A New List of 39 Recommendations (Updated)

In 1982, President Reagan appointed a special commission to study the problem of drunk driving in America. They came up with 39 recommendations, #8 of which was to raise the drinking age to 21 in all 50 states. Of all the recommendations, that was the one that got the most attention, often at the expense of the others. Most of the other 38 were just simple common sense measures, and many of these were implemented to some extent in both the United States and Canada. 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 fact, the decline was slightly faster in Canada (ditto for the UK and Australia as well, who remained at 18).  And fatalities declined in all age groups, not just those under 21.  While the problem of drunk driving has been greatly reduced in both the US and Canada, it remains persistent.  We still hear all too often about innocent people killed by drunk drivers who already have multiple DUIs on their record, in addition to countless others who simply weren't caught until it was too late.

More than a quarter-century later, a new set of 39 recommendations is long overdue. We know a lot more about the problem now than we did in 1982, and have a better sense of what works in the long run and what does not. The nature of the problem has also changed, with most of the deaths caused by so-called "hardcore" DUI offenders who drive drunk repeatedly.  By the time someone finally gets caught even once, they had already driven drunk an average of 88 times--often hundreds of times.  And it's an open secret that the vast majority (nearly 9 out of 10) of them are over 21, with 21-24 year olds being the worst offenders of all.  Thus a multifaceted and wholehearted approach is essential. But what is currently being done is both over-inclusive and under-inclusive, and progress has stalled until very recently.  And as long as we keep following outdated methods, we will surely fail to see any further progress in the future.  The updated list, devised by Twenty-One Debunked, is as follows, with those in red being the highest priorities:

