By Sindy Bolaños-Sacoman, Owner & CEO, SBS Evaluation & Program Development Specialists

Why did the alcohol conversation stop twenty years ago?  The focus of prevention has turned to opioids and fentanyl, but more people in the U.S. die of alcohol-related causes than from opioids and other drugs¹.

Community organizations and coalitions can start having these much-needed conversations to raise awareness and uncover this silent epidemic. There are several benefits to community education (e.g. town halls) and advocacy including, alcohol focused data presentations, sharing information about evidence-based strategies known to effectively decrease alcohol consumption, and increasing awareness of alcohol related harms. The more community members know, the better equipped they will be to counter the pressure from the alcohol industry, to address policy initiatives, and to implement local strategies.

Important data topics include how a specific state compares to the nation, local rates for alcohol related harms (e.g. cancer, homicide, poisoning, alcohol use disorder, suicide, heart disease, and motor vehicle crashes), and rates for excessive drinking including heavy drinking, binge drinking, underage drinking, and drinking while pregnant. Vital to the conversation are topics on equity, social determinants of health, and trauma (including historical trauma) and their impact on alcohol misuse. Consider how different populations or sub-populations are impacted by alcohol; this can include Tribal communities, the unhoused, LGBTQI people, a specific gender, rural communities, etc. Ensure that you have a variety of people at the table representing local populations; different opinions shed light on different community needs.

There are some recommended evidence-based-strategies known to successfully decrease alcohol-related harms. The top recommended strategies include⁴:

• Increase Alcohol Taxes^{2,4,5,9,10,11 -}increasing alcohol taxes have been shown to decrease drinking (including underage drinking) and decrease many alcohol-related harms.
• Regulating Alcohol Outlet Density⁴-limiting the number of businesses selling and distributing alcohol in neighborhoods is one of the most effective strategies for reducing alcohol-related harm.
• Increase Alcohol Screening and Brief Intervention^4,6- screening and brief intervention services provided in clinical, community, or fully online settings have been shown to reduce excessive alcohol consumption and related harms, reduce binge drinking intensity and frequency.
• Limit the Days and Hours Alcohol Sales Occur^4,7- decreasing days and hours that alcohol is sold is effective in reducing excessive alcohol consumption and related harms. Limiting access by regulating the hours during which alcohol can be legally sold- evidence shows that two or more hours are to be considered.
• Responsible Beverage Service Training^3,4- has demonstrated favorable results in reducing excessive alcohol consumption among patrons, minimizing alcohol-related harms from excessive drinking that has already occurred. This is a training program designed for those that serve alcohol to increase responsible serving following the legal requirements of alcohol service.
• Dram Shop Liability^4,8,12 - dram shop liability laws are effective in preventing and reducing alcohol-related harms related to excessive drinking including those due to death or injury from motor vehicle
• Enhance Enforcement of Laws Prohibiting Sale of Alcohol to Minors⁴ - increasing the frequency of retailer compliance checks

References

1. Weir, K. (2023) More People in the U.S. die of alcohol-related causes than from opioids and other drugs. Psychologists are working to change that: cultural beliefs paint alcohol use disorder as black and white, a mindset that often means too few people get help for problematic drinking. Monitor on Psychology Vol 54 No.4
2. Daley J.I., Stahre MA, Chaloupka FJ, Naimi TS. The impact of a 25-cent-per drink alcohol tax increase. Am J Prev Med. 2012; 42:382-389.
3. Woodall W.G, Starling R, Saltz RF, Buller DB, Stanghetta P. Results of a Randomized Trial of Web-based Retail Onsite Responsible Beverage Service Training: WayToServe. J Stud Alcohol Drugs. 2018; 79: 672-679.
4. The Community Guide (2023). https://www.thecommunityguide.org/pages/about-community-preventive-services-task-force.html
5. World Health Organization. Excise tax on alcoholic beverages (2024). https://www.who.int/data/gho/data/indicators/indicator-details/GHO/excise-tax-on-alcoholic-beverages
6. The Community Guide. Alcohol Excessive Consumption: Electronic Screening and Brief Interventions (e-SBI). (2021). https://www.thecommunityguide.org/findings/alcohol-excessive-consumption-electronic-screening-and-brief-interventions-e-sbi.html
7. The Community Guide. Alcohol Excessive Consumption: Maintaining Limits on Hours of Sale. (2021) https://www.thecommunityguide.org/findings/alcohol-excessive-consumption-maintaining-limits-hours-sale.html
8. The Community Guide. Preventing Excessive Alcohol Consumption: Dram Shop Liability (2013). https://www.thecommunityguide.org/media/pdf/Alcohol-Dram-Shop.pdf
9. Alaska Mental Health Trust Authority. Does an Increase in Alcohol Tax Reduce Alcohol Misuse. (2020). https://alaskamentalhealthtrust.org/wp-content/uploads/2020/03/Trust-Whitepaper_-Alcohol-Taxes-and-Alcohol-Misuse_March-2020.pdf
10. Change Lab Solutions. (2019) Alcohol Tax Revenues, Social and Health Costs, & Government Expenditures. http://alcohol-psr.changelabsolutions.org/alcohol-psr-faqs/alcohol-taxes-faq/alcohol-tax-revenues-social-and-health-costs-government-expenditures/
11. Alcohol Harms Alleviation. (2023). https://www.ahacoalition.org/
12. Guide to Community Preventive Services. (2010). Alcohol - Excessive consumption: Dram shop liability. Retrieved from https://www.thecommunityguide.org

Sindy Bolaños-Sacoman is the owner and CEO of SBS Evaluation & Program Development Specialists, the Founder and Director of the New Mexico Tribal Behavioral Health Provider’s Association and a Core Team Member of the Alcohol Harms Alleviation Coalition. Sindy serves as a consultant, trainer, technical advisor, and evaluator to communities across New Mexico. She is also a Program Evaluation Advisory Council Member with the Substance Abuse and Mental Health Services Administration (SAMHSA). She has expertise in program development, program evaluation, community mobilizing, alcohol policy, strategic planning, grant writing, Medicaid, crisis intervention, behavioral health treatment, substance use prevention, and evidence-based strategies to reduce substance use consumption.