The Journey-Destination Problem

What we call the "journey-destination problem" is the fact that journeys are often much more dangerous than destinations.  For example, there is the fear that lowering the drinking age to 18 would, even if better overall in the long run, would still have adverse unintended consequences in the short run.  And we at Twenty-One Debunked address that fear head-on in our proposal to lower the drinking age to 18.

First and foremost, lowering the drinking age from 21 to 18 (in line with the rest of the world, and a good chunk of American history) is NOT a radical change at all.  So any (real or imagined) fears related to lowering it even further below 18, or abolishing the age limit altogether, do NOT apply to lowering it to 18.

Secondly, it is NOT like the (real or imagined) fears of suddenly legalizing something that was previously completely illegal for everyone.  Alcohol in its various forms has been broadly legal, tolerated, and openly advertised for most of recorded history.  It is the "devil we already know", basically.   So "same as before, but without the arrests or injustices" is actually pretty close to accurate here.

Thirdly, simple and practical things like raising the alcohol taxes and cracking down harder on drunk driving, drunk violence, drunk and disorderly conduct, and stuff like that, would basically render any feared unintended consequences academic in practice. This is true whether the drinking age is lowered to 18 gradually OR suddenly.

Fourthly, it's not the 1970s or 1980s anymore.  America is almost a completely different country now in so many ways, including for drunk driving.  The original, albeit still fatally flawed, crisis-based justification for coercively raising the drinking age to 21 in the 1980s is itself grossly outdated and basically academic now in the 21st century, hence the need for the pro-21 crowd to invent new, ever more specious and spurious justifications (such as junk neuroscience, and a perversion of the precautionary principle) for keeping it at 21, because reasons.

And finally, it is ultimately a matter of principle, as it is fundamentally a civil rights issue, far more so than it is a public health and safety issue.  Not everything can be reduced to crude utilitarianism, after all.  "Let us do evil, that good may come" is always and everywhere a trap, a lesson that is unfortunately too often learned the hard way.

(Mic drop)

America Is Still Drowning In The Bottle

Americans are still drowning in the bottle to this day, and paying a heavy price for it.  While the pandemic and especially the lockdowns were clearly gasoline on the fire, that fire has been burning for a very long time before that.  The ageist abomination that is 21 drinking age, and all of its illiberal ancillary laws, has clearly done NOTHING to stem that tide in the long run.  And it's truly no coincidence that alcohol (of all types, but especially hard liquor) is now the cheapest it has been in many, many decades relative to inflation and (especially) income.  That's largely because alcohol taxes have greatly lagged behind and were thus eroded by inflation in recent decades, with the tax on distilled spirits lagging the very most of all.

To quote the latest CDC report on the matter:

Average annual number of deaths from excessive alcohol use, including partially and fully alcohol-attributable conditions, increased approximately 29% from 137,927 during 2016–2017 to 178,307 during 2020–2021, and age-standardized death rates increased from approximately 38 to 48 per 100,000 population. During this time, deaths from excessive drinking among males increased approximately 27%, from 94,362 per year to 119,606, and among females increased approximately 35%, from 43,565 per year to 58,701.

Thus, as Twenty-One Debunked has long advocated, we need to raise the alcohol taxes across the board, and harmonize them all based on alcohol content.  To raise just the beer tax alone, for example, would result in drinkers simply switching to liquor, similar to how minimum unit pricing in Scotland disproportionately affected strong cider and perversely incentivized switching to liquor.  MADD (Mothers Against Drunk Driving) has long heavily beaten the drum (though not so much recently) for raising the beer tax, but has also largely been strangely silent on the distilled spirits tax.  Perhaps some alleged palm-greasing from both the liquor industry and/or foreign beer industry may be at work here?  Things that (should) make you go, hmmmm.....

We advocate raising all federal alcohol taxes to about $30 per proof-gallon, equal to the inflation-adjusted value for the distilled spirits tax in 1991 (in 2023 dollars), the last time it was raised. That would add anywhere between one and two dollars (depending on alcohol content), to the price of a six-pack of beer, a gallon of wine, or a fifth of liquor, while also incentivizing reduced-alcohol beers and wines.  And while that may not be very much of a difference to a moderate drinker, for heavy drinkers it sure adds up, as it also does for the youngest drinkers as well.  And contrary to what some believe, the price elasticity of demand for alcohol is NOT zero or trivial, and the public health benefits of higher alcohol taxes and prices are well-known and established.

To sweeten the deal, we support a relatively reduced tax rate for the smallest producers, and we also support tax incentives for producers who fortify their beverages with thiamine (vitamin B1) and perhaps other vitamins as well.  And we would also support phasing in alcohol tax hikes a bit more gradually if that is the only way to get them passed.  But raise these taxes, we certainly must.

(And, of course, we also also lower the drinking age to 18 yesterday, full stop.  We are still Twenty-One Debunked, after all.)

