Dangerous Alcohol Drinking Abuse on 21st Birthday

A most dangerous practice has become common in recent years: consuming 21 alcoholic drinks within a short period after a person turns 21 years of age.

No one should ever under any circumstances consume 21 drinks within a short period. This can easily cause alcohol poisoning and death.

What can be done to discourage this so-called passage rite? No one knows for sure, but there are a number of possibilities to consider.

“Being Carded”

College students who receive a birthday card for their 21st birthday alerting them of the dangers of alcohol poisoning may be less likely to have a high-risk birthday celebration. A survey of 1,731 Michigan State University students found that those who had received the card were 6% less likely to get drunk on their birthday.

The card reads "You're turning 21... CELEBRATE!" Inside, the card says "We want you to turn 22... celebrate responsibly!" The back of the card describes the tragic death of a student who died on his 21st birthday from an overdose of alcohol. Each card comes with a wallet-size card with helpful information about alcohol poisoning.

A non-profit group, BRAD (Be Responsible About Drinking) has sent the cards to thousands of students across the country. 1


Legislation has been proposed in Texas that would make it illegal for anyone to drink alcohol at a bar or restaurant before 7:00 a.m. on that person’s 21st birthday. Thus, people couldn’t drink during the first seven hours after becoming 21 years of age.

The coordinator of alcohol and drug education at University Health Services at the University of Texas, Charles Roper, said he doesn’t know of any research supporting the bill's intent. However, he said he “can't imagine that it would make one bit of difference," He points out that if people can't celebrate at midnight on their birthday, they’ll simply celebrate the next evening. 2

Such a well-intentioned law might actually make the problem worse by driving people into private parties or having other unintended and counter productive outcomes. For that reason it’s important to draft alcohol legislation carefully and then to evaluate its effectiveness.

Parental Advice

Research has repeatedly demonstrated that parents, not peers, have more influence on their children’s drinking decisions. Therefore, it’s important that parents not only model moderation but also explain the dangers of alcohol poisoning.

Researchers at Columbia University and Queens College have found that young people select friends who share their attitudes about drinking. And their attitudes have been shaped by observing their parents. Therefore, the peer group largely reinforces what young people have already learned from their parents. 3

Social Norming

Using the social norms marketing technique should reduce the assumed social pressure to engage in this dangerous drinking behavior. The social norms marketing approach has consistently proven to be highly effective in reducing alcohol abuse. It’s based on the fact that young people typically over-estimate the extent of alcohol use and abuse. When the actual incidence of use and abuse is measured and then widely and intensively reported, most students promptly modify their behavior. Therefore, surveys that demonstrate that fewer people are risking their lives on their birthdays than most people think should reduce the perceived social pressure to do so.

The social norms technique is very inexpensive to use and the benefits occur quickly.

Alcohol Knowledge

It’s important that young people not fall victim to common myths about drinking. For example, it’s important for them to know that standard drinks of alcoholic beverages contain equivalent amounts of alcohol.

A glass of white or red wine, a bottle of beer, and a shot of whiskey or other distilled spirits all contain equivalent amounts of alcohol and are the same to a Breathalyzer. A standard drink is:

  • A 12-ounce bottle or can of regular beer
  • A 5-ounce glass of wine
  • A one and 1/2 ounce of 80 proof distilled spirits (either straight or in a mixed drink)

Young people need to know that there is no beverage of moderation, only behaviors of moderation.

Teaching Moderation

Our children learn from observing our behavior and we are the most significant role models in their lives. Therefore, we need to:

  • Be good role models. We need to be living, day-to-day examples of good drinking behavior.
  • Reject "do as I say, not as I do." If we abuse alcohol, we can't expect our children not to follow in our footsteps when they begin to drink.
  • Convey appropriate attitudes. We should never laugh at intoxication or inappropriate behavior. We can use news events, TV episodes, movies, or personal events as opportunities to discuss what is appropriate and inappropriate behavior.

Teaching responsible use does not require the consumption of alcohol any more than teaching world geography requires visiting Nepal or teaching civics requires that children run for elective office or vote in presidential elections. We teach civics to prepare children for the day when they can vote and assume other civic responsibilities if they choose to do so.

Of course, in those many states in which parents can legally serve their children alcoholic beverages, teaching young people to drink in moderation within the home is highly desirable. It’s much better for youths to learn to drink in the parent’s house than in a fraternity house.

Teenagers who report drinking alcohol with their parents are less likely than others to have either consumed alcohol or abused it in recent weeks according to a federally funded nation-wide study of over 6,200 teenagers in 242 communities across the U.S.

Drinking alcohol with parents “may help teach them responsible drinking habits or extinguish some of the ‘novelty’ or ‘excitement’ of drinking” according to senior researcher Dr. Kristie Long Foley of the School of Medicine at Wake Forest University. Dr. Foley describes drinking with parents as a “protective” behavior. 4

This finding is to be expected. Those societies and cultural groups with very high rates of drinking but very low rates of alcohol-related problems have certain common keys to success. One such protective key is that in such groups young people learn about moderate drinking from their parents and they do so from an early age. 5

The problem of heavy drinking on 21st birthdays requires us to think creatively in order to reduce its occurrence and save lives.


  • 1. Durbin, D-A. Twenty-First Birthday Cards Working at Michigan State. Associated Press, July 10, 2002; USA Today, July 11, 2002, 6-A.
  • 2. Gilbert, Jeffrey. Bill would put lid on birthday binges: Measure aims to stop midnight rite of passage on 21st birthday. Houston Chronicle, January 23, 2005.
  • 3. Los Angeles Times, June 25, 2001; also see www.latimes.com/
  • 4. Foley, Kristie Long, et al. Adults’ approval and adolescents’ alcohol use. Journal of Adolescent Healthy, 2004, 35(4), 345-346.
  • 5. Hanson, David J. Preventing Alcohol Abuse: Alcohol, Culture and Control. Westport, CT: Praeger, 1995.


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