Choose Responsibility

A new Associated Press study, announced yesterday, has revealed that 157 college-age people (aged 18 to 23) drank themselves to death between 1999 and 2005, and that the number of alcohol-poisoning deaths per year rose from 18 in 1999 to 35 in 2005.  Interestingly, 83 of the people who died were under the legal drinking age of 21. 

Additional analysis revealed that college students are more likely to die from binge drinking-related alcohol poisoning than non-college students, and that freshmen are most at risk during their first semester at college.  With the legal drinking age set at 21, people (especially underage drinkers) are dying from binge drinking, and the number of deaths is continuing to climb due to the common mentality of “if you’re under 21 and someone’s got alcohol, you’ve got to drink it, because you never know when somebody’s going to have it again.”   

Some colleges have begun to adopt programs to educate students about responsible drinking—an important first step that will hopefully have some good consequences in the future.  Regardless, this new study really points out a vital question:  Is 21 working?

A new study, published in Accident Analysis and Prevention, has examined minimum legal drinking age 21 and drunk driving fatalities over the last few decades, and concludes that there has been decreases in teen drunk driving fatalities since MLDA 21 went into effect.  The study also reports that laws enforcing strict punishment for the use of fake IDs are significantly effective in reducing drunk driving fatalities, according to U.S. News & World Report.  Interestingly, one of the primary researchers for the study is a former board member for MADD…

This review by U.S. News & World Report is a prologue to an upcoming, larger article on teen brain research and the role of alcohol.  We are interested to see what the authors come up with, and will keep you posted on the status of that piece.

The results of a nationwide survey looking at the social context of underage alcohol use, performed by the Substance Abuse and Mental Health Services Administration, were released today.  This National Survey on Drug Use and Health looked at many aspects of alcohol use and drinking behaviors amongst 12-20 year olds, and the major finding capturing the headlines is that underage drinkers are obtaining alcohol from adults, including parents and guardians.  Blaming parents and adult family members for underage alcohol use and labeling them as “enablers” may be a hasty conclusion, however.  The study indicates that 40% of underage drinkers obtained alcohol from an adult (someone over 21) for free in the past month.  However, one in four youths received alcohol from an unknown adult, and only one in twelve youths received alcohol from a parent or guardian. 

More importantly, the study does not clearly specify how parents are giving their kids alcohol.  A glass of wine at a family dinner might be statistically the same as a mother buying a keg for a son’s graduation party; however, the implications of these actions are much different.  Conclusions from the study stress that parents should be involved by providing proper guidance and ensuring their kids’ safety by preventing them from the dangerous act of drinking.  Is it possible, however, that allowing a son or daughter a glass of wine with dinner helps teach responsible drinking, and thus can be considered parental guidance?  A recent Time Magazine article discussed in a June 20^th post does an excellent job debating this issue.

In general, we are having a hard time seeing how the results of this study support a legal age 21.  Kids are finding alcohol and drinking underage, and one in five underage drinkers have binged at least once in the last month.  Moreover, this drinking is happening in private, unsupervised locations, and over half of underage drinkers have drank in someone else’s room or house during the past month.  If you ask us, that is more scary than the fact that some youths are sharing a beer with mom and dad. 

We encourage you to visit this ABC article for more information, links, and comments.

The London subways were a nasty sight on the morning of June 1^st due to the impromptu party the previous night, when British teens and young adults celebrated the last hurrah for drinking on public transportation.  The Economist discussed this party and drinking, in general, in a recent article, and noted the changes in drinking patterns of Britain’s youth.  While more teens now report never trying alcohol, those who have tried it are drinking larger quantities, and this is especially true for those 11-13 years old.  Demographic changes have not been drastic enough to explain this shift in drinking behavior, and it is believed that more hostile regulations on drinking in pubs and bars have encouraged teens to move their drinking elsewhere, such as the trains, parks, or street corners.  In pubs, people must behave properly in order to prevent being thrown out, and social pressures and norms tend to keep people in line and behaving according to the status quo.  Supervision and social restraint disappear when teens drink in private and are more free to do whatever they want, get as drunk as they want, etc.  Along with increases in quantity of alcohol consumed, spirits are now more common than ever before.  They also tend to be consumed when teens drink on their own, and not in pubs which often offer more beer and wine. 

