White Noise Syndrome

Has anyone ever seen the 2007 horror film White Noise 2? (Spoiler alert) A man has a near-death experience that has left him with the supernatural ability to predict exactly who will die and when.  He acts on his premonitions, and saves several lives, only to find out that exactly three days later, the people he saves start killing others upon being possessed by an evil entity.  In other words, the net effect is an increase in deaths.  He then realizes he wasn't supposed to save those people, regrets his choices, and actually considers killing those he saved in order to rectify this horrible, unforseen tragedy.  We watch such films with revulsion and assume they are mere fiction.

But what if there was a government policy, at the expense of tax dollars and civil liberties, that at best delayed deaths of young people by a few years and potentially even increased the number of premature deaths over the lifecycle?  What if there were entire orgainizations who wholeheartedly endorsed such a policy as "saving lives" or "for the children" while ignoring or minimizing its dark side?  And what if anyone who questions such a policy is subjected to a heckler's veto and even occasional censorship to chill debate? 

Well, that describes the 21 drinking age perfectly.  Fans of this blog already know about a study done by Dee and Evans (2001) which showed that raising the drinking age merely shifted deaths into the future by a few years, and perhaps even increased them.  Asch and Levy (1987 and 1990) and Mike Males (1986) were some of the first people to notice this redistribution of mortality.  And remember, the longer a drunk driver lives, the more innocent people he or she can take to his grave with him or her.  Of course, not every study agrees with Dee and Evans' conclusion, but there is some new evidence that supports this view.

Kitt Carpenter and Carlos Dobkin (2009) have a new study out that shows a discrete and significant jump in mortality at exactly age 21.  The effect is true only for external causes of death, including motor vehicle accidents, suicides, deaths labled as "alcohol related," and those labeled as "other external," but not homicides or drug-related deaths.  The effect also occurs for self reported alcohol consumption as well.  Ruling out alternative explanations, they conclude it is due to the effect of the drinking age.   But unfortunately, they also make the specious claim that such an effect is not merely a delay in deaths but a true lifesaving effect of the policy.

We at Twenty-One Debunked who have read the paper fail to see a true lifesaving effect over the lifecycle.  First of all, only deaths between one's 19th birithday and 23rd birthday are included, and the data are rather grainy, making longer range projections very difficult for what would happen in the absence of the observed drinking age effect.  Yes, the effect persists to an extent, but one can clearly see it gradually decline over time.  It would have been better if they expanded the data to include ages 18 through 24 (are 18 year olds somehow irrelevant to the debate?).  And there could be other age-related factors that give an illusion of persistence, such as a "toning down" of drinking in the few months just before turning legal as well as the fact that 22-23 year olds are more likely to have cars and live away from their parents than 19-20 year olds.  Indeed, our own crude back-of-the-envelope calculations after reading the paper (and its graphs) in which we project while excluding ages 20.5-21.5 suggest exactly that--it is most likely just a temporary effect overall.

Of course, death rates are merely the tip of a very large iceberg.  Carpenter and Dobkin (2008) also conducted another similar study, this time concerning various types of crime, with similar results overall.  Arrest rates were used as the proxy measure of crime.  They found a discrete and significant jump in the arrest rates of several offenses, such as assault, drunkenness, disorderly conduct, and especially DUI, at exactly age 21.  However, there was no noticeable effect for other crimes.  Interestingly, even rape, which has a reputation for being alcohol-related, appeared to be unaffected.  (We suspect this is due to the fact that drinking is less likely to be done "underground" after 21, and thus in environments less conducive to rape, which may outweigh the increase in drinking.  Or perhaps the supposed causal link between alcohol and rape has been overstated.)  The authors draw the same conclusions that they did in the other study, which is unfortunate for precisely the same reasons.

While our own back-of-the-envelope projection estimates suggest that the increaes in assault and disorderly conduct arrests are merely temporary and seem to wear off by age 22, the effects on DUI and drunkenness arrests do still seem to persist to at least age 23.  However, the fact that 21-23 year olds can drink in bars may make drunk drivers more likely to get caught, and also the increase in both DUI and drunkenness may be an artifact of the fact that people over 21 can no longer be charged with underage drinking, as evident in the simultaneous sharp decrease in "liquor law" (i.e. underage drinking) arrests upon turning 21.  Thus, some behaviors that would lead to underage drinking arrests before 21 would likely lead to DUI and/or drunkenness arrests instead after turning 21.

In other words, these studies show that banning young people from drinking until age 21 (when they are more likely to have cars, and family controls are much weaker) may not be the best way to introduce them to alcohol.  In fact, it appears on balance to be one of the worst ways, and is akin to setting a time bomb.  There is zero evidence that people magically become mature enough to handle alcohol upon turning 21.  Indeed, the aforementioned studies suggest quite the opposite, at least in the short term.

