Youth Initiatives and Efforts to Reduce Underage Drinking

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1 Youth Initiatives and Efforts to Reduce Underage Drinking JC Fell Pacific Institute for Research and Evaluation, Beltsville Drive, Suite 300, Calverton, Maryland USA Background Although tremendous progress has been made in reducing alcohol-related traffic deaths since Mothers Against Drunk Driving (MADD) was founded in 1980 in the United States, traffic deaths continue to be the leading cause of death for youth in the United States. Alcohol is related to 6.5 times more deaths of youth than all other illicit drugs combined. Underage drinking is America s No. 1 youth drug problem, contributing to death and injury to thousands of young people every year from crime, suicides, rapes, assaults, alcohol poisoning and unintentional injuries costing at least $53 billion annually in societal costs. 1 Since 1988, the minimum legal age to purchase or possess alcohol has been 21 in all states and the District of Columbia (DC) in the United States. Yet almost half of 8 th graders and about three-quarters of high school seniors report that they have consumed alcohol at some time during the past year. Over half of high school seniors report being drunk within the past year 2 and close to a third of youth in this country report that they started drinking alcohol at aged 16 or younger. Two-thirds of youth report initiating drinking at age 18 or younger. 3 Youths aged 12 to 17 who report drinking alcohol within the past month are more than twice as likely to get involved in school fights than youth who do not drink alcohol. 4 Nearly half of all college students report participating in highrisk (or binge) drinking (5 or more drinks per session) during the course of the year. 5-6 Alcohol has been shown to be involved in more than 40% of all college student academic problems and 28% of all college dropouts. 7 The relative risk of being killed in a single vehicle traffic crash for young males (aged 16-20) at blood alcohol levels as low as is almost 5 times that of sober male drivers of the same age. 8 New medical research shows that the brain is not fully developed until about age 21 in most people. Excessive drinking by youth can cause irreversible brain damage and reduce brain function performance by as much as 10%. 9 Recent research shows that the early onset of drinking by youth increases their risk in the future for alcohol abuse problems 10 and alcohol-related crashes and assaults. 3 Most European countries with lower drinking ages than the United States experience substantially higher percentages of youth that engage in high-risk (binge) drinking and self-reported intoxication in the past month. 11 Even without strict enforcement, minimum drinking age 21 laws still save an estimated 1000 lives per year in reductions in traffic fatalities involving young drivers. 12 From 1988 when all states had enacted such legislation to 1995, alcohol-related traffic fatalities for youth aged 15 to 20 declined from 4187 to 2212, a 47% decrease. However, since that time, this decline has ended, with youth alcohol-related fatalities fluctuating between 2200 and 2400 including slight increases since The rate of underage drinking drivers in fatal crashes varies considerably by state. 13 This stagnation has occurred despite the passage by all states of zero tolerance laws for drivers age 20 and younger, which were designed to strengthen the minimum legal drinking age (MLDA) laws.

2 Sources of Alcohol for Youth Underage focus group participants report that their first drinking incidents occurred in junior high school, and at that age, they frequently obtained alcohol from their parents supply or from older siblings and friends. By the mid-teens, parties where alcohol is available become the major source. In the mid to late teens, youth purchase alcohol from commercial alcohol outlets. 14 The ways youth obtain alcohol vary considerably depending on many factors, including their age and regional variations, but youth report that their most common sources of alcohol are adults (aged 21 and older). 15 (see Figure 1) Commercial Availability Age 20 and Younger No ID required Real ID used Fake ID used Age 21and Older Friends Siblings Coworkers Strangers Parents Provides directly to <21 Provides at parties to <21(e.g., kegs) Provides to <21outside outlet (e.g., shoulder tap) Alcohol easily available to <21 in homes Figure 1. Sources of Alcohol for Underage Drinkers Ninety-four percent of underage college students indicate it is either very easy or easy to obtain alcohol. 16 Although the majority of underage drinkers obtain alcohol from someone aged 21 or older, buying alcohol from a commercial outlet is another way to get alcohol. Surveys reveal that anywhere from 3 to 21% of youth report buying their alcohol directly from a commercial outlet. 17,18 When researchers first began reporting the results of alcohol compliance checks in the United States, sales to underage decoys ranged from 33% to 97%. 19,20 Even more recently, more than 15% of 6 th graders reported they were able to purchase alcohol from a store, bar, or restaurant. 17 Home delivery services and ordering alcohol through the Internet appear to be somewhat newer methods for underage drinkers to obtain alcohol. Ten percent of 12 th graders and 7.3% of 18- to 20-year-olds reported purchasing alcohol through a home delivery service in the past year. 21 In summary, the evidence indicates that most underage youths find it relatively easy to obtain alcohol and that much of it comes from older peers or parents. Nevertheless, direct purchase from on- and off-premise alcohol outlets remains a significant factor in underage consumption. The National Academy of Sciences Report A comprehensive report by a committee established by the National Academy of Sciences (NAS) Institute of Medicine 22 was recently released on strategies to reduce underage drinking in this country. The report was developed in response to a congressional request for the committee to review a broad range of federal, state and non-governmental programs (including environmental interventions and programs focused on youth attitudes and behaviors) to develop effective strategies to reduce and prevent underage drinking. Early on, the committee reached the fundamental conclusion that underage drinking cannot be successfully addressed by focusing on youth alone. Youth usually obtain alcohol directly or indirectly from adults. 23,24 Therefore, the committee concluded that efforts to reduce the problem need to focus on adults and must engage the society at large.

