Revisiting the minimum legal drinking age

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This MLDA has been the subject of no less than 70 studies, all examining the impact on a number of outcomes including road injury and death.  Several studies in the 1970s found that motor vehicle crashes increased significantly among teens when the MLDA was lowered:1 including findings that lowering the MLDA was associated with an average 10% increase in road trauma for young people.2

The United States Federal Government was convinced of the evidence for public health benefits  and in 1986 the then President, Ronald Reagan, supported legislation that made Federal road funding conditional on US states introducing a standard age 21 MLDA. Consequently the vast majority of States introduced the 21 age limit. A review of 17 studies from the States that raised the MLDA to 21 estimated that under age crash involvements were reduced on average by 16%.2The evidence indicates that a higher MLDA is effective in reducing youth alcohol consumption and in preventing alcohol-related deaths and injuries among youth. When the MLDA has been lowered, road crashes, injury and deaths have increased, and when the MLDA is increased rates have declined.3

A common argument among opponents of a higher MLDA is that, because many minors still drink and purchase alcohol, the policy doesn’t work. The evidence shows, however, that although many youth still consume alcohol, they drink less and experience fewer alcohol-related injuries and deaths.2,3 It is sometimes argued that increasing the MLDA in the USA has increased illicit drug use, but this is incorrect. Annual trends in national school surveys show that illicit drug use declined in the USA after the national implementation of the age 21 MLDA in the 1980s. In 1987, 56.6% of USA students in their final year of high school (year 12) reported they had previously used an illicit drug. Rates fell steadily in subsequent years reaching an historic low of 40.7% in 1992 and since then have risen slightly to 46.7% in 2009.4 Lifetime alcohol use was 92.2% for year 12 students in 1987 and fell steadily to an historic low of 71.9% in 2008.4 A cross-national comparison found that rates of substance use (either alcohol or illicit drug use) were twice as high for Australian compared to US children in 2002, with much of this effect explained by the substantially higher rates of alcohol use in Australian children.5

The benefits of increasing the MLDA to 21 are evident not just in road safety prior to age 21 but also in improved road safety after age 21 until age 25.2,3 Recent neuro-imaging studies show that the human brain is still developing through to the mid 20s. Episodes of heavy alcohol use that are common amongst young adults have detrimental implications for healthy brain development.6 Research shows that when the MLDA is increased to 21, people under age 21 drink less overall and continue to do so through their early twenties.3 Decreasing the MLDA below age 21 has also been shown to result in population increases in other alcohol-related harms including suicide7 and youth crime.8

With most research on the effects of MLDA laws having been conducted in the United States in the 1980s, it is sometimes argued that the introduction of alternative policies such as random breath testing for alcohol impaired drivers has made MLDA policies redundant. However, recent evidence on the adverse crash effects of lowering MLDA in New Zealand suggests that the policy impacts are independent of alternative road safety policies. In New Zealand the MLDA was lowered from 20 to 18 in 1999. An analysis found that alcohol-involved crash injury rates increased between 12% and 50% for cohorts in the 15 to 19 age groups after the MLDA was lowered.9 The effect of lowering the MLDA occurred despite the previous policy having been implemented with little or no enforcement. A range of studies show that the benefits of increasing the MLDA can be enhanced when strong enforcement is also implemented.

The 2007 National Drug Strategy Household Survey found that 42% of Australians support raising the MLDA to 21, a significant increase since 2004. It is often considered that young voters in the 18 to 20 age range would oppose raising the MLDA to 21. However, such opposition is unlikely to be universal. Many young people are aware that the potential benefits for their age group includes a reduction in alcohol-related violence and injury and increased road safety. The Dalgarno Institute encourages public debate as a means of clarifying that there is overwhelming scientific evidence that favours raising the MLDA to 21.

