18-vs.-21

Gordie Bailey Jr. had been in college only one month before he overdosed on alcohol. Urged on by members of a fraternity he was intent on joining, the 18-year-old drank until he passed out, was dumped onto a couch and was found dead the next morning.

The 2004 incident at the University of Colorado was one of the approximately 1,700 alcohol-related deaths that occur among college students each year in the United States. They include traffic accidents, falls, suffocation, drowning and alcohol poisoning. Hundreds of thousands of other students commit crimes, become crime victims, fail classes, make poor sexual decisions or sicken themselves by drinking too much alcohol. In a survey published last year by the American College Health Association, just over one-third of college students admitted they had binged on alcohol at least once in the previous two weeks – a number that appears to be rising.

Underage drinking has long alarmed college administrators and health professionals. But now a deep schism is forming among those same people on how to address the problem.

Last month, more than 100 college presidents signed a petition calling for a debate on whether the minimum legal drinking age should be lowered from 21 to 18.

The statement says in part: “Our experience as college and university presidents convinces us that 21 is not working. A culture of dangerous, clandestine ‘binge-drinking’ – often conducted off-campus – has developed.”

Some health professionals agree it’s time to discuss the proposal, but other health experts and college officials are aghast. None of the presidents from any of the Inland Northwest colleges and universities has signed on to the petition.

Each side has statistics to support its position – but most of the health and safety evidence falls squarely on the side of an age-21 limit.

“There is a growing body of knowledge that suggests strong reasons for parents and other concerned people to try to keep alcohol out of the hands of young people as long as we can,” says Susan Foster, vice president and director of policy research at the National Center on Addiction and Substance Abuse at Columbia University.

Statistics on traffic fatalities prove the law works, says Michele Simon, research and policy director at the Marin Institute, an alcohol industry watchdog group in San Rafael, Calif. In 1984, a federal standard was established setting the minimum legal drinking age at 21. Since then, traffic fatalities among drivers ages 18 to 20 have fallen by an estimated 13 percent, according to the National Highway Traffic Safety Administration.

Also:

•Among studies comparing the years before 1984 with the current era was a 2001 report from the National Institute on Drug Abuse, which found that college students who reported drinking in the last month fell from 82 percent in 1980 to 67 percent in 2000.

•In 2007, the University of Michigan’s annual Monitoring the Future survey found that annual alcohol use by high school seniors has dropped from 77 percent in 1991 to 66 percent last year.

Perhaps the strongest evidence for the harmful health effects of drinking at a young age come from studies on biology and addiction, Foster says.

•A 2002 report from the American Medical Association, citing numerous studies, concluded that alcohol use during adolescence and young adulthood causes damage to memory and learning capabilities.

•A study in the 2006 Archives of Pediatrics & Adolescent Medicine found that teens who began drinking before age 14 had a lifetime risk of alcohol dependence of 47 percent compared with 9 percent for those who began drinking at 21. For each additional year under age 21 of drinking, the greater the odds he or she would develop alcohol dependence. Though the cause of this correlation is unknown, some experts believe pure biology – priming the young brain to need alcohol – is involved.

•And in a 2002 analysis of 33 high-quality studies on the age-21 drinking law’s effects, University of Minnesota researcher Traci L. Toomey found that all but one study showed the higher age resulted in lower rates of alcohol consumption and traffic crashes.

“It is the most well-studied alcohol control policy we have in this country,” says Toomey, an associate professor in the school of public health.

A growing number of college administrators and health professionals aren’t convinced that the age-21 laws help curb problem drinking.

“Not all the evidence is on one side of the question,” says John M. McCardell Jr., former president of Middlebury College in Vermont and founder of Choose Responsibility, a nonprofit group that advocates for changes in minimum-drinking-age laws and that circulated the college president’s petition. “We’re not ignoring science. There is science on both sides of the question.”

For example, the reduction in traffic fatalities may be credited to other safety measures, such as the use of restraints, better automobile design, improved hospital trauma care and stricter traffic laws, in addition to the lower drinking age, some studies suggest.

Those on the age-18 side have studies as well.

•A 2003 study from the Centers for Disease Control and Prevention found that, though fewer high school-age students drink now compared with the late 1970s, the rates of binge drinking among all adults 18 and older have risen. Published in the Journal of the American Medical Association, the study encompasses 1993 to 2001 and showed rates of binge drinking have increased the most (56 percent) among underage drinkers.

This out-of-control drinking may be fueled, McCardell says, by the age-21 laws, which drive underage youth to drink in clandestine settings and apart from older adults who might model more appropriate behavior.

“College presidents are limited on campus to a message of abstinence-only,” he says. “They can’t say drink moderately or drink responsibly. They can only say abstain.”

Though alcohol-related traffic deaths have declined overall since 1982, deaths have begun to inch up again in recent years, according to the National Highway Traffic Safety Administration.

•A 2003 study showed that in many countries with lower minimum drinking ages, 15- and 16-year-olds are less likely to become intoxicated compared with teens in the U.S.

McCardell agrees that studies show the younger someone starts drinking, the greater the likelihood of developing alcohol dependence. But, he says, the 2006 Archives of Pediatrics & Adolescent Medicine study shows that the correlation is greatest at younger ages.

“Between 13 and 18, the effect is dramatic. But between 18 and 21 it’s visible but insignificant,” McCardell says. “What we ought to look at is not keeping 18-year-olds from drinking, it’s keeping 13-year-olds from drinking.”

A major question not answered by research is whether mild or occasional drinking, such as a beer or glass of wine, causes any physical harm or precipitates harmful behavior in 18-year-olds, says Brenda Chabon, associate professor of clinical psychiatry and behavioral sciences at Montefiore Medical Center in New York.

“It’s the way people drink, not the fact of drinking,” Chabon says. “What would harm a developing brain is repeated hangovers and blackouts and head trauma from falling. But if someone were drinking moderately from age 18, I haven’t seen any data to show that would have harmful effects in the long run.”

There is little evidence in humans to suggest that mild to moderate drinking in late adolescence causes any damage, says David J. Hanson, professor emeritus of sociology at the State University of New York at Potsdam, who has studied the literature.

“The research is almost exclusively based on rats and humans who are alcohol addicted,” he says. “It doesn’t look at moderate drinking at all. We’ve got a lot of cross-cultural evidence that it isn’t harmful at all.”