The Emperor Is Naked

We should have written about this last year, but we recently learned that MADD has severed all ties with the Century Council, and all of the reasons why.  For those who don't know, the Century Council (TCC) is an organization dedicated to fighting drunk driving and underage drinking, that is funded entirely by America's leading distillers.  Cynics, however, would say that the organization is just a political ploy to deflect blame from the alcohol industry.  MADD's Dear John letter to them noted that the primary reason for the split was the Century Council's initial opposition to mandatory ignition interlocks for first offenders, a group MADD rightly referred to as "ticking time bombs" since they have already driven drunk 88 times on average before being caught.  For that particular issue, we at Twenty-One Debunked tend to agree with MADD.  Ignition interlocks are the mimimum that should be imposed on drunk drivers, and in fact we think the laws against DUI should be much tougher.  Usually only extremely die-hard libertines or those with vested interests would be opposed to that, and TCC has since officially switched to neutrality on the ignition interlock issue.

However, another less-publicized reason noted in the letter was that TCC allegedly condoned drinking before the age of 21, despite the organization's generally unequivocal stance supporting the 21 drinking age.  This was based solely on a quote by TCC's president, taken way out of context, concerning an ad campaign designed by college students through the American Advertising Federation's student competition to reduce excessive drinking.  The actual quote was, "[t]he behavior is taking place, the best thing we can do is reduce the harm." Despite the TCC reaffirming its support for the 21 drinking age, MADD still was not satisfied since their refusal to retract that specific quote (though clearly true) could somehow be perceived as "undermining" the drinking age or "condoning" underage drinking.   Now that's just lunacy--even the slightest hint that one can see cracks in the facade of prohibition is somehow bad?

Just go to any college campus (except perhaps Brigham Young or Bob Jones) and you will see that the emperor isn't wearing any clothes.  The 21 drinking age simply doesn't work--the majority of 18-20 year olds still drink.  And while fewer of them now drink regularly than they did back in the 1970s, which may or may not have anything to do with the drinking age, the more they do when they do.  And the problem of truly dangerous drinking, though always there, is arguably worse in colleges today.  Forcing alcohol underground only makes it that much more dangerous (and appealing), a lesson we should have learned in the 1920s but somehow conveniently forgot when it comes to today's young people.  We need better solutions, the kind that can only work with a lower drinking age.  What better time than now?

The Fake Controversy

The Canadian women's ice hockey team is supposedly in hot water after some of its members were drinking beer on the ice to celebrate winning against the American team in the Vancouver Olympics.  At least one of them was 18, and the drinking age in British Columbia is 19 (but 18 in Alberta where they trained, as well as in the player's native Quebec).  They weren't out of control, and the festivities occurred after the fans had left. 

The American media has been making a big deal out of this.  Why?  Because in the good old US of A, the drinking age is 21, and many older adults are both terrified and titillated simultaneously at the idea of those under 21 drinking.  Especially when it is done by young women.  Thus it makes a good story over here.  But the rest of the world (including Canada) just laughs at our puritanical immaturity and cultural schizophrenia regarding alcohol and young people.

In Canada, they recognize 18-20 year olds as full adults, and treat them as such.  The drinking age is 18 or 19, depending on the province, and they do not appear to be any worse off for it than us.  Drinking at that age is viewed as normative behavior, and they recognize that alcohol abuse (rather than mere use) is the real problem.  Perhaps we can learn a thing or two from our neighbor to the north.

Vermont Debates the Drinking Age

The Vermont legislature is currently debating whether or not to lower the drinking age to 18.  And we hope they choose to do so.  Someone's gotta go first, and Vermont's independent streak will make them a good choice.

For those who don't know, Vermont was the first state (except the 10 states that were 18 since the 1930s) to lower the drinking age from 21 to 18 in 1971, along with the voting age and age of majority.  This remained the case until 1986, when it was raised back to 21 due to federal coercion.  Actually, Governor Richard Snelling flat-out refused to raise the drinking age in spite of the highway funding penalty, vetoing several bills, and thought that it would be better to actually get tougher on drunk driving and improve alcohol education.  It was not until they got a new governor that the state finally sold out and it was raised. 