We all know what the road to hell is paved with.  Let's defuse this ticking time bomb and lower the drinking age to 18, legalizing alcohol for all legal adults in America.  What better time than now?

Chasing the Dragon

Doing the same thing over and over again and expecting different results is a functional definition of insanity.  So why does our government continue to pursue policies that fail?  It could be that some bad public policies, such as Prohibition, the War on (some) Drugs, and the 21 drinking age are simply addictive.  But how exactly can failure be addictive?

The answer lies in the fact that several of these policies began with at least perceived success.  Prohibition, for example, coincided with a large decrease in alcohol consumption in the first year or two.  The 21 drinking age coincided with reduced drunk driving fatalities in the 1980s.  And it occurred in both cases despite little to no enforcement.  Whether or not the relationship was causal is immaterial to the government's perception of success.  For Prohibition, alcohol consumption (and its attendant social problems) began rebounding after the first two years, and by 1929 consumption reached at least 70% of pre-Prohibition levels, possibly even 100% by some estimates.  Even during the Great Depression, it continued to rise, albeit at slower rate.  Enforcement increased dramatically, but it could not duplicate or prolong the initial, temporary "success" the government was now hooked on.  Most scholars agree that Prohibition did more harm than good, and most Americans agree as well.

For the 21 drinking age, there were numerous confounding factors that likely explain the fatality decline better, especially since it occurred in Canada as well, who did not raise the drinking age to 21.  But numerous studies still claim that raising the drinking age was causally linked, and the effects occurred largely at a time during which enforcement was weak.  Miron and Tetelbaum (2009), however, find that was not the case, at least not in the long run.  By separating out states that raised it voluntarily (before 1984) from those who were coerced by the feds in 1984-1988, a striking pattern was discovered.  After controlling for numerous confounders and secular trends, it was observed that states that raised the age voluntarily did see a small lifesaving effect, but it was only temporary, lasting no more than 1-2 years. Kind of like Prohibition, though this time the rebound was masked by confounders and secular trends.  The coerced states, however, saw no lifesaving effect, and in many states it merely threw gasoline on the fire.  A similar pattern was seen for high school drinking and "binge" drinking rates as well.  And in all states, increasing enforcement over time does not appear to have any noticeable correlation.  In other words, the idea that raising the drinking age somehow saved lives and continues to do so was nothing more than a mirage.  Of course, this should come as no surprise to those who study history, or know anything about young people, but I guess we can't expect the government to do so.

In addition, another addictive aspect of these policies is actually the oldest addiction of all:  POWER.  Policies like Prohibition and the drinking age inevitably give more power to any government that enacts them.  And once they experience it, they cannot seem to get enough.  This further reinforces the pursuit of unattainable success that characterizes the various prohibitions on consensual activities throughout history.  It is also no accident that the targets of enforcement tend to be the least powerful members of society.
 
It's time to stop chasing the dragon.  You are never going to catch it.

Will Australia Raise the Drinking Age?

NOTE: This blog is primarily about the United States and is thus written from an American perspective.


Just as more and more Americans want the drinking age to be lowered to 18 over here, there is a growing movement to raise the Australian drinking age (currently 18) to 19 or even 21. The movement, which appears to be spearheaded by Prof. Ian Hickey, cites hackneyed and specious claims about "dain bramage" and alcohol-related violence. Interestingly, drunk driving in Australia is barely even mentioned at all since it is less of a problem over there than here (they are much tougher on DUI than America is), and we can really learn a lot from them. Fortunately, the government is not interested in raising the drinking age, and thus it probably won't happen. Because if it did, it would merely throw gasoline on the fire.

If they want to see what a failure the 21 drinking age is, they should come to America. We tried raising the drinking age to 19 in the early 1980s. Didn't work, so we raised it to 21 in the mid 1980s. Still didn't work. Then we added all these ancillary laws such as dram shop, social host, use and lose, zero tolerance, internal possession. And we toughened up enforcement. Guess what? It still doesn't work.

If Australia is worried about kids under 18 getting wasted, they should enforce the current drinking age better. And the biggest problem group over there, like in America, is people in their twenties. Raising the drinking age targets the wrong group. It would be best for them to raise the alcohol taxes (and make them proportional to alcohol content), shorten pub sales hours (currently 24/7), increase alcohol education, and have zero tolerance for drunk violence. Being drunk is no excuse for misbehavior--millions of people get drunk without ever becoming violent. And forcing drinking underground (where it can't be monitored) is unlikely to reduce violence in any sense. Even if it somehow did for 18-20 year olds, which is unproven, it would merely shift the behavior to 21-24 year olds (which already have a problem).

