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. 2016;38(1):32-45.
doi: 10.1093/epirev/mxv010. Epub 2016 Jan 24.

Alcohol Use and Firearm Violence

Charles C Branas, SeungHoon Han, Douglas J Wiebe

Alcohol Use and Firearm Violence

Charles C Branas et al. Epidemiol Rev. 2016.

Abstract

Although the misuse of firearms is necessary to the occurrence of firearm violence, there are other contributing factors beyond simply firearms themselves that might also be modified to prevent firearm violence. Alcohol is one such key modifiable factor. To explore this, we undertook a 40-year (1975-2014) systematic literature review with meta-analysis. One large group of studies showed that over one third of firearm violence decedents had acutely consumed alcohol and over one fourth had heavily consumed alcohol prior to their deaths. Another large group of studies showed that alcohol was significantly associated with firearm use as a suicide means. Two controlled studies showed that gun injury after drinking, especially heavy drinking, was statistically significant among self-inflicted firearm injury victims. A small group of studies investigated the intersection of alcohol and firearms laws and alcohol outlets and firearm violence. One of these controlled studies found that off-premise outlets selling takeout alcohol were significantly associated with firearm assault. Additional controlled, population-level risk factor and intervention studies, including randomized trials of which only 1 was identified, are needed. Policies that rezone off-premise alcohol outlets, proscribe blood alcohol levels and enhance penalties for carrying or using firearms while intoxicated, and consider prior drunk driving convictions as a more precise criterion for disqualifying persons from the purchase or possession of firearms deserve further study.

Keywords: alcohol; firearm; gun ownership; gun possession; homicide; injury; suicide.

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Figures

Figure 1.
Figure 1.
Selection process for research articles on alcohol use and firearm violence, 1975–2014.
Figure 2.
Figure 2.
Meta-analysis odds ratios between any alcohol use and firearm possession for US adolescents. Refer to Table 5 for the details of each study's population, sample number, study location, data source, and type of firearm possession. The 5 studies were found to be heterogeneous (I2 = 79.2%, P = 0.001). The summary estimate presented (diamond) was calculated by using study sample weights. Stevens et al. (13) report relative risk instead of odds ratio. CI, confidence interval; OR, odds ratio.
Figure 3.
Figure 3.
Meta-analysis odds ratios between any alcohol use and firearm carrying for US adolescents. Refer to Table 5 for the details of each study's population, sample number, study location, data source, and type of firearm possession. The 3 studies were found to be heterogeneous (I2 = 79.5%, P = 0.008). The summary estimate presented (diamond) was calculated by using study sample weights. CI, confidence interval; OR, odds ratio.
Figure 4.
Figure 4.
Meta-analysis odds ratios between heavy alcohol use and selection of firearms suicide means for US suicide decedents. Refer to Table 6 for the details of each study's population, sample number, study location, data source, and type of firearm possession. The 6 studies were found to be heterogeneous (I2 = 97.2%, P = 0.000). The summary estimate presented (diamond) was calculated by using study sample weights. CI, confidence interval; OR, odds ratio.
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References

    1. Kellermann AL, Rivara FP. Silencing the science on gun research. JAMA. 2013;309(6):549–550. - PubMed
    1. Branas CC, Wiebe DJ, Schwab CW et al. Re: “Getting past the ‘f’ word in federally funded public health research” [letter] Inj Prev. 