Interestingly, Vermont in 2008 actually had zero under-21 drunk driving fatalities, down from 14 in 1982.  Of course, that's easy for a state with a population of only 621,760.  And the decline began at least four years before the drinking age was raised.   This is in spite of their proximity to Quebec (where the drinking age is 18), the state's rural nature, and its above-average "binge" drinking rate.  Since the pretext for raising the drinking age in the 1980s was reducing drunk driving, many of the state's 18-20 year olds are probably now wondering, "Can we have our civil liberties back now?"

Most states either hate guns or hate gays.  Vermont, however, uniquely tolerates them both.  And if they lower the drinking age to 18, they will truly be the most free state in the country.  Even freer than their neighbor New Hampshire, the one with the motto "Live Free or Die," which also happens to be the motto of the True Spirit of America Party.

Social Host Laws Revisited

We at Twenty-One Debunked have repeatedly stated that there was no hard evidence that "social host" laws (laws that impose civil and/or criminal liability on those who merely allow (not give) those under 21 to drink on property they control, especially if injuries or fatalities subsequently occur) save any lives or reduce underage drinking.  In fact, a 2008 study by Fell et al. (a true believer in the 21 drinking age no less) found no effect of such laws, at least not for criminal ones.  That is not surprising since even district attorneys find these laws difficult to enforce, including the notorious law in Massachusetts. 

But a new study by Dills (2009) appears to have found a lifesaving effect for social host laws among 18-20 year olds, at least according to the author.  And it supposedly remained even after several other variables (drinking age, 0.08 BAC limit, seat belt law, zero tolerance, beer tax, etc.) and fixed effects were controlled for.

However, this claim does not appear to stand up to closer scrutiny.  After reading the paper ourselves, we find the following issues with the study:

• The fatalities were divided into three categories:  drinking, drunk driver, and sober.  The fact that data from the 1977-2005 were used would likely introduce biases relating to BAC testing rates.  Testing rates were much lower in the 1970s and early 1980s, and determination was often subjective.
• Restricting the data to 1982-2005 (the only years for which that FARS has alcohol-related data, and likely less biased) reduced the size and significance of the effects of both social host laws and the drinking age.  The former was only significant at the 10% level, while the latter was not even statistically significant at all. 
• None of the models showed a "dose-response" relationship when the effects of various drinking ages (18, 19, 20, and 21) were tested.  In fact, some even had the "wrong" sign.
• Many of the covariates such as BAC limit, beer tax, zero tolerance, and seat belt laws were statistically insignificant, suggesting something wrong with the models.
• Dram-shop laws were not controlled for, and since many social host states have these as well, this may be a potent confounding factor.  Some past studies have found effects of dram-shop laws, while others have not.
• Other variables that were not controlled for include sobriety checkpoints, roving patrols, 0.10 BAC laws, harsher DUI penalties, administrative license revocation, police per capita, and several others.
• There was no distinction between statutes and case law, which suggests a potential endogeneity problem.
• There was no over-21 comparison group.
• In general, states that adopted social host laws already had declining fatalities before adoption.
• Using survey data among 18-20 year olds, effects of social host laws were not significant (even at the 10% level) for drinking, "binge" drinking, and drunk driving in the past 30 days when other variables and state trends were controlled for.  For the frequency of drunk driving per respondent, it was only significant at the 10% level despite a very large sample size of over 52,000 people.
• Effects on those under 18 were not tested in any sense.

For those who don't know, statistical significance refers to the likelihood that a result did not occur by chance.  However, it only controls random errors, not systematic ones (such as bias or confounders).  Traditionally, a 5% level is chosen, meaning that if the p-value (the probability of getting another result at least as extreme) is below 0.05, it is considered statistically significant.  Results with a p-value above 0.05, such as many of the results in the Dills study, are traditionally rejected.