As for brain damage, there is no conclusive evidence that drinking at 18 is significantly worse than doing so at 21, all else being equal. Maybe for those younger than 18, but that's already illegal. So let's not confuse the issue. Again, lack of enforcement (in Australia) is the problem. And many young people would likely benefit from education about alcohol, which needs to start young since drinking starts young over there (and here as well).

Yes, Virginia, Australia DOES have a drinking problem, and a legendary one at that.  But America does too.  In fact, all predominantly Anglo-Celtic cultures do to some extent.   That's not news.  With few exceptions, the more Anglo-Celtic they are, the worse the drinking culture.  Ditto for pub/street violence--they don't call it a Glasgow kiss for nothing.

How Anglo-Celtic is each country? (Figures are approximate)

US:  30%
Canada:  50%
Australia: 70%
New Zealand: 70%+
UK: 86%
Republic of Ireland: 95%

Due to changing demographics, America is less Anglo-Celtic now than in the past.  This perhaps explains the decline in drinking since 1980 more than anything else, and it is less true for Australia and other such cultures.

The drinking age is irrelevant.  Drunken violence (and other problems) flourishes in cultures that tolerates misbehavior when drunk, such as Australia, New Zealand, the UK, and of course the USA.  Alcohol must never be considered an excuse. 

Why Have Virtually All Prohibitions Failed?

This is a question that many people have asked, and essentially all serious scholars know the truth. Even those who admit alcohol prohibition failed, but claim the 21 drinking age (as well as the War on (some) Drugs) was a success, likely know precisely why, but are afraid to admit it. And it's more than just an inability to legislate morality or the fact that a given substance is too much a part of the social fabric. So, as Professor Charles Whitebread of USC Law School said:

Every single person who has ever written seriously about the national alcohol prohibition agrees on why it collapsed. Why? Because it violated that iron law of Prohibitions. What is the iron law of Prohibitions? Prohibitions are always enacted by US, to govern the conduct of THEM. Do you have me? Take the alcohol prohibition. Every single person who has ever written about it agrees on why it collapsed.

He further elaborates:

Large numbers of people supported the idea of prohibition who were not themselves, opposed to drinking. Want to see it? Let me give you an example, 1919. You are a Republican in upstate New York. Whether you drink, or you don't, you are for the alcohol prohibition because it will close the licensed saloons in the City of New York which you view to be the corrupt patronage and power base of the Democratic Party in New York. So almost every Republican in New York was in favor of national alcohol prohibition.
And, as soon as it passed, what do you think they said? "Well, what do you know? Success. Let's have a drink." That's what they thought, "let's have a drink." "Let's drink to this." A great success, you see.

There you have it. There is always an US and a THEM. Liberty for "just us," not all. And if you STILL don't get it by this point, he goes on to drive the point home even further:

I just want to go back to the [English] prohibition against the drinking of gin [in the 1800s]. How could a country prohibit just the drinking of gin, not the drinking of anything else for forty years? Answer: The rich people drank whiskey and the poor people drank [guess] what? -- gin. Do you see it?

He also points out that the rationale for drug prohibitions often follow the same pseudo-logic. Cannabis was banned partly due to anti-Mexican racism and competing business interests, opium banned due to racist fears of the Chinese immigrants, and cocaine was banned due to (largely fabricated) fears of superhuman, coked-up black men going on murdering sprees and raping white women. (Cocaine ironically became popular due to Southern liquor laws designed to keep whiskey out of the hands of lower-class blacks, thus driving them to a more dangerous substitute.) And the very first laws on the books against these other substances specifically targeted such groups. Even to this day, minorities are disproportionally targeted for Drug War enforcement, while the Clinton drug czar Lee Brown speciously claims that drug legalization would be "genocide" against blacks. You read that right. WE can handle it, while THEY cant.

Of course, Dr. Whitebread was not talking specifically about the 21 drinking age, but it too follows the same "iron law" as an age-based selective prohibition of sorts. In fact, it applies a fortiori in this case--the "us" group being adults over 21 and the "them" group being "minors" under 21, the latter being politically impotent at the time it was passed. Supporters of the 21 drinking age, who usually drink themselves, invariably say something to the effect of "well, WE can handle it, but THEY can't." And guess who takes that as a dare?

Nevermind that 18-20 year olds are judged capable of handling war, guns, cigarettes, questionable "dietary supplements," gambling, cars, trucks, motorcycles, chainsaws, dangerous jobs, sex, marriage, and even having kids. But not beer. This would clearly fail the Martian test (can you explain it to a Martian without sounding like an idiot?) for obvious reasons.

In the entire history of the world, there has never been a society in which adults drank but teens did not, nor has the reverse ever been true. While this is also true for other substances, it is especially true for those substances that have gained the widest acceptance in a society. And no substance in history has ever achieved this widespread status quite like ethanol. And that, my friends, is why the 21 drinking age is the greatest alcohol policy failure since Prohibition.

