Have A Safe And Happy Memorial Day Weekend

This coming Monday, May 31, is Memorial Day, often known as the unofficial first day of summer and National BBQ Day.  But let's remember what it really is--a day to honor all of the men and women of our armed forces who made the ultimate sacrifice for our country, past and present.  And that of course includes all of those who died serving our country before they were legally old enough to drink.  Let us all take a moment of silence to honor them.

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

And as always, arrive alive, don't drink and drive.  It's just not worth it, period.  And it's very simple to prevent.  If you plan to drive, don't drink, and if you plan to drink, don't drive.  It's not rocket science.   Designate a sober driver, call a cab or rideshare, crash on the couch, or even walk if you have to.  Or don't drink--nobody's got a gun to your head.

"No Safe Level" Is A Red Flag For Junk Science

According to a wise man named Paracelsus (essentially the Western world's first toxicologist) long ago, it is the dose that makes the poison.  Anything (even water) can be poisonous in a high enough quantity, and conversely there is, practically speaking, a safe level for everything.  It is all a matter of degree.  So why, when it comes to things like alcohol, do the "experts" seem to lose all common sense?

Take the latest study of alcohol and the brain at Oxford, for example.  This one claims that there is no safe level of alcohol for the brain, that is, any amount will cause damage.  The observational study, which notably has not even been peer-reviewed yet, finds a negative linear correlation between alcohol drinking volume and the volume of gray matter (as well as white matter) in brain scans, even after controlling for every confounder they could think of.  While it is known that excessive drinking can damage the brain, the shocker here seems to have more to do with much lower levels of drinking previously thought to be safe.

I bet the reader can quickly spot the problem here.  If not, here it goes.  A closer look at the data shows that, given how small the overall effect size is, with alcohol explaining only 0.8% of the variance in gray matter, combined with the tendency of people (especially heavier drinkers) to undercount their drinks, the apparent harmful effects of light to moderate drinking may very well be spurious at the lower end of the curve even if likely genuine towards the higher end.  That, and the lack of peer review of course.

They also found an additive effect of "binge" drinking over and above the effect of drinking volume alone, particularly for daily "binging", which was fairly strong and consistently statistically significant.  But given the rather wide confidence intervals, for less than daily "binge" drinking, it was not always statistically significant.  Given the typically fairly low definitions used for "binge" drinking, it would not be surprising that the confidence intervals are so wide.

It also appears from this study that people with hypertension (high blood pressure) and/or a high BMI are significantly more sensitive to the apparent adverse effects of alcohol than the average person for whatever reasons as well.  The interaction was not just additive, but multiplicative.  That will certainly require further study going forward. 

We are not in any way encouraging anyone to drink alcoholic beverages. But specious inferences should not cloud the issue either.

There is a safe level everything, even arsenic apparently.  So why would that not be true for alcohol?  Especially since our own bodies can actually produce a bit of it as a byproduct, believe it or not?

On the bright side, at least the study looked largely at older adults (age 40+) and did not indulge in the usual youth drinking panic routines.  Even if the observed effects are 100% true, that would of course mean that young people are not uniquely vulnerable to the adverse effects of alcohol on the brain.

25, You Say? Let's Nip That In The Bud

A handful of psychiatrists in Minnestota, where cannabis has not yet been legalized for recreational use (but is currently being considered), is calling for the age limit to be 25 when it is legalized.  They cite anecdotal evidence of young patients with psychosis that they claim is caused by today's high-potency weed.  And here is why they are, in a word, wrong:

1. First of all, these psychoses that they cite are occurring despite recreational cannabis remaining illegal in Minnesota for all ages.  Legalizing it with an utterly unrealistic age limit of 25 will only preserve and entrench the current black market while worsening criminal justice inequities, both age and racial disparities.
2. The brain continues developing well into the 30s and 40s, and the risk period for schizophrenia continues until about 30, so 25 is arbitrary.
3. While excessive cannabis use can be harmful at any age, and starting use before age 18 and especially before 15 is likely more harmful than starting at 18 or older, there is really no clear and convincing evidence that using it at 18-20 is any worse than using at 21-24 or 25+, especially for light or moderate use.  To claim otherwise is unscientific, disingenuous, and really pushes the limits of the precautionary principle.
4. As we have noted many times before, the relationship between cannabis and psychosis is quite complex, and far more nuanced than Reefer Madness.  Though there is likely a tiny, exquisitely vulnerable sliver of the population that should really avoid weed like the plague at any age, that is no reason for blanket bans or restrictions (by age or otherwise) for legal adults.  That would be unscientific and unjust.
5. And finally, if today's high-potency weed is in fact the culprit in an alleged (and far from certain) recent increase in psychosis among young people, the solution is NOT to raise the age limit and force it deeper underground, but to put a cap (say, 10% or 15%) on the potency of THC on legal weed (and perhaps also setting a minimum level of CBD, which counteracts many of the adverse effects of too much THC), and/or taxing it based on THC/CBD levels.  And also warn people who are at increased risk of psychosis as well via honest public education messaging without sensational fearmongering.

There it is.  Problem solved.  No good reason to set the age limit any higher than 18, let alone 25.  Let's nip this ageist idea in the bud, pun intended of course.

UPDATE:  Twenty-One Debunked believes that proper labeling and tax incentives alone will likely be enough to encourage lower THC and higher CBD levels even in the absence of hard THC/CBD limits.  Taxing cannabis at a higher rate base on THC levels (whether proportionally, or perhaps disproportionally when exceeding a specific threshold or for specific product categories) and applying an offsetting tax discount based on CBD levels would do the trick, as the market would adjust accordingly.

Also, getting back to the subject of psychosis in young people, don't forget to take your fish oil.  Yes, you read that right.  Apparently a new study found that there is an inverse correlation between omega-3 fatty acid levels during adolescence and psychosis in young adulthood.  This dovetails nicely with a study from 2010 that found that just 12 weeks of giving fish oil supplements to teens at ultra-high risk of psychosis greatly reduced their risk of developing psychosis a year later compared with those given placebo.

Latest California Smoking Age Study More Smoke Than Fire

Last month, a new study looking at the results of California's smoking age hike from 18 to 21 in 2016 turns out to be less than meets the eye.  The study, looking at BRFSS survey data for 18-20 year olds pre versus post implementation, found that, compared to 21-23 year olds in California and to 18-20 year olds in the eight comparison states, 18-20 year olds did not see any significant change in the rate of decline of current or ever smoking, but did see significantly faster declines in the rates of daily smoking in the three years after the age limit was hiked to 21 versus before implementation.  Interestingly, vaping was not examined at all due to apparent data gaps at the time, so this study says absolutely nothing about vaping.

While the part about daily smoking sounds impressive on the surface, one should keep in mind that cigarette taxes were hiked by $2.00/pack in 2016 (effective April 2017), and generally the younger a person is, the more price-sensitive they are since they tend to have less disposable income, and furthermore the earlier they are in the course of their tobacco habits.  So it would stand to reason that the tax hike alone, which makes regular and especially daily smoking that much more of an expensive burden on the smoker, would have had a larger impact on 18-20 year olds than 21-23 year olds in California.  That would also explain why current or ever smoking (which were essentially not affected at all) would be much less affected than daily smoking as well.  

Of note, Pennsylvania had also raised their cigarette tax in 2016 yet still kept their age limit at 18 (until July 2020, that is), yet interestingly that state was NOT one of the eight comparison states.  The results of this study would thus likely have been very different if Pennsylvania was one of the comparison states.

Alternatively, some of the progression to daily smoking may simply have been delayed by a few years by the age limit hike, yielding no real long-run benefits, kinda like some studies have strongly suggested about drunk driving deaths when the drinking age was raised to 21.  Indeed, by 2019 the daily smoking rate among 21-23 year olds was actually a bit higher than it was in 2016.