In other words, the evidence from the study in support of social host laws is rather weak, and is likely to be a spurious correlation.  In fact, the reported 9% decrease in drunk driving fatalities is both too small to be conclusive evidence of causality (especially when statistical significance is examined), and too large to be plausible given that the majority of people are likely unaware of the existence of these laws, especially civil ones (which are usually only sporadically enforced).  Most likely, social host laws are acting as a proxy for something else, such as tougher DUI laws and/or enforcement.

To our knowledge, there has been only one other study of social host laws to date. A 2000 study by Stout et al. did manage to find a significant negative correlation between all-ages civil social host laws and both self-reported "binge" drinking as well as self-reported drinking and driving among adults over 21 in national survey data from 1984-1995.  While numerous variables were controlled for, the following were not:  state fixed effects, state trends, blood alcohol limit, sobriety checkpoints, overall DUI enforcement, and drinking age.  Again, it could have been a proxy for something else.  And traffic fatalities or any other consequences of drinking were not examined in the study, so questions relating to those are left unanswered by that study.  Generalizability is also limited, and it says nothing about the persistence of the reported effects or whether they are applicable to anyone under 21, especially in today's world.  Those who use the study to justify social host laws as worthwhile should bear in mind that the same study found that mandatory fines and especially mandatory jail for a first DUI offense to be more effective in reducing self-reported drinking and driving than social host laws.

What about the "collateral damage" that occurs from social host laws?  For one, a host (however broadly defined) can be fined, sued, or even jailed--in some cases for several years.  And civil liberties often need to be violated to enforce such draconian prohibitions.  But what about the "children," you know, the ones these laws were ostensibly written to "protect"?  In the five years since San Diego passed their own local social host ordinance in 2003 (California itself has none), there have been more police responses to parties, and more alcohol-related teen hospital admissions.  In other words, there was likely just as much drinking if not more so, but the bigger teen drinking parties of the past seem to have broken up into many more smaller (and more dangerous) ones with presumably more booze to go around.  And only the bold and reckless (and/or ignorant) are hosting them now that it is a crime.  Looks like the Law of Eristic Escalation in action yet again.

We at Twenty-One Debunked do not support any type of social host law, civil or criminal, as they contravene the very idea of personal responsibility and likely do more harm than good by forcing alcohol deeper underground, making it more dangerous than it has to be.  At the very least, we do not think that such laws should apply to drinking by those over the age of majority (18), regardless of the current legal drinking age.  Of course, we want that to be 18 as well.  And we have repeatedly noted that social host laws are just another pathetic attempt to prop up the greatest alcohol policy failure since Prohibition.  We would be better off going after those who actually do drive drunk and endanger the public, regardless of age.

Let's Talk About Canada

When advocates of lowering the drinking age bring up Europe for comparison, they often paint themselves into a corner.  America and Europe are very different, so in many ways it's apples and oranges.  But European countries are not the only ones that have lower drinking ages.

We do in fact have a good yardstick for what would have happened had the drinking age not been raised to 21 in the 1980s.  It's called Canada.  Their drinking ages have remained at 18 or 19, depending on the province, for the past three decades.  And it is the country that most resembles America in many ways, especially in terms of its car culture.  So let's talk about Canada then.

ALCOHOL-RELATED TRAFFIC FATALITIES

It is often claimed by proponents of the 21 drinking age that raising the drinking age saved lives.  While alcohol-related traffic fatalites did decline, correlation does not prove causality.  First of all, the trend began in 1982, two years before the National Minimum Drinking Age Act that forced all states to raise their drinking ages to 21 by 1987.  Perhaps the trend began even earlier, as total 18-20 year old fatalities began declining in 1979-1980, but 1982 is the first year that FARS has reasonably reliable data for alcohol-related fatalities.  And Canada saw a remarkably similar trend, as you can see in the graphs below (courtesy of NHTSA).