It is true that Thomas Jefferson once famously said, "no nation is drunken where wine is cheap".  Granted.  But the second half of that very same quote was, "and none sober when the dearness [expensiveness] of wine substitutes ardent [distilled] spirits as the common beverage.  It is, in truth, the only antidote to the bane of whiskey."  And now in 2024, it would seem that ALL categories of alcoholic beverages are too cheap for America's own good, and a fortiori for ardent (distilled) spirits today.

America Is Still Drowning In The Bottle

Americans are still drowning in the bottle to this day.  While the pandemic and especially the lockdowns were gasoline on the fire, that fire has been burning for a very long time before that.  The ageist abomination that is 21 drinking age, and all of its illiberal ancillary laws, has clearly done NOTHING to stem that tide in the long run.  And it's truly no coincidence that alcohol (of all types, but especially hard liquor) is now the cheapest it has been in many, many decades relative to inflation and (especially) income.  That's largely because alcohol taxes have greatly lagged behind and were thus eroded by inflation in recent decades, with the tax on distilled spirits lagging the most of all.

Thus, as Twenty-One Debunked has long advocated, we need to raise the alcohol taxes across the board, and harmonize them all based on alcohol content.  To raise just the beer tax alone, for example, would result in drinkers simply switching to liquor, similar to how minimum unit pricing in Scotland disproportionately affected strong cider and perversely incentivized switching to liquor.  MADD has long heavily beaten the drum (though not so much recently) for raising the beer tax, but has also largely been strangely silent on the distilled spirits tax.  Perhaps some alleged palm-greasing from both the liquor industry and/or foreign beer industry may be at work here?  Things that (should) make you go, hmmmm.....

We advocate raising all federal alcohol taxes to about $30 per proof-gallon, equal to the inflation-adjusted value for the distilled spirits tax in 1991, the last time it was raised. That would add anywhere between one and two dollars (depending on alcohol content), to the price of a six-pack of beer, a gallon of wine, or a fifth of liquor, while also incentivizing reduced-alcohol beers and wines.  And while that may not be very much of a difference to a moderate drinker, for heavy drinkers it sure adds up, as it also does for the youngest drinkers as well.  And contrary to what some believe, the price elasticity of demand for alcohol is NOT zero or trivial, and the public health benefits of higher alcohol taxes and prices are well-known and established.

To sweeten the deal, we support a relatively reduced tax rate for the smallest producers, and we also support tax incentives for producers who fortify their beverages with thiamine (vitamin B1) and perhaps other vitamins as well.  And we would also support phasing in alcohol tax hikes a bit more gradually if that is the only way to get them passed.  But raise these taxes, we must.

(And, of course, we also also lower the drinking age to 18 yesterday, full stop.  We are still Twenty-One Debunked, after all.)

It is true that Thomas Jefferson once famously said, "no nation is drunken where wine is cheap".  Granted.  But the second half of that very same quote was, "and none sober when the dearness [expensiveness] of wine substitutes ardent [distilled] spirits as the common beverage.  It is, in truth, the only antidote to the bane of whiskey."  And now in 2024, it would seem that ALL categories of alcoholic beverages are too cheap for America's own good, and a fortiori for ardent (distilled) spirits today.

Lithuania Study Finds Raising Drinking Age Did Not Save Lives After All

Lest anyone speciously claim that Lithuania's raising of the their drinking age from 18 to 20 effective January 1, 2018 somehow saved lives, keep in mind that in 2017 they also greatly raised their alcohol taxes, banned alcohol advertising, and greatly cut trading hours for alcohol sales in 2018.  So once again, we see a great deal of confounding here.  

In fact, one recent study found that once such confounders were adjusted for, any supposed lifesaving effect of the drinking age hike itself on 18-19 year olds disappeared, implying that it was a spurious effect.  The study looked at all-cause deaths, which is probably the most bias-free measurement of the "final bill".  And the drop in deaths was actually larger in 20-21 year olds (who were already too old to have been affected at that time*) than for 18-19 year olds or 15-17 year olds. Relative to the former group, the effect was null, and interestingly no "trickle-down" effect was observed for 15-17 year olds either.  And controlling for alcohol taxes and GDP also rendered the net effect null as well.

Thus, raising the drinking age any higher than 18 is very unlikely to save lives on balance.  But raising alcohol taxes, etc. is very likely to do so, for all ages.

QED

*NOTE:  If many years of post-hike data were observed, it would probably have been better to use a slightly older age group (e.g. 22-23, 23-24, or 24-25 year olds) instead as the control group, since previous studies have found that mortality is often shifted to the age group just above the new drinking age.  However, since just one year of post-hike data was included, the choice of control group remains largely appropriate for such short-term effects, and in any case the relative results were in the "wrong" direction even if mortality were displaced as such.

