effect size of all in terms of reducing cannabis-related problems.  As for the fear that higher cannabis taxes would drive users back to alcohol, well, we all know by now how to prevent that hypothetical from happening:  simply raise the taxes on alcohol as well.

In other words, freedom has nothing to fear from the truth.  That, and don't fear the reefer--but DO treat it with the respect it deserves nonetheless.

Sunday, August 12, 2018

Why Are Traffic Deaths on the Rise? (Part Deux)

After decades of a massive secular decline in traffic deaths, reaching an all-time record low in 2014 per VMT as well as per capita, such deaths have been creeping up again since then.  2015 and 2016 both saw national increases in fatalities, and while 2017 saw a slight decrease from 2016, the number of deaths still remains stubbornly higher than it was before the increase.  In fact, 2015-2016 is the largest two-year jump in deaths in half a century.  So why has progress stalled and begun to reverse in recent years?

The list of most likely factors includes the following:
  • Lower gas prices
  • An improving economy since the Great Recession
  • An increase in distracted driving (and walking), primarly from smartphones
  • Higher speed limits than in the past 
  • Infrastructure in disrepair from decades of gross neglect
  • Slacking on traffic safety improvements in general since the early 1990s
All of these things are true, and all of them are known to be correlated with traffic casualties.  Other factors are involved as well, to be sure, but these are the big ones.  The first three are the proximal causes, while the last three are the more distal ones.

Of course, drunk driving and not wearing seatbelts remain rather persistent contributors to the number of these deaths, but such behaviors remain far lower than they were decades ago.  Nevertheless, they remain at dangerous levels, and it is apparently a bit too early to feel safe in that regard.  And with real alcohol prices at record lows today and alcohol consumption on the rise for the past two decades, there is definitely a cause for concern in that regard.

What about drugged driving, then?  Is it really on the rise, like some have claimed?  Perhaps, but it may simply be that we are getting better at detecting it rather than an actual increase.  Or perhaps it is a bit of both.  The opioid epidemic certainly doesn't make the roads any safer, with such doped-up drivers nodding off behind the wheel.  And contrary to the anti-legalization folks, there does not seem to be any firm link between cannabis legalization and traffic fatalities.  In fact, some studies have found decreases in highway deaths following cannabis liberalization, due to an apparent substitution with alcohol (and perhaps opioids as well).  As for the specious claim of preliminary evidence linking the increase in pedestrian deaths in some legalization states in the first half of 2017 with legalization, that does not really pass the smell test because 1) not all legalization states even saw any increase during that time, 2) small numbers tend to fluctuate wildly, and 3) why would cannabis legalization only affect pedestrian deaths and not other traffic deaths during that time as well?

One thing is for sure.  Whether this spike in traffic casualties is a short-term blip or the start of a longer-term trend (which will only be known in hindsight), it should be a major wake-up call that we clearly cannot afford to be complacent about it any longer.  The USA has seriously lagged behind other industrialized countries for decades in terms of progress on traffic safety (all of which have lower drinking ages than we do, interestingly enough), and we need to catch up, yesterday.  That includes the safety of pedestrians and cyclists as well, who have borne the brunt of the recent increase in traffic deaths.  And even when vehicle miles (or kilometers) traveled are taken into account, the USA still has either higher fatality rates and/or has seen less progress since the 1980s compared with nearly all other industrialized (and even semi-industrialized) nations.

A short list of things we can do include:
  • Crack down on drunk driving, drug-impaired driving, reckless driving, and distracted driving--yesterday.
  • Stiffen the penalties for hit-and-run crashes--yesterday.
  • Reduce speed limits, especially on side streets, arterials, and smaller highways--yesterday.
  • Install speed cameras and red-light cameras in more places (but be sure to also lengthen the yellow lights and double-reds to prevent it from backfiring with more rear-enders).
  • Raise the gas tax by a penny per week until it is at least 50 cents/gal higher than now ("A Penny for Progress") and/or implement a carbon tax-and-dividend scheme.
  • Raise the alcohol taxes significantly as well (note how those taxes have been lagging behind inflation for decades in most states).
  • Design roads/streets to be more pedestrian-friendly and bike-friendly as well.
  • Invest more in public transportation, as well as "safe-rider" programs as well. 
  • Rebuild America's neglected and crumbling infrastructure, generating millions of new jobs in the process.
  • And last but not least, make the road test harder like it is in many other countries, and make driver's licenses easier to lose for serious and/or repeated traffic violations.
After all, if it saves even ONE life, it's worth it, right?  Thought so.  So what are we waiting for?