Mike Males observes that in the USA, youth have the least amount of freedom relative to adults. The key word here is relative. Look at other countries around the world and see if you can see a pattern. Ever notice how the less relative freedom teens have, the worse the excesses (of all kinds) are among adults in such cultures? The reason for that is very simple. Those adults feel they need not worry about being good role models, since teens will face harsh punishment for emulating their behavior. Do as I say, not as I do--farcical (and pharisaical) to say the least. Being "grown-up" apparently just means making better excuses for bad behavior rather than truly behaving better. And what passes for "education" is often little more than "just say no" and disingenuous scare tactics. Such cultural schizophrenia is clearly not the best way for teens to be socialized into the adult world. And the excess-loving adults they eventually become are living proof.

But why is America like that? How could these obvious farces still be with us? Dr. Males notes that it is more than just fear of young people in general, it is that today's youth are more racially diverse (i.e. less white) than the older generation, and this is more true in America than any other industrialized country. So the in-group-out-group thing is even more pronounced since there is more than one dimension to this fear/loathing of the Other. How did we get to be so primitive?

A Proven Method to Eliminate Underage Drinking

Fed up with underage drinking? Want to not just reduce it, but eliminate it for good? Well, we know of a scientifically proven, universally effective, but little known way to guarantee that your kids will not drink a drop before reaching the magic age of 21. It has been verified in randomized controlled trials, is truly self-evident, and costs nothing. In fact, it is not all that difficult when you think about it, despite the interesting fact that the vast majority of parents had not even considered it. How, you ask? Well, here's what you gotta do.........



(keep scrolling down)



(farther)




(almost there)




(keep going)




DON'T HAVE KIDS!


Not only is it 100% effective against underage drinking, it also has other benefits, such as saving $250,000 per child over the first 18 years, reduced overpopulation, less urban sprawl, and a cleaner environment. The Earth will love you.

Yes, that is the only foolproof way to guarantee abstinence from alcohol (or anything else for that matter) until 21. But seriously. For those of us that live in the real world (you know, the one in which the majority will have kids and about 90% of those kids will drink before age 21), we need to admit that the 21 drinking age is a miserable failure. And admit that we do not have a "teen" drinking problem, we have an American drinking problem. Only then can real solutions be given a serious chance of working.

Do Zero Tolerance Laws Really Work?

This is a question to which most researchers would answer "yes," due to numerous empirical studies as well as in theory, but many have had their doubts. Enter Darren Grant, an economist at Sam Houston State University, who did a recent study that shows that there are good reasons to doubt the effectiveness of such laws.

Zero Tolerance (ZT) laws are what they sound like: laws that prohibit people (under 21 in this case) from driving with any measurable amout of alcohol in one's blood. These laws were justified by studies that found that the relative risk of a fatal crash for 16-20 year old drivers begins rising at a lower BAC, and more rapidly, than for those over 21.  By 1998, all 50 states and DC have passed such laws. Many states did so voluntarily, but the rest were forced by Congress to do so or lose highway funding (sound familiar?) and capitulated. ZT laws had to set the BAC limit for drivers under 21 at 0.02 or less in order to pass muster for Congress.  And until now, virtually every study has supported their effectiveness.

Grant's study found that ZT laws had essentially no effect on traffic fatality rates or the BAC distribution of fatalites. Data was from 1988-2000, during which time all states had a 21 drinking age. Several control variables and fixed effects were accounted for. Whether a state had a "partial" ZT law (a lower BAC limit for youth that was either >0.02 or had an age limit below 21) before adopting a "full" ZT law (satisfying the federal mandate), which several did, was also accounted for. Similar effects were observed on daytime and nighttime fatalities, despite the fact that most alcohol-related fatalities are concentrated at night. In addition, effects were compared to drivers over 21, who should not be affected by the ZT laws, but such effects were in fact similar, which suggests a spurious relationship due to unknown coincident factors. Finally, the fractions of total fatalities that were zero BAC, low BAC, and high BAC drivers were equivalent before and after a ZT law was passed, further casting doubt on its effectiveness.

What are we to make of all this? Previous studies were either pre/post studies that omitted key variables, or longitudinal studies that were otherwise less thorough than this one. This study appears to trump the rest, and it is thus very tempting to say that zero tolerance = zero intelligence.

That being said, we at 21 Debunked still recommend that if the drinking age is lowered to 18, which we strongly advocate for all 50 states, that the ZT laws generally remain as is, with an age limit of 21. Better yet, ZT laws ought to be strengthened by making the BAC limit 0.02 for the first x number of years of licensed driving for all ages, or age 21, whatever is longer. Several countries with lower drinking ages (Canada, Germany, Netherlands, etc.) interestingly set ZT age limits higher than the legal drinking age and/or base it on the number of years of licensed driving one has, with the latter making even more sense.  Puerto Rico, with a drinking age of 18, also recently adopted a 0.02 limit for those under 21. And there are good reasons for America maintaining some type of "full" ZT law even after the drinking age is lowered.