1. Lower the drinking age to 18, ideally in all 50 states and DC. The more states, the better.
2. Raise and equalize all of the federal alcohol taxes to the 1991 real value of the liquor tax. That would be $21.33/proof-gallon for all beverages, proportional to alcohol content.   Use the bulk of the revenue for education, treatment, and DUI enforcement.
3. Lower the blood alcohol limit to 0.05 BAC for administrative penalties, while keep the BAC limit 0.08 for criminal penalties, as some Canadian provinces have done.   Maintain a Zero Tolerance law (0.02 BAC) for drivers under 21 and/or all drivers with less than 3-5 years of licensed driving. 
4. Increase the number of roving patrols and sobriety checkpoints for DUI enforcement, and their publicity.  Checkpoints should be considered a supplement to patrols, not a substitute.
5. Increase alcohol education programs, but make them more honest and comprehensive. An excellent model is AlcoholEdu, by Outside the Classroom. This can also be combined with social norms marketing campaigns.
6. Toughen the penalties for driving under the influence, with graduated penalties based on BAC.  See the chart below. 
7. Make fines for DUI proportional to the relative risk at a particular BAC. For example, 0.15 would be 50-100 times higher than 0.05. 
8. Restrict alcohol advertising to no more than what is currently allowed for tobacco. That means no TV, radio, or billboards.
9. Increase alcohol treatment. Require all DUI offenders to undergo an alcohol assesment to determine if they have an alcohol use disorder. If so, force them into treatment via DUI court and monitor them electronically with a SCRAM bracelet, in addition to other penalties.
10. Use fines and fees from offenders to pay for enforcement of DUI laws, to make the program completely self-sustaining.
11. For the eight states that currently lack it, institute administrative license suspension/revocation. The administrative penalty for refusing a breathalyzer or any other test should be greater than or equal to that for failing it.
12. Have mandatory jail time for all DUI offenses of 0.08 or greater, including first offenses. Make driving with 0.15 BAC or higher a felony on the first offense, and 0.08 or higher a felony on the second offense, punishable by up to 5 years in prison.
13. Those who kill or seriously injure someone else in an alcohol-related, at-fault crash should get a mandatory minimum of 10 years in prison, permanent license revocation, and forfeiture of any and all vehicles owned by that person upon conviction.
14. Do not allow plea bargains for any DUI offense.
15. For anyone convicted of drunk driving, drunk violence, or repeated drunk and disorderly conduct, blacklist them from buying alcohol or even entering a bar for at least a year or until age 21, whichever is longer.  Do the same for anyone furnishing alcohol to anyone under 18 that is not one's own child.
16. De-register any car owned (or registered) by a DUI offender, boot it, and confiscate the plates upon arrest.  Or better yet, impound the vehicle at the offender's expense.  When (if) they get their license back, or get a conditional license, give them special "scarlet letter" DUI plates. 
17. Require ignition interlocks for all conditional licenses, and for any DUI offender that gets their license back, forever.
18. Make ignition interlocks standard on all newly manufactured vehicles sold in the USA, with use and maintenance of these devices voluntary for non-offenders.
19. Abolish the "assigned risk" pools for auto insurance, or at least forbid any DUI offenders from joining them.
20. Repeal all "alcohol exclusion" laws for insurance, which have been shown to do more harm than good.
21. Make it a federal crime to drive drunk across state lines.  Punishable by a mandatory 5 years hard labor in federal prison.
22. Eliminate any rules of evidence that prohibit admission of chemical test refusals--it should be used against a DUI defendant in court.
23. Make the road test tougher--an hour long like it is in the UK.
24. Make licenses easier to lose for moving violations, especially during the first two years.
25. Bring back free driver's ed classes for all high school and college students.
26. Require all drivers involved in fatal accidents to be tested for alcohol and drugs.
27. Lift state-mandated smoking bans in bars, which have been shown to increase DUI fatalities.
28. Extend bar hours to 3 am or later, but have a one-way door policy after 1 or 2 to reduce late night bar-hopping. Or let the locals decide rather than the state.
29. Raise the gas tax by a penny each week until it is $1.00 higher than it currently is.  Call it "a penny for progress."
30. Improve public transportation, especially very late at night. Use the alcohol and gas taxes to pay for it.
31. Lift any cap on the number of taxicabs wherever it exists, or better yet, subsidize taxi service to reduce the costs.
32. Encourage the hospitality industry to set up "safe rider" programs, particularly in rural areas.
33. Limit or reduce alcohol outlet density in cities and other high-density areas, but increase it in rural areas. More rural bars within walking distance = less drunk driving deaths.
34. Dry counties and towns should go wet, especially if their neighbors are wet.
35. Abolish all social host laws, both civil and criminal. Furnishing alcohol to minors should not include merely providing a safer location to drink.
36. Put a price floor on alcoholic beverages, especially for off-premises sales.
37. Kegs and cases of beer should be sold only in beer distributors, which should close at 10 pm. A purchase age limit higher than 18 may be desirable for such bulk quantities, which are very unlikely to be for personal use. Ditto for very large quantities (i.e. multiple liters) of hard liquor.
38. Increase media campaigns against drunk driving, similar to the Australian model.
39. Last but not least, park a police car in front of every bar possible to watch for drunks getting into their cars about to drive.  Then nail them.  It would be like shooting fish in a barrel.

Recomendation #1 implies that, at the very least, we should repeal the federal highway funding penalty for doing so, and let the states use their Constitutional rights to decide for themselves. Recommendations #3, #4, and especially #21 should take care of any potential adverse effects of unequal drinking ages across states or internationally, as well as dry counties that refuse to go wet.

To avoid collateral damage, recommendation #2 should not apply to microbrewers. Their beer is already relatively expensive anyway, and those who abuse alcohol tend to go for the mass-produced, cheap stuff.

If all 39 of these recommendations were followed, the alcohol-related fatality rates should be cut by at least half in the first year alone. If only the ones in red were followed, or even just the first six, there would still be a dramatic drop in fatalities in both the short and long term. Some of them, such as #1, are a bit counterintuitive (the whole purpose of this blog explains in detail why #1 is actually a good thing rather than something to fear).

