Challenging Dogma - Spring 2011

Sunday, May 8, 2011

The Irresponsibility of Choose Responsibility’s Proposed Minimum Legal Drinking Age of Eighteen

You can vote, marry, enlist in the military, enter a contract, but you can’t buy a beer. This belief leads the many crusades against the “unfair” minimum legal drinking age of twenty-one that was established in the United States through the Minimum Legal Drinking Age Act. The United States passed a minimum legal drinking age in an attempt to reduce the number of alcohol related automobile accidents and decrease overall alcohol consumption in adolescents1. There has been success in controlling adolescent and young adult drinking as a result of this legislation, but at the same time, another problem has emerged that is undermining the credibility of current legislation and stirring opposition amongst community and political leaders2.

The battle against binge drinking has been a never-ending endeavor. Every day, news stories detail the problems of binge drinking on college campuses and highlight the continuing arguments over the most effective strategy to combat this epidemic. Gaining popularity is the proposition of a lower minimum legal drinking age, which would allow young adults aged eighteen, nineteen, and twenty the opportunity to purchase and consume alcohol and presumably learn more responsible drinking behaviors. One particular organization leading the charge is Choose Responsibility, founded by former Middlebury College President Emeritus John M. McCardell Jr. Dismayed at the continuing abuse of alcohol amongst many college students, McCardell attributed this failure to the minimum legal drinking age of twenty-one and the push of underage drinking to underground, unsupervised environments. To substantiate his cause, Choose Responsibility outlines several adjustments deemed necessary to effectively implement a lower drinking age while maintaining accountability for newly certified young adults.

Choose Responsibility proposes an educational certification process that licenses eligible young adults to drink. This program would provide individuals who are at least eighteen years old and have completed high school licensure to purchase, possess, and consume alcohol. If an individual does not want to enroll in the course to obtain the license, they must wait until they are twenty-one to be able to purchase and possess alcohol. Regardless of licensure, both groups will be able to consume alcohol under the supervision of their parent or legal guardian3. This program would be accompanied by a waiver of the ten percent federal highway appropriation reduction so that states have an incentive to pursue alternative alcohol policies, as well as implementation of a data collection system to monitor and evaluate drinking trends for young adults4. By confronting binge drinking through education and policy change, McCardell believes that changing the minimum drinking legal age will prompt underage drinkers to adopt more sensible behaviors and reduce the occurrence of heavy drinking. However, if he were to take a deeper look into the behaviors and current data investigating binge drinking, McCardell would find that the solutions are more stringent policy enforcement and targeted social interventions, and luckily, they are ready to be put into action.

Misrepresentation of the Success of Current Alcohol Policy

Choose Responsibility states that the current legal drinking age of twenty one infantilizes adults aged 18 to 20 years, which in turns causes these otherwise responsible adults to exhibit infantile (i.e. reckless) behavior towards their alcohol consumption. In its campaign to lower the drinking age to eighteen, Choose Responsibility cites that while the number of young adults between the ages of 12-20 that abstain from drinking has increased, the number of young adults in that same age group who binge drink has increased as well. By this association, Choose Responsibility concludes that the minimum legal drinking age of twenty-one has not done its job to curb underage alcohol consumption and needs revision. However, it is misleading to base a campaign that promotes lowering the drinking age upon this statistic. In fact, for its proposed efforts to reduce underage alcohol-associated automobile fatalities and overall underage alcohol consumption, the minimum legal drinking age of twenty-one is very successful1. Binge drinking was not an issue that the policy was battling, and although the problem has risen over the past couple of decades, it is not something worth creating new, more lax legislation. The minimum legal drinking age of twenty-one is usually accompanied by other state alcohol control laws and evidence shows that states with more control policies and laws to complement the minimum legal drinking age had lower levels of drinking and related problems in underage individuals. Enforcement of laws that prohibit the sale of alcohol to minors, increasing alcohol excise tax, and limiting alcohol outlet density have all shown to be effective strategies that prevent underage drinking1. Choose Responsibility may see a problem in the lack of uniform implementation of the minimum legal drinking age of twenty-one, but that is the real problem: lack of uniform implementation, not lack of effectiveness. If Choose Responsibility wants to combat binge drinking in young adults, then they need to step up and support more stringent efforts to that show young adults that binge drinking is a dangerous activity that will not become acceptable within our society. If it becomes legal for young adults to drink, then binge drinking cannot be seen as illicit because the young adults have a right to do it. Providing a defense against binge drinking requires strong support, which cannot be found in legal access to alcohol.

