1. Alcohol and Firearms Violence: A Response IOM Forum on Global Violence PreventionIOM Forum on Global Violence Prevention Garen Wintemute, MD, MPHGaren Wintemute, MD, MPH December 18, 2014December 18, 2014

2. 30d alcohol use: 55% any, 17% binge, 6% chronic, Firearm ownership: ~50M total; 35% of men, 11% of women 30d alcohol use among firearm owners: 8.9-11.7M binge, 2.5-3.6M chronic 30d alcohol use: 55% any, 17% binge, 6% chronic, Firearm ownership: ~50M total; 35% of men, 11% of women 30d alcohol use among firearm owners: 8.9-11.7M binge, 2.5-3.6M chronic Alcohol and FirearmsAlcohol and Firearms Sources: 2010 BRFSS (alcohol), General Social Survey (firearms)

3. Firearm Behaviors and Alcohol UseFirearm Behaviors and Alcohol Use Referent: Persons who do not own firearms

4. Prevalence of acute intoxication – 37% of violent felony perpetrators (report) – 25.7% of firearm suicide perpetrators (tox) – 30.2% of firearm homicide victims (tox) Alcohol abuse and risk: – Interpersonal violence perpetration, 3x-6x (pre-existing) – Firearm violence victimization, 3x-6x (acute) – Firearm suicide, 3x-10x (pre-existing); 75x-85x (acute) Dose-response Prevalence of acute intoxication – 37% of violent felony perpetrators (report) – 25.7% of firearm suicide perpetrators (tox) – 30.2% of firearm homicide victims (tox) Alcohol abuse and risk: – Interpersonal violence perpetration, 3x-6x (pre-existing) – Firearm violence victimization, 3x-6x (acute) – Firearm suicide, 3x-10x (pre-existing); 75x-85x (acute) Dose-response Alcohol Abuse and ViolenceAlcohol Abuse and Violence

5. Death Rates from Firearm Violence 1981-2012

6. Death Rates from Firearm Suicide Males, 2012

7. Intervention Federal statute silent – (endorsement of state restrictions) State statutes vague – Expanded access? 3 states (and DC) have per se laws Little to no enforcement California proposal: multiple DUI convictions Would it work? Federal statute silent – (endorsement of state restrictions) State statutes vague – Expanded access? 3 states (and DC) have per se laws Little to no enforcement California proposal: multiple DUI convictions Would it work?

8. Handgun Purchase and Risk of Arrest among Violent Misdemeanants Referent: Persons whose purchases were denied

9. Future Research: Firearm-SpecificFuture Research: Firearm-Specific Prevalence of co-existent alcohol abuse and firearm access, misuse Alcohol abuse and risk among firearm owners – Victimization and perpetration Alcohol access (e.g., outlet density) and risk Effects of alcohol on firearm use behaviors – Judgment, performance Effects of interventions Prevalence of co-existent alcohol abuse and firearm access, misuse Alcohol abuse and risk among firearm owners – Victimization and perpetration Alcohol access (e.g., outlet density) and risk Effects of alcohol on firearm use behaviors – Judgment, performance Effects of interventions