When we say graduated penalties, the table below is a good guide to what they should be:

BAC Threshold	First offense	Subsequent offenses within 10 years
0.02-0.08 (under 21 or novice, administrative only)	$250 fine ($500 if over 0.05) 30 day suspension (90 day if over 0.05) 3 day impoundment	$500 fine 6 month suspension (2nd), 1 year revocation or until 21 (3rd or 2nd over 0.05) 7 day impoundment Ignition interlock 1 year or until 21
0.05-0.08 (administrative only)	$500 fine 3 day suspension 3 day impoundment	$750 fine (2nd), $1000 (3rd) 30 day suspension (2nd), 1 year revocation (3rd) 7 day impoundment (2nd), 30 day impoundment (3rd) Ignition interlock 1+ year
0.08-0.10 (criminal)	$1000 fine Minimum 1 year revocation (or until 21, whatever is longer) Mandatory 30 days in jail, up to 6 months Ignition interlock 5+ years after re-license	$2500 fine License revoked for at least 10 years (forever for 3rd offense) Mandatory 1+ year in jail (possible felony) Possible vehicle forfeiture upon conviction
0.10-0.15 (criminal)	$5000 fine Minimum 5 year revocation Mandatory 6 months jail, up to 1 year Ignition interlock forever	$7500 fine License revoked forever Mandatory 5 years prison (felony) Vehicle forfeiture upon conviction
0.15+ (felony)	$10,000 fine Minimum 10 year revocation Mandatory 1 year in prison, up to 5 years Ignition interlock forever	$20,000 fine License revoked forever Mandatory 5+ years prison (felony) Vehicle forfeiture upon conviction

In addition to (and independently of) criminal penalties, those who blow above 0.08 or refuse the test should be given the following immediate adminstrative penalties upon arrest:

Test failure, first offense:  90 day suspension, 7 day impoundment
Test failure, second offense in 5 years: 1 year suspension, 30 day impoundment
Test refusal, any offense:  1 year suspension, 30 day impoundment 

Conditional licenses should only be given for grave reasons, be highly restricted, and require ignition interlocks.

All offenses would require completion of an alcohol education program and alcohol abuse screening, paid for by the offender. 

Driving with a  BAC above 0.08 with kids under 16 in the car should be an automatic felony, and treated like 0.15+.

In other words, though we've clearly wrestled the problem to the ground, we have unfortunately allowed ourselves to become complacent and distracted.  It's time to finish the job.

Common Sense in Alberta, Canada

The Canadian province of Alberta (just north of Montana) has had a legal drinking age of 18 since 1970, when it was first lowered from 21 along with the age of majority.  Recently, a few police chiefs have been talking about wanting to raise the drinking age to 19, which it currently is in most other provinces except for Manitoba and Quebec.  They claim it would reduce binge drinking, drunk driving, and other alcohol-related problems among young people.  However, the current Tory government of the province doesn't buy that line of reasoning, and states that they have no intention to raise the drinking age.   Premier Alison Redford says that the move is "off the table", and we at Twenty-One Debunked couldn't agree more.

Instead, the provincial government is moving forward with plans to toughen up their DUI laws and make them similar to the successful model found in their neighboring province, British Columbia.  A previous post discusses the BC success story in more detail.

Before You Go Out Drinking--Watch This:

Here is a great Australian video everyone should watch about the dangers of driving under the influence, regardless of age.  It just might make you think twice before taking such a risk.  (Warning--contains some graphic images)



Moral of the story:  Drunk driving is like Russian roulette, and you never know who will be hit with the proverbial bullet when you play.  In fact it's worse because it all too often kills innocent people who aren't playing that stupid game.  It's actually very simple to avoid:  if you plan to drive, don't drink, and if you plan to drink, don't drive.  Thus, there is no excuse.

ARRIVE ALIVE, DON'T DRINK AND DRIVE!!!

ATVs to Stop Underage Drinking? Really?

Police apparently have a new weapon in the perennial (and futile) crusade against "underage" drinking:  all-terrain vehicles.   Apparently raising the drinking age to 21, and the ever-toughening enforcement of this law, has (predictably) pushed teen drinking further and further into the woods than in the past, often into areas where cop cars can't enter.  But now, in some places (such as Enfield, CT) the police will use ATVs to patrol remote wooded areas to check for teen drinking parties.  No word yet on whether this has actually been successful in curbing "underage" drinking, but I think we already know the answer to that question, especially as far as 18-20 year olds are concerned.

