Thursday, February 11, 2016

Debunking Sarah Longwell on combating America's alcohol problem.

In response to the CDC's recommendations that women who are both sexually active and capable of having a child not drink alcohol unless they use birth control, and the resulting angry backlash from some quarters, Sarah Longwell, the managing director of the American Beverage Institute, wrote an article that has appeared in multiple outlets, such as the Des Moines Register. She claims in the article that, although the CDC's recommendations are aimed at preventing fetal alcohol spectrum disorders, "achieving this worthy public health goal shouldn’t require women to suddenly stop drinking and having sex. And expecting women to take that advice is utterly unrealistic." 

First, before I debunk her column, I would like to provide some background on the American Beverage Institute: it is a lobbying organization that fights against alcohol control policies like lowering blood alcohol limits, increasing alcohol prices, and ignition interlock systems in cars. 


The first assertion she makes is attacking a straw man: the CDC's recommendations were not that women who are sexually active and drinking alcohol stop doing at least one of them, but rather that they stop drinking alcohol if they are sexually active and not using birth control. She goes on to misrepresent the CDC's recommendations again in the column, falsely claiming that they recommended that because "fertile women could have a baby at any time; ladies, either put down your light beer or stop having sex." 


Anyway, she then discusses whether the US even has a drinking problem, saying: "While medical bodies, including the American Academy of Pediatrics, say “no amount of alcohol is safe during pregnancy,” many individual doctors suggest a glass of wine or two during pregnancy isn’t an issue. University of Chicago economist Emily Oster reviewed hundreds of academic studies and ignited a firestorm when she authored a book arguing that occasional drinking during pregnancy (1-2 drinks per week in the first trimester, 1 daily thereafter) isn’t problematic." What she doesn't mention is that since Oster's book was published in 2013, many other studies have been published, the overall effect of which has been to cloud the issue. Some of these studies have found that light drinking during pregnancy has adverse effects.  


She then criticizes the CDC because, and I quote:

"Every year, the CDC generates splashy headlines about how “excessive drinking” is costing our economy billions of dollars each year and that “one in three adults drinks excessively.”" 

The thing is, it's not just the CDC who is concerned about this problem in America: the World Health Organization said in 2014 that in 2010, about 23% of men and 11% of women in America were problem drinkers.


She goes on to criticize the CDC's definitions of heavy drinking (>15 drinks/week for men and >8/week for women) and states that: 

"There is a clear difference between an adult who enjoys two glasses of wine with dinner and one who chronically consumes several bottles. However, targeting policy recommendations to those with alcohol abuse problems isn’t in the CDC’s wheelhouse." 

What she doesn't mention is that 90% of people who drink excessively are not alcoholics.

So what are the policies the CDC recommends that Longwell disapproves of? Let's ask her:
"The CDC advocates for higher alcohol taxes, though the National Institute on Alcohol Abuse and Alcoholism reports that alcohol tax increases had no effect on the 5 percent of consumers who are the heaviest drinkers. Instead, higher prices encourage moderate drinkers to cut back and heavy drinkers to switch to cheaper brands."

Not true (at least if she's saying these taxes don't work, which seems to be what she's implying). A 2010 review showed that increasing the price of alcohol, including through taxes, significantly reduced alcohol-related mortality and injury, and suggested that "doubling the alcohol tax would reduce alcohol-related mortality by an average of 35%, traffic crash deaths by 11%, sexually transmitted disease by 6%, violence by 2%, and crime by 1.4%."


Lastly, I will focus on her argument about lowering the blood alcohol limit, as promoted by the CDC:

"The agency also recommends states lower the legal blood alcohol concentration (BAC) limit for driving from .08 to .05 percent. The average BAC for a drunk driver involved in a fatal crash is .15 — nearly twice the current legal limit. If setting the limit at .08 hasn’t stopped these heavily intoxicated drivers from getting behind the wheel, .05 is unlikely to succeed. Even Mothers Against Drunk Driving doesn’t think .05 is the answer."

Well, the problem with the statement that "setting the limit at .08 hasn’t stopped these heavily intoxicated drivers from getting behind the wheel" is that it implies that because some laws are often broken by people, the laws don't work. In fact, contrary to Longwell's implication, studies show that lowering the BAC limit at 0.08% has saved lives. One study from before every state had a BAC limit of 0.08 (as is the case now) found that "It all states adopted 0.08% legal blood alcohol limits, at least 500 to 600 fewer fatal crashes would occur annually." Another study from four years later put the number at between 400 and 500.



I can't help but notice that the arguments made by this employee of an alcohol industry lobbying organization is making similar arguments to organizations lobbying on behalf of the gun industry: "don't target law-abiding citizens, target the criminals! Criminals don't follow the law, so making it stricter won't stop crimes!" Of course, this totally ignores the fact that if you extend this argument to any horrific act, it could be used to "debunk" the imposition of any law banning such an act, because criminals will just disobey it anyway. The arguments made by Longwell don't make any more sense, and her arguments about there being a distinction between some people who drink 15 drinks/week and others reek of special pleading.











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