21 to Drink? The Debate Around America’s Outlier Status 

    America’s minimum drinking age law, set nationally at 21 since 1984, appears to be written in stone. But in 2008, a glossy campaign to lower the drinking age, called the Amethyst Initiative, shook up the age-old debate about youth drinking for the first time in decades. Named for the Greek legend claiming the purple quartz protected people from the ills of drunkenness, the campaign was started by John McCardell, a former history professor and president of Middlebury College in Vermont, who over the years grew wary of campus drinking culture.

    The initiative, whose motto was “Rethink the Drinking Age,” garnered coverage across mainstream media and racked up support among college students, administrators and more than 100 college presidents, from Duke to Dartmouth to Johns Hopkins.

    This [21] law has been an abysmal failure,” McCardell told 60 Minutes in a 2009 segment about the debate he ignited. “It hasn’t reduced or eliminated drinking. It has simply driven it underground, behind closed doors, into the most risky and least manageable of settings.”

    Young people indeed regularly flout the drinking age law. Government surveys show that 2.2 million adolescents aged 12-17 drank alcohol in the past month, while 1.2 million report binge drinking in the past month.

    If those figures seem high, they used to be much higher. Since the 21 law passed in the ‘80s, youth drinking has steadily declined in the US. But college drinking, especially binge drinking—defined as five or more drinks in two hours for men, or four for womenis a more stubborn curve to flatten.

    It was binge drinking among college students aged 18, 19 and 20 that most concerned the Amethyst Initiative. McCardell and the college presidents believed that the law, by requiring secrecy around underage consumption, created an allure for alcohol. So they urged Congress to rethink the Uniform Minimum Drinking Age Act of 1984, which threatened states with millions of dollars in lost highway funding if they set the drinking age lower than 21 (Fox News later called this move “blackmail” against the states).

    South Dakota challenged the constitutionality of the drinking age law in the 1987 Supreme Court case South Dakota v Dole, but the court upheld the federal mandate—21 to drink has remained the law of the land ever since.  

     

    An Age-Old Argument

    “Debates about drinking are as old as time,” Joy Getnick, a historian who wrote her doctoral thesis on “The Drinking Age Debates,” told Filter. “It’s not a modern issue. Some of the first drinking laws dating back to the 1600s were about unaccompanied minors in saloons.” From a historian’s perch, Getnick says the question at the heart of the argument is whether laws can, or even should, govern private behaviors.

    Americans have long debated when to drink, what to drink, where to drink and how to drink. So McCardell’s campaign to lower the drinking age tapped into a volatile history. After the repeal of Prohibition in 1933, most states set the legal age to drink at 21. Those foundations began to shake in 1971 after the passing of the 26th Amendment, which lowered the voting age from 21 to 18. Several states then lowered the drinking age.

    The termblood borders was popularized to describe deadly crashes involving young people crossing state lines to drink where it was legal.

    Young men being shipped across the world to fight in Vietnam also loosened up attitudes to alcohol. A popular refrain of the time captures the rebellious mood: If I’m old enough to vote and I’m old enough to die in combat, I’m old enough to have a beer. It does sound convincing, until one asks whether 18  is also too young to be shipped off to war.

    Some lowered drinking ages in the ‘70s created conflict between neighboring states that had different laws. The termblood borders was popularized to describe deadly crashes involving young people crossing state lines to drink where it was legal. Research began to show a national spike in fatal car crashes among drunk and underage drivers.

    Soon, drunk driving was a hot-button issue and Mothers Against Drunk Driving mobilized support for raising the drinking age. Since its inception in the ‘70s, MADD has helped put more than 1,000 new drinking laws on the books across the country, ranging from harsher penalties for drunk driving to sobriety checkpoints.

    MADD played a part in pressuring President Ronald “Government-Is-the-Problem” Reagan to sign the 1984 Uniform Minimum Drinking Age Act into law, even though it ran counter to his states’ rights stance. Since then, no state has been willing to gamble its highway funding on lowering the drinking age.

    McCardell personally believed the drinking age should be lowered to 18, in line with most of the world. He emphasized that he didn’t just want to change the law, which he deemed unenforceable, but hoped to refashion the national drinking culture, especially on college campuses. Instead of using the blunt instrument of criminalization to control behavior, he advocated for a massive education campaign to teach young people how to avoid negative consequences like alcohol poisoning and dissuade them from drunk driving.

