21st Birthday Drinking a Serious Health Hazard

Custom Prevalent Among College Students

Young man drinking alcohol
Photo © Peter Dazeley/Getty Images

A prevalent custom among college students to drink heavily on the day that they turn 21 years of age poses a serious health hazard, according to a study of 2,518 current and former college students.

In a published study called, "21st Birthday Drinking: Extremely Extreme," Patricia C. Rutledge, Ph.D., of the University of Missouri - Columbia, and her colleagues analyzed the results of an online survey of college students who had already turned 21 years old.

They were asked if they drank on their 21st birthday and, if so, how much they drank.

The study is believed to be the first to confirm the growing custom known as "21 for 21," the practice of having 21 drinks when someone turns 21 years old, the legal drinking age in the United States.

83 Percent Drank on Their 21st Birthday

The results of their survey included:

  • 83% of the students reported drinking on their 21st birthday.
  • 34% of men reported consuming 21 drinks or more.
  • 24% of women consumed 21 drinks or more.
  • The maximum number of drinks for women was 30.
  • The maximum number of drinks for men was 50.

Serious Medical Outcomes

Based on the information provided by the survey participants, Rutledge estimated the blood alcohol content (BAC) of the participants on their 21st birthday. They found that 68% of the females and 79% of the males had estimated BACs of 0.08 or higher on their birthday, or over the legal limit for intoxication in all 50 states.

Almost half of the men (49%) and 35% of the women had estimated BACs of 0.26. The researchers noted that a blood alcohol content level of 0.26 is associated with "potential serious medical outcomes," including disorientation, coma, and even death.

Not Just the Problem Drinkers at Risk

"This study provides the first empirical evidence that 21st birthday drinking is a pervasive custom in which binge drinking is the norm," said Rutledge in a news release.

"This research should serve as evidence that there needs to be more public education about the dangers of 21st birthday binge drinking."

The study found that even 36% of students who never drink when they were underage participated in drinking to celebrate their 21st birthday.

"The risks here are not limited to those with a history of problematic drinking, and there needs to be a strategy to address a custom that can lead to alcohol poisoning and, possibly, death," said Rutledge.


Rutledge, Patricia C., et al Journal of Consulting and Clinical Psychology. "21st Birthday Drinking: Extremely Extreme" June 2008.

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