Alcohol Under 21 years old Rory M Doyle, M.Sc Office of the Chief Medical Examiner Washington, DC Rory.Doyle@dc.gov
EU Drinking Age Limits Country Drinking age Purchase Age Country Drinking Age Purchase Age Germany (16 w/adult)* (16 w/adult)* Greece Austria 16 ( Spirits) 16 ( Spirits) Ireland Italy 16 16 Luxembourg (17 w/adult)* (17 w/adult)* Sweden 20 ( off) 20 ( off) Holland (16 w/adult)* ( 16 w/adult)* Belgium 16 (15 w/adult)* 16 (15 w/adult)* Denmark (15 off) (15 off) Finland France 16 (12 w/adult)* 16 (12 w/adult)* Portugal Spain 16 (12 w/adult)* 16 (12 w/adult)* UK (16 off) (16 off) * Beer and wine only
America Drinking Age Limits Country USA** Argentina Colombia Chile Mexico Drinking age 21 **19 states exceptions Purchase age 21 Country Canada# Brazil Honduras Peru Drinking Age 19 21 19 21 # in Alberta, Quebec, Manitoba Purchase Age
Other Drinking Age limits Country Australia New Zealand Russia Republics Eastern Europe China Drinking Age None,, 21 16, None Purchase Age None,, 21 16, None
US Drinking Age Limit! Age Limit- 21 (Established 1987)! National Minimum Drinking Age Act, 1984! Federal Highway Act funding! Desire to curb traffic fatalities due to Alcohol consumption particularly among under 21 year olds! Alcohol Related Fatality Statistics (NHSTA) 43% drop for under 21 year olds (1987-1996) 28% drop in general population 14% drop for under 21 year olds (1981-1986) 4% drop in general population
US Drinking Age limit! Other Factors Accident rates due to other factors Economic changes Driving earlier Gasoline prices Automobile ownership! Canada and EU study showed similar reduction in accident rate without raising drinking age Reduction due to initiatives and strategies towards drinking behavior
US Drinking Age limit Social factors! General drinking patterns and drinking behavior constant over time, Hughes et al! Collegiate drinking patterns constant, More illegal drinking- Reactance Theory, Engs et al! Massive education efforts and drinking perils set up by Federal, State, Private (MADD) groups! Inconsistency as to social treatment of under 21 year olds! Other countries have determined that similar changes to Drinking Age limit creates a social, enforcing and economic problem, ICAP Report 2002
Blood Alcohol Concentration Limits Worldwide Country BAC (mg/ml) Country BAC (mg/ml) Country BAC (mg/ml) USA 0.8/1.0 Belgium 0.5 Denmark 0.5 Finland 0.5 Luxembourg 0.8 Holland 0.5 Portugal 0.5 France 0.5 Germany 0.5 Greece 0.5 Ireland 0.8 Italy 0.5 Spain 0.5 Sweden 0.2 UK 0.8 Canada 0.8 Australia 0.5 New Zealand 0.8 Austria 0.5 Eastern Europe 0, 0.1, 0.3, 0.5
World Driving Age Limit UK 17 Denmark Poland 17 Switzerland Germany Italy Netherlands Spain Norway Finland Sweden Luxembourg Ireland 17 Belgium France USA 16
Alcohol Consumption! WHO Global Review per Capita Highest Alcohol- Slovenia Highest Beer- Czech Republic Highest Spirits- Russia Highest Wine- Luxembourg Age- 15 plus
Alcohol Consumption Adults! US- 26 th World (110 million drinkers plus) 11 th Beer, 19 th Spirits, 29 th Wine! US- 45 million Kilolitres per year (Est) Beer- 23, Spirits- 11, Wine- 6 Youth! US- 40 th World! Cost- $58 billion (1996) - $90 billion (2002)
Standard Drink
Standard Drink! Standard Drink varies per country! US- Beer 12oz, Wine 5oz, Spirits 1.5oz Alcohol Strengths- Vary per country! Cognac, Gin, Rum 40%! Vodka 37.5%! Fortified wine 20%! Champagne 13.%1! Table Wines 11%! Beer 3.13 to 5.%
Standard Drink N.B. The definition used for a "binge" is five or more drinks at a sitting, and nine or more drinks for "harmful drinking."