In a word:  NO.

Instead of patrolling the woods in an attempt to ferret out "underage" drinkers, wouldn't it be better to use those resources to patrol the roads to hunt down drunk drivers of all ages?  That would save far more lives, but that would make too much sense, wouldn't it?

Have A Safe And Happy New Year

With the New Year's Eve festivities approaching, we at Twenty-One Debunked want to remind everyone to celebrate responsibly.  There is absolutely no excuse for drunk driving at any age, period.  We cannot stress this enough.  It's very simple--if you plan to drive, don't drink, and if you plan to drink, don't drive.  And there are numerous ways to avoid mixing the two.  Designate a sober driver, take a cab, use public transportation, crash on the couch, or even walk if you have to.  Or stay home and celebrate there.  Or don't drink--nobody's got a gun to your head.

The Truth is In: Swift Justice Works

According to the latest traffic fatality statistics, there was a 40% drop in alcohol-related traffic deaths in the Canadian province of British Columbia (BC) in the twelve months ending on September 30, 2011 compared to the same period a year ago.  Such a massive drop in a single year is quite noteworthy indeed.  While part of that may be due to significantly higher gas prices in 2011, the decrease in fatalities was apparently much larger in BC than the rest of the nation.  So it had to be something specific to that province as well.

About a year ago, there were significant changes to BC's impaired driving laws.  For example, under the new laws, if a driver is stopped by police and blows 0.05-0.08 BAC, the driver will immediately lose his or her license for three days for a first offense, a week for a second offense, and 30 days for a third offense.  Vehicles may be impounded for up to the same number of days each time.  If a driver blows 0.08 or higher, or refuses to be tested, he or she will lose his or her license for 90 days and the car may be impounded for up to 30 days.   There are also stiff fines and towing and storage costs, and an ignition interlock device must be installed (at the driver's expense) when the impoundment ends.  Thus, total costs can range from $600 to $4060 depending on the severity and number of offenses, and that alone can be a deterrent in itself for many people. 

These administrative roadside penalties are also quicker and easier to enforce (and process) than the Criminal Code penalties as well due to their streamlined nature.  Prior to the law change in September 2010, numerous drunk drivers (in fact the majority) were getting off relatively easily with only a 24-hour driving ban, while only relatively few were nailed with criminal charges and convictions.  Like the rest of Canada, there were fairly tough laws on the books, but enforcement of those laws was another story.  But since then, things have gotten much more consistent, and since police have spent less time processing suspects, they have had more time to catch drunk drivers.  And if you look at the data, you will see a decrease in criminal charges (despite presumably increased enforcement) since then along with the decrease in deaths.  It has been so successful that now the neighboring province of Alberta wants to adopt similar laws.

However, in November the BC Supreme Court had blocked some of these penalties from being enforced, after ruling that it violated the Canadian Charter of Rights and Freedoms because there was "no adequate avenue for review." Effectively, that aspect of the law was held to be unconstitutional by Canadian standards due to lack of recourse (i.e. due process) for those busted.  The three-day license suspensions and impoundments, on the other hand, can still be enforced for those who blow in the "warn" range of 0.05-0.08, along with the rest of the penalties, but for those who blow above 0.08, things will revert back to the old law until the current law is rewritten to comply with the Charter.  It remains to be seen whether these sanctions will be reinstated, and if not, what effect this will have on traffic fatalities in the future.

In the USA, most states have at least a milder version of what BC had instituted in 2010, usually minus the vehicle impoundment.  Called "administrative license suspension/revocation" (ALS/ALR), it has generally held up in the courts provided that there is at least some semblance of due process, which is typically just an informal DMV hearing.   This type of law has proven to be highly cost-effective in reducing traffic deaths.  And while a temporary license is generally given pending the hearing, short-term impoundment of the vehicle and the driver immediately following arrest is not unprecedented (see "John's Law") and can very easily occur in some states.  But all of these laws need to be strengthened and enforced better, as alcohol-related traffic fatalities remain unacceptably high despite being at a record low.   Since we now know what works and what doesn't, what are we waiting for?

