I rejoiced to see the following article in CNN’s Health Care in America commentary: “Drinking age of 21 doesn’t work.” Finally a sensible statement about the issue. The 21-year-old drinking age has not been an effective solution to the problem of drunk driving, or alcohol-related deaths among young adults. Not only is it ineffective, it might actually pose more risks for young people.

The National Minimum Drinking Age Act was passed by the Congress in 1984 and signed by the president. This Act raised the drinking age to 21. This was government’s reaction to the threatening and growing problem with drunken driving accidents and fatalities. However, this is probably the only preventative measure that the government took and it wasn’t nearly enough. Simply raising, or lowering the drinking age does not deal with the real problem. Young people need to be educated on the effects of alcohol (on behavior and driving), the importance of personal decisions and potential risks. Psychologists attest the truth of the old saying that ‘the forbidden fruit tastes the sweetest’. This is especially true for young people, who often need to resist control and authority to declare their autonomy. The author of the article makes an excellent point: “The law does not say drink responsibly or drink in moderation. It says don’t drink. To those affected by it, those who in the eyes of the law are, in every other aspect legal adults, it is Prohibition. And it is incomprehensible”(John M. McCardell, Jr). This can further aggravate the rebellious spirits. In addition, young Americans are aware that almost all other countries (except Indonesia, Mongolia and Palau) either have no minimum drinking age, or have a lower age limit (usually 18, but sometimes even 16).

It is no longer 1984. “Now, 25 years later, we are in a much different, and better, place. Thanks to the effective public advocacy of organizations like Mothers Against Drunk Driving, we are far more aware of the risks of drinking and driving. Automobiles are much safer. Seatbelts and airbags are mandatory. The “designated driver” is now a part of our vocabulary” (John M. McCardell, Jr).

Alcohol-related fatalities have declined in the past 25 years, in all age groups. Yet, the greatest number still involves people at age 21, followed by 22 and 23. “The problem today is different. The problem today is reckless, goal-oriented alcohol consumption that all too often takes place in clandestine locations, where enforcement has proven frustratingly difficult. Alcohol consumption among young adults is not taking place in public places or public view or in the presence of other adults who might help model responsible behavior. But we know it is taking place.” It is taking place in dorm rooms, off-campus apartments or remote fields (that involve driving). Drinking in such remote and isolated places hides greater risks than ordering drinks in a bar, where the bartender can refuse to serve at any point the individual appears intoxicated. If drinking is taking place in a public setting, there are many mediators and people who can react in case of emergency and call 911. This is not the case in locked and secret places where all of the drinkers can be underage and therefore be hesitant to call the police, because they don’t want to get in trouble. The CNN article explains that “of the 5,000 lives lost to alcohol each year by those under 21, more than 60% are lost OFF the roadways, according to the National Institute of Alcoholism and Alcohol Abuse.”

The main problem today in not drunken driving. It is “clandestine binge drinking” “A study published in the Journal of the American Academy of Child and Adolescent Psychiatry revealed that, among college-age males, binge drinking is unchanged from its levels of 1979; that among non-college women it has increased by 20%; and that among college women it has increased by 40%” (John M. McCardell).

The bottom line is that the drinking age of 21 does not eliminate the problems or change the fact that young adults and teenagers ARE drinking, even if it is considered illegal. Then, we need to be thinking how we can create the most safe environment possible, so that young people can explore drinking with minimal risks.

The danger is found in drugs’ effect on GABA receptors.

Drugs like alcohol, barbiturates, and benzodiazepines all seems to affect the same target – the major inhibitory neurotransmitter GABA. Neurons containing GABA receptors are very common in the nervous system and their function is to inhibit other neurons. One such receptor that is affected by GABA is the GABAa receptor that contains chloride channels. When the receptor is excited, an influx of Cl ions takes place, increasing the negative charge on the inside – hyperpolarization – making initiation, or propagation of an action potential much more difficult. However, this GABAa receptor has not only a binding site for GABA, but two other binding sites as well. One is the sedative-hypnotic site, the other is the anxiety site. That’s why it is possible that both sedative-hypnotic drugs (alcohol and barbiturates) and antianxiety drugs (benzodiazepines) can bind to the same receptor, amplifying their effects. Sedative-hypnotic drugs (alcohol or barbiturates) have precisely this effect -making it hard for action potential to take place and, therefore, sedating the body and affecting bodily functions. Antianxiety drugs (benzodiazepines) enhance binding effects of GABA and so alcohol, or barbiturates will have an even stronger sedative effect, possibly leading to coma, or even death.