    He thought the way college kids learned to drink was dangerous, and that the 21 law was part of the problem. Aside from the forbidden-fruit aspect, he also said the law prevented open and honest dialogue about drinking—the illegality forced adults to take a “Just Say No” approach and deny the reality that young people are already drinking.

    Caleb, who preferred to only use his first name because he belongs to an anonymous recovery support group, told Filter that the only education about drugs and alcohol he received in high school was from DARE officers who spoke to his science class. Before Caleb graduated from high school in 2009, college partying loomed large in his mind and he wanted experience drinking before he got there. So one weekend, when his parents were out of town for his brother’s soccer tournament, Caleb set out to learn his limits.

    The 21 law ultimately did not deter him from drinking, but it did prevent reality-based education.

    “I ended up getting black-out drunk at my parents’ house,” he said. The 21 law ultimately did not deter him from drinking, but it did prevent reality-based education about alcohol and how to drink it without harming himself or others.

    Caleb continued to struggle with his drinking in college, until he found support through therapy and LGBTQ-friendly mutual-aid support groups. He’s not sure whether the law is a major determinant in youth drinking either way, but he does believe better education is sorely needed. “Since it’s illegal, they can’t tell you how to drink. You have to figure it out for yourself and sometimes that doesn’t go well.” Today, he’s studying to get his PhD in public health and focuses his research on substance use.

    The kind of excessive, unsupervised drinking Caleb engaged in throughout college was what most alarmed McCardell and many of his supporterssome of whom were parents who lost their kids due to college drinking escapades that turned deadly. But after gaining some traction and sparking a national debate, the Amethyst Initiative slowly fizzled out, and the drinking age debate fell out of the news cycle.

    There is no one reason why McCardell and the college presidents failed, although a public feud with grieving mothers is an unenviable position for any campaign. In a press release, MADD criticized the Amethyst Initiative as “misguided” and scolded the college presidents for “deliberately misleading… the public on the effectiveness of the 21 law.” Perhaps states just want their highway funding. Maybe the mountain of favorable public health research for the 21 law was too high a hurdle. Raising the drinking age is widely accepted to have caused a reduction in traffic fatalities, although this has sometimes been contested.

    “Since the drinking age was raised, the percentage of people under the age of 21 who engage in binge drinking has been more than cut in half,” Ralph Hingson, the director of the National Institute of Alcohol Abuse and Alcoholism’s division of epidemiology and prevention, told Filter. “Alcohol-related traffic deaths are also down 80 percent.”

    In 2009, while the Amethyst Initiative was still gaining steam, public health researchers revisited the evidence of the 21 law and declared “case closed” for the drinking age debate. According to the researchers, science definitively proves the 21 law has been good for society and improved youth drinking on a host of outcomes.

     

    The Case Isn’t Closed

    The case may be closed among researchers who study traffic safety and public health. But other scholars and experts believe there is ample reason to keep the drinking age debate open, and continually question any law that restricts the rights and liberties afforded to adults in the US. 

    Across most of America, the age of majority—the age at which one is considered an adult—is 18.

    Historians, criminal justice scholars and harm reductionists are among those who raise thorny questions and criticisms about the 21 minimum. “Large-scale policies like the [minimum legal drinking age] are not to be set in stone; they instead should constantly mature as a result of developing research and the evolving needs and demands of society,” a group of scholars at Temple University’s Department of Criminal Justice wrote in response to their colleagues’  bold assessment that the “case is closed” on the debate.

    The Temple researchers quibble with the methods used to show that the 21 law itself is responsible for fewer traffic fatalities. The variables in play are endless: better roads, safer cars, ubiquitous seat-belt wearing, medical and surgical advancements, ride-sharing apps and cell phonesall developments that have radically changed driving safety since the ‘80s. Then there are questions like, what time of day was the crash? What was the weather? How experienced was the driver? That’s a lot to control for.

    “Have all extra-legal methods of reducing the harms been exhausted before employing criminal sanctions?”

    Focusing the lens on proving this one law led to overwhelmingly positive outcomes is too narrow, argue the Temple scholars, who are instead interested in the moral and philosophical questions surrounding such a sweeping policy.

    For starters, are criminal penalties the best line of attack to achieve a safer and healthier society? “Have all extra-legal methods of reducing the harms been exhausted before employing criminal sanctions?” they ask. “These laws are positioned to punish young people who merely imbibe alcohol and do not cause any further damage to themselves or others.”