• ZT laws send a strong message that alcohol and driving don't mix, and removing them may be seen by some as implying otherwise.
• Inexperience in drinking as well as driving, regardless of age, can be a deadly combination.
• If the drinking age was 18, one would have three years of legal drinking experience and up to five years of driving experience at 21.
• ZT laws would be a good precautionary measure against the alleged adverse effects of lowering the drinking age, and would help assuage fears about such effects.
• Federal law requires ZT laws as a condition of highway funding. It's bad enough to have to deal with that kind of coercion with the drinking age, let alone additional funding losses.
• Some studies find positive externalities from ZT laws, such as reduced suicide rates, which may or may not be causally related. 
• ZT laws have strong public support, and frankly, it would be politically impossible to lower the drinking age without maintaining such laws.

However, we recommend that laws that set the BAC limit to 0.00 be changed to 0.02 to prevent false positives, and violating a ZT law (but not violating the adult BAC limit) should not be a criminal offense. For those who violate adult BAC limits, there should be graduated penalties that are proportional to BAC, eliminating the current perverse incentives resulting from reduced marginal penalties for each additional drink above the 0.08 threshold. And those penalties should be tougher than the current ones as well. In addition, we also recommend lowering the adult BAC limit of 0.08 down to 0.05, like it is in many other countries, since impairment begins well before 0.08. In addition, preliminary breath testers (i.e. handheld ones) should be not be sufficient evidence; that's what evidential breath testers are for.

But most importantly, we should never lose sight of the fact that the average BAC in an alcohol-related fatality is 0.16 in general and 0.14 for drivers under 21. Moreover, only 5.8% and 5.4% of total fatalities, for all ages and ages 16-20, respectively, involve a BAC below 0.08--and most of such deaths would probably still have occurred in the absence of booze.  And drivers age 21-24 are the most overrepresented in alcohol-related fatal crashes (at all BACs) as well.  Thus, the highest priority in the fight against impaired driving should be catching and deterring those very high BAC drivers of all ages (who are responsible for the lion's share of such deaths), rather than strategize on how best to catch young drivers with BACs below 0.05 (who are responsible for only a small fraction). In other words, we need to see the forest for the trees.

What Will South Dakota Do? (Updated)

The latest state in which there is an attempt to lower the drinking age is South Dakota. Which, as you may know, was the second to last state (followed only by Wyoming) to raise the drinking age to 21 in 1988 under federal duress and coercion. State Rep. Tim Rounds (R) currently has a proposal to let 19-20 year olds drink beer in bars if accompanied by someone over 21. Even that is rankling people like MADD, though. Rounds says he will drop the proposal if it will cost the state federal highway funding, which it likely will (it is unlikely that he found a loophole in the federal law).

Here's some advice, Mr. Rounds. You don't start out with a compromised position like this one. You will only have to compromise further. Obama learned this lesson the hard way when it came to healthcare (in 2003 he actually wanted single-payer, similar to Canada, and probably most Americans would have agreed). We know Rounds had a plan that was even more liberal than his current one last year.

If it passes, this will do good to pave the way for further changes in the drinking age, so let's cheer him on. We at 21 Debunked look forward to the day when in all 50 states, all 18-20 year olds will have the same rights as those over 21. In every way.

UPDATE:  Tim Rounds is still moving forward with the proposal as of January 2009, though he faces an uphill battle in the legislature.  Unfortunately, it appears to be too much of a compromise, and it is unclear whether even that would get around the federal highway funds coercion.  His latest plan would create special bars for 19-20 year olds to drink only beer and only on premises, though he dropped the requirement of being accompanied by someone over 21. 

Unfortunately, he added a provision that would make it a felony DUI for anyone under 21 to drive with even the slightest amout of alcohol in one's system.  It is already illegal to do so in all 50 states for those under 21, and it seems excessive and out of proportion to make it a felony (read: life-destroying) offense to drive after a single drink.  While we at Twenty-One Debunked do not support any kind of impaired driving, however slight, we think there is a significant difference between one beer and ten, and that the law should reflect that difference.  And what about false positives?

FEB. 2010 UPDATE:  The bill has officially been killed by the legislature, unfortunately.

Post #21--Would a Split Drinking Age Be Better?