Overlooking the Motives that Drive Binge Drinking in Young Adults

By lowering the drinking age to eighteen, Choose Responsibility is not challenging the culture that encourages young adults to binge drink. In fact, by making alcohol more accessible to under-aged adults, particularly college students, Choose Responsibility creates the potential for exacerbation of binge drinking, because of the newfound ease at which many students find they will be able to access alcohol. Binge drinkers were more likely to report that alcohol is easy to obtain compared to college students who did not binge drink, indicating that the problem lies in the enabling environment of colleges and not on the legality of a student’s age to access alcohol5.

Several studies have shown that college students are more likely to engage in heavy drinking compared to their non-attending peers and that social perceptions of binge drinking have been linked to increased binge drinking rates among college students1. Analyses of student drinkers found that binge drinking students were more likely to live in a “wet” environment, be affiliated with a Greek organization, or perceive a greater proportion of their friends to binge drink and were more likely to cite “because everyone else does” and “fitting in with others” as important reasons for drinking. This reinforces the importance of college-wide social norms in influencing individual student behavior and presents an opportunistic belief where both group and individual level drinking interventions will most likely succeed5. In surveys of college students regarding their attitude towards the current minimum legal drinking age of twenty-one and whether it should be lowered to eighteen, there was an strong association between frequency of the student’s binge drinking and the strength of their belief that the legal drinking age should be lowered. In conjunction with studies that show lower legal drinking ages do not lead to more responsible drinking behaviors amongst young adults, this association may be predictive of the changes we could expect with a lower legal drinking age in the United States; namely, that binge drinking will not decrease because students who currently binge drink will be able to do so more freely and will less repercussions6.

Leading the force behind Choose Responsibility’s college-focused campaign is the Amethyst Initiative, an organization of United States college and university presidents and chancellors who believe there is irresponsible drinking amongst college students and who want a reconsideration of the minimum legal drinking age. The Amethyst Initiative takes no stance on furthering any particular piece of alcohol control legislation, but rather encourages debate about the consequences of current drinking policies and devising better ways to promote responsible alcohol use among young adults7. For all their talk about fighting the binge drinking problem with more permissive policies in the future, these presidents and chancellors could be taking action and effectively reducing the dangerous alcohol behaviors among their students right now by implementing more comprehensive campus policies and programs. It is not surprising students that attend colleges where alcohol control policies are strongly enforced show reduced rates of alcohol abuse1. Despite what the Amethyst Initiative and Choose Responsibility may preach, lowering the drinking age is not the essential solution to preventing binge drinking on college campuses. Binge drinking is introduced and reinforced through many social and behavioral factors, so it’s necessary to challenge these factors all together. There is an array of effective individual and group level interventions available, so that if any college or university president really had the initiative, they would join forces with their students and local communities to promote more urgent, comprehensive alcohol programs rather than sit back and wait for an unpromising policy to be passed8.

Misguided Prevention Efforts in Adolescent Drinkers

As well as misjudging the motives behind binge drinking in young adults, Choose Responsibility also avoids the problem of binge drinking in adolescents with their alcohol education and licensure provisions. Eighteen, nineteen, and twenty year olds will be eligible to obtain a license entitling them to the privileges and responsibilities of adult alcohol purchase, possession, and consumption of alcohol, but only after completing high school and an alcohol education program2. By requiring young adults to complete high school, Choose Responsibility believes they are reasonably compromising on the young adult’s newfound right to legally purchase, possess, and consume alcohol with the more dire concern of alcohol becoming more accessible to younger high school students. Given this interest in preventing adolescent drinking, Choose Responsibility should be more involved in implementing control measures already documented as being effective in curbing alcohol accessibility to adolescents rather than create a new program that does not restrict the sources of alcohol currently available to adolescents.