About That Finland Study

This year, a new study came out in The Lancet that looked at the long-term differences in alcohol-related morbidity and mortality between birth cohorts in Finland that either were or were exposed to the lowering of their legal drinking age from 21 to 18 on January 1, 1969.  That is, based on how old they were when the drinking age was changed.  The study and its interpretation had a clear pro-21 bias. 

While the results did show that, exposed cohorts did have higher morbidity and mortality later in life relative to the unexposed cohorts, the results were ultimately inconclusive since several other changes happened at the same time. For example, the lowering of the drinking age occurred in tandem with other alcohol liberalization policies (in a previously very stringent policy regime with fairly low alcohol consumption) that greatly increased alcohol availability in general and thus consumption in a short period of time.  Urbanization also increased rapidly as well.  Culture changes (especially of the drinking culture) also inevitably occurred as well against a backdrop of increasing general alcohol consumption, and those who came of age during or right after the change would logically have been more affected than those who already came of age just before it, regardless of the legal age limit.  So teasing out the specific effects of the legal drinking age change is really practically impossible in this case.

A cursory reading of the Wikipedia article about Finnish drinking culture will tell you all you need to know about why the age limit is largely irrelevant.

Previous studies on the very long-term effects of the 21 drinking age in the USA and elsewhere have been very scarce and ultimately inconclusive at best as well.  (At least one Swedish study seems to suggest a null effect though.)  And this new Finland study, quite frankly, adds very little.  Causation can thus neither be confirmed nor ruled out, in other words.

Regardless, in any case, even if it were partly causal, using a study like this to justify the ageist abomination that is the 21 drinking age is mission creep at best, and grasping at straws at worst, given that the original justifications for it are either debunked, obsolete, or both.  The idea that some vague conception of "public health", especially theoretically in the distant future, somehow trumps civil rights (and selectively for only one demographic group, no less) is the very worst of utilitarianism and health fascism, and has no place in a free society.

And as long as we are on the subject of Finland, that same country has also since shown us what can be done to rapidly decrease alcohol-related mortality and morbidity at very little cost to society at large and without trampling civil rights:  raising the tax/price of alcohol.  Even the pro-21 crowd, including the authors of the aforementioned study, seem to be willing to concede that.  But apparently that doesn't satisfy the ageists' desire for power and control.  Their libido dominandi seems to know no bounds in that regard.

QED

UPDATE:  And while we are at it, lest anyone speciously claim that Lithuania's raising of the their drinking age from 18 to 20 effective January 1, 2018 somehow saved lives, keep in mind that in 2017 they also greatly raised their alcohol taxes, banned alcohol advertising, and greatly cut trading hours for alcohol sales in 2018.  So once again, we see confounding.  In fact, one study found that once such confounders were adjusted for, any supposed lifesaving effect of the drinking age hike on 18-19 year olds disappeared, implying that it was a spurious effect.

If The 21 Drinking Age Really Saves Lives In The Long Run, Then Explain This

Sometimes the truth is literally hiding in plain sight.  A good, bias-free way to examine the supposed lifesaving effects of a policy would be to look at excess all-cause mortality or its inverse, life expectancy.  That gives a clear picture of the "final bill" of net effects, regardless of the "why" behind it.

For example, a recent article notes how life expectancy in the USA has lagged behind that of practically every comparable country in the world, in both absolute AND relative terms.  America is clearly an outlier, and not in a good way, despite being the richest and most powerful country on Earth.  

So what gives?

Is it Covid?  The collateral damage from lockdowns?  Or the vaccines?  While things clearly deteriorated further during the pandemic, and especially after the vaccines were introduced, the diverging trend in life expectancy began well before that.  

Is it fentanyl, or the opioid crisis more generally?  That's a big part of it, and something you really don't see nearly as bad anywhere else in the world, but the trend pre-dates even that by quite a while.

Is it illicit drugs in general?  Partly, but those "epidemics" ebbed and flowed repeatedly while the divergence continued regardless.

Is it tobacco? Well, as deadly as it is, given how Americans generally smoke less than Europeans, and always have, that cannot be a significant reason for the divergence. 

Is it obesity?  Partly, but several other countries are also catching up to us in that regard, so that only explains a fraction of it.  (And why are we so fat in the first place?)

Is it poverty?  Lack of healthcare?  Inequality?  Or any other adverse effect of neoliberalism?  Very likely at least part of it. After all, the American life expectancy began diverging from peer countries in the early 1980s during the "Reagan Revolution".  Before that, it was well within the normal range of wealthy countries.  But not even the UK under Margaret Thatcher could deteriorate quite like we did.

Is it guns?  Partly, but again that only explains a fraction of the trend, and there were already plenty of guns in the USA well before the divergence.

Is it traffic deaths?  Getting even warmer.  Traffic safety has clearly lagged behind the rest of the developed world indeed, and it's not only because we have more cars either.

