Juan A. Martinez’s Post

Transcript

Yeah, and I'm really interested in like the social messaging surrounding various substances and to sort of explore alcohol abuse further. I want to ask you, some argue that the legal drinking age should be lowered since it gives parents an opportunity to teach their children responsible drinking habits. Whereas others argue that the legal drinking age should remain at 21 to prevent alcohol related injuries in youth. What's your sense of what the proper legal age to purchase alcohol should be? That's a great question. That's a great question. And so and so and it might be smarter to answer that question a little differently. OK, so there's no question that, that, that, that. That underage drinking has has has remained about the same in frequency over the years, so that the the current lowered drinking age does actually not prevent people from drinking. OK, you know, people still have access through friends, family, fake ID's, you know, and so they're not. If that were the metric of success, then it does not look like it's working. If but, but and and we may have created in that and there's not good science to support this. Set this next statements. But they're important statements. And we may have created a much worse world because the way young people drink right now is that they drink. They do high intensity drinking before attending events, right. So. So they they pregame or tailgate or there's a bunch of some Borg is this word now you know like they they they do this high intensity drinking and and that means that they consume a lot more alcohol and a lot shorter period and and so. Alcohol overdose rates are up, OK? People are presenting to emergency rooms with severe acute intoxication and blood alcohol concentrations of .2 to .3, right? So that's not good. On the other hand, on the other hand, it's likely that if you give unfettered access, right, with this problem that we don't really understand, People don't understand that that drinking, that the person you know, having having being able to be the, the tough guy with alcohol, you know, being able to hold your liquor is a high risk. We don't educate anyone on that And therefore, therefore, you know, 18 year olds are gonna, are gonna, are gonna, you know, view this as a contest. You know, like I can drink the most and I don't get in trouble and they're going to have more alcohol use disorder and the consequences of alcohol use are consequence of the health consequences are absolutely rising. There is a paper you should pick up that the CDC published on Friday, Friday, this Friday, February 29th. Between 2016 and 2020 alcohol related deaths surged 20, almost 30 percent, 25% of men, 35% of women. So women are catching up. This is amazing. This is the 100, the 170,000 deaths in 2020 that were due directly to alcohol. So, so the stop us, Let's stop and bump pack. All those statements are admitted 500 deaths a day. That's more than opiates. Or 100,800 thousand deaths. So it's almost double opiates at this point. Ohh. Wow. It's, it's it's more than Alzheimer's. It's more than diabetes. OK, so, so, so, so it's coming up on stroke, right. So it's now in the top four causes of death period in the United States. OK, All of those deaths, Not all of them. 70% or so are chronic are due to liver disease that's developed, you know like and now it takes a long time to get alcohol associated liver disease. A point where you might die from it like that. Like, studies show that takes 10 years of heavy drinking at about 10 drinks a day. OK, that's a that's a worldwide number. So that means that the death rate rising from chronic liver disease in 2020 is just the tip of the iceberg. It represents drinking in 2010. OK, OK, OK. So alcohol, alcohol, death rates have been rising since 2000 or so, 20 years now they're really jumping and. A lot of us are freaked out that there is this that this epidemic of of of of severe liver disease coming right that is going that the modeling data suggests that we'll double again in the next 10 years, double again in the next 10 years. So this is all hands on deck moment and I hope your listeners listen closely and I hope your other people you're interviewing you start asking about this, this, this, this is right Today, 50% of all liver transplants go for alcohol associated liver disease. OK, so this is new. This is not, this is not, this is not the drinking of your it's not your granddad's drinking problem. Right? And and you could argue that that is coming from the training of pregaming and and have you binge drinking, right? You could argue that. But again if you were going to loosen that control and let 18 year olds drink, you better train them how to do it and better make sure that they don't that, that, that, that, that they just don't take the heavy binge drinking inside someplace else, right. So what could help? Well. You know, when I was a college student, we had this thing called 32 beer, you know, and it was hard to drink too much of it O lower alcohol beverages could be a difference. And there is some. And alcohol free beverages are coming along. Maybe reduced alcohol beverages are a choice. Yeah, maybe. If like we allowed eighteen to let's say 25 year olds to purchase low reduced alcohol and then passed 25, you could purchase legally. Exactly. Yeah. That's a great idea. Yeah, there's a great. There's your entrepreneurial future. Yeah, you know, like purveyors of low alcohol. Beverages you know where it's kind of hard to get there it's kind of hard to get. You know I do have patients who drink 20 beers a day. Wow. OK. So you know reduced alcohol beer, let's say it was you know 10%. It was a half of what the your it was like 3% alcohol instead of 6. You know you know why they they person could drink you know 20 beers on those and get a 10. Beer problem right. But but but but but I think I think in general lowered alcohol concentrations and beverages. Could be useful in the alcohol industry could actually you know probably make more money on that than they make on their current products. And I have heard data and I hope this is true but data but I have heard people talk about how drinking as much lower right now in young people than it has been in past generations. And I'm curious a lot of those alcohol related deaths are in older folks and there are some promising data alcohol related deaths are spread across all age ranges and and and we measure something called disability adjusted life years dallies at and alcohol. Is the leading cause of short of increased of increased disability adjusted life year loss right and and in all developing countries right so it and all developed in all middle income countries I should say so so so so you know that problem that's been known for a long time the the. The there are, I believe that the the number of drinking kids has gone down a little bit but not not a lot and by the time they're in their 20s it's with the same as everyone else. And and again I don't think any of us have you know like this idea that it's binged. I mean binge drinking is the problem but the idea that we maybe made binge drinking worse by our alcohol policies does not have. I mean that that has not been rigorously tested and and you know, nor have any. All of our prevention efforts are sort of absolutist. Again, binary don't drink right, you know, and and so we, we don't really have a, we don't really have a, a testing system for for testing how to really train people to drink well.