Nationwide, approximately 64% of 8th graders and 84% of 10th graders reported that alcohol was readily available to them for consumption. They obtained their alcohol at parties, from friends, and at home, in some cases provided by a family member9. This is under the current minimum legal drinking age of twenty-one, indicating that even with a more restrictive alcohol age policy presently in place, adolescents have no difficulty accessing alcohol. Reducing alcohol consumption amongst adolescents is dependent on removing their sources of alcohol and instilling more appropriate values in terms of limiting their alcohol use9. Although Choose Responsibility believes they are promoting responsible alcohol behaviors through their alcohol education course, even at the age eighteen cut-off they are missing the younger adolescents who are already binge drinking. In such a formative stage of life, the responsibility of alcohol education rests more heavily on the parents, whose own drinking behaviors and values strongly influence their children’s attitudes towards drinking10,11. Choose Responsibility supports more liberal policies to allow parents to freely educate their children about responsible drinking, but this does not necessitate lowering the drinking age nor do their actions actually target the most appropriate age groups to educate. Given the strong influence that parents have over their children’s behavior, Choose Responsibility needs to focus on empowering parents to sit down with their children at an early age to discuss drinking issues rather than hold the authority themselves. It is somewhat contradictory of Choose Responsibility to state that with the legal minimum drinking age of twenty-one, parents “must either ignore the reality of alcohol consumption among young people and forbid their children from drinking or break the law by serving alcohol to their under-21 children.”12 Thirty states have exceptions that allow parents to provide alcohol to their children in the privacy of their home and no law exists that prevents parents from just talking to their children at any time about alcohol awareness13. In that case, if Choose Responsibility wants to allow young adults aged eighteen to twenty to drink with parental supervision, they should focus on expanding individual state exceptions that provide adolescents and young adults in the remaining twenty states with the ability to consume alcohol within their home rather than create an educational program and license to complicate the process even more. Heavy alcohol use in high school is a predictor of heavy alcohol use in college, so it is important to aim binge drinking prevention efforts to middle and high school age groups and let parents be the guides in deciding how their children will be raised5.

Proposed Intervention

It is clear that decreasing the rates of binge drinking requires a comprehensive approach that unites communities, colleges, and families in supporting adolescents and young adults as they encounter the pressures of underage drinking. A new public health intervention, the “Choose Rationality” program, addresses each of these audiences separately to delegate their individual responsibilities in preventing underage drinking and how these actions relate to the current problem. The community-focused intervention will provide more support to reinforce state alcohol policies that currently limit underage purchase and consumption; the college intervention will implement recommended individual and group level alcohol interventions to students, with assistance from Greek councils to provide specialized programming for high risk drinkers; and the high school intervention will emphasize parent and school influences on teen drinking behaviors.

Community-Focused Intervention

In its criticism of the current minimum legal drinking age of twenty-one, Choose Responsibility overlooked many useful strategies that are available on a community level to reduce underage binge drinking. As previously mentioned, states with more stringent alcohol control policies and laws to complement the minimum legal drinking age had lower levels of drinking and related problems in underage individuals1. Rather than spend time pushing new policies that lower the minimum drinking age through a waiver of either the 10% federal highway appropriation reduction or of the federal law entirely, Choose Rationality would work with current policies of a minimum legal drinking age of twenty one to strengthen their enforcement and reaffirm our society’s interest in raising smart, well-adjusted individuals. Although each state differs in the strictness of its policies, most have common policies like excise taxes and prohibition of underage purchase of alcohol that can be targeted for more legal enforcement. Policy-wise, there would be a push to make Responsible Beverage Service training mandatory for alcohol outlet and restaurant employees in every state. This program educates participants about local ordinances and penalties regarding underage alcohol sales, ensuring that store and restaurant employees are fully aware of the legal liability they hold if they serve to minors14. This can coincide with increased compliance checks to assure that businesses are following the law and penalizing those servers or managers that violate it. As well, Choose Rationality would advocate increasing alcohol taxes to make purchasing alcohol more difficult and use the revenue to provide funding for other underage alcohol program. Although this may seem inconvenient to adults, there is evidence that this considerably reduces youth alcohol consumption15. By implementing more stringent state-wide alcohol sales policies, Choose Rationality advocates accountability in selling alcohol to minors and sending the message that our laws are serious principles to be enforced and that alcohol abuse will not be tolerated.

College Intervention

College students garner the most attention in the binge drinking epidemic, yet there remains a widespread problem across campuses nationwide. The reluctance of many university and college presidents to take sustained action against binge drinking has stifled the success of interventions aimed towards college students, but they should not be alone in combating the problem. Rather than campaigning to decrease the minimum legal drinking age, a new intervention should focus on providing alcohol intervention resources and support to university and college presidents so that their anti-binge drinking efforts on campus are continual and inclusive of all heavy drinking risk groups.