Or is it perhaps the pink elephant in the room?  That is, Americans drowning themselves in the bottom of the bottle?  Yes, and we are paying a heavy price for it:  alcohol is indeed one of the largest contributors, that actually kills more Americans than opioids and all illicit drugs combined.  Let that sink in. 

Along with suicide and drug overdoses, alcohol-related deaths are in fact one of the most common types of "deaths of despair" in this country.

So to those who support the 21 drinking age, riddle me this:  if your beloved policy saved so many lives on balance like you claim, why did America's life expectancy lag behind all of our peer countries that generally did NOT raise their drinking ages any higher than 18?  And why are alcohol and traffic deaths such large contributors to the divergence?

Take as long as you like with your answer.

And bonus points for those who loudly cry "think of the children!" when it comes to public policies they dislike, and are still able to somehow explain why American infant and child mortality is so much worse than peer countries as well.

(Mic drop)

UPDATE:  But don't European countries supposedly have higher liver cirrhosis death rates than the USA?  Well, some do, but many countries are the same or lower.  The UK, for example, used to be higher, but by 2016 it was lower.  Canada, Australia, and New Zealand also have lower cirrhosis death rates as well.

Don't Ban Alcohol. Tax It Instead, And Restrict Quantities.

South Africa has had the dubious distinction of being the only country in the (non-Muslim) world to ban all alcohol sales during their coronavirus lockdown.  They recently lifted that ban.

To be clear, Twenty-One Debunked does NOT support such a thing at all, as it is excessive and overbroad.  We also don't support general lockdowns either, given that they are also of dubious effectiveness and fly directly in the face of a supposedly free society and its Constitution.  But it is true nonetheless that alcohol abuse (and alcohol-related domestic violence and child abuse) is a problem in nearly all lockdown countries regardless, and large gatherings are of course a very big no-no during the still-ongoing COVID-19 pandemic.  Now is clearly NOT the time to throw a kegger!  Thus, we support the following done in the USA for the remaining duration of the pandemic, which we define as at until least 30 days after the number of new cases reaches and remains at zero, or for 90 days total, whichever is longer:

• Raise the taxes on alcohol, dramatically.
• Maintain and enforce a ban on non-essential gatherings of 500 people or more, with perhaps a lower, double-digit limit on indoor gatherings specifically (since those are riskier).
• Ban the sale of kegs to anyone who is not a licensed bar or restaurant owner.
• Put a cap on the amount of alcohol an individual can purchase per person per day, such as no more than one case or 30-pack of beer, one gallon of wine, or two liters of hard alcohol less than or equal to 100 proof or one liter of hard alcohol greater than 100 proof.
• Reopen bars and restaurants with "Swedish rules" for the first couple of weeks:  restrict occupancy, table service only, outdoor seating preferred, no eating or drinking perpendicular (standing up).  Delay the reopening of nightclubs and casinos until a few weeks after bars reopen.
• For the first couple of weeks, require restaurant and bar staff to wear masks, and patrons to wear masks while not eating or drinking.
• Crack down heavily on drunk driving, drunk violence, and domestic and child abuse.
• Put a moratorium on enforcement of the 21 drinking age for any 18-20 year olds who are drinking responsibly and following such protocols above.  (Of course, the drinking age should be lowered to 18 yesterday.)

So what are we waiting for?

What If We Can't Lower The Drinking Age Anytime Soon? (Re-Post)

Perish the thought, but it looks like the utterly vile and ageist abomination that is the 21 drinking age will not be lowered to 18 (or even lowered at all) anytime soon.  It's plain to see that the movement to lower it has completely run out of momentum by now, and the movement to raise the smoking/vaping age to 21 has unfortunately only gained momentum in recent years, and with no signs of stopping.  In fact, the federal government recently raised the federal tobacco/vaping purchase age to 21.  And while the cannabis legalization movement still has enough momentum, unfortunately all US states (though not Canada) that have chosen to legalize it so far have chosen 21 as their legal toking age.

Does that mean our movement is dead, never to rise again?  Of course not, but our movement is in a sort of "dark night of the soul", apparently, and a very long one too.  Depressing as it sounds, we must realize that it is always darkest before the dawn, and we must redouble our efforts to tackle the 21 drinking age while the country is hopelessly distracted by tobacco and especially vaping these days.

One bright spot among recent trends is the increasing tendency towards criminal justice reform.  We may be able to use that to our advantage, in fact.  If we can't lower the drinking age right away, we can at least reduce the harm by decriminalizing underage drinking (and smoking and toking), reducing it to a mere infraction (ticket) offense (if there are to even be any penalties at all) without any arrests, criminal penalties, or criminal record, bypassing the criminal justice system entirely.  Some states, such as New York and DC, already have that in place for alcohol, while many other states are still quite draconian by comparison.  We should also seize upon the trend towards reducing or eliminating driver's license sanctions for non-driving related offenses, and apply that to underage drinking (and smoking and toking) as well.  We should re-prioritize law enforcement resources towards retail sellers rather than young buyers and users, and make "underage" drinking (and smoking and toking) by 18-20 year olds the lowest law enforcement priority.  And of course, in our zeal to lower the drinking age to 18, we must not throw people under 18 under the bus in the name of cowardly political expendiency in that regard either.

