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Abstract #163705

Amy Wallace, MD, MPH, VA Outcomes Group REAP, VA Medical Center, 215 N. Main St, White River Junction, VT 05009, 802 291 6285, aew@dartmouth.edu, Andrew C. Horrigan, MD, Department of Psychiatry, Dartmouth Medical School, One Medical Center Drive, Lebanon, NH 03766, David A. Bulkin, BA, Department of Psychological and Brain Sciences, Dartmouth College, Wheelock Street, Hanover, NH 03755, and Todd A. MacKenzie, PhD, VA Outcomes Group REAP, VAMC, 215 N. Hartland Rd, White River Junction, VT 05009.

Background: Establishing a safe drinking age is important because adolescent exposure to alcohol can impair neurological functioning and may be associated with greater vulnerability to alcohol use disorders; the latter assumption is based on small observational studies. Using large administrative databases, we examined whether exposure to a minimum legal drinking age (MLDA) under 21 was associated with later alcohol problems using alcohol treatment episodes as a proxy. Methods: From the Department of Health's Treatment Episode Data Set, we extracted alcohol-related treatment episodes from years 1992-2004 by state residence in five age cohorts. We used poisson regression to calculate incidence rate ratios for treatment based on age group exposure to the under-21 MLDA. Using states with historical 21-year MLDAs as the reference group, we calculated odds ratios of treatment for residents of states with an under-21 MLDA by year and age group. Results: Across 1992-2004, incident rate ratios of treatment were increased with exposure to under-21 MLDAs for 25-29 year-olds (IRR=2.1, p<.001) and 30-34 year-olds (IRR=1.6, p<.002) but not significantly so for older age groups. Odds ratios for treatment of residents in under-21 MLDA states were significantly higher for all ages through the mid 1990s, after which time rates converged with those with historically 21 year MLDA states. Discussion: Compared to residents of states whose MDLA was historically 21, residents of states with under-21 MLDAs were more likely to receive alcohol treatment, particularly those aged 25-34. With decreasing exposure to legal drinking under age 21, treatment rates across states have equalized.

Learning Objectives:

• Understand the rationale for establishing a safe minimum legal drinking age.
• Describe how longitudinal, administrative data can inform policymakers about population risks and consequences to policy decisions.
• Articulate the differences in later alcohol use disorders between states with differing historical minimum legal drinking ages.

Keywords: Alcohol Use, Adolescent Health

Presenting author's disclosure statement:

Not Answered