And as we have previously noted, in NYC and elsewhere, raising the smoking age to 21 does not seem to actually reduce high school smoking rates compared with keeping it 18, so the "trickle-down" theory that is often used as a specious justification for Tobacco 21 laws is very unlikely to be the case in California (or anywhere else) either.

Thus, this study is more smoke than fire.  And regardless, we at Twenty-One Debunked would still oppose the 21 smoking age on principle regardless of its effects.  Young adults who are old enough to go to war, be tried as adults, etc. should NOT have the state dictating what otherwise legal substances they choose to put into their own bodies at all, period.  Seriously.

And that is a hill we will die on.

Et Tu, DeSantis?

Florida's controversial Governor Ron DeSantis (R) has been a bit of a mixed bag overall.  The True Spirit of America Party (TSAP) is, to put it mildly, not exactly a fan of Republicans in general and Trump supporters in particular, but has nonetheless generally agreed with his light-touch, focused protection handling of the COVID-19 pandemic, which has actually yielded a lower cumulative per capita death rate than the national average (and much lower than several lockdown states) despite Florida's significantly older and fatter population.  And in terms of excess all-cause mortality, wide-open Florida even did better than the overall strictest state of all, California.  There are some bad things about DeSantis of course, such as his latest Georgia-style voter suppression efforts and his heavy-handed and poorly-written anti-rioting law that arguably throws out the proverbial baby with the bathwater, but generally he is not too terrible by current low-bar Republican standards.

And of course, Twenty-One Debunked in particular has supported the fact that he was one of the most prominent holdouts in keeping the legal smoking age at 18 despite the trend towards raising it to 21 at the local, state, and eventually federal levels.  After all, he has previously opposed and vetoed every single attempt to raise Florida's smoking age any higher than 18.  Well, until now, that is.  Like most other governors, as of today, DeSantis has officially SOLD OUT and signed into law a bill that raises Florida's smoking and vaping age to 21, effective October 1, 2021.  True, this new law does have an exemption for military service members aged 18-20, making it a shade less bad than some other states, but we still oppose this law on principle like we oppose all inherently ageist Tobacco 21 laws, period.

One could argue that any state law that sets the age limit below 21 is effectively void since the federal smoking age has been 21 since December 2019, but that is beside the point.  A state that chooses to remain 18 in spite of the federal Tobacco 21 law is a principled state with integrity, and is at the very least NOT helping the federal government enforce such an ageist abomination.  Today, Florida lost that status.

DeSantis is now the 34th governor to raise the age limit for tobacco and vaping to 21, bringing it to now more than two out of three states who set it at 21.  With "allies" like him (and Trump, who raised the federal age limit to 21), who really needs enemies?

NEWS FLASH: Vaping Black Market Concoctions Is Bad For Your Lungs

That is what the conclusion should have been from the latest vaping study finding that cannabis vaping is more harmful to the lungs than nicotine vaping, cannabis smoking, and tobacco smoking.  But that does not appear to be the way the mainstream media is presenting the study, without any sort of nuance or detail.  The study did not distinguish between black market, gray market, and legitimate market products, nor did it bother to examine or even mention the old-fashioned way of vaping weed (namely heating regular and pure whole bud in a loose-leaf vaporizer).

Have we really forgotten the primary culprit in the EVALI (vaping illness) epidemic in 2019, namely questionable additives and diluents such as Vitamin E acetate (et al.) that were almost entirely found in black and gray market cannabis vape oil concoctions?  Especially since EVALI was significantly less common in states where cannabis is fully legal compared to states where it is not, as there are by definition much safer alternatives to the black market in legal states (though a significant black market still remains in highly taxed and tightly regulated states like California as well, or at least did in 2019-2020).

The solution is really quite simple:  legalize cannabis 18+, ban any additives that have not been proven safe for human consumption via inhalation, implement strict quality control standards, don't overtax it, charge excessive licensing fees, or otherwise have excessive barriers to entry into the legitimate market, and crack down on any remaining illicit markets.

And for users, as we have said before, DO NOT vape, juul, or dab anything you find on the black market!

Problem solved.  We ignore these facts at our peril.