And of course, we need to prioritize cracking down on drunk driving, drunk violence, drunk vandalism, rape and sexual assault, and other serious stuff like that at ANY age, not the mere victimless "crime" of responsible drinking by 18-20 year old young adults.

So what are we waiting for?

The Kids Are Still (Mostly) Alright in 2019

The latest 2019 Montoring the Future survey results are in.  And while the mainstream media are hyping this year's significant increase in teen vaping (of both nicotine and cannabis), they seem to be glossing over the good news.  For example, teen alcohol and (combustible) tobacco use have both plummeted to record lows, prescription drug abuse (especially opioids and amphetamines) is way down (in contrast to adults), and nearly all other substances (even heroin, again unlike adults) have held steady this year at relatively low levels compared with previous decades.  The one notable exception is LSD (acid), which showed a modest increase this year, but still remains far lower than it was before 2000.

Even cannabis use in general held steady overall this year, and while "daily" (i.e. 20+ days/month) use did see a modest increase this year for grades 8 and 10, in grade 8 it was no higher than it was in 2011 (prior to recreational legalization in any state) and is still quite low.  And keep in mind that for grades 8 and 10, data only go back to 1991, unlike grade 12 which goes all the way back to 1975. Thus, one can extrapolate based on grade 12 data that "daily" use for grades 8 and 10 are also both most likely far lower than they were in the late 1970s and early 1980s, as we know to be the case for grade 12.  And actual, true daily use (i.e. literally every day) is likely even lower still as well.

Even the vaping data are a bit outdated now, since the MTF survey was taken in the spring of 2019, at least several weeks or months before the new "mystery" vaping illness (now called EVALI) outbreak was suddenly announced during the summer.  Since then, the widespread fear of this scary but fortunately now-waning epidemic has likely reduced the popularity of vaping in general, so next year's data will likely be significantly lower than it was in early 2019.

Additionally, the data from another survey, the NSDUH, show that past-year and past-month cannabis use in general has been stable or declining for years for 12-17 year olds nationwide, even as it has been modestly and steadily rising for both 18-25 and 26+ year olds in recent years, and as it has become increasingly legal and socially acceptable to use cannabis and admit to doing so.  The same survey also finds that rates of cannabis use disorder (i.e. abuse/dependence) have been steadily declining for 12-17 year olds since the pre-legalization era, and have been relatively stable for 18-25 (undulating plateau) and 26+ year olds (flat) overall since 2002.

But don't expect the fearmongering mainstream media to tell you that, of course.

A Generation of Sociopaths?

Are Baby Boomers (i.e. the generation born between 1946-1964) really a generation of sociopaths and/or narcissists?  That is in fact the conclusion of a controversial new book by Bruce Gibney, titled A Generation of Sociopaths.  And while we at Twenty-One Debunked are really not fond of condescending broad generalizations about any generation, there does seem to be at least a kernel of truth to his thesis, and it is nonetheless a breath of fresh air to have a book that at least doesn't glibly vilify Millennials and/or Gen Z like so many do nowadays.

According to Gibney, himself a member of Gen X, traits associated with antisocial personality disorder and narcissism do seem to be more prevalent in Boomers compared to any generation before or since.  And the hard data pertaining to behaviors associated with such traits, especially crime rates and substance abuse, do indeed seem to bear this thesis out rather nicely, as do the voting records of that generation.  Reagan, both Bushes, Bill Clinton, and especially Trump could never have been elected without the Boomers voting for them in large numbers.  These candidates all basically promised Boomers (especially white, middle class ones) the moon while asking essentially nothing of them in return, and no price was too high as long as someone else (i.e. future generations) paid for it.  And all of these candidates, to one degree or another, did serious damage to our country--economically, socially, and ecologically.

Granted, "not ALL Boomers" are like that.  But enough of them are to be a problem, and more so than any other generation.  Sound familiar?  It really should.

The real question here is WHY this generation who had so many advantages in terms of wealth and power turned out the way that they are.  Gibney, predictably, blames "permissive parenting" and the fact that they were the first generation raised with television.  True, as the Dr. Spock generation they (mainly white, middle-class Boomers) were raised more permissively than previous generations, and likely more so than subsequent generations in at least some ways.  The mid to late 1970s could indeed be considered a time of "peak permissiveness" in terms of both parenting practices and public policy, and such trends towards permissiveness indeed began from about 1945 onward.   No doubt about that.

