This column was originally published in AMA eVoice on October 18, 2007. Dr. Davis is president of the American Medical Association.
Did you know that, according to the National Highway Traffic Safety Administration, more than 25,000 lives have been saved since states began setting the legal drinking age to 21? That statistic is just one piece of overwhelming research that proves the lifesaving benefits of laws that establish the minimum legal drinking age at 21.
That was one of the main points made during a news conference I participated in last week launching Support 21, a coalition of Mothers Against Drunk Driving, the National Transportation Safety Board, the Insurance Institute for Highway Safety, and the AMA. The coalition was formed to explain the importance of laws establishing the legal drinking age at 21, especially because misguided efforts are under way to lower the legal drinking age.
More than 50 peer-reviewed studies have looked specifically at the effect of these laws on traffic fatalities, and each of them found that an increased drinking age significantly lowers alcohol-related fatalities. And in a review of more than 50 studies from states and countries that changed their drinking ages, the Centers for Disease Control and Prevention found that increasing the drinking age decreases fatalities and crashes by 16 percent, and that lowering drinking ages increases fatalities and crashes by 10 percent.
Recent public opinion research shows strong support for a minimum drinking age of 21. According to a July 2007 Gallup poll, 77 percent of Americans say they would oppose a federal law that would lower the drinking age in all states to 18. And six out of 10 Americans support stricter penalties for underage drinking.
As I said at last week's news conference, it's impossible to ignore the growing body of literature demonstrating the dangers of early alcohol use for those underage. One such piece of evidence is an AMA report on the effects of alcohol on the brains of children, adolescents, and college students. That report, a comprehensive compilation of two decades of scientific research on how alcohol alters the developing brain and causes possibly irreversible damage, dispels the myth that youth are more resilient than adults to the adverse effects of drinking.
Underage drinking is especially a problem on college campuses. Drinking by college students aged 18 to 24 contributes to an estimated 1,400 student deaths, 500,000 injuries, and 70,000 cases of sexual assaults or date rapes each year, according to a 2002 study commissioned by the National Institute on Alcohol Abuse and Alcoholism's Task Force on College Drinking.
To lower those figures, the AMA is heavily involved in efforts to reduce underage drinking. Among those is a national initiative to ban alcohol advertising during college sports events, asking colleges to put student safety over profit and adopt an institution-wide policy prohibiting alcohol ads on locally produced sports programming in all athletic activities. That includes coaches' shows, televised coverage, and printed programs.
Overall, 276 colleges nationwide and three conferences have signed a college commitment to ban alcohol advertising. Tusculum College, Lane College, and the South Atlantic Conference (PDF, 81KB) are the most recent additions to that list, thanks to a letter-writing effort by the Tennessee Medical Association.
That campaign is an offshoot of "A Matter of Degree: The National Effort to Reduce High-Risk Drinking Among College Students," a collaboration between the AMA, the Robert Wood Johnson Foundation, and 10 university-community coalitions to reduce alcohol abuse among college students. During an upcoming Web cast, to be presented by the AMA from noon to 1 p.m. CST on Oct. 23, an expert panel will address the extent and implications of high-risk drinking among college students and will summarize evidence-based strategies from "A Matter of Degree." All physicians and medical students are invited to participate in the Web cast.
Several AMA members have formed a working group on alcohol control—the AMA Action Team on Alcohol and Health. Co-chaired by Stuart Gitlow, MD, and Thomas Shieh, MD, the group gathers at AMA meetings and has a listserv where ideas are exchanged. If you'd like to subscribe to the listserv, send an e-mail to Richard Yoast of the AMA Department of Alcohol, Tobacco, and Other Drug Abuse.
Underage drinking is just a subset of the overall problem—alcohol abuse. To help physicians incorporate alcohol screening and intervention into their practices, the AMA has partnered with the National Institute on Alcohol Abuse and Alcoholism to produce "Helping Patients Who Drink Too Much — A Clinician's Guide" (PDF, 2MB). The AMA offers a number of other resources related to alcohol abuse, including a tool kit for physicians to identify and help risky drinkers and links to information about support groups and treatment options.
To bolster alcohol control programs, more resources are needed. To that end, the AMA adopted a resolution in 2005 (policy D-30.995) endorsing increases in federal, state, and local taxes on beer, wine, and liquor. The new revenues would be earmarked to the prevention of alcohol abuse and drunk driving, treatment of persons with alcohol dependence or at-risk drinking patterns, and public health and medical programs that serve vulnerable populations.
As we combat alcohol problems domestically, we need to remember that they are common throughout the world. Both the AMA (policy D-30.993) and the World Medical Association have adopted policy urging the World Health Organization (WHO) to develop an international treaty on alcohol modeled after the WHO's successful tobacco treaty (the Framework Convention on Tobacco Control), which has now been ratified by 151 countries (not including the United States, unfortunately).
I don't have enough space to mention the many alcohol abuse resources that are available online, but a new Web site from the National Institute on Drug Abuse is worth a look. It shares the latest on relevant research, clinical practice, clinical trials, materials for patients, and trends in drug abuse (including alcohol abuse) and addiction to help physicians and medical students stay current on the latest science-based facts on drug abuse and addiction.
Alcohol abuse is a destructive problem—among adults and those underage. Let's work together to lessen the impact it has on all of us and, in the process, create healthier, safer communities.
Please send comments, questions, and replies to amaprez@ama-assn.org.
Content provided by: Ronald M. Davis, MD