The threat of mixing drugs and alcohol is not just a myth, it is a deadly cocktail that you don’t want to be experimenting with.

Mothers who endanger the health and well being of their children are considered deviant, possibly, in almost all cultures in the world. Certainly, this is a sensitive and loaded topic that normally provokes strong societal response. The labeling of a deviant mother often involves the legislative system, child services and other governmental organizations. Beyond doubt, most people will agree it is absolutely deviant for an expectant mother to drink alcohol. However, is drinking during pregnancy a discussed issue in our society? Do we just assume that everyone is aware of the medical research on the negative effects of alcohol? Do we simply expect pregnant women to be responsible?

An adult’s decision making on behalf of a minor should serve the best interest of the child. The same should be true for a mother’s decisions that might affect her inborn baby. This is not a matter of personal choice anymore, as, inevitably, another life is to be affected.

Scientists explain, there are many poisonous substances – teratogens – that could be endangering the life of a fetus that is particularly vulnerable in this early stage of prenatal development. Alcohol is the most common teratogen (National Task Forces on Fetal Alcohol Syndrome and Fetal Alcohol Affects, 2002). Teratogenic exposure of alcohol may cause Fetal Alcohol Syndrome (FAS) or Fetal Alcohol Effects (FAE).

The life of the inborn child that is ‘poisoned’ with the alcohol can be severely impaired by a debilitating disorder such as FAS. With this syndrome, the alcohol ingested during pregnancy affects the normal development of the baby. Facial features are particularly vulnerable to change, especially the situation and opening of the eyes, ears and the upper lip of the baby.

Even if the newborn looks unharmed, alcohol could have still affected the brain, and more specifically the Central Nervous System, causing hyperactivity, poor concentration, impaired spatial reasoning, and mental retardation (Streissguth & Conner, 2001). In addition, the child has a slow physical growth and relatively small stature, compared to peers. The poor coordination, mental retardation, poor reasoning and judgment could profoundly affect the life of the child, making even the simple daily activities an impossible burden. Even if the condition of the child is not severe, there are, certainly some differences.

Alcoholics’ children who have never had a drink on their own still show distinct brain patterns that can only be compared to those of alcoholic adults (Agarwal, 2001). Scientists warn that children affected by FAS are at much greater risk of psychiatric problems. Also, they are more likely to engage in criminal behavior. Statistics reveal that more than 50% of children with Fetal Alcohol Syndrome grow up to have trouble with the law. Many of the shocking homicide cases that have been covered in the press have involved a person, who was diagnosed with a Fetal Alcohol Syndrome.

On a macro level, it is shocking to learn how many people are affected directly, and how many more suffer the consequences around them. According to the US Department of Health and Human Services, 1 out of 500 children is “damaged” in certain degree because of the irresponsible alcohol consumption of the mother. Many of these children require special help and need to be included in specialized programs that yearly cost billions of dollars. Many of the children require special educations and face the Juvenile Justice System. By no means should this issue be underestimated, especially when data demonstrates a threatening growth of the rate of Fetal Alcohol Syndrome each year.

Scientist and physicians are not certain as to what amount of alcohol is dangerous. Some still advice pregnant women to have a glass of red whine, while others are strictly against such practice, saying: “No amount of alcohol is safe for the fetus.”

When a pregnant woman is drinking, do we have the right to intervene? Could we enforce our understanding and concern? As far as I know, there are no laws prohibiting ‘pregnant drinking’ although it does not sound to me like a bad idea. The irony is we try to protect young people from alcohol until the age of 21, but that is virtually  useless if we do not protect them prenatally.

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