    Instead of applying criminal penalties, leaving “blemishes” on young people’s record that may impact their future, the Temple group aims to reframe the debate. What if, they wonder, instead of criminal laws, the government and rest of society emphasized non-punitive strategies like harm reduction, higher taxes, breathalyzers in cars, sobriety checkpoints andlike McCardell argued forscientifically validated health education for young people? With all these in place instead of the 21 law, what would the outcomes look like?

    Research shows that one of the best ways to curb alcohol consumption is not through tough laws, but by raising prices through higher taxes. Higher prices are especially effective among younger people who are more sensitive to price fluctuations. And although such measures have been criticized for penalizing poorer people, recent research has disputed this (indeed, richer people generally drink more). “We know of no other preventive intervention to reduce drinking that has the numbers of studies and consistency of effects seen in the literature on alcohol [of] taxes and prices,” the Temple scholars quote from the literature.

    A variety of perspectives criticize the 21 law. On ideological grounds, some despise the means by which the law came to be, arguing that it undermines federalism and that drinking age should be up to the states. Some who question the law don’t doubt that it has led to positive public health benefits, and even acknowledge that harm may result from lowering the age, but say it should be done on principle.

    Yet an essential question remains: Can a healthier and safer society be built without relying on punitive laws, criminal sanctions and restricting rights? 

     

    The International Outlier

    A minimum age of 21 is out of step with most of the world. Most provinces in Canada, for example, have a minimum of 19; Alberta, Quebec and Manitoba are set at 18 years. In Mexico, the minimum age is also 18, as it is in Australia and most of Western Europe. Iraq and Sri Lanka are among a handful of other countries where the law is 21.

    So how does the US stack up against other countries on youth drinking outcomes? And have other countries found ways to improve them without raising the legal age?

    Conventional wisdom among many Americans is that drinking in Europe is normalized from a young age, and therefore creates a safer, less problematic drinking culture. “It’s a myth,” said Hingson of the NIAAA. “It’s simply not true. Compare Europe to the rest of the world, and they have the highest per capita alcohol consumption, and the highest proportion of people who meet alcohol dependence.”

    According to the World Health Organization, European adolescents do report higher levels of drinking and binge drinking than Americans. In fact, nearly every European country reports higher levels of drinking than the US.

    Still, whole-population drinking levels don’t necessarily reflect drinking harms. A 2001 Harvard study comparing Canadian students to American students found that more Canadian students drink overall, but that American students who do drink wind up drinking much more than their Canadian counterparts. There are perhaps trade-offs that come with either a higher or a lower age.

    “I was pretty shocked when I saw how American college kids drink.”

    And when you ask people from inside or outside the States about US drinking culture, the high-risk college party experience inevitably comes up as stereotypically American.

    “I was pretty shocked when I saw how American college kids drink,” Peter Davidson, an adjunct professor of medicine at UC San Diego, told Filter. Davidson, who has published numerous peer-reviewed articles on drug use and harm reduction, arrived in the US in his 20s, as an exchange student from rural Australia where the drinking age is 18.

    “Me and my peers started drinking around 15 or 16 years old,” Davidson said. “If a kid was puking on the front lawn, adults were around to provide guidance and keep things reasonably sane.” Davidson and his friends tended to drink at their parents’ homes, and did so without the kind of hiding and secrecy found among underage drinkers in the US.

    By the time Davidson arrived in the States for college, he had gotten the “dumb, silly” drinking out of his system, and credits early exposure for that. “When the US kids left home and there were no adults or supervision around, they were drinking the way me and my friends were drinking back in high school. The drinking behavior being modeled by their peers seemed pretty negative to me.”

    How does Australian drinking among young people compare to American drinking? The latest Australian surveys show more people aged 12-17 are abstaining from alcohol than previously. In 2013, 72 percent of 12 to 17-year-olds abstained from drinking. By 2016, the percentage who report abstaining rose to 82 percent, according to government surveys. That’s a high amount of abstention among people one year away from legally drinkingand not attributable, clearly, to an age limit.

    It’s difficult to find one-to-one comparisons between countries, but in the US, 7 percent of 8th-graders, 20 percent of 10th-graders and 33 percent of 12th-graders report having drunk in the past month.