UPDATE:  On Dec 23, just in time for the holidays, the judge who struck down parts of the controversial BC law ruled that the entire law can temporarily remain in effect as written until June 30, 2012, citing public safety concerns.  The province has until that date to amend the law so it will comply with the Charter, or else it will be automatically void after that date.  Which can and should be easily done simply by creating some kind of appeals process, and confirming any failed roadside breath tests with a more accurate machine.  That said, all penalties are back on the menu for now, so drunk drivers beware.

So Where Do Very Underage Drinkers Get Their Booze?

All 50 states and DC have a legal drinking age of 21 thanks to federal coercion, but apparently there are some parts of the country where the average age of onset of drinking is as low as 12.  Think about that for a moment--that's nine years below the legal age, and that's the average in some communities!

So with all of this very underage drinking going on, with numerous kids starting to drink nearly a decade before they are legal, where are they getting all that booze?  The answers can be found in a survey of kids in one such community in South Dakota.  And 37% of the kids surveyed said that friends over age 21 would buy it for them, while 8% got strangers to buy for them and 4% had other means.  But wait--wasn't raising the drinking age to 21 supposed to stop kids under 18 from getting their older friends to buy for them?  Guess not.

Of course, the average age of onset in the USA as a whole has generally been in the 16-17 range since 1965 despite fluctuations in the legal drinking age.  And the average age at first drink actually dropped from 16.6 in 1980 to 16.2 in 2002.  Even 8th graders (13 year olds!) can apparently their hands on alcohol more easily than even cigarettes, which have an age limit 18 in 46 states (and often poorly enforced).  There seems to be little to no correlation between the legal drinking age and the average age of onset of drinking.  But if not that, what does explain why some communities drink earlier (and/or more so) than others?  Like the above-referenced article points out, a combination of socioeconomic disadvantage, low alcohol prices, and the drinking patterns of their parents and grandparents seems to be the main culprit.  And there is nothing at all surprising about that.

A community group has made recommendations to address the problem.  Such recommendations include restricting alcohol advertising in the area, raising alcohol taxes, working with retailers on pricing and the placement of alcohol in stores, and increasing compliance checks on retailers by law enforcement.  We at Twenty-One Debunked believe that these commonsense measures are a good idea overall, and would support them even more if the drinking age was lowered to 18 as well.  Remember that the success story of Puerto Rico did not require a drinking age of 21 to succeed.  And nor did America's experience with tobacco use reduction over the past few decades require an increase in the smoking age to 21.

Happy Drink Nothing Day!

You have probably heard of Buy Nothing Day.  Celebrated on Black Friday, the day after Thanksgiving and the biggest shopping day of the year, this self-explanatory holiday is meant to be a protest against consumerism.  But perhaps you didn't know that the biggest drinking day of the year is the day before Thanksgiving.  That's right, it's not New Year's Eve, but Thanksgiving Eve.

Thus, last year we at Twenty-One Debunked have decided to create our own protest holiday, Drink Nothing Day.  It is designed as a way for people 21 and over to show solidarity with those under 21 by not drinking any alcohol that day.  To observe this holiday, which can only logically be done by folks over 21, one must not drink any form of alcohol at all during the entire 24 hours of that date, as well as the following day until sitting down for Thanksgiving dinner (or until the sun goes down, whichever occurs earlier).  Then, one may drink, but one must give thanks that prohibition no longer applies to him or her.  Other things include wearing two black armbands:  one to symbolize those soldiers who died before being able to drink legally in the very country they served, and another to symbolize those under 21 who were killed by a drunk driver over 21.

We will continue to observe this holiday until the drinking age is lowered to 18 in all 50 states.

Yet Another Sketchy Study--DEBUNKED!

A recent study now claims that raising the drinking age to 21 saves the lives of roughly 1200 women per year who otherwise would have died of suicide or homicide, including later in life as well.  The pro-21 crowd (and the media) are really eating it up.  But is it really true, or should we be skeptical?

