Americans Are Still Drowning In The Bottom Of The Bottle

And the pandemic, or more accurately, the lockdowns and isolation (antisocial distancing) imposed on Americans, was only gasoline on the already-raging fire.  The USA was in fact the only major country to see a net increase in overall alcohol consumption during the pandemic, and one of only a few countries to see an increase in alcohol-related deaths as well, especially among prime working-age adults.  After decades of the failed social experiment of the ageist abomination that is the 21 drinking age, we are now seeing a clear divergence from the rest of the world (and not in a good way!) among the generations who came of age since then.

Of course, the neo-temperance crowd as well as the ageists (is there really any other kind these days?) would counter that this only proves that Americans can't handle their alcohol, so therefore lowering the drinking age to 18 would be even worse.  But what they are tacitly admitting by saying this specious argument is that Americans are inferior to Europeans--do they really want to concede that?  Didn't think so.  And by that same logic, they might as well call for bringing back Prohibition for all ages, as that would be the ultimate logical conclusion of that utterly patronizing and paternalistic argument.  

Besides, we know now that, while all policy measures have their hard limits, the most time-tested, efficient, effective, and cost-effective one of all is to simply raise the price of alcohol, generally via taxation.  Wayland Ellis has pointed that out several times, and it is the one thing that he and the polar-opposite Philip N. Cook can agree upon.  The late Mark Kleiman also made a similar argument years ago.  Alcohol taxes and prices have been lagging behind inflation for decades in the USA, so therefore the lowest-hanging fruit to make headway against America's growing drinking problem is to raise such taxes.  In fact, if set high enough, practically no other alcohol regulations or restrictions are needed at all.  

Another promising idea, would be similar to what parts of the Northern Territory of Australia, as well as parts of Western Australia, currently have:  something called the Banned Drinker Register (BDR).  It is exactly what it sounds like, and targets actual problem drinkers individually only, with no collateral damage to non-problem drinkers.  This can also be paired with something like South Dakota's 24/7 Sobriety Program for those convicted of drunk driving, drunk violence, drunk vandalism, or repeated disorderly conduct violations.  In addition, problem drinkers can also have themselves voluntarily added to the blacklist for a fixed period of time, much like problem gamblers are currently allowed to do. (Call it "86 Me" or something like that.)  Mark Kleiman would certainly have approved of that as well.  And aside from the downside of ID checking of all buyers that would be required to enforce the BDR (not radically different from the status quo), it is actually the most libertarian policy that there is.  Libertarian purists, of course, would probably only support the South Dakota style 24/7 program and the voluntary blacklist, and that would be fine with Twenty-One Debunked either way.

And of course, let America be America again, and lower the drinking age to 18.  If you're old enough to go to war, you're old enough to go to the bar.  'Nuff said.

Is There A "Laffer Curve" Effect for Alcohol Taxes/Prices Versus Alcohol-Related Harms?

The famous (and controversial) Laffer Curve, sometimes called the Laffer-Khaldun Curve, posits that raising taxes beyond a certain point will decrease revenue rather than increase it.  Would such a relationship also hold for alcohol, not only for revenue, but for alcohol-related harms as well?  

Twenty-One Debunked has repeatedly noted that previous studies have generally found a reasonably strong inverse relationship between alcohol prices/taxes and alcohol-related harms.  That is probably the only thing that both Philip N. Cook and Wayland Ellis would agree upon, which really says something as they are on polar opposite ends to the alcohol regulation spectrum in general, and in particular the issue of the 21 drinking age.  

But does there ever reach a point beyond which this relationship breaks down and ceases to be true, or even reverses?  The recent experience of Scotland seems to suggest as much.  As British libertarian author and blogger Christopher Snowdon (no relation to the Wikileaks guy) notes in his blog, Velvet Glove, Iron Fist, a recent study found that Scotland's minimum unit pricing (MUP) scheme did NOT work as intended.  This mandated price floor of 50 pence per British standard unit of alcohol (about $1 per standard Amercian drink at the time, before the sterling crumbled recently) failed to meaningfully reduce alcohol consumption, particularly among the heaviest drinkers.  In fact, some population subgroups even saw increases in consumption.  And there was no effect on alcohol-related ER visits or crime either.  And it didn't even help the beleaguered pub industry either as promised.  Oops!

