How do you feel about the drinking age in the United States? Do you think that we should be more like other Western countries whose legal age is 18? Or do you think that the current drinking age is the safest/best option? It seems like the legal drinking age is one of those issues where people tend to take one side or the other and try to justify their position, regardless of evidence or most current research.
Well folks, I am here to say that changing your mind is possible, or at least it is possible to be swayed. I have long been a proponent of lowering the legal drinking age to 18, in part because of all the other rights and responsibilities given to 18 year olds, and in part because a higher drinking age makes alcohol the forbidden fruit, which leads to sneaking around and other high risk behaviors. However, recent evidence has caused me to question my initial stance, because I now realize that a drinking age of 21 really does save lives. Raising the drinking age (which happened in 1984) has been shown to delay the age that many people start to drink and therefore reduces the risk of developing dependency (aka alcoholism) later in life. It also reduces the incidence of drinking and driving among individuals under the age of 21.
But what about Europe? They have a lower drinking age and it seems to work for them; why can’t it work for us? I have uttered these words myself many times, but research is also working to disprove this argument. Emulating Europe may work for many other health topics (healthcare, nutrition, physical activity) , but Europe’s rate of binge drinking among youth is higher than the United States, and 15 European Countries have a higher rate of deaths due to alcohol than the United States, including Germany and France. I think when it comes to preventing dependency and saving lives, particularly due to drinking and driving, the case is closed on the drinking age of 21.
So the evidence is clear about how drinking age impacts drinking and driving accidents and age of first consumption. But how do we change social norms around drinking on college campuses and how does the drinking age of 21 impact high risk drinking among college students? Binge drinking is consuming five or more drinks in a row. The graph below shows the2-week prevalence of consuming five or more drinks in a row among college students vs. young adults who are 1 to 4 years beyond high school (12th graders are included for comparison). The general trend is in the right direction, but it does not appear that the 1984 national mandate of a drinking age of 21 has made a significant impact on high risk drinking (though I have not run a statistical analysis of this). The rate of binge drinking also appears to have flat-lined somewhat since 2002 for college students. 
The graph below shows the percent of people who used alcohol in the past month by different age groups. As you can see, the heavy alcohol use and binge drinking was highest among people aged 21-25 followed closely by 18-20 year olds. 
Here at UNC, while nearly a quarter of undergraduate students do not drink at all, 65.2 % of underage students consumed alcohol in the previous 30 days, and 43% of students reported binge drinking in the past 2 weeks according to the 2012 Core Survey on Alcohol and Other Drugs, a bi-annual assessment conducted campus wide.
At Student Wellness we try and use a risk reduction public health approach because it has been shown to be a more effective and realistic way of approaching alcohol use for college students. This means that we recognize that the only way to completely remove risk for people under the age of 21 is by abstaining, while at the same time recognizing that many students will choose to drink. For students who do choose to drink, we want to help them minimize the risks as much as possible. It is with this philosophy in mind that we talk to students who do decide to drink about using alcohol in moderation and how to eliminate risk as much as possible. As members of the Carolina community, it is important to know that many perceptions around alcohol use on college campuses are incorrect and a large proportion of students do not drink at all. These misperceptions seriously impact how we norm alcohol use on this campus. At the same time, we should recognize that binge drinking is a real problem that needs to be addressed and a drinking age of 21 has not significantly reduced the prevalence. We also need to acknowledge that binge drinking is not necessarily a normal part of college life for all students, and there are real long term health impacts from binge drinking.
Regardless of which side of the drinking age debate your are on, the end goal should be to recognize that drinking does not have to be part of college life, but if you choose to drink, there are ways it can be done in safer and healthier manner. Be safe and have a good summer!
UNC Healthy Heels 