3 Among a group of strategies described in the NAS report include recommendations in the following areas: National Adult-Oriented Media Campaign Partnership to Prevent Underage Drinking Alcohol Advertising Entertainment Media Limiting Access of Alcohol to Youth Youth-Oriented Interventions Community Interventions Government Assistance and Coordination Alcohol Excise Taxes MADD fully endorses this report and supports the recommendations from it. The NAS report has substantial potential to influence policy on future strategies to reduce and prevent underage drinking, including both state legislation and program policies. In addition, it may influence resource allocations, an important factor given the evidence that most states have implemented their underage laws without providing funds for the increases in existing law enforcement levels. 25 The NAS report is also significant because it points to the limitations in current laws and the need for enforcement. MADD and Underage Drinking Prevention Programs MADD s mission has always been to stop drunk driving and support the victims of this violent crime. Because of the link between underage drinking and youth traffic fatalities, MADD added the prevention of underage drinking to their mission statement in MADD believes that young people must be an integral part of the solution to the serious problem of underage drinking. That is why MADD creates and implements a variety of youth alcohol use prevention programs to help young people stay alcohol-free. MADD s youth programs are rooted in the latest scientific research and strive to empower children, teens, and parents with knowledge so that individuals will be able to keep themselves and others safe from harm. Programs encourage good decision-making and engage youth in specific interventions designed to reduce underage drinking. MADD Youth Summit On September 29 October 4, 2000, MADD brought together 435 young people in Washington, DC, who represented each congressional district in the United States to discuss and develop recommendations to prevent underage drinking. The summit was designed to bring young people from across the country who are concerned about underage drinking and impaired driving (1) to provide them with a forum to discuss alcohol-related topics from a national and community perspective, and (2) to obtain new solutions and creative approaches from the young people directly affected by the problems of youth access to alcohol and youthful impaired driving. During the summit, five topicbased plenary sessions provided the students with an opportunity to work jointly with their peers and those who directly influence laws that affect minors: legislators, law enforcement officials, federal agencies, and the media. Delegates collectively voted on their top recommendations to address the problems. The summit culminated with delegates presenting their top recommendations to America at a national news conference held on the steps of the US Capitol. Following the news conference, the young people met with their elected members of Congress to discuss ways to implement their recommendations in their home states and communities. Because young people can understand and communicate the impact of alcohol on their peers, they also are uniquely qualified and credible in creating effective public policy