It turns out that there are in fact several reasons one should be skeptical of such an audacious claim.  First of all, there was no noticeable effect of the drinking age on suicide and homicide rates among the general population exposed to the law change--only when the results were separated by gender was any sort of pattern noticed, and only among women born after 1960.  The fact that men (who tend to drink more than women, and who also are more likely to kill themselves and others) were completely unaffected is very difficult to explain away assuming the effect is genuine.  Secondly, the odds ratios were fairly small, 1.12 and 1.15, and any odds ratios less than 2.0 ought to be taken with a grain of salt (if not a whole pound).  It could very likely be the result of chance, bias, or confounding factors.  Thirdly, the study only looked at where the individuals were born, not where they lived at age 18. Fourthly, comparing the USA with countries with lower drinking ages does not appear to support the claim that allowing 18-20 year olds to drink results in higher homicide and suicide rates.  For example, Canadians of both genders have lower homicide rates than Americans, and suicide rates that are intermediate between the lower 48 states and Alaska.

Unfortunately, we were unable to access the full text of the study, so we don't know what confounders (if any) the authors attempted to adjust for, except for state and birth-year fixed effects.   However, since summaries of the study say that the effect was seen in 38 out of 39 states, that implies that the 12 states that did not change the drinking age at all (remained at 21 throughout) were not included.  This is important since that would be a rudimentary way to test for secular trends, as we have done in this previous post.  So many other things have changed during that time, making it difficult to tease out the impact of the drinking age change.  And why weren't women (or men for that matter) born before 1960 affected?  This study seems to leave the reader with more questions than answers.

The true believers in the 21 drinking age will need a lot more convincing in the error of their ways, however. That's why we took the initiative and looked up the mortality data ourselves in the publicly available CDC WONDER database. And here is what we found:

Female homicides, all USA:

Female suicides, all USA:

Female homicides, "always-21" states:

Female suicides, "always-21" states:

Female homicides, "18 at some time" states

Female suicides, "18 at some time" states

The above charts look at the female homicide and suicide rates of various age cohorts (15-19, 20-24, 25-34, 35-44, and 45-54) for the years 1979-1998.  The study we are critiquing used the years 1990-2004 instead of 1979-1998, but we felt the latter would be more appropriate since a) the WONDER data are grouped into 1979-1998 and 1999-2007, each with somewhat different death codes, and b) more cohorts would be included.  Voila--there is essentially no difference in the patterns of either rate over time between the various groups of states (all states, states that were always 21, and states that were 18 at some time) despite changes in the legal drinking age.

It is really transparent and obvious why a study like this would come out now, at a time when many policymakers are seriously considering lowering the drinking age.  After the arguments about drunk driving fatalities have been debunked time and time again, it was necessary to come up with other "public health" arguments for continuing to violate the civil rights of 18-20 year old young adults.  But make no mistake--these arguments are really just a more socially acceptable way of saying that some people's rights are more important than others.  That is, the antithesis of what America supposedly stands for.

Australia Revisited

Every once in a while, it seems that a vocal minority of Australians want to raise their country's drinking age (currently 18) to 21.  Recently, this issue has been revisited due to the nation's notorious drinking problem, in a land where binge drinking is an art form among all ages.  But many Australians are not at all convinced that raising the drinking age will solve anything. 

A case in point is the New South Wales Police Commissioner, Andrew Scipione, who originally suggested that the drinking age should be raised but is now against the idea.  He knows that it would not fix anything, and that the real problems have other solutions.  For example, Professor Sandra Jones (University of Wollongong) notes that raising the prices of alcohol (i.e. through taxes and/or a price floor), reducing overall availability, and reducing advertising would all go a long way to reducing Australia's drinking problem, citing the nation's experience with cigarettes.  But more fundamentally, the problem is largely a cultural one that raising the drinking age simply won't do jack to fix.  And all they have to do to is come to America to see what we mean.

For more info about Australia's drinking age debate, see our previous post about this issue.