At the college level, a combination of individual and group level interventions would provide the most effective solution, especially when dealing with the audience of college students. In 2002, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) College Drinking Task Force created a list of recommended strategies to address excessive college drinking, which implement research-based approaches to alcohol programs that comprehensively target individual students, the student population as a whole, and the relations between the college and its surrounding community16. A recent survey of college and university presidents showed that most were familiar with the NIAAA recommendations, but many had not implemented any of the recommendations to supplement their own education programs17. The NIAAA recommendations are useful because of the wide selection of strategies offered and the flexibility for presidents to choose those recommendations most suitable to their college’s specific needs. As well, the Task Force ranks the strategies based on research and effectiveness to provide realistic expectations of their outcomes. By using the “3-in-1” framework that focuses simultaneously on individual students, the student population, and the local college community, everyone on and around the college campus gets involved in the binge drinking prevention efforts and challenges the alcohol expectancies within the college society. Examples of recommended strategies include offering brief motivational enhancement interventions in student health centers and emergency rooms (individual level), increased enforcement of minimum drinking age laws (student population), and responsible beverage service policies in social and commercial settings (community)16.

The success of these interventions can be maintained through partnerships with outside organizations that influence college student beliefs. The Greek system is recognized as a bastion of binge drinking, so it would not be unreasonable to expect more enforcement of anti-drinking policies by the North American Interfraternity Conference (NIC) and the National Panhellenic Conference (NPC), two of the nation’s largest advising Greek councils5. These organizations state their interest in addressing alcohol misuse and promoting alcohol-free activities and educational programs, so they need to step forward and become a more involved presence on college campuses18. This includes providing more Greek targeted alcohol programming, because despite the NIC and NPC’s intentions to retain an honorable reputation for Greek life and not single out their members, they need to recognize that Greek-affiliated students have a more specialized drinking problem (due in part to their residence in fraternity and sorority housing) and exercise more authority over their members’ conduct, especially in consideration of their own standards. Delegates from each campus Panhellenic and Interfraternity council should be required to represent the Greek system in their college’s designated alcohol education program so that there is collaboration between the general student population and Greek students on collective and special interest alcohol policies.

High School Intervention

Despite the close age proximity of many high school students to Choose Responsibility’s proposed minimum legal drinking age of eighteen, the organization believes it can prevent adolescent drinking by restricting their proposed alcohol licensure and education program to those individuals who have completed high school. This does not consider controlling the sources of alcohol already available to adolescents and preventing those individuals who do complete high school from supplying students who are still in school. Choose Rationality approaches adolescent and young adult drinking not by commanding an education and licensure system based on their responsible drinking ideals, but by opening the forum for parents so that they may feel less constrained in talking to their children about drinking. It will still be left open to a parent’s discretion to decide whether they want to provide their children with alcohol, but Choose Rationality would not advocate supervised drinking as a responsible course of action to teach adolescents and young adults about appropriate drinking behaviors. Teens that wait until age twenty-one to drink experience less harmful drinking consequences compared to those teens that are allowed to drink underage, even with parent supervision10. As such, Choose Rationality’s campaign would reflect a zero-tolerance drinking stance, so that parents understand the importance of limiting drinking in their children while moderating their own alcohol use to model positive attitudes that influence their children’s behavior10. Educational materials would be targeted to parents that emphasize conversation with their children and limiting access to alcohol.

Choose Rationality would cooperate with middle and high schools to strengthen their zero-tolerance drug policies on school grounds. School environments that deliver strong abstinence or harm-minimization drug policy messages have fewer students that engage in drug use, so advising school administrators on actively and continually enforcing substance-free policy, as well as working to notify parents of their children’s misconduct, will help to reinforce the seriousness of misusing alcohol as an underage teen19. This would utilize social norms marketing to correct beliefs regarding alcohol as a socially acceptable drug for teens to use through posters and classroom presentations that actively involve students in communicating information to their peers. By using friends to deliver the message, Choose Rationality engages teenagers in decreasing their social expectations of alcohol use and binge drinking.

References

1. Wechsler, Henry, Toben F. Nelson. “Will increasing alcohol availability by lowering the minimum legal drinking age decrease drinking and related consequences among youths?”

American Journal of Public Health 100.6 (2010): 986-992. American Journal of Public Health online, 15 April 2010. Web. May 5, 2011.