A new study of the drinking age (Males, 2008) apparently finds that a split (or "graduated") drinking age of 18 for beer/wine and 21 for liquor would reduce combined violent deaths (traffic crash deaths plus homicides) among 18-20 year olds with similar reductions for 16-17 year olds and 21-24 year olds. It studied the effects over time of raising the age to 21 in the 1980s, based on a state's former drinking age (18 for all beverages, 18 for beer/wine only, or 19 and 20), relative to states that were 21 throughout. When they were raised to 21, the ones that were previously 18 for all beverages, as well as the former 19 and 20 states, saw a decrease in combined deaths, mainly from traffic crashes. But the 11 states that were 18 for beer and/or wine only, they saw an increase in deaths, with the lion's share of the increase being homicides. Interestingly, a few states that were 18 for all beverages saw increases or no significant change as well when the ages were raised to 21.

What are we to make of all this? Several states had split drinking ages, many of which had them for decades. When we look at the dates that the 21 law became effective, we see that all of them but Oklahoma (1983) raised them in 1985 or later. Ditto for the "18 for all beverages" states that saw increases or no significant changes. Hmmmm....what happened around that time? In 1984, the federal government coerced the states with lower drinking ages to raise them to 21 or lose 10% of annual highway funding starting in 1988. So, it could simply be that for many of the coerced states, raising their drinking ages merely threw gasoline on the fire!

This interpretation, rather than anything special about a split drinking age, appears to be more likely to be true when we consider a study by Miron and Tetelbaum (2009). In their study, which controlled for more variables than Males (2008) but looked only at traffic fatalities, they separated out the states based on the year the drinking age was raised to 21. The states that were coerced (i.e. those who raised the age after 1984) overall saw no lifesaving effect. On the other hand, the ones that raised their drinking ages voluntarily in 1983 or earlier did see a small lifesaving effect, but that only lasted a year or two and then wore off. Robustness checks were done as well. Interestingly, Miron and Tetelbaum found no clear relationship for the purchase ages of various beverage types when measured separately, but they did find an increase in fatalities among drivers under 18 when the drinking age was 19, 20, or 21 as opposed to 18.

We at 21 Debunked therefore see no reason why a split drinking age is superior to a drinking age of 18 across the board. We would support the former as a steppingstone to the latter, but ultimately favor the latter hands down. We never understood it since you can get just as drunk on one as you can on the other, and beer is grosslly overrepresented in DUI fatalities. If states feel that they must have special restrictions for 18-20 year olds, which are probably unnecessary, one or more of the following may make more sense:

• Keep the age at 21 for kegs, cases, and other bulk quantities of alcohol; let 18 year olds buy everything else.
• Limit the quantities 18 year olds can buy off-premise to 216 ounces of beer, 1 gallon of wine, or 1 fifth of liquor per person per day.
• Require 18-20 year olds (or even just 18 year olds) to sign a logbook upon purchase, similar to what is done for Sudafed at all ages.
• Have kegs and cases be sold only in beer distributors regardless of age, making the first two things easier to enforce.
• Keep it 21 for internet alcohol orders, like some states currently do with cigarettes.
• Have shorter trading hours (beginning later and/or ending earlier) for off-premises sales for 18 year olds than for those over 19 (or 20 or 21).
• Allow some bars to set the limit higher than 18 if they wish (no new law needs to be made).

Also, we feel that the age limit should be the same for on- and off-premise sales, at 18. If we let 18 year olds buy cigarettes and guns for off premise use, why not a 6-pack? Their younger friends will find a way to get booze either way, and both 8th graders and 10th graders currently find alcohol easier to get than cigarettes. Furthermore, if there is a wide gap between the two (i.e. 18 for bars and 21 for stores), that may perversely encourage drunk driving for those rural 18-20 year olds whose nearest bar is 10+ miles away while a store that sells 6-packs is a mere 500 feet away. However, such perverse incentives could in theory be minimized by letting 18 year olds have the same drinking rights as 21 year olds currently enjoy, with the one exception being off-premise purchase, and having that purchase age be 19 instead of 21. We don't have any studies to back this up, but we also know of no hard evidence that it is any safer than 18 across the board.

In contrast, there is some evidence that restricting bulk alcohol sales may have benefits. A study of college students in college towns by Kuo et al. (2003) found that the availability of 6-packs was negatively associated with self-reported "binge" drinking, 12-packs showed no effect, while 24-packs (cases), 30-packs, and kegs all showed significant positive associations. In other words, the more 6-packs available, the less "binge" drinking. The more cases and kegs, the more "binge" drinking. (Liquor and wine were not studied; nor were 18-packs.) They also found that beer price was inversely related to "binge" drinking, and store advertising was directly related, just as expected. While we were unable to locate any jurisdiction in the world that has age-specific bulk-only alcohol restrictions, it stands to reason that such a thing would make more sense than splitting the age by venue or beverage type regardless of quantity.

