The Amethyst Initiative, initiated in summer 2008, brought forth a debate among college presidents and higher education officials in the United States regarding the minimum legal drinking age of 21. Advocates of this initiative argued that the higher legal drinking age in the U.S. compared to other countries results in more dangerous drinking behaviors among young adults.

This debate prompted various states to consider lowering the drinking age to 18 however, no state had implemented such a change. The central question at hand is whether the age-21 drinking limit effectively reduces alcohol consumption by young adults and its associated harms. Young adults aged 18-25 commonly engage in heavy episodic drinking, which poses significant health risks and contributes to various accidents and injuries.

Since a substantial percentage of young adult deaths are due to external causes, policies affecting alcohol consumption among this demographic have the potential to impact mortality rates. A paper by Carpenter and Dobkin (2011) reviewed a substantial body of empirical evidence and argues that setting the minimum legal drinking age at 21 does, indeed, reduce alcohol consumption and its associated harms.

The study does however acknowledge that this finding alone may not be sufficient to justify a minimum legal drinking age of 21 as it does not consider the potential benefits of alcohol consumption. The study suggests that the balance between reducing harms and consumer surplus from alcohol consumption should inform the choice of an appropriate minimum legal drinking age.