1. Shults RA, Elder RW, Sleet DA, Nichols JL, Alao MO, Carande-Kulis VG, Zaza S, Sosin DM, and Thompson RS. (2001)Reviews of evidence regarding interventions to reduce alcohol-impaired driving. American Journal of Preventative Medicine. 21(4 suppl 1): 66–88.

2. Smith DI, & Burvill PW. (1986) Effect on traffic safety of lowering the drinking age in three Australian states. Journal of Drug Issues. 16, pp. 183–98.

3. (Wagenaar AC. Minimum drinking age and alcohol availability to youth: Issues and research needs. In: Hilton ME, Bloss G, eds. Economics and the Prevention of Alcohol-Related Problems. National Institute on Alcohol Abuse and Alcoholism (NIAAA) Research Monograph No. 25, NIH Pub. No. 93-3513. Bethesda, MD: NIAAA; 1993:175-200.)

4. Johnston, L. D., O’Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2010). Monitoring the Future national survey results on drug use, 1975–2009: Volume I, Secondary school students (NIH Publication No. 10-7584). Bethesda, MD:National Institute on Drug Abuse.

5. Toumbourou, J.W., Hemphill, S.A., McMorris, B.J., Catalano, R.F., & Patton, G.C. (2009) Alcohol use and related-harms in school students in the United States and Australia. Health Promotion International. 24(4), 373-82.

6.White AM, & Swartzwelder HS.Hippocampal function during adolescence: a unique target of ethanol effects. Annals of the New York Academy of Sciences, vol. 1021, pp. 206-20.

7. Birckmayer J, Hemenway D. (1999) Minimum-age drinking laws and youth suicide, 1970–1990. American Journal of Public Health. 89, 1365–1368.

8. Smith DI, Burvill PW. (1987) Effect on juvenile crime of lowering the drinking age in three Australian states. Br J Addict. 82:181–188.

9. Kypri, K., Voas, R.B., Langley, J.D., Stephenson, S.C.R., Begg, D.J., Tippetts, A.S., & Davie, G.S. (2006) American Journal of Public Health. 96(1), 126 – 131.

Action

Write to the newspapers pointing out the benefits the research is indicating from restoring the MLDA to 21.

Sample letter 1:

The serious problem with young people binging on alcohol and taking drugs as entertainment is publically acknowledged. The 2007 Victorian Drug Statistics Handbook revealed that alcohol related ambulance call outs (4805) was double the number of such call outs in 2002. The 2009/2010 figures (“Trends in Alcohol and Drug-Related Ambulance Attendances”, research jointly funded by Ambulance Victoria and The Turning Point Alcohol and Drug Centre, 15 August, 2011) revealed alcohol related call outs were increasingly for young women.

Harm minimisation policies on their own are not working. Raising the minimum legal drinking age back to 21, as it was up to the early 1970s in Australia, should be given serious consideration as research from the USA is showing that it is very effective in reducing injuries and death from road trauma and also reducing other alcohol related harms such as suicide and youth crime.  

I would like to see a vigorous public debate calling on our policy makers to examine the overwhelming evidence that raising the legal minimum drinking age to 21 has reduced injury and death (especially from road accidents)  among young people.

Sample letter 2:

The NSW Police Commissioner, Andrew Scipione, was reported in the Sydney Morning Herald, 10 October, 2011, as saying that there needs to be a debate about the manner in which alcohol is advertised and marketed to ensure children and teenagers are not getting the wrong message. Mr Scipione was optimistic that the binge drinking culture of the young could be addressed “within 20 years.”

The problem is so serious that we don’t have 20 years to deal with it. Whatever other measures are taken to regulate advertising and such like there should be a vigorous public debate about also raising the minimum legal drinking age back to 21, as it was in Australia up to the early 1970s. There is overwhelming evidence (from the USA and, more recently from NZ) that raising the legal minimum drinking age to 21 has reduced injuries and deaths from road accidents and other alcohol related harms such as suicide and youth crime.

The whole drinking culture would be fundamentally changed for the better if the law prohibited drinking alcohol until one had turned 21.