Long‐Term Effects of Minimum Drinking Age Laws on Past‐Year Alcohol and Drug Use Disorders

Abstract

BACKGROUND Many studies have found that earlier drinking initiation predicts higher risk of later alcohol and substance use problems, but the causal relationship between age of initiation and later risk of substance use disorder remains unknown. METHOD We use a ‘natural experiment’ study design to compare the 12-month prevalence of DSM-IV alcohol and substance use disorders among adult subjects exposed to different minimum legal drinking age laws MLDA in the 1970’s and 1980’s. The sample pools 33,869 respondents born in the US 1948–1970, drawn from two nationally representative cross-sectional surveys: the 1991 National Longitudinal Alcohol Epidemiological Survey (NLAES) and the 2001 National Epidemiological Study of Alcohol and Related Conditions (NESARC). Analyses control for state and birth year fixed effects, age at assessment, alcohol taxes, and other demographic and social background factors. RESULTS Adults who had been legally allowed to purchase alcohol before age 21 were more likely to meet criteria for an alcohol use disorder (OR 1.31, 95% c.i. 1.15, 1.46, p < .0001) or another drug use disorder (OR 1.70, 95% c.i. 1.19 to 2.44, p = .003) within the past year, even among subjects in their 40’s and 50’s. There were no significant differences in effect estimates by respondent gender, black or Hispanic ethnicity, age, birth cohort, or self-reported age of initiation of regular drinking; furthermore, the effect estimates were little changed by inclusion of age of initiation as a potential mediating variable in the multiple regression models. CONCLUSION Exposure to a lower minimum legal purchase age was associated with a significantly higher risk of a past-year alcohol or other substance use disorder, even among respondents in their 40’s or 50’s. However, this association does not seem to be explained by age of initiation of drinking, per se. Instead, it seems plausible that frequency or intensity of drinking in late adolescence may have long-term effects on adult substance use patterns.

Effects of increased alcohol availability during adolescence on the risk of all‐cause and cause‐specific disability pension: a natural experiment

“…First, supporting previous research on increased alcohol availability, we found that lowering the legal age limit for alcohol purchases can have long‐term alcohol‐related health consequences 2, 5, 6, 7, 8, 9. Secondly, the study provides further evidence that alcohol consumption during adolescence is associated with later health problems 16, 17, 18.…”

“…Previous research, using a natural experiment setting of a policy change, has investigated the short‐ and long‐term effects of changing the legal age limit for alcohol purchases on alcohol consumption and alcohol‐related harm 5, 6, 7, 8, 9, 10. One area where research is scarce, but potential costs are high, concerns the association between increased alcohol availability during adolescence and the risk of disability pension.…”

Did the 18 Drinking Age Promote High School Dropout? Implications for Current Policy

“…If cross-state migration is uncorrelated with MLDA and high school dropout, as we assumed, our estimates likely underestimate the true relationship between permissive MLDA and high school dropout. We have established that this is a reasonable assumption in previous work (Grucza et al, 2012;Norberg et al, 2009).…”

“…MLDA exposure was determined as described elsewhere (Grucza et al, 2012;Norberg et al, 2009;Plunk et al, 2013), using a variety of sources, including peer-reviewed research (Du Mouchel et al, 1987;O'Malley & Wagenaar, 1991;Wagenaar, 1982), the Statewide Availability Data System (Ponicki, 2004), and news sources (Associated Press, 1996). We assessed three different thresholds of MLDA exposure in our analyses: (a) any permissive MLDA, to include the legal drinking age of 18, 19, or 20; (b) a threshold including the drinking ages of 18 and 19; and (c) a threshold that only considered the impact of the MLDA of 18.…”

The Healthcare Burden Imposed by Liver Disease in Aging Baby Boomers

“…On the other hand, public policy and prevention can have a dramatic influence. Increased taxation of alcoholic beverages and raising the minimum drinking age reduce consumption and abuse during later adulthood [13,14]. Furthermore, studies indicate that brief screening and counseling during medical visits are extremely cost-effective ($1755 per quality-adjusted life year saved) [15].…”