Sunday, August 5, 2018

Which Ancillary Laws Actually Work to Reduce Teen Drinking? (Spoiler Alert: Almost None)

The legal drinking age (at least in terms of purchase and public possession) has been 21 in all 50 states and DC since 1988 (notwithstanding the Louisiana Loophole through 1995), but states and localities have differed since then on the "ancillary" laws that are used to prop up the 21 drinking age.  These laws include, among others:
  • Laws against private possession and/or consumption 
  • Internal possession laws
  • Laws against furnishing alcohol to people under 21
  • Dram shop liability laws
  • Social host liability laws (civil or criminal)
  • Keg registration 
  • Use alcohol and lose your license ("use and lose" laws)
  • Zero-tolerance laws for DUI
  • Fake ID laws and ID scanner laws
  • Age limits for serving alcohol
Most if not all of these laws have been studied to some extent, with mixed results and even some serious plot twists.  Most of these studies have been conducted by MADD-affiliated researchers such as James C. Fell, Robert Voas, and Ralph Hingson, so they should probably be taken with at least a grain of salt, if not a whole pound.  But even with this potentially significant bias, most of these laws were found to have either no effect, inconsistent effects, very small effects, or even perverse effects in terms of "alcohol-related" traffic fatalities among young people.

If these laws (and by extension, the 21 drinking age itself) did work as intended, one would expect the effectiveness of these laws to show up not only in traffic fatality statistics (which are the tip of a very large iceberg), but also in surveys of teen drinking as well, especially when recent data are studied.  A 2014 study done by Vanessa H. Sacks et al. of Child Trends examined the relationship between 14 different ancillary laws (and alcohol taxes) and both current drinking (any in the past 30 days) and "binge" drinking (5+ drinks "within a couple of hours") among high school students from 2005-2011 as reported on the Youth Risk Behavior Survey (YRBS) of those years.  The 14 laws studied were the following:
  • Laws against consumption of alcohol by people under 21
  • Exceptions to possession laws
  • Exceptions to furnishing laws
  • Social host liability laws 
  • BAC limits for people under 21 (i.e. zero-tolerance laws)
  • Use-and-lose laws (strength measured in three different ways)
  • ID scanners in retail locations
  • Keg registration
  • Age limits for serving alcohol 
  • Beer excise taxes in 2005
  • Distilled spirits excise taxes in 2005
And the results?  All but three such laws had no significant or even perceptible effect individually on either current drinking or "binge" drinking rates.  The only three that did have any statistically significant correlation were:
  • Beer taxes were significantly and negatively associated with both current drinking and "binge" drinking rates.  No surprise there, as this dovetails nicely with the reams of evidence that have found similar results.  (Distilled spirits taxes showed no correlation either way, but that apparently null result is likely due to multicollinearity since beer and liquor taxes are highly correlated with each other).
  • Keg registration laws were significantly and negatively correlated with current drinking, but not "binge" drinking, in one of two models.  This result should probably be interpreted with caution though, given how multiple other studies have found a positive correlation between keg registration and "alcohol-related" youth traffic fatalities.
  • Use-and-lose laws (i.e. driver's license penalties for mere possession or consumption of alcohol) showed a positive correlation with current drinking, that is, such laws seemed to perversely increase teen drinking.
  • And the real kicker: after controlling for drinking rates in previous years and the number of ancillary laws in previous years, states with a greater total number of such policies perversely had higher rates of both current and "binge" drinking.  But drinking rates in previous years did not predict the number of policies in place in later years, thus ruling out the possibility of reverse causation.
Thus, while the researchers caution that these results alone are not definitive enough to establish causation, it is quite clear that such results certainly cast serious doubt on the effectiveness of such laws, and by extension the 21 drinking age itself, in reducing teen drinking and related problems.  With the notable exception of alcohol taxes, the effects of such laws are most likely negligible or even perverse overall.  That, of course, dovetails rather nicely with Miron and Tetelbaum (2009), who found that raising the drinking age to 21 seems to have had "only a minor impact on teen drinking".  And we couldn't agree more.

