Understanding Alcohol Abuse
           
     
Underage Drinking
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By Maia Szalavitz
STATS Senior Fellow
29 April 2005

Can you honestly say that you never drank alcohol during high school? If so, you are in a distinct minority: nearly 80% of high school seniors admit to at least trying a drink and about 50 percent report having consumed alcohol during the last month. While these numbers are down from their peaks in the late 70s and early 80s, a large majority of young people still drink regularly long before they reach the legal age of 21.

Clearly, efforts to eliminate underage drinking have failed. It is also plain that many successful Americans have a history of high school and college alcohol use - sometimes involving of periods of excess. If youthful drinking were a genuine bar to political office, higher education or career advancement, government, academia and industry would grind to a halt.

Nonetheless, the media and some activist groups, government agencies and foundations constantly promote the idea that most teen drinking is extremely risky and carries a high probability of causing alcoholism or death. For example, an August 2004 press release from the Office of Juvenile Justice and Delinquency Prevention and the National Liquor Law Enforcement Association screams, "The carnage caused by underage drinking in America is unrelenting," and notes that alcohol kills "6.5 more kids than all other drugs combined."

Similarly, a recent CNN medical segment ["Teenage binge drinkers are more likely to become adult alcoholics" 6/16/04"] reported that a study had found that teen binge drinking was linked to an increased risk for alcoholism. CNN mentioned that 70% of teens binge drink - but did not note that only 3.81% of adults are alcoholics. The channel's physician-reporter Sanjay Gupta ended his report with a conclusion not backed by the data he cited, saying, "So really, the message to parents out of this is even a small drink, even only a sip early on in life could be a problem later on."

Headlines like the San Francisco Chronicle's "Teenage Drinking a U.S. Epidemic" [2/26/02] and the New York Post's "Boozed-Up Teens In Dangerous Liaisons," [2/7/02] shout along with the advocates' PR campaigns, often including hyped-up quotes from people like the National Center on Addiction and Substance Abuse (CASA)'s head Joe Califano, such as "Alcohol is the fatal attraction for many teens."

As a result, politicians call for ever stricter legislation; activists say that alcohol advertising is targeting teens and should be banned; and schools enact "zero tolerance" policies that expel kids for doing once what the vast majority of American adults did many times at their age.

Do these efforts make sense? Are we using our resources wisely by trying to prevent all teens from taking a sip till 21-or could we better spend our money by focusing on reducing the genuine harm that can occur when some young people drink to excess?


Costs and Consequences

According to a 1999 study conducted by the Pacific Institute on Research and Evaluation (PIRE), about 3,500 deaths per year are caused by drinkers under the age of 21. Homicides account for the greatest number of these deaths (roughly 1,600 per year), followed by drunk driving (1,400), and teen suicides (260). The remaining 300-odd deaths are caused by other accidents, drownings, burns, and alcohol overdoses.

Interestingly, the proportion of deaths judged to be alcohol-related was lower than one might expect from the hysterical coverage teen drinking is usually given in the media. For example, just under 20% of car accident deaths caused by drivers 21 and younger are related to intoxication-and this proportion has been dropping for the last 20 years.

The PIRE researchers also estimated that 21% of murders committed by youth were caused by alcohol. This was based on research showing that 42% of killers report being intoxicated at the time of their crime and on other studies which found that while half of alcohol-linked killings would probably have occurred even if alcohol hadn't been consumed by the perpetrator, the other half would not have taken place if the killer had been sober. The figures for suicide were even lower, with just 12% of male suicides and eight percent of those committed by females attributable to alcohol.

But while the PIRE analysis looked at deaths caused by intoxicated youth, it didn't separate out which of those deaths occurred among other young people. Another analysis footnote icon tried to calculate this number, seeking to determine the number of deaths of youth aged 10-19 related to alcohol.

Using 1995 figures, it found a very similar number to that compiled by PIRE: 3300 deaths of young people could be attributed to alcohol-related incidents including homicides, suicides, car accidents and alcohol overdoses .

From this report and the census population estimate of teens aged 10-19 in 1995, a very rough estimate of the risk of alcohol-related death in this age group can be calculated. The odds of a teen dying an alcohol-related death come to approximately .00009 per year or 9 in 100,000 footnote icon. If one calculates the figure only among those who admit to drinking in the last month, the figure is still less than 2/100ths of one percent.

This still represents a significant proportion of the untimely deaths among youth: the total number of deaths among those aged 10-19 in 1995 was 14,600, meaning that 23% of adolescent deaths that year can be blamed on alcohol. And while the risk of death is relatively low, the risk of injury is not. The PIRE study estimated that about 1 million non-fatal injuries were caused by underage drunk drivers and 1 million assaults were committed by youth under the influence of alcohol. About 5,100 injuries were related to drunken suicide attempts and 40,000 to the results of alcohol poisoning. These estimates relied on statistics from the CDC's National Hospital Ambulatory Medical Care Survey.

The PIRE study estimated the costs related to underage drinking at $52.8 billion per year footnote icon. The vast majority of these costs - $38.5 billion - were related to loss of quality of life due to deaths and serious injuries from car accidents and violent assaults. These figures are calculated by determining what people are willing to pay to reduce their risk of incurring such harms - they do not derive from pay-outs in lawsuits or actual government expenditures. Actual lost income and other non-health related costs related to youth drinking added up to $10.6 billion, while medical costs amounted to $3.6 billion.

Drinking Age
There are two major conflicting schools of thought in alcohol policy. One focuses primarily on reducing alcohol consumption rates throughout the population: I will refer to them here as the "dry" group, using the terminology of Robin Room, a top alcohol expert and the Director of the Center for Social Research on Alcohol and Drugs at Stockholm University. This group includes most American advocates like the National Center on Addiction and Substance Abuse and the Center on Alcohol Marketing and Youth (CAMY). The "dry" group pushes for measures like high alcohol taxes, restrictions on advertising and selling times and high drinking ages. They tend to favor most measures that restrict access to alcohol-up to and including absolute prohibition in some cases (though most do not believe this is actually feasible).

The second group, the "wets" claim that these kinds of "prohibitionist" measures actually increase damage by, for example, driving young drinkers underground where they are more likely to drink dangerously. They support efforts like lowering the drinking age in order to allow young people to learn to drink moderately. They believe such measures would encourage youth to seek help (rather than avoid doing so for fear of being caught) if they do get into trouble. "Wets" include groups like the Drug Policy Alliance and experts like author Stanton Peele.

There is some evidence to support both perspectives: Those who believe in lowering overall consumption cite studies linking higher alcohol taxes and a higher drinking age with fewer drunk driving deaths, lower crime rates footnote icon and even lower rates of sexually-transmitted disease.

Those who believe these measures increase rather than reduce harm point to studies showing that youth drinking was declining footnote icon long before the U.S. adopted a national drinking age of 21 in 1987. They also say that the states that waited longer to raise their drinking ages did not have more drinking by young people than those that did it sooner footnote icon.

 
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