Beer Strengths Proof of Volume Alcohol by Weight Content Brand 23.6 11.8 9.16 Samichlaus Bier 21.83 10.91 8.73 EKU Malt liquor 14.78 7.39 5.93 Elephant Malt Liquor 9.33 4.66 3.73 Budweiser 9.03 4.51 3.61 Coors 9.70 4.85 3.88 Heineken 9.93 4.96 3.97 Molson Ale
Brain and Alcohol! Adolescent Brain and body developing! Alcohol effect more powerful! Brain more sensitive at low doses/ less sensitive at higher doses! Learning impaired at lower doses! Memory function impaired! Liver function impaired! Sleep less thus drink more
Alcohol Myths and Teens! Alcohol gives you energy- Depressant, slows abilities! Switching drinks will make you more drunk BAC determines drunkenness not flavor! Drunk quicker with hard liquor Alcohol is alcohol! Everybody reacts the same with alcohol- Weight, mentality, body chemistry, food, mood, etc! Cold Shower and Coffee will sober you up No reversal of effects
Alcohol Myths and Teens! Just beer, no harm Organ damage to liver, digestive system, etc.! Hangover only worst thing Can kill if too much! Drugs are bigger problem than alcohol 6.5 times more people killed than drugs. 10 million addicts and #1 problem with youth! Alcohol makes you sexy Performance problems! Drunk people only hurt themselves 4 people per drunk effected
Alcohol Surveys Data collected-! Harvard School of Public Health College Alcohol Study! Core Institute, Southern Illinois University! Monitoring the Future, University of Michigan! National College of health Risk Behavior Survey, CDC! National Household Survey on Drug Abuse, SAMHSA! State and Local Surveys by Health Departments and Educational Boards
Alcohol Survey! Pro s Indication of alcohol usage Anonymous Trends of abuse Help in establishing initiatives and strategies! Con s Questionnaire format Peer pressure School pressure Value of results questionable
Underage Drinking Findings! 87% adults had first drink under 21! Drinking at 15 implies 4 times likely to be alcohol dependent! Drinking at 14 increased lifetime alcohol abuse! 61% of alcohol consumed by heavy drinkers and underage! Early drinking age associated with violence
Underage Drinking Access! One third of high school students! Home is best place Influence! Animated films- 50% use alcohol! Advertising with talking lizards, etc! 41% tried new packaged beverages
Alcohol Trends High School (EU v USA)
Alcohol Trends
Alcohol Trends High School (SAMHSA) Youth 12-17! 7.2 million once a year! 2.7 million once a month! 1 million once a week! Girls and boys same rate! Black youth less likely! 66% believe 4-5 drinks hazardous! 47% believe 4-5 drinks once/twice hazardous Drink any alcohol! 13% drinking problem! 6% tolerance! 3% psychological! 1% health Rates constant! Current- 30.6%! Binge- 15.2%! Heavy- 6.9%
Alcohol Trends High School (SAMHSA) Drink regularly! 39% drinking problem! % tolerance! 8% psychological! 4% health Seniors 5 or more! 66% drove! 42% drove w/o seat belt Drinking 5 or more! 77% drinking problem! 63% tolerance! 20% psychological! 12% health Rates! Highest among Seniors! Highest among White males in North Central! Lowest among Black females in cities
Alcohol Trends High School (Monitoring the Future) 8 th Graders! 25% once a month! 8% drunk! 15% binge per 2 week! 1% daily 10 th Graders! 40% once a month! 22% drunk! 25% binge per 2 week! 2% daily 12 th Grader! 53% once a month! 34% drunk! 30% binge per 2 week! 4% daily
High School Alcohol (NIAA) Beliefs! Preschoolers negative view! Boys more favorable belief, More grown up! Positive benefits! Greater social acceptance! Faster rate as get older! 56% encouraged! 75-89% readily available! Negative scholastic performance Risk factors! Curiosity, fit in, relax! Genetic factors- Unknown! Behavior- Aggressive, restless! Psychiatric- Anxiety, depression! Suicide! Illicit drug use! Learning disorders! Delinquency! Pregnancy
Alcohol and Youth (AMA)! 9.5 million (9%) current drinker under 21! 4.4 million binge, 1.9 million heavy! First drink at 12.8! 70% of under 17 bought alcohol recently! 88% Under 15 and 75% under 13! Under 17 lack knowledge of alcohol! Under 17 year olds account for 35% of Beer sales (1.1 billion cans of beer)
Binge Drinking (AMA)! Binge drinking-considered to be 5 drinks! 33% under 17, 5 or more drinks once a month! 36% male and 29% female! 43% college students binge (5 for male, 4 for female)! 71% College bingers were High school bingers! 81% Fraternities and Sororities! College athletes binge drink at higher frequency than in 1993! Average consumption per college student 4 to 6 drinks per night
Race, Ethnicity and Gender! 44% White, 33% Hispanic, 30% African American of all under 21 year olds! 23% Male, 20% Female recently (30 days)! Increased binging Decreased binging Asian (21.9-23%), White (47.5-46.8%) Black (16.5-.3%) Hispanic (38.5-37.6%)
Core Survey 2000 (n=55,000)! Ethnicity White- 80% Black 7.4% Hispanic- 3.9% Other- 8.1%! Under 21-64.6%! Alcohol Year- 85.3% Month- 74.4%! Average Drinks Male- 9.87 Female- 4.37! Binging 49.7% five or more! Consequences Hangover- 65% Poor performance- 24.4% Police- 16.5% Damage- 9% Violence- 31.8% Nausea- 55.3% Driven car- 29% DUI- 1.6% Sex- 16% Injury- 16.5% Suicide- 5%
Core Survey 2000! Beliefs Break Ice- 75.8% Social- 74.4% Male bonding- 58.5% Female Bonding- 46.6% Men Sexier- 16.5% Female Sexier- 27.4%! Differences with 1999 Alcohol Year- 85.1% Month- 73.3% Average drinking Male- 8.87 Female- 3.97! Beliefs similar! Violence increased! Binging Rates same
DC Survey 2003 (n=50) in Progress! High School! Ethnicity 80% Black 20% other! Under 17 37% drank recently! Average 4 drinks at a time Binging Unknown! College! Ethnicity 40% White 30% Black 30% other! Under 21 45% recently! Average 5-6 drinks at a time! Binging twice a month