Percent Change from 1982-1997 US: drivers age 16-20 in fatal crashes with positive BAC (FARS) Canada: driver fatalities age 16-19 with positive BAC (TIRF)	Percent Change from 1982-1997 US: percentage of drivers age 16-20 in fatal crashes with positive BAC (FARS) Canada: percentage of driver fatalities age 16-19 with positive BAC (TIRF)

Interestingly, the decline in alcohol-related traffic fatalities since 1982 occurred at about the same rate in both countries, with no evidence of divergence in the expected direction despite the fact that Canada did not raise the drinking age to 21.  In both countries, drivers under 21 saw some of the largest declines of all compared with other age groups, though all ages saw some decline over the long run.  Moreover, progress continued for Canadian teens from 1997-2005, while unfortunately it stalled for their American counterparts during that time, only resuming after gas prices began to skyrocket (which Americans were not used to) and the economy began to sag.  In 2005-2006, the rate of total 15-24 year old traffic fatalities (per 100,000 people) for the USA was 25.5, and 16.9 in Canada, the latter being 33% lower than the former.

In other words, the downward trend in fatalities can be explained entirely by other factors, which likely include, inter alia:

• Tougher laws and penalties for DUI
• Better DUI enforcement
• More education and awareness of the problem of impaired driving
• Designated driver programs
• Seat belt laws
• Safer cars and roads due to improved engineering
• Demographic changes
• Changes in gas prices

In fact, some things, such as the 0.08 BAC limit, were already in place in Canada well before 1982.  The BAC limit in the US was still 0.12-0.15 in most states in 1982, and since then all 50 states, DC, and Puerto Rico lowered it to 0.10 and eventually to 0.08.  Zero-tolerance laws for younger drivers, which were enacted in all 50 states and DC by 1998 (beginning in the 1980s), were nonexistent until well into the 1990s in most Canadian provinces, and until very recently no province's law was as strict as in the USA.  Also, graduated driver license rules for younger drivers had eventually become stricter than Canada's in several states.  If anything, fatality rates for all ages should have declined faster in the US relative to Canada, but for some reason they did not.

Worse still, according to a 2004 book by Leonard Evans, former safety researcher for General Motors, America has been lagging behind several other countries in terms of traffic safety.  The table below shows the change in the number and rate of total traffic fatalites (all ages) over time in the US and three other countries that maintained lower drinking ages since 1979.

Country	MLDA	1979 Fatalities	2002 Fatalities	% Change (raw)	% Change (per vehicle)	% Change (per VMT)
USA	21	51,093	42,815	-16.2%	-46.2%	-52%
UK	18	6,352	3,431	-46.0%	-67.1%	-70%
Canada	18 or 19	5,863	2,936	-49.9%	-63.5%	N/A
Australia	18	3,508	1,715	-51.1%	-79.1%	N/A

TEEN DRINKING AND "BINGE" DRINKING

Of course, highway fatalities are not the only concern raised about the drinking age.  Proponents of the 21 drinking age also claim it reduced teen drinking and "binge" drinking (5+ drinks in an occasion).  But that trend, as measured by the Monitoring the Future (MTF) survey, began in 1979, which was several years before most states adopted the 21 law.  And raising the drinking age may lead to reduced reporting in surveys even in the absence of actual behavioral change.  So all teen surveys ought to be taken with at least a grain of salt, if not a pound.

The province of Ontario (with a drinking age of 19 since 1979) has a similar survey (OSDUS) going back to the 1970s, though not all the measurements are the same.  The following table, again courtesy of NHTSA, shows the changes in Ontario during the most relevant time period (1979-1991 unless otherwise stated) compared with the USA.  The American data are for grade 12 only, while the Ontario data are for grades 7-13 combined, so they are not directly comparable.  The trends, however, are strikingly similar.

