Online Program

A multi-state analysis of acute alcohol use and suicide: Impact of alcohol availability

Tuesday, November 5, 2013 : 8:50 a.m. - 9:10 a.m.

Lauren A Ogden, BA, School of Community Health, Portland State University, Portland, OR
Norman Giesbrecht, PhD, Social & Epidemiological Research Department, Centre for Addiction and Mental Health, Toronto, ON, Canada
Nathalie Huguet, PhD, School of Community Health, Portland State University, Portland, OR
Raul Caetano, MD, MPH, PhD, School of Public Health, University of Texas Dallas Regional Campus, Dallas, TX
Kenneth Conner, PsyD, Department of Psychiatry, University of Rochester, Rochester, NY
Mark S. Kaplan, DrPH, School of Community Health, Portland State University, Portland, OR
Bentson H. McFarland, MD, PhD, Department of Psychiatry, Oregon Health & Science University, Portland, OR
Kurt B. Nolte, MD, University of New Mexico School of Medicine, Office of the Medical Investigator, Albuquerque, NM
Background: Suicide is a major health problem with 38,364 deaths in the United States in 2010. Some 7,235 deaths and 242,456 years of potential life lost resulted from alcohol-attributable suicides in 2001-05. Alcohol control policies are the most potent population-level interventions to influence alcohol consumption and related harms but relationships among alcohol availability, acute alcohol use, and suicide are understudied. This research assessed relationships between alcohol outlet density and the fraction of suicides involving alcohol. Methods: Data were derived from the 2003-10 restricted National Violent Death Reporting System for 9 states (Alaska, Colorado, Georgia, Maryland, New Jersey, New Mexico, Oregon, Virginia, Wisconsin) where alcohol outlet density data were obtained. Blood alcohol content (BAC) on 26,929 suicide decedents was derived from toxicological analysis and determined the presence or absence of alcohol in blood samples. County on- and off-premise alcohol outlet density represents the rate of outlets per 10,000 residents and was categorized into tertiles. Multi-level logistic regression was conducted to assess the effect of county-level outlet density on BAC positivity after controlling for age, gender, and race. Results: Alcohol outlet density varied from 0 (dry county) to 438 per 10,000. A significant association was found between alcohol outlet density and alcohol-attributable suicides. Suicide decedents in the highest density tertile were 21% more likely to be BAC positive (adjusted odds ratio=1.21, p<.001) than those in the lowest tertile. Medium and low alcohol density did not differ. Implications: Pending additional research, results suggest caution with regard to further increases in access to alcohol

Learning Areas:

Public health or related public policy

Learning Objectives:
Describe the prevalence of acute alcohol use among suicides from 9 states over 8 years, and demographic characteristics of those who committed suicide. Demonstrate the associations between suicides that involve acute alcohol use and alcohol outlet retail density in those states and their counties. Recommend areas for further research and a precautionary approach with regard to communities planning to relax controls on access to alcohol.

Keyword(s): Suicide, Alcohol Use

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have conducted research on alcohol policy issues for several decades including NIH funded studies and collaboration on WHO-affiliated projects on alcohol-related trauma and impact of access to alcohol.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.