But stating such time-series correlations does NOT actually establish causation.  Another factor, overlooked by Gibney, explains Boomer (and early Gen X) traits, behaviors, and statistics far more than anything else:  preschool lead poisoning from leaded gasoline and paint.   Leaded gasoline begain being used in the 1930s, and after WWII, gasoline consumption (and thus lead pollution) increased dramatically until the 1973-1974 oil crisis and the phaseout of leaded gasoline beginning in 1976.  Lead paint, which was banned completely in 1978, had already been phased down in decades prior, but lingers in older housing stock.  Thus, the first permissively-raised generation and the first televison-raised generation and the wealthiest generation in history and the most heavily lead-poisoned generation in history are all in fact one and the same.

And unlike the specious correlations with parental permissiveness and screen time, the correlation with early lead poisoning (a known nasty neurotoxin) and various traits and behaviors that can be described as sociopathic (or at least poor impulse control) is undeniable and meets all of the Bradford-Hills criteria of causation.  As researcher Rick Nevin notes, relationship between preschool lead exposure and such adverse later outcomes as major and minor crime, juvenile delinquency, unwed/early pregnancy, and stuff like that remains highly robust across studies numerous time periods, nations, cultures, and functional forms.  And while white, suburban and rural, middle-class Boomers were arguably much less affected by such lead poisoning than their poorer, urban, black, and/or Latino counterparts in terms of lead poisoning, that doesn't mean that they were completely unaffected by it, since there was still plenty of lead to go around everywhere.  The difference was really one of degree, not kind.

Fortunately, thanks to the phaseout of leaded gasoline and paint, newer housing stocks, and reduction of lead emissions from incinerators, lead poisoning in children today is now at the lowest level in at least a century.   But there is still much work to be done.  There is plenty of old housing stock with deteriorating lead paint, and there is still too much lead in the drinking water of many communities across the country.  According to Nevin, replacing old windows in old housing with new, double-glazed, energy-saving windows, along with stablilizing currently deteriorating old lead paint on walls, would be "low-hanging fruit" in terms of lead abatement that would more than pay for itself in the long run.  As for drinking water, replacing the older service lines would be expensive and time consuming (though still worth doing nonetheless), but in the meantime we could stop adding fluoride yesterday (which is not only neurotoxic in its own right, but potentiates the neurotoxicity of lead and increases lead corrosion and leaching from pipes) and perhaps use ozone instead of chlorine (which also leaches lead) for disinfection of the drinking water supply.

And while many of the Boomer-induced problems left for future generations are indeed real, we should also note that Gibney's fretting about the national debt and Social Security's supposedly impending insolvency is misplaced since these things are really non-problems for a Monetarily Sovereign government like our own federal government.  It is in fact a Big Lie that federal taxes actually pay for federal spending and that the federal government can somehow run short on dollars.  And that big, scary number that is our so-called "national debt" is not debt in the usual sense of the term but rather more like a national savings account.  Author Rodger Malcolm Mitchell, himself a member of the Silent Generation, would have some choice words for authors like Gibney in that regard.  But that is a topic for another discussion.

So perhaps what is really needed here, instead of vilification of an entire generation, is that crucial trait that sociopaths and narcissists lack:  empathy.

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.

Latest 2017 MTF Survey Results

The results of the annual Monitoring the Future survey for 2017 are in.  And here is a brief summary of the results:

• Alcohol use in general as well as "binge" drinking among all three grades (8, 10, 12) remains at the same record-low levels as 2016.  
• Tobacco use overall in all grades continued its long decline to a new record low in 2017, particularly for cigarettes, though vaping (e-cigarettes) did increase slightly in 2017 after decreasing a bit in 2016.
• Cannabis use went up slightly in 2017 from 2016 after declining for several years, though generally still remains below 2012 levels, and of course far below the peaks in both 1979 and 1997.  This dovetails with another recent study of legalization states which found no significant increase in teen use post-legalization.
• Opioids, including heroin, remain at very low levels among teens, while the opioid epidemic continues largely unabated among adults.
• Inhalant use went up slightly among 8th graders after a long decline, though still remains at low levels.
• All other substances decreased or saw no significant change either way in 2017.

So what can we conclude from all of this?  First, we can conclude that cannabis legalization did not increase teen cannabis use as the fearmongers claimed it would. Nor did the use of other substances increase as the "gateway" theory would have predicted--in fact, most other substances decreased.   So much for that theory.  Second, it would appear that e-cigarette vaping is to some extent displacing cigarette smoking, rather than exerting a "gateway" effect as was often feared--smoking would have increased along with vaping if those fears were true, and in fact the opposite has occured instead.  Which any way you slice it, is ultimately a net win for public health even if vaping is not completely harmless.  In fact, the drop in cigarette smoking was much faster from 2013-2015 than it was in the years before or since, coinciding with the period of greatest increase in e-cigarette use.   And finally, we can conclude that the kids are (mostly) alright, at least compared to the many adults around them who continue to drink themselves to death and/or rot and rust in opioids.