We believe that these points echo our own ideas about the drinking age in the U.S. since, just as British young adults want to avoid the strict bars and drink on their own, Americans who cannot enter bars and legally drink also turn to drinking on their own.  Dangerous binge drinking often results, which can get out of control due to a lack of monitoring and supervision at private parties.  Lowering the drinking age could help prevent binge drinking by allowing young adults an opportunity to drink in public settings (bars, restaurants) where they might feel it is more inappropriate to binge drink and get ragingly drunk.  Their behavior could also be better monitored and supervised by others; a bartender is more likely than a drunk friend to cut someone off.

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We are pleased by the coverage the drinking age received in this week’s issue of Time (“Should the Drinking Age be Lowered?,” June 16, 2008), but feel that there is more to be said about the several points John Cloud makes to defend his conclusion that challenging the 21 year-old drinking age is a misguided endeavor

• “First of all, while binge drinking is a serious problem, the data do not show that it has gotten worse since states raised their drinking ages” Well, frankly, that depends on where you’re looking. According to the CDC, 18-20 year-olds experienced the steepest increase in binge drinking rates—56%–between 1993 and 2001. Amongst the entire population of underage drinkers (12-20 year-olds, as according to the National Survey on Drug Use and Health), overall rates of binge drinking increased from 15.2% to 18.9% between 1991 and 2003. During the same time period, there was a steady decline in the prevalence of alcohol consumption among 12-20 year-olds. While fewer young people are drinking, those who choose to drink are drinking more, and drinking more recklessly. Neither by these indications, nor those Mr. Cloud presents in his essay has the 21 year-old drinking age and the current approach to educating young people about responsible alcohol use had the intended effect of reducing both the use and misuse of alcohol among adolescents and young adults.
• “No researchers have documented an increase in the percentage of alcohol-poisoning deaths among college students, although the raw number has probably increased with the growing college population.” In fact, several well-regarded, widely cited studies have looked at the rate of non-traffic, alcohol related injury deaths among young adults. Their findings? Between 1998 and 2001, these deaths increased from 991 to 1151—a rise of 16%, with the indication of a continued upward trend at a rate outpacing the size of the population. An increasing number of lives are being lost to alcohol off the highways, and surely these lives deserve as much consideration in this argument as those lost on the highways.
• “Choose Responsibility supporters have also claimed that other countries that haven’t raised their drinking ages — including Canada and the United Kingdom — saw their drunk-driving fatalities drop even faster than in the U.S. But that’s simply not true.” Canada, which is for many reasons the most comparable nation to the United States in terms of driving habits and cultural tendencies, experienced a 28% decline in alcohol related traffic fatalities between 1982 and 1992. In this same time period, which represents the most substantive decline in traffic fatalities since data was first gathered, the United States experienced a 26% decline. Though it varies by province, the drinking age across Canada is either 18 or 19 and remained as such throughout the time period in question. Furthermore, the National Highway Traffic Safety Administration has noted that where youth drinking and driving is concerned, Canadian reductions followed a virtually identical pattern to the United States. Their conclusion? “This means that the changes [in youth drinking and driving rates in the US and Canada] must have resulted from some combination of the difficult-to-assess educational and motivational programs and from other factors outside of traffic safety. This conclusion suggests that a substantial portion of the reduction in the United States also resulted from these same causes”

To clarify in a more general sense, Choose Responsibility believes foremost that the 21 year-old drinking age is a policy whose intended and unintended consequences must be considered side by side, and that cause and effect relationships drawn between it and measurements of a its success—namely the decline in alcohol related traffic fatalities seen throughout the 1980s and early 1990s—must be extended to the many other areas of our society that this law has affected. To ignore the reality that excessive, reckless alcohol use among young people has either remained impervious to change or increased in the past decade is to minimize the very real threat that such behaviors pose to all Americans, regardless of their age.

We do not believe, as Mr. Cloud suggests, that lowering the drinking age would immediately address the pervasive binge drinking culture endemic to young people in America. We do believe that alcohol education is sorely lacking in its ability to prepare young people for the realities they will face in adult life, which for all will involve decisions about the role of alcohol. We do believe that there are better ways to ensure young people have the ability to make responsible decisions about alcohol use than our current prohibitionist tack. Given this, we ultimately believe that the time has come for new voices and fresh ideas in the debate over the legal drinking age—that much, Mr. Cloud has correct.

Over 100 high-school students from New Jersey were caught and breathalyzed this past Friday night when police broke up a party in West Dover, VT, the Rutland Herald reported on Sunday. The police ended what was supposed to be a three-day after-prom party, taking place at three houses that the teens had rented, and 62 students received citations for being in possession of a malt beverage. Such a large scale party once again brings to light the issues of underage drinking and binge drinking, and the party’s isolated location in Southern Vermont highlights the problem of the secretiveness, stealth, and complex planning that often accompanies underage drinking—something that can increase its dangerousness.