    With a drinking age of 18, Australia has better alcohol-related health outcomes.

    According to the World Health Organization, Australia reports 10 percent more “heavy episodic” drinking among 15 to 19-year-olds than the US. But America has more fatal car crashes, more liver cirohosis, more cancer caused by alcohol, and more alcohol use disorders than Australia. WHO also gives each country a “years of lost life score” due to alcohol: Australia scores a 2 and the United States a 3. With a drinking age of 18, Australia has better alcohol-related health outcomes. It’s interesting to reflect on the cultural contrasts that might account for this.

    “The route Australia took with underage drinking was not to teach kids that drinking is bad and not to do it, but rather to work out how to consume alcohol in a way that leaves you with a positive and not a negative, regretful experience,” Davidson said. “There’s a subtle harm reduction approach in schools. It’s less about ‘saying no’ and more about how to negotiate drinking around your peers.”

    For instance, if a friend is drinking much more than you are, how do you avoid succumbing to social pressure to join them? Education about these sticky situations can help teens to do what they want to do, not what they think is expected of them.

    Like the US, Australia had a horrific drunk driving problem. Davidson described an aggressive campaign by the Australian government to mitigate it. “When I grew up drunk driving was very common, people even thought that driving drunk made them better drivers. But today, drunk driving is viewed as ridiculous and frowned upon, especially by young people. Drunk driving laws got a bit harsher, but we still didn’t change the drinking age.” 

     

    It’s the Culture, Not the Age

    “History aptly proves that youth drinking behavior will not change until American alcohol culture changes,” Getnick wrote in her “Drinking Age Debates” thesis.

    Like McCardell and the college presidents a decade ago, Getnick came away from her research on youth drinking believing that the drinking age law is too high. The law legally prevents important conversations from happening.

    “From a technical standpoint, you can’t help people learn safe behaviors if you prohibit the behavior entirely,” she said. “Students are drinking well before they’re 21. We should focus on harm reduction, on preventing problematic behaviors versus focusing on a numerical age. Non-abstinence education is significantly more effective than abstinence.”

    It sometimes feels like everyone is arguing over the wrong questions.

    If US drinking laws curtail the rights of, and criminalize, 18 to 20-year-olds and those who supply alcohol to them without conferring a clear public health benefit, that matters. But when re-examining America’s drinking age debate, it sometimes feels like everyone is arguing over the wrong questions.

    Focusing exclusively on one short age-window, the debate so often ignores the decades of life after one turns 21. By all accounts, America’s youth today drink less than before. They’re also driving less and having less sex. And despite the spread of legalization, youth marijuana use is not increasing. Teen culture is not shaped by laws, and is always in flux. For a host of reasons, today’s youth appear to be extra risk-averse—increases in youth nicotine vaping, when set against declines in smoking, plausibly reflect this too.

    Many may call these trends a public health success, while others question whether young people are merely prolonging the markers of adulthood—driving, drinking, sex, drug experimentation—into later and later years.

    All these 18-year-olds will graduate into adulthood some day. And if they drink the way older adults drink now, they could well face unnecessary harms. The number of alcohol-related deaths has substantially increased over the years—albeit the net health impact of whole-population drinking is far from settled. A recent study found the number of alcohol-related deaths per year doubled from 35,914 to 72,558 between 1999 and 2017.

    Death rates were highest not among teenagers or underage drinkers, but among mostly men between ages 45-74. Meanwhile, the largest increase in deaths during this time period occurred among legal drinkers aged 25-34. Officially recorded alcohol-related deaths outnumber even those related to opioidsexperts might debate the validity of the figures, including categorization of the many deaths that involve opioids in combination with alcoholyet neither news coverage nor public health emergency declarations reflect this complexity.

    Given where alcohol harms are centered today, the drinking age debate, while far from irrelevant, does not feel like the highest priority amid a harmful drinking culture. While adults are busy trying to control youth drinking, they’ve too often lost control of their own.

     


     

    Adapted image via CDC/Public Domain

    R Street Institute supported the production of this piece through a restricted grant to The Influence Foundation. Filter’s editorial independence policy applies.

    • Zachary Siegel

      Zachary is a journalist focusing on drugs, justice and health. His work has appeared in publications including the New York Times Magazine, The Appeal, Slate and New York magazine. He is a fellow of the Health in Justice Action Lab at Northeastern University School of Law.

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