How to Quash a Black Market in Five Easy Steps

A black market (or underground economy) typically occurs when the legitimate market for a particular good or service is either nonexistent, out of reach, or otherwise far too insufficient to meet the demand for that good or service.  Black markets are by definition illegal to one degree or another, while informal markets that are technically legal or quasi-legal are known as gray markets.   While the usual proximal cause for a black market is prohibition of a good or service (and thus no legitimate market existing), a black market can also occur (albeit to a much lesser extent) when the taxes and/or other government fees on or surrounding the product or activity are excessively high relative to what consumers are willing to pay (and relative to the informal economy).  Sometimes taxes can be so high so as to be considered "prohibition by price", though the relative price difference is typically far more important than the absolute price.

Twenty-One Debunked believes in raising alcohol taxes significantly in conjunction with lowering the drinking age to 18.  The level we suggest ($24/proof-gallon, equalized for all alcoholic beverages), though significantly higher than now, would still be too low to encourage a significant amount of moonshining and bootlegging.  But what about cannabis, which is currently being legalized in more and more states, many of which started out with fairly high taxes and/or licensing fees?  Though a positive development overall, in some of such places, the black market still exists to one degree or another, albeit much less so than when cannabis was illegal.  And of course we all know that places like NYC with extremely high cigarette taxes have their share of black markets in untaxed, out of state, counterfeit, and/or stolen cigarettes as well.  So how does one solve such a problem?

Enter Rear Admiral Luther E. Gregory.  In the 1930s, Prohibition was repealed, and Washington State along with other states were now faced with the task of shutting down the well-established bootleggers and speakeasies that persisted even after Repeal.   Admiral Gregory was asked to head the state's Liquor Control Board, and given carte blanche to come up with a solution, one which worked surprisingly well in fact:

1. End Prohibition, first of all.
2. Give amnesty and issue licenses to anyone willing to play by the state's rules, whether former bootleggers or otherwise.
3. Set the alcohol taxes as low as possible at first, the lowest in the country in fact.
4. Punish sellers who don't play by the rules, with an iron fist--i.e. blacklisting scofflaws from ever selling liquor in the state again.
5. After holding down alcohol taxes for three years, abruptly raise taxes to the point where they're now the highest in the nation.

Problem solved.  The legal market proved to be competitive with what was left of the black market, and drinkers preferred the former over the latter, driving the latter out of business.  And the black market never came back even after raising taxes dramatically.  Looking back, it should have been so obvious indeed.

Substitute "cannabis" for "alcohol", and there is no reason why this strategy would not work in this day and age.  And instead of holding down taxes for three years, merely one year should be sufficient to get the same results, even if the hike is automatically scheduled.  Doing so would minimize the greatest risk of the strategy, namely, that the fledgling legal cannabis industry would then become so powerful that they would resist and successfully quash any attempt to raise taxes in the future.  They would not become that powerful in just one year, and probably not for several years, but the black market could be easily quashed in that timeframe all the same.

As for cigarette taxes, both NYC and NYS should implement this strategy as well.  And of course, the low-tax states such as Virginia should also raise their cigarette taxes (within reason) so as to not be such a source state for cigarette smuggling to other states.  And of course, lower NYC's age limit back to 18 as well.  Same for cannabis in legalized states as well.

In fact, this strategy would work for just about any type of black market.  That's because it is based on the hard facts of economics, not half-baked wishful thinking.  Unlike prohibition or unrealistically high age limits, taxes are not a "blunt" policy instrument, but rather a razor-sharp, double-edged sword.

So what are we waiting for?

Tobacco, The Ulitmate Dark Horse of Drugs

Almost immediately after posting a recent article about the roundly debunked "gateway drug theory", we at Twenty-One Debunked felt we should post another separate article about the particular case of tobacco, especially in the form of commercial cigarettes. While our organization does not generally view tobacco as a particularly high-priority issue, perhaps it is something we should be revisiting given both recent evidence as well as recent efforts to raise the smoking age to 21.

While the primary dangers of smoking tobacco (i.e. cancer, heart disease, stroke, emphysema, birth defects, etc.) have been well-known for decades, what has been much less appreciated is the neurotoxic properties of cigarettes.  The thing is, nicotine is a known neurotoxin, and it is likely that at least some of the thousands of other chemicals in cigarette smoke are also toxic to the brain as well.  One reported effect of nicotine is that it can "prime" the brain's reward system for addiction in general, including to other substances.  This seems to be particularly true for the early adolescent brain.  While these findings are based primarily on rodent studies, human studies seem to dovetail with this idea far more for tobacco than for cannabis or even alcohol.  Thus, the psychopharmacological aspect of the gateway hypothesis seems to hold true indeed for tobacco, and if there were such a thing as an actual gateway drug (which is a very big "if", if you ask us), tobacco would have to be it, hands down.

