Problem Drinkers: can you spot them in kindergarten?

Have you ever heard or read a statement something like this?

“Children who begin drinking before age 21 are more than twice as likely to develop alcohol-related problems. Those who begin drinking before age 15 are four times likelier to become alcoholics than those who do not drink before age 21.”*

Or how about this:

“Research tells us if we can keep the kids off cigarettes and alcohol, by the time they graduate (presumably...from high school) there’s almost zero percent chance they will abuse any other type of drug.”**

Makes it sound like there's a definite link there, doesn't it, between early-onset drinking and alcoholism? That's called causality, as in one thing -- drinking before you're 15, or before you graduate from high school -- causes another -- alcoholism. After all, those who begin drinking before age 15 are four times more likely to become alcoholics. Sounds pretty damning.

Ever considered how ice cream causes drowning? "Research shows" that when ice cream consumption goes up, drowning deaths also increase. It's true, but it's also unrelated, and it's a well-known example of what happens when researchers confuse correlation with causality. See, ice cream consumption goes up in the summer...which is also when more people go swimming. The more people go swimming, unfortunately, the more drowning incidents there are. Nothing to do with ice cream consumption.

I know some of you are thinking, hold on, Lew: there's a lot more connection between teen drinking and adult drinking than there is between ice cream and swimming. How do I know there isn't a real relationship? Good question, fair question (the kind of question I wish more New Dry researchers would ask).

Here's the answer.
“AFD (age at first drink) is not specifically associated with alcoholism but rather is correlated with a broad range of indicators of disinhibited behavior and psychopathology. Moreover, individuals who first drink at a relatively early age manifest elevated rates of disinhibitory behavior and psychopathology before they first try alcohol. Taken together, these findings suggest that the association of AFD with alcoholism reflects, at least in part, a common underlying vulnerability to disinhibitory behavior. Whether an early AFD directly influences risk of adult alcoholism remains unclear.” (McGue, M., et al. Origins and Consequences of Age at First Drink. I. Associations with Substance-Use Disorders, Disinhibitory Behavior and Psychopathology, and P3 Amplitude. Alcoholism: Clinical & Experimental Research. 25(8): 1156-1165, August 2001.)

And further, the same authors also report:

“Problems seen in adulthood among early drinkers existed prior to their taking that first drink, which suggests that developmental processes were already disrupted prior to that first drink. Thus, an early AFD is more likely a 'symptom' of an underlying vulnerability of disinhibitory processes rather than a 'cause' of increased rates of alcoholism."

A 'symptom' ... rather than a 'cause.' It's correlation, not causation. Both behaviors -- early drinking and alcoholism -- are outcomes of disrupted personal development. When I think about the kids in my high school who drank or used drugs, with only a couple exceptions, they were kids who'd been in trouble since grade 3 or 4 (I went to a rural public school where we didn't have a lot of families moving in and out; I was with most of these kids from kindergarten to 12th grade). They started drinking because they already had problems, the kinds of problems that can lead to alcoholism.

Here's what the people who write press releases for groups like CASA and PIRE and the Marin Group probably saw in a report from the National Institute on Alcohol Abuse and Alcoholism. Unfortunately, they probably only read the part in boldface:

People who begin drinking before age 15 are four times more likely to develop alcohol dependence at some time in their lives compared with those who have their first drink at age 20 or older. It is not clear whether starting to drink at an early age actually causes alcoholism or whether it simply indicates an existing vulnerability to alcohol use disorders. For example, both early drinking and alcoholism have been linked to personality characteristics such as strong tendencies to act impulsively and to seek out new experiences and sensations. Some evidence indicates that genetic factors may contribute to the relationship between early drinking and subsequent alcoholism.

But it's the first part that gets quoted in newspaper stories, and in the years since that report came out, the quotes have gotten further and further from the NIAAA's cautions in the rest of the paragraph. And no one ever calls them on this.

I don't want anyone to think that I don't consider underage drinking to be a serious problem. Given the way people under the legal age drink in this country, it's a very serious problem. But here's the thing. I got these quotes from Alcohol Problems & Solutions, an excellent website I've been reading for years, done by David Hanson, a professor emeritus at SUNY Potsdam who's been researching alcohol issues all his life. And Hanson finished up the piece in question with this very neat summation of why we should resist all the ridiculous measures like keg registration and laws that seize houses for underage drinking: "If alcohol policies are based on false assumptions, they are likely to be ineffective and a waste of effort and resources."

I am thinking of the children. I'm thinking of the adults too. I just wish the people who are responsible for creating and implementing alcohol policies...would think more clearly.

*That's former Secretary of Health (and well-known anti-everything loonbag) Joseph Califano, in "Teen Tipplers: America’s Underage Drinking Epidemic," from the ever-popular Center on Addiction and Substance Abuse (CASA) in a 2002 press release.

**And that's a Drug Abuse Resistance Education (DARE) official in the Green Bay Press-Gazette, on May 18, 2004.