Saturday, August 4, 2018

Halfway Decent Study, Wrong Conclusion

Much has been made of a recent Australia and New Zealand study finding that teens who drink regularly (at least once a week) before the age of 17, and especially by age 13, are statistically more likely to go on to drink heavily, become alcohol-dependent, drive drunk, use/abuse other substances, and smoke cigarettes during adulthood.  And while correlation itself does not prove causation, there may very well still be at least somewhat of a causal link all the same that cannot be readily explained away, particularly for those who begin any significant drinking before age 15.  That said, the specious conclusion that New Zealand and Australia somehow should raise their drinking ages any higher than 18 is unwarranted and not actually supported by the data in this study.

Take it from us in the USA, who have had a legal drinking age of 21 since the 1980s (and much earlier than that in some states).   It simply does NOT work, and merely forces drinking further underground and makes it far more dangerous than it has to be.   It infantilizes young people and erodes respect for the law, and overall does more harm than good.  So what should be done to reduce and/or delay youth drinking, assuming that is the goal?
  • Raise the taxes on all alcoholic beverages across the board, ideally making such levies proportional to alcohol content.  That is the single most effective and cost-effective way to reduce alcohol-related harms without actually violating anyone's rights.  So raise them as high as you possibly can without triggering widespread moonshining and bootlegging.
  • Set a minimum price floor for alcoholic beverages as well, for both on and off-premise sales.  Both this as well as raising alcohol taxes would have a larger impact on young people since they are more price-sensitive on average.
  • Reduce alcohol outlet density in places where such outlet density is very high.
  • Restrict or ban alcohol advertising, especially ads aimed at young people.
  • Crack down on drunk driving, drunk violence, drunk vandalism, and drunk and disorderly conduct--for ALL ages.  Hold individuals accountable for their behavior, no matter how wasted they are.  Period.
  • Increase alcohol education and treatment programs.  Yesterday.  And include social norms marketing in this broadly-defined education program.
  • And last but not least, before they even consider raising the drinking age, how about actually enforcing the 18 drinking age they have now?  Seriously.  And by that, we mean targeting vendors with complicance checks, rather than the young people themselves.
And there you have it.  There are far better alternatives than raising the legal drinking age.  And raising the drinking age can actually work at cross-purposes with the alternatives discussed above.  True, delaying the onset of youth drinking--especially regular drinking--can evidently be beneficial to a point.  But when you make the perfect the enemy of the good, you ultimately end up with neither.

To South Africa: Don't Be Like Us, Seriously

In recent international news, South Africa has apparently been getting closer to raising their legal drinking age to 21, which if it passes will put them among the tiny handful of countries with the drinking age that high (Palau, Sri Lanka, Kazakhstan, some Muslim countries, and of course the biggest outlier of all, the USA).  So here is our advice to South Africa:

We know you want to join the 21 Club and raise your drinking age to 21, in the hopes that it will reduce your legendary drinking problem.  But take it from us in the USA, who have had a legal drinking age of 21 since the 1980s (and much earlier than that in some states).   It simply does NOT work, and merely forces drinking further underground and makes it far more dangerous than it has to be.   It infantilizes young people and erodes respect for the law, and overall does more harm than good.  Think about that.

So what should you do to reduce your legendary drinking problem?  Well, for starters:
  • Raise the taxes on all alcoholic beverages across the board, ideally making such levies proportional to alcohol content.  That is the single most effective and cost-effective way to reduce alcohol-related harms without actually violating anyone's rights.  So raise them as high as you possibly can without triggering widespread moonshining and bootlegging.
  • Set a minimum price floor for alcoholic beverages as well, for both on and off-premise sales. 
  • Reduce alcohol outlet density in places where such outlet density is very high.
  • Restrict or ban alcohol advertising, especially ads aimed at young people.
  • Crack down on drunk driving, drunk violence, drunk vandalism, and drunk and disorderly conduct--for ALL ages.  Hold individuals accountable for their behavior, no matter how wasted they are.  Period.
  • Increase alcohol education and treatment programs.  Yesterday.
  • And last but not least, before you even consider raising the drinking age, how about actually enforcing the 18 drinking age you have now?  And by that, we mean targeting vendors with complicance checks, rather than the young people themselves.
And there you have it.  There are far better alternatives to raising the drinking age. And raising the drinking age can actually work at cross-purposes with the alternatives discussed above.  Take it from us, you will one day regret doing so.  Honestly, the best advice we can give you is "don't be like us".

Seriously.