That's some pretty weak sauce if you ask us!

(And apparently not just Scotland, but also in Ireland has now implemented MUP as well.)

One study concluded at the end of 2018, long before the pandemic and lockdowns of course, and the other concluded in January 2020.  But what happened in the UK as a result of the lockdown-induced reduction in alcohol availability and marketing?  After all, as Joseph Califano of CASA famously said, "availability is the mother of abuse", so alcohol abuse and problems should have plummeted, right?  WRONG.  Snowdon notes that while overall alcohol consumption declined in the UK, the number of alcohol-specfic deaths actually increased.  Apparently, the average level of drinking in a population does not determine the extent of heavy drinking, it's the other way around.  And this natural experiment proves it more elegantly than any other study in history, and that also explains partly why MUP in Scotland failed to have the desired and predicted effects on the heaviest drinkers, who are apparently less sensitive to price and availability than the general population.

After all, the determinants of heavy drinking, and especially alcohol dependence, are likely quite different than those of drinking in general, and price is clearly one of the much lesser factors in their behavior.  And given the outsized impact on population health being driven by such a small minority of heavy drinkers, targeting the entire population so bluntly is unlikely to improve overall population health by very much if at all.

That's not to say that alcohol that is extremely cheap in a relative sense by historical and international standards, such as in the USA today, doesn't still generate some problems that respond to modest tax/price hikes at all.  That is probably still true, noting that America was the only major country in the world to see a net increase in overall alcohol consumption during lockdowns (to say nothing of the heaviest end of the drinking scale, let that sink in).  In the UK, even prior to the Scottish MUP scheme as well as during, it should be noted that nationwide alcohol taxes were already quite high and outpacing inflation for a while, and as of 2014 it was already prohibited to sell alcohol "below cost" in stores nationwide.  Thus further price hikes on the lower-end beverages may have had a more limited marginal effect and pushed the total prices to the wrong side of a Laffer-esque curve.  But we do know now that the overly simplistic models of the neo-temperance lobby leave a lot to be desired, to put it mildly.  The "whole population approach" clearly has some very hard limits.

After all, drinking per se is not the problem, excessive drinking (and the outrageous behavior that often goes with it) is the real problem.  And the 95th percentile of drinkers (top 5% of drinkers) seems to be quite inelastic (i.e. insensitive) to price.  Cart, meet horse.

The upshot:  while Twenty-One Debunked still supports raising alcohol taxes in the USA, within reason, we note that the effects are far more nuanced than we once thought, and often quite tenuous. 

UPDATE:  Apparently, alcohol-related deaths did drop by 10% in the first full year after MUP was implemented in Scotland, to the lowest level since 2013.  Another study found a 13% drop in alcohol-related deaths.  But in light of the other lackluster findings above, the actual causality of this correlation remains unclear for the time being.  Only time will tell if there are any long-term benefits to this policy, which is set to sunset in 2024, six years after it was first implemented in May 2018.  MUP does seem to be effective in Canada and Northern Territory, Australia. 

Also, another nuance that gets glossed over is that while alcohol taxes are now relatively high on beer, wine, and spirits in the UK, they are still quite low for cider.  Thus, MUP had the largest effect on the prices of cheap, high-strength ciders, many of which are "ciders" in name only due to a legal loophole.

And back to the topic of lockdowns, did you know that in 2020, for 13-18 year olds, the number of drug/alcohol deaths actually DOUBLED compared to the average of the several years leading up to it?   Lockdowns are clearly NOT benign for children or young people at all, and the next person to say "kids are resilient" can go take a long walk off a short pier!

(Corrections were made to some of the dates in the article above.)