Drinking Behavior	1979	1991	% Change, 1979-1991
Annual drinking: USA	88.1%	77.7%	-12%
Annual drinking: Ontario	76.9%	58.7%	-24%
Daily drinking: USA	6.9%	3.6%	-48%
Daily drinking: Ontario	0.9%	0.4%	-56%
5 or more drinks: USA (past 2 weeks)	41.2%	27.9%	-32%
5 or more drinks: Ontario (past 4 weeks)	27.0%	21.9%	-19%
5 or more drinks: USA (past 2 weeks, 1979-1993)	41.2%	27.5% (1993)	-33%
5 or more drinks: Ontario (past 4 weeks, grades 7, 9 and 11 only, 1979-1993)	24%	15% (1993)	-38%
Drive after drinking: USA (past 2 weeks)	31.2% (1984)	18.7%	-40%
Drive after drinking: Ontario (annual)	43.2% (1983)	20.1%	-53%

Of course, that is only one province.  What about the rest of Canada?  Unfortunately, most Canadian provinces do not have longitudinal data going back that far, or even before 1996, so we are stuck with doing a crude cross-section using current data for our international comparison.  The following table consists of the past-month prevalence of "binge" drinking (5+ drinks in an occasion) for high school seniors as reported in recent surveys, in selected states and provinces.  American data were taken from the national Youth Risk Behavior Survey, while Canadian data were taken from various provincial surveys. 

Location	Binge Drinking (Grade 12)	Drove after drinking (Grades 9-12)	MLDA	Year
USA (overall)	36.5%	10.5%	21	2007
North Dakota	47.0%	18.7%	21	2007
South Dakota	47.3%	13.0%	21	2007
Montana	46.2%	18.5%	21	2005
Vermont	38.0%	9.2%	21	2007
Wisconsin	42.7%	14.3%	21	2007
Alberta	46%	N/A	18	2005
Alberta	48.5%	10.3%	18	2008
Atlantic Provinces	49.7%	N/A	19	2007
Manitoba	47%	N/A	18	2007
Ontario	48%	11.6%	19	2007
Saskatchewan	70%+	N/A	19	2008
Puerto Rico (USA)	33.2%	7.3%	18	2005
Guam (USA)	30.3%	7.8%	18	2007
Northern Mariana  Islands (USA)	36.5%	14.1%	21	2005

Care was taken to compare apples to apples, and that is why the YRBS was used for American data instead of the Monitoring the Future survey.  Canadian surveys and YRBS report past-month "binge" drinking, while MTF reports it for past two weeks (and thus contains lower numbers).  The Manitoba figure was for the past-year, as comparable data for past month were not available, and can thus be considered an upper bound for past-month "binge" drinking.

Note the similarity between the northern states and Canadian provinces which are geographically and demographically similar--they generally tend to be around 50%.  There does not appear to be a significant correlation between the drinking age and "binge" drinking rates.  Remember again that the American data are more likely underreported than the Canadian data due to the drinking age difference and cultural factors.

Also note the below-average numbers for the US territories of Guam and Puerto Rico, both of which have a drinking age of 18.  In fact, even the temperance-oriented Robert Wood Johnson Foundation concedes that Puerto Rico was able to reduce both alcohol-related traffic fatalities and underage (under 18) drinking since the 1990s without raising the drinking age.  From 1982 to 2009, Puerto Rico saw a whopping 84% decline in teenage (16-20) drunk driving fatalities, while the nation as a whole saw a 74% drop, in both cases to record-low levels.  Now that's a great American success story.

In other words, it appears that Miron and Tetelbaum (2009) were spot on when they said that the drinking age appears to have "only a minor impact on teen drinking," just like they were right about its lack of a lifesaving effect on the highways. 

OTHER EFFECTS, OR LACK THEREOF

As for allegedly creating a nation of brain-damaged, alcoholic felons by allowing 18-20 year olds to drink, this myth does not hold water either.  In international standardized tests, Canadian 12th graders beat their American counterparts despite the former having similar or lower scores in 4th grade.  In fact, nearly all the countries that beat us set the drinking age at 18 or even lower!  The alcoholism rates in both the USA and Canada are also roughly equivalent, and the adult per capita alcohol consumption rate is actually slightly lower in Canada.  Alcohol-related death rates, both in terms of liver cirrhosis as well as "alcohol use disorder", are also lower in Canada according to the World Health Organization.  In fact, Canadians live on average three years longer than Americans.  And the rates of violent crimes, especially the most serious ones like homicide, tend to be significantly lower in Canada as well.
 