The New Jersey teens are most likely juniors and seniors in high school and, therefore, would still be unable to drink even if the drinking age was 18. However, the furtive nature of their party and the huge quantity of alcohol present (police found 18 kegs of beer, 8 bottles of vodka, and 5 cases of beer) demonstrates a culture of secret binge drinking characterized by strategic planning, execution, and excessiveness that transcends the high-school/college boundary and is present amongst high school and college students, alike. Not being allowed to drink in public, such as at bars and restaurants, fuels this binge drinking culture, as young adults are driven to drink heavily in short amounts of time, in an attempt to “pre-game” parties and events.

The recent Vermont party also raises the issue of parental enabling of underage drinking, since the fact that the teens had three rented houses and such a large amount of alcohol suggests that parents may have been involved in planning the party. Recently, social host laws have been enacted in some communities to try and inhibit this parental involvement by claiming that parents will be held responsible and steeply fined for underage drinking in their homes. As the details of the Vermont party are investigated further, more information as to the involvement of parents will hopefully become available.

Science does not stand alone — its findings become meaningful when viewed at large, not selectively, and when its formulas are placed in an everyday context, and its principles critically evaluated. By claiming that science rests on one side of the drinking age question, and neglecting the scientific and mathematical findings that disprove its case, the authors of yesterday’s editorial in USA Today illustrate a narrow-minded view of science. The authors’ attempts to crouch behind science are even more disappointing, having admitted in the first half of their article the dangerous unintended consequences generated by Legal Age 21.

If science supports the pro-21 argument, then why do the other 50 studies (surely, not cited by the newspaper) fail to support a cause-and-effect relationship between a higher drinking age and lower fatalities? If science proves that the 21 year-old drinking age is responsible for a decline in traffic fatalities and consequently, lives saved, then why have more lives been saved by seat belts and airbags in 2004 and 2005 than in the entire history of Legal Age 21? And further, how would the authors and MADD explain the (scientific) fact that alcohol-related fatalities have reached their highest level in the last decade?

 Then there is the social reality of alcohol in the lives of young adults — made more difficult and dangerous by Legal Age 21.  Drinking has been forced out of the open, into unsupervised venues where risky binge drinking has become the norm. Why are young adults, excelling in many other ways, choosing to put their lives at risk by consuming dangerous quantities of alcohol? The answer is tied to a scientific term called reactance motivation, and a certain historical movement called Prohibition. If we infantalize individuals who in all other instances are considered adults, it is not a surprise that we receive increasingly infantile behavior. Over 1,000 young adults aged 18-24 die every year from alcohol-related causes taking place off the roads and highways — victims of risky drinking practices. These dangerous consumption patterns are documented and widespread, and bear anatomical and neurological consequences far outweighing those associated with the moderate consumption of alcohol.

 Science does not rest on either side of the question, and needs to be evaluated seriously and realistically. There are too many questions left unanswered, and too many lives lost, to risk using limited science as a shield from social reality.

In the interest of full disclosure, we present below both the link to MADD’s press release and the text of Choose Responsibility’s response.

http://www.madd.org/news/12045

Science speaks for itself” (MADD press release). Indeed it does. While it is true that “almost 50 peer-reviewed studies” have “found that an increased drinking age significantly lowers alcohol-related fatalities” (MADD press release), an equal number of studies have found no relationship between the drinking age and alcohol-related fatalities (Wagenaar and Toomey, 2002).

Thus, if science is allowed to speak for itself, we must not listen selectively.

While it is true that alcohol-related traffic fatalities have declined since the age was raised to 21, the downward trend began before the law was changed, and it has remained essentially flat for the last decade (NHTSA). Meanwhile, more than 1,000 18-24 year-old lives are being lost to alcohol each year off the roadways, and this number is increasing at an alarming rate (Hingson, 1998, 2001). These lives are being put at risk in the dark corners and behind the closed doors to which Legal Age 21 have banished them.

Thus, we need to look at all the ways alcohol, and the drinking age, put lives at risk, not just at traffic fatalities. The 21 year-old drinking age has forced drinking underground. Clandestine, goal-oriented, unsupervised drinking, a consequence of Legal Age 21, is putting an increasing number of young adult lives at risk.