The Truth Should Be Self-Evident--Not All "Bingers" are Created Equal

Binge drinking. We all have heard the term used incessantly in the media, who usually claim it is getting worse. Our kids are out of control, they say, and we need to get tougher. Except, of course, when the issue of the 21 drinking age comes up--then it has gone way down, and the raising of the drinking age in the 1980s gets all (or nearly all) the credit.  Predictable to say the least.

So which is it? It depends on your definition of "binge" drinking. The term originally meant a multi-day, very heavy drinking session in which the drinker neglects usual responsibilities and behaves recklessly--also known as a bender. Fortunately, very few people do this, both now and back in the day. But in 1994, Henry Wechsler of the Harvard University School of Public Health redefined the term to mean anytime someone drinks 5 or more drinks in the same evening, later modified to be 4 or more for a woman. This "5/4 definition" is the one most commonly used nowadays, with the gender-neutral 5+ definition a close second since the latter has been tracked by national surveys since 1975. And yes, it (defined this way) has gone down since its peak in 1979 for everyone except college students and non-college females. But that downward trend began several years before a significant number of states raised their drinking ages to 21, and also occurred in states that stayed 21 throughout.

But is it really an accurate index of harmful drinking? That question appears to have been answered fairly in a new study. Using self-reported alcohol-related injuries (major or minor) in the past 6 months as the dependent variable, researchers examined the effect of the number of drinks per drinking day, and the frequency of occasions having that number of drinks in the past month, among college students. This clearly makes more sense than lumping them all together, or looking only at total volume or frequency. Results were that risks increase rapidly after consuming 8+ drinks (males) or 5+ (females), on at least four days per month. Effects were further magnified among those who scored high on sensation-seeking. It was also found that the 5/4 definiton loses much of its predictive power when days of 8/5+ are removed from the equation. And remember, none of these models account for speed or context of drinking, or even distinguish drunk driving, and students often undercount their drinks as well (due in part to the ubiquitous "red party cups" and the popularity of hard liquor).  But one benefit to this study is that body weight was controlled for, since the effect of a specific number of drinks varies widely across individuals.

Another recent study found that a 7/6+ cutoff was far more predictive of alcohol-related problems (relative to non-bingers) than a 5/4+ one.  Those who met the 5/4+ cutoff but not the 7/6+ one averaged 5.4 drinks per occasion, while those who met the 7/6+ cutoff averaged a whopping 9.1 drinks.  In terms of negative consequences, those males who typically drank 5-6 drinks (and 4-5 for females) generally did not fare significantly worse than the nonbingers, but the heavier 7/6+ group clearly did.

Clearly, the 5/4 definition is an arbitrary convention with little to no scientific basis. Kind of like, well, the 21 drinking age. An ideal definition would take into account context, speed, and BAC, set at rational thresholds. However, a quick, context-neutral, numerical definition is needed for survey purposes. While for the vast majority of the college-age population a 5/4+ threshold is a good negative test for acutely dangerous drinking, a 10/8+ threshold is a better sufficient test for the same, and intermediate between the two is an 8/6+ threshold.  Thus, we at 21 Debunked propose two thresholds: 8/6+ drinks and 10/8+ drinks. It's probably best to jettison the word "binge" entirely--call the first threshold "heavy episodic drinking" or "high risk drinking," and the second one "extreme drinking." Unfortunately, these have not been measured very well over time, so to answer the first question, we don't know for sure.

But if we are to go with anecdotal data and statistical proxies for extreme drinking, we can probably safely that say such drinking has been on the rise, at least for college students. For example, another study found that between 1998 to 2005, there was a significant increase in alcohol-related nontraffic deaths among students, driven by a near tripling of alcohol poisoning deaths. (The actual statistics were simply those for 18-24 year olds multiplied by 30%, so this actually includes many non-students as well) That being said, we should note that the majority of college drinkers still drink responsibly, whether legally or illegally, and only a small minority drinks to these ludicrously high levels. However, the latter appears to be where the real problems lie, and where our efforts are best concentrated.  But we still keep on barking up the wrong tree time and again.

It's also worth noting that in the first study mentioned, participants from 3 out of the 4 American universities surveyed had higher rates of alcohol-related injury than those from the one Canadian university, though the difference was not statistically significant.  It is quite plausible that the 21 drinking age, by forcing drinking underground, exacerbates such problems. (Canada's drinking age is 18 or 19, depending on the province)

We at Twenty-One Debunked do not endorse any kind of drinking, underage or otherwise, and we do not mean to imply that drinking below a specific threshold is safe for everyone. To our knowledge, no such absolute threshold exists. But we do think that we need to get our priorities straight as a society when it comes to drinking.  America's young people--our future--deserve nothing less.

Latest Bit of Scarelore--Is it True?

In a desperate attempt to hang on for dear life, knowing its days are numbered, the pro-21 crowd is recycling an old fear: that alcoholism rates would increase dramatically if the drinking age is lowered below 21. And they now have a study to "prove" it, or so they say.