In short, puritanical America, with our 21 drinking age, appears to be the less healthy society of the two.  And while correlation does not prove causation, the aforementioned statistics certainly won't convince anyone that our illiberal policies are doing much good in reducing alcohol-related problems or improving public health and safety.  We need to see the forest for the trees, something America chronically fails to do in terms of alcohol policy.


Perhaps we can learn a thing or two from our neighbor to the north?

QED


2011 UPDATE:  Errata have been found (and updated) for some surveys.  Also, additional data have been (and will be) added to this post from time to time--stay tuned. 

A Teachable Moment

Too young to drink legally, but old enough to be sued?  Welcome to the world of the American teenager.

In Massachusetts in October 2008, a 17 year old honor student, Taylor Meyer, went out drinking with several friends after a football game, and unfortunately did not survive.  They went to some house parties and eventually the woods by a swamp, Taylor wandered off, and her body was found in the frigid swamp a few days later.  The details of what actually happened in the woods are not yet known, and it is thus a bit premature to speculate on the roles of her friends that night.  Though it is highly unlikely anyone forcibly poured the booze down her throat, and the autopsy showed that the death was consistent with drowning rather than foul play.

Now, in 2010, Taylor's mother is suing seven of the girl's friends, five of which are under 18 and six of which are under 21, for wrongful death.  She says it is about "accountability" rather than money, and the amount she is suing for was not disclosed.  Nevermind the fact that those teens are, due to their age, deemed too irresponsible and immature to drink legally.  If that's the case, how can they be mature enough to be held legally liable for a friend's self-inflicted death?  Look, you can't have it both ways--either they're adults or they're not.  The hypocrisy is so thick you can cut it with a knife.

Unfortunately, this is what happens when alcohol is forced underground. Many preventable deaths occur as a result of the 21 drinking age, just like during Prohibition.  So why is no one in the MSM saying this?  If anyone should be sued, it should be the government, as well as fanatical groups like MADD, for helping to create a more dangerous environment for young people.  Those folks have WAY more blood on their hands than they care to acknowledge.

Our litigious culture feels the need to sue for just about everything, and this is just one of many examples. Personal responsibility has sadly become a forgotten virtue in our society, and parents increasingly abdicate their responsibility for their children as well.  They often expect the state to raise them, and when things go wrong it is always someone else's fault.  Alas, this has become the new "normal" for America.

The mother in this case, however, believed she was doing the right thing.  From what she said, she (like many American parents of teenagers) appears to have raised her daughter on a "zero tolerance" model with respect to alcohol, perhaps even more so than average.  And she is left wondering what more she could have done, such as check her daughter's Facebook.  The problem with the "zero tolerance" approach, however, is that there is little to no room for harm reduction.   Many teens, like Taylor, are going to drink either way.  And the 21 drinking age often creates a false sense of security for parents, as well as increased dangers for their teenage children.  Better alcohol education, and a more relaxed view of alcohol, could oddly enough have prevented this tragedy.  A feast or famine mentality, fear of getting busted, forbidden fruit attraction, and a schizoid drinking culture all combined, in this case, to spell disaster.

We can learn a lot from tragedies like these, and how to prevent them from happening in the future.

New Organization for Lowering the Drinking Age

We at Twenty-One Debunked are clearly not alone in wanting to lower the drinking age.  Within the last week, the nation's first commercial (aka .com), non-blog website, Drink at 18, launched.  (In contrast, we're still just a blogged site--they beat us to it!)  Though they are not in any way affiliated with us, we wish them the best.  The more supporters our common cause has, the better, since there is still a dearth of websites dedicated to lowering the drinking age (compare that to the number dedicated to legalizing cannabis).  Check the site out for yourself--it's good.

Are there any significant differences between us, besides the fact that our site is primarily devoted to debunking junk science (as our name implies)?  Perhaps we have a somewhat more detailed plan of action for lowering the drinking age, but Drink at 18 is new and still has time to formulate such details.  Rome wasn't built in a day.  And any other differences are mostly cosmetic, such as the fact that we don't sell merchandise (yet).  We salute you, Drink at 18.