2. "Fact Sheets-Minimum Legal Drinking Age - Alcohol." CDC.gov. Centers for Disease Control and Prevention, 20 July 2010. Web. 05 May 2011. .

3. "Education." Chooseresponsibility.org. Choose Responsibility. Web. 05 May 2011. .

4. "Waiver." Chooseresponsibility.org. Choose Responsibility. Web. 05 May 2011. .

5. Weitzman, Elissa R., Toben F. Nelson, Henry Wechsler. “Taking Up Binge Drinking in College: The Influences of Person, Social Group, and Environment.” Journal of Adolescent Health 32.1 (2003): 26-35. Journal of Adolescent Health, 26 June 2002. Web. 5 May 2011.

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6. Martinez, Julia A., Miguel A. Muñoz García, and Kenneth J. Sher. "A New Minimum Legal Drinking Age (MLDA)?: Some Findings to Inform the Debate." http://www.ncbi.nlm.nih.gov. National Institutes of Health, 9 Dec. 2008. Web. 05 May 2011. .

7. “About." Amethystinitiative.org. Amethyst Initiative. Web. 05 May 2011. .

8. DeJong, William, Mary E. Larimer, Mark D. Wood, Roger Hartman. “NIAAA's Rapid Response to College Drinking Problems Initiative: Reinforcing the Use of Evidence-Based Approaches in College Alcohol Prevention. Journal of Studies on Alcohol and Drugs Supplement Suppl. 16 (2009): 5-11. Pubmed Central. Web. May 5, 2011.

< http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2701095/pdf/jsad5.pdf>

9."Reduce Availability: Introduction." Youthbingedrinking.org. Center for Applied Research Solutions. Web. 5 May 2011. .

10. McMorris, Barbara J., Richard F. Catalano, Min Jung Kim, John W. Toumbourou, Sheryl A. Hemphill. “Influence of Family Factors and Supervised Alcohol Use on Adolescent Alcohol Use and Harms: Similarities Between Youth in Different Alcohol Policy Contexts.” Journal of Studies on Alcohol and Drugs 72.3 (2011): 418-28. Journal of Studies on Alcohol and Drugs. Web. May 5, 2011.

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11. Schor, E.L. “Adolescent alcohol use: social determinants and the case for early family-centered prevention. Family-focused prevention of adolescent drinking.” Bulletin of the New York Academy of Medicine 73, 2 (1996): 335-356. Pubmed Central. Web, May 5, 2011.

< http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2359305/pdf/bullnyacadmed01032-0124.pdf>

12. “Arguments Against Legal Age 21”. Chooseresponsibility.org. Choose Responsibility. Web. 05 May 2011. < http://www.chooseresponsibility.org/article/view/15540/1/2642/>.

13. “State Policies.” Chooseresponsibility.org. Choose Responsibility. Web. 05 May 2011.

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14. "Mandate Responsible Beverage Service (RBS) Programs." Youthbingedrinking.org. Center for Applied Research Solutions. Web. 05 May 2011. .

15. "Raise Alcohol Taxes." Youthbingedrinking.org. Center for Applied Research Solutions. Web. 05 May 2011. <http://youthbingedrinking.org/strategies/a_strategy1.php>

16. Task Force of the National Advisory Council on Alcohol Abuse and Alcoholism. “A Call to Action: Changing the Culture of Drinking at U.S. Colleges.” collegedrinkingprevention.gov. National Institute on Alcohol Abuse and Alcoholism. April 2002. Web. 5 May 2011. .

17. Nelson, Toben F., Traci L. Toomey, Kathleen M. Lenk, Darin J. Erickson. “Implementation of NIAAA College Drinking Task Force Recommendations: How Are Colleges Doing 6 Years Later?” Alcoholism: Clinical and Experimental Research 34.10 (2010): 1687-693. Wiley Online Library, 9 July 2010. Web. May 5, 2011.

18. "NIC Resolutions." Nicindy.org. North-American Interfraternity Conference. Web. 05 May 2011. .

19. Evans-Whipp, Tracy J., Lyndal Bond, John W. Toumbourou, Richard F. Catalano. “School, Parent, and Student Perspectives of School Drug Policies.” Journal of School Health 77.3 (2007): 138-146. Wiley Online Library, 14 Feb. 2007. Web. May 5, 2011. < http://onlinelibrary.wiley.com/doi/10.1111/j.1746-1561.2007.00183.x/pdf>

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