The study pools data from both a 1992 survey and a 2002 survey, and finds that those who were exposed to a drinking age of less than 21 when they were ages 18-20 were about 1.3 times more likely to have an alcohol use disorder, and about 1.7 times more likely to have a substance use disorder other than alcohol, in the past year. Even (scratch that, especially) when the respondents were in their 40s and 50s. The researchers attempted to control for confounders, but we all know there can always be some that were missed. And we know that if you torture the data enough, it will confess to anything.

We at 21 Debunked think that the relationship between MLDA and later alcohol problems is likely spurious for the following reasons:

• At least part of the relationship seems to be mediated by self-selective cross-state migration (i.e. budding alcohol abusers moving to states with more lenient laws). But there was no data on state of residence at age 18, only birth state and current state.
• The relationship was apparently NOT mediated by earlier age of drinking onset, as would be expected if the relationship was truly causal. Also, there was no significant effect on drinking before 18, so we can rule out the often claimed "spillover effect" on younger kids.
• Drug addiction (especially hard drugs) was affected more strongly than alcohol addiction for whatever reason, the opposite of what would be expected assuming causality.
• No distinction was made between a drinking age of 18, 19, or 20, which may have a misleading impact on the results.  Though this could bias the results in either direction.
• The effect on past-year alcohol use disorders was strongest among respondents in their 40s and 50s, and weakest (and statistically insignificant) among those in their 20s, the opposite of what would be expected from a causal relationship. Both drinking age exposed groups start out fairly close, disorders decline at the same rate at first, and divergence does not occur until around age 35.
• Regressions did not control for state-specific trends, religion, or completely for ethnicity. Whites were treated as a monolithic group (despite wide variation in drinking cultures), and no distinction was made for Native Americans (who tend to have higher alcoholism rates).
• Unemployment and education were controlled for, but not poverty.
• The odds ratio for the relationship between MLDA <21 and later alcohol use disorders was an anemic 1.33. In epidemiology, odds ratios and (relative risks) below 2.0 are difficult to interpret and are often due to residual or unmeasured confounding, bias, or even chance. This caveat is especially true for retrospective and non-longitudinal survey studies such as this one. For example, the New England Journal of Medicine would likely consider this association "weak" and thus unfit for publication in most circumstances.
• And there's always the usual recall bias, as well as good old-fashioned denial. They don't call it a "pink elephant in the room" for nothing.

In other words, the results are preliminary at best. And there's plenty of counter-evidence as well. According to NIAAA data from 1981, courtesy of Mike Males (1986), states with a drinking age of 21 back then actually had higher rates of alcoholism than states with lower drinking ages, and much higher rates of alcohol-related diseases despite both lower teen and adult drinking rates. North Dakota, who nonetheless remained at a constant 21 since the 1930s, is currently the worst state in terms of alcoholism. The worst city is Reno, Nevada, whose state had not seen a drinking age less than 21 for 75 years.

And why does Canada (MLDA 18 or 19 depending on province) not have a higher alcoholism rate than America? Demographically, they probably should! Ditto for most other countries with lower drinking ages, even the notoriously binge-drinking British and Australians? Some may say culture, but Canada's culture is not radically different than ours, and Britain's should, if anything, be more conducive to alcoholism than ours.

Another new study, this one done in Australia (with a legal drinking age of 18), explores the "age at first drink" effect on alcohol dependence from a new angle. Studying numerous twins, they find that there appears to be a gene-environment interaction among those who begin drinking before 15, especially before 13. Such very early drinking, or some environmental factor closely linked to it, appears to activate the bad genes. Though this could simply be a common vulnerability from other differences in environment rather than a truly causal effect of age. Or perhaps the context of drinking matters. The older one starts drinking, the more the environment matters, and the less genes do. But interestingly, and most importantly for the purposes of this discussion, the effect of age at first drink levels off after 18, with no significant difference between those who begin drinking at 18, 19, 20, or even 23. (Funny how this "leveling" effect occurs precisely at the age that corresponds to the MLDA. Coincidence? Hmmm.....)

This jibes well with a Canadian study done in 2000 that found that, while those who begin drinking between 11-14 have the highest risk for later alcohol dependence, even when taking time since first drink into account, there was no significant difference (in the long run) between those who began at 17-18 and those who began at 19 or later.  For the latter group, the onset of dependence was merely delayed.  Again, no conclusive proof of causation, but the authors concluded that prevention programs that succeed in delaying drinking to even 15-16 would likely produce substantial benefits.  This is probably a better idea than trying to make the perfect the enemy of the good, like those who support the 21 drinking age never cease to do.

In other words, we need to see the forest for the trees.  Something we as a society fail to do time and again.