4 solutions to the underage drinking problem. These youth advocates are continuing to make a difference in helping to solve the underage drinking problem and to create a better and safer future for themselves and their generation. Youth in Action One of MADD s most successful community-based youth programs is called Youth In Action (YIA). MADD s YIA program partners young people with community adult leaders to work toward environmental prevention strategies. Projects focus on strengthening enforcement of underage drinking laws and policy change. YIA teams have been trained in more than 40 communities across the country. Their partnerships with local law enforcement agencies, schools, and community leaders have helped pass key underage drinking legislation and saved young lives. YIA focuses on the community environment that condones underage drinking, from the store clerk who doesn't check IDs, to the police officer who might pour out the beer and send teens home, to an adult who doesn t mind buying beer for a kid who slips him an extra $10. These teams look for community solutions instead of focusing their attention on their peers, and also engage in specific interventions because research says these projects work. YIA teams across the country conduct: Alcohol Purchase Surveys. A young looking 21-year-old attempts to purchase alcohol without an ID. No actual purchase is made. It is merely a survey to see if the clerk will sell alcohol to a presumed minor without ID. Compliance Checks. With the help of the police, young people act as underage buyers. They are instructed to go through with the sale, whether the clerks ask for IDs or not. The police may cite or arrest the store clerk. Shoulder-Tap Surveys. With law enforcement present to ensure safety, a young person (or group of young people) approaches strangers outside an alcohol retailer to see if these adults will willingly purchase alcohol for them because they are too young to buy it legally. Those that answer yes receive, instead of money, a card outlining the law and penalty for furnishing alcohol to a minor. Those that refuse to purchase alcohol are handed a card thanking them for serving their community by refusing to provide alcohol to a minor. Law Enforcement Recognition Programs. YIA teams publicly thank local law enforcement officials who are working to prevent underage drinking. This can be done in many ways: a formal banquet, a media event, or even just by bringing food to officers at the station or out on location where police officers are working on the job. Either way, this is a unique opportunity for teens to thank police officers for doing their job. Roll Call Briefings. YIA teams set up meetings with their local police departments to make presentations at shift-change meetings. Two or three YIA members go to the police station with an adult leader to encourage police officers to enforce the zero tolerance law. Many YIA teams have handouts (printed cards or notepads) outlining the law and declaring their support for it. Protecting You/Protecting Me Protecting You/Protecting Me (PY/PM) is another program developed by MADD in response to educators, parents, and community leaders seeking an alcohol-use prevention program for elementary school students that could be incorporated into the core curriculum. PY/PM was named a Model Program by the US Department of Health

5 and Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Substance Abuse and Prevention (CSAP). PY/PM includes the latest brain research, provides all curriculum and training materials necessary for national replication, and includes an evaluation component that continually demonstrates significant results. The PY/PM curriculum teaches 1 st through 5 th graders basic safety skills and alcohol s effects on the developing brain, and also shows kids how to protect themselves by making good decisions, such as what to do when riding in a car with an unsafe driver. The curriculum is designed to fill the gap in current prevention programs that have not yet incorporated the latest research on children's brains and the developmental risks associated with exposure to alcohol before the age of 21. The goal of the curriculum is to prevent injury and death of children and youth due to underage consumption of alcoholic beverages, and vehicle-related risks, especially as passengers in vehicles in which the driver is not alcohol-free. Evaluation of PY/PM has shown that students receiving the lessons are more knowledgeable about their brains, more media literate, less likely to ride with a driver who is not alcohol-free, and less likely to drink when they are teenagers. PY/PM is endorsed by the American Academy of Pediatrics and the National Association of Elementary School Principals. By the end of 2003, nearly 200,000 elementary students were exposed to MADD s PY/PM lessons in more than 1200 schools across the country. Conclusion MADD firmly believes that if underage drinking can be controlled, alcohol-related deaths in the United States can be substantially reduced. The most effective strategies are environmental: closing the loopholes in existing MLDA laws in the states, enforcement of underage drinking laws and impaired driving laws, and limiting access to alcohol by youth. MADD s programs not only support these measures, but also provide youths and adults with the information, knowledge, and tools to have a substantial impact on the problem. References 1. Levy DT, Miller TR, Cox KC. Costs of underage drinking: Updated edition. Washington DC: US Department of Justice, Office of Justice Programs, Office of Juvenile Justice and Delinquency Prevention (OJJDP); October Johnston LD, O'Malley PM, Bachman JG. The monitoring of the future: National results on adolescent drug use: Overview of key findings, Bethesda, MD: National Institute on Drug Abuse; Hingson R, Heeren T, Levenson S, Jamanka A, Voas RB. Age of drinking onset, driving after drinking, and involvement in alcohol-related motor vehicle crashes. Washington, DC: National Highway Traffic Safety Administration (NHTSA); January DOT HS Substance Abuse and Mental Health Services Administration (SAMHSA) National household survey on drug abuse: Main findings. Rockville, MD: U.S. DHHS; Wechsler H, Lee JE, Kuo M, Seibring M, Nelson TF, Lee HP. Trends in college binge drinking during a period of increased prevention efforts: Findings from four Harvard School of Public Health study surveys, J Am Coll Health. 2002;50(5):

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