While it is true that “the neurotoxic effect of excessive alcohol use” (MADD press release) can affect the development of the adolescent brain, no one is advocating excessive alcohol use. Researchers involved in studies of the adolescent brain have stated that, unless the drinking age is raised to 25, when the adolescent brain is fully developed, there is nothing magical about some other age. Indeed, at least one such researcher, Professor Scott Swartzwelder of Duke University, has stated that his studies do “not mean that an 18 year-old who has a beer or two every couple of weeks is doing irreparable damage to her brain. It is the 18 year-old (or 30 year-old for that matter!) who downs five or six drinks on his way to a dance that worries me.”

Thus, we mustn’t be misled by scare tactics. We must listen carefully to what scientists are saying. Most of the rest of the world, where the age is lower than 21, exhibits no evidence of brain impairment. Moderate, responsible use of alcohol poses little neurological risk. Excessive use of alcohol, at any age, may be health- or life-threatening. Clandestine drinking, fostered by Legal Age 21, raises that threat.

 We commend Dale Pratt-Wilson for working to curb “underage” drinking. She has devoted her career to keeping alcohol out of the hands of our nation’s youth, and has collaborated with organizations such as Leadership to Keep Children Alcohol-Free in order to curb drinking amongst children aged 9 to 15. We applaud this mission. However,  in today’s The Daily Tar Heel, Ms. Pratt-Wilson unabashedly confuses young adults with children — infantalizing those who, in every other respect, are adults.

The opinion piece cites the work of H. Scott Swartzwelder, Clinical Professor of Psychiatry and Psychology and Neuroscience at Duke University and member of the Board of Trustees of Choose Responsibility. Swartzwelder proves that the adolescent brain is not fully developed until age 25; however, the researcher himself agrees that 21 is not a magical number. Rather, Legal Age 21 has forced drinking underground and led to excessive, dangerous, and lethal drinking. It has created a culture of pregaming and drinking games, where drunkenness is the goal and alcohol consumption is forced out of safe, communal spaces and into dorm rooms, off-campus houses, and underground locales.

A quick glance at Europe disregards the markedly different historical drinking cultures of its northern and souther countries. History and an extensive body of cross cultural research would suggest that cultural attitudes towards alcohol use play a far more influential role than minimum age in these countries, which have more drinking occasions per month, but boast fewer dangerous, intoxication occasions.

Enforcement is not the answer. For every 1,000 incidences of underage alcohol consumption, only two result in arrest or citation. The cost of  “improved enforcement resources” is exponential and will further drive drinking underground. The fact is, the majority of college-aged students drink — in unsafe environments without adequate education or guidance. Infantile behavior is a product of infantalization. Adults will act like adults when the law is synchronized with reality.

Addiction expert and author of the recent book Addiction Proof Your Child Stanton Peele was interviewed recently by CNN on how parents should teach their children about alcohol. Along with his 19 year-old daughter, Anna, he discusses the importance of introducing adolescent children to alcohol in the home, modeling responsible behavior, and allowing them to sample alcohol on family occasions. Peele argues that taking such an approach is proven to lessen the likelihood of binge drinking and that more American parents need to play an active, supportive role in teaching their children about alcohol.

He says many of the programs set up to stop alcohol abuse contribute to the teen binge-drinking crisis. Any program that tells kids flatly not to drink creates temptation, he says. “Preparing your child to drink at home lessens the likelihood that they are going to binge drink,” he says. “Not sharing alcohol with your child is a risk factor for binge drinking.”

Peele’s advice is straightforward, responsible, and realistic. The vast majority–over 90% of young people who drink–start drinking before age 21. Adolescents will be exposed to alcohol before they are 21, likely in situations where their peers are drinking excessively and illegally. There is nothing new or revolutionary about this argument–in most other cultures (which incidentally have lower rates of youthful binge drinking…go figure!), alcohol is introduced in a family setting where norms about its use are instilled and it is held up as a food source rather than an intoxicant.

Yet apparently evidence from centuries of this practice around the globe aren’t enough proof for Partnership for a Drug-Free America.

“That’s ridiculous,” says Calvina Fay, executive director of the Drug Free America Foundation. “By allowing teens to drink,” Fay says, “you are giving permission to your children to do harmful things.”

Fay’s statements are reactionary and short sighted. Consuming alcohol is a normative experience for young Americans. Denying that reality, and chastising parents who are giving their children essential experience by serving alcohol in the home is dangerous and has perpetuated the culture of excess we are currently facing. We need to encourage policies that make moderate use an option for young adults, rather than supporting an unrealistic, no use policy for 18-20 year-old young adults.

Bottom line: Prohibition doesn’t (and has never) worked!