18 Year Old Elected Mayor--Too Bad He Can't Legally Drink

In the small town of Dawson, Iowa, an 18 year old high school senior named Colton Morman was just elected mayor.  This makes him one of the youngest mayors in US history.

We at Twenty-One Debunked believe that the idea that one can be old enough to be mayor but still not allowed to drink legally is absurd.  We wish him well.

Will Israel Emulate the American Failure?

Perhaps.  A recent government proposal in Israel, if passed, would restrict alcohol to a greater extent than it is now.  The bill would ban off-premise alcohol sales after 11 pm, furnishing alcohol to minors, and most notably would (possibly) raise the drinking age from 18 to 21.   Other restrictions may include raising the prices for spirits, banning alcohol advertising, and requiring special licenses to sell alcohol.

Allegedly, there has been an "epidemic" of teen drinking and drunkenness in just the past few years over there.  But it is unlikely that raising the drinking age to 21 would help.  Hell, they don't even enforce the current drinking age of 18!  Perhaps if they did so, along with several of the other reforms that have been proposed, the "epidemic" drinking could be reduced, or at least contained.  Attempting to emulate America's greatest alcohol policy failure since Prohibition would likely just throw gasoline on the fire.

How Common is Extreme Binge Drinking? Now We Know

We at 21 Debunked have repeatedly voiced disapproval at those who insist on calling 5 drinks a "binge," as well as noting the dearth of longitudinal data concerning the practice of imbibing 10 or more drinks in an evening, sometimes called "extreme" drinking or "extreme binge" drinking.  The Monitoring the Future (MTF) survey of middle and high school students has not been gathering data on this truly dangerous activity, so we have been left in the dark about its true prevalence.  Until now. 

Lloyd Johnston, the overseer of the survey, has recently been asking high school seniors whether they have had 10+ drinks or more in at least one occasion in the past 2 weeks.  The most recent data say 11% have done so, and 6% have had 15+ drinks in a row.  While clearly a small minority, it is not a trivial fraction either, and is probably an underestimate.  And, most relevant to the drinking age debate, these numbers have not changed significantly since Johnston began following them, despite ever-intensifying enforcement.  So recent declines in prevalence of 5+ drinks in a row appear to be somewhat misleading, especially since underage drinkers tend to undercount their drinks.  Lying (or exaggerating or minimizing) is also fairly common in teen surveys.

For what it's worth, according to the same surveys 25% of seniors and 18% of sophomores admit to having had 5+ in a row in the past two weeks, and these numbers are leveling off after a decade-long decline.  It seems that fewer teens are drinking, but the more they do when they do.  That may explain why in emergency rooms in several cities across the country, admissions related to teen binge drinking increased in recent years in spite of surveys showing less drinking.

Tracking this dangerous behavior is long overdue.  We already know that among college freshmen, 20% of males and 8% of females have done extreme drinking (10+ males, 8+ females) in the past two weeks.  But that was a one-semester snapshot in the fall of 2003, with no other years for comparison.  The rate of "binge" drinking (using the 5/4 definition) in the past two weeks was 41% for males and 34% for females, which does jibe well with known statistics (roughly 40%) that use that definition.  But one must wonder if there is even any relationship at all between the rates of drinking, "binge" drinking, and "extreme" drinking.

Indeed, from 1993 to 2005, the percentage of college students who "binge" drank (5/4 definition) in the past two weeks has not changed a whole lot, but the percentage who do so three more times in the past two weeks ("frequent binging") has gone up significantly.  And since the aforementioned study found that extreme drinking was strongly correlated with frequent "binging," the former most likely rose as well.  Further evidence comes from another study that found that the number of alcohol poisoning deaths (a good indicator of truly dangerous drinking) among college students nearly tripled from 1998 to 2005. 

Bottom line:  when you criminalize normative drinking, you inevitably normalize truly dangerous drinking.  We saw the same thing during Prohibition.  And we all pay a heavy price for it.

Would you drive a car knowing its brakes would fail 11% of the time?  Didn't think so.