Additionally, tobacco is also emerging as a potential "dark horse" in the etiology of psychosis and schizophrenia as well.  This has been informally hypothesized for many years now while being overlooked by most researchers, and is only very recently beginning to be taken seriously by mainstream science.  Perhaps cannabis (which is often mixed with tobacco in many countries, and whose use is often predicted by prior and concurrent tobacco use in general) has been taking a major bum rap in that regard as well?  All while Big Tobacco has subtly and sedulously promoted tobacco smoking as "self-medication" for decades, of course.

That said, Twenty-One Debunked strongly opposes any attempts to raise the smoking age any higher than 18.  Instead, we (along with the TSAP) believe that we should deal with cigarettes the way we would deal with any other defective product such as the historical examples of the Ford Pinto, lawn darts (Jarts), leaded gasoline and paint, DDT, incandescent light bulbs, and old-style refrigerators.  Either 1) require the defects to be sufficiently fixed, or 2) failing that, remove such products from the market.  And yes, commercial cigarettes as they exist today are indeed defective by design in that they addict, enslave, and kill far more people than they have to.  Worldwide, they kill about 6 million people per year, hence the name of Robert N. Proctor's bombshell of a book, Golden Holocaust.

Since 2013, the endgame strategy that the TSAP (and Twenty-One Debunked) currently supports has been to let tobacco phase itself out by gradually reducing the nicotine content of cigarettes to a (relatively) non-addictive level.  Since 2009, the FDA now has the authority to set a legal limit on the nicotine content of tobacco products, as long as the limit is not zero.  Much research indicates that there is a threshold level of nicotine required to create and sustain addiction, and if all cigarettes were to fall below this threshold, smoking rates would plummet precipitously.  In fact, one tobacco executive was quoted as saying, "‘If our product was not addictive we would not sell a cigarette next week."  This idea was originally proposed by Henningfield and Benowitz in 1994, and has been endorsed by the American Medical Association and several other experts including Proctor himself.  Malcolm Gladwell also discussed it in his aptly-titled 2000 book The Tipping Point.   Thus, the TSAP recommends reducing the maximum nicotine content (not delivery) of cigarettes from the current level of 1-2% to less than 0.1% within 5 years, and doing the same for quasi-cigarettes (i.e. little cigars) and perhaps roll-your-own tobacco (but no other products).  That alone would reduce smoking prevalence by as much as 80% within a fairly short timeframe, with further reductions possible in the more distant future.  Alternatively (or in addition), the FDA could require the pH of such products to be raised to 8 or higher to discourage deep inhalation, as is naturally the case for most typical cigars and pipe tobacco currently.

The TSAP and Twenty-One Debunked also recommend that the following measures be taken as well:

• Ban the use of additives in cigarettes, especially those that are harmful or increase the addictiveness of tobacco.
• Ban the use of any radioactive fertilizers or harmful pesticides for growing tobacco.
• Phase-out the practice of flue-curing tobacco, which is a major resource hog and bad for the environment.
• Improve the quality control standards for tobacco products (and electronic cigarettes) to be at least as high as for food.
• End all government subsidies for tobacco farming and production.
• Divest completely from Big Tobacco at all levels of government.
• Vigorously enforce the current age limit of 18 for tobacco and e-cigarette sales to achieve 100% retailer compliance. 
• Continue to allow widespread availability of reduced-harm tobacco and nicotine products (i.e. snus, e-cigarettes, etc.) so that smokers can easily switch to less dangerous alternatives.
• Improve education and smoking cessation programs, funded by tobacco tax revenues.
• Give out free nicotine patches, gum, etc. to any smokers who want to quit.  NYC already does this. 

At the same time, the TSAP most certainly does NOT support outdoor smoking bans or any other policy that treats smokers like criminals or second-class citizens.  Smokers are NOT the villains here, as that dubious honor belongs to the merchants of death known as tobacco companies.  In fact, we have repeatedly pointed out that, far from being a drain on society, smokers actually save society money in the long run since they more than pay their way as far as taxes go.  Cigarette taxes, especially in NYC where they are extremely high, have basically become a "reverse Robin Hood" way to rob from the poor and give to the rich, since smoking has increasingly become a poor man's vice.  And the wide disparity in cigarette taxes across states has led to a serious black market for untaxed/low-tax/counterfeit/stolen cigarettes, with the main beneficiaries being organized crime syndicates and even terrorists.  Thus, we recommend that the handful of states with cigarette taxes higher than $2.00/pack reduce their tax to $2.00/pack or lower, and the states with taxes of less than $1.00/pack raise it to $1.00-$2.00/pack.  NYC should cut its tax in half.  At the federal level, we recommend no further tax hikes, but a national price floor of $5.00/pack including tax to discourage smuggling.

The tobacco industry has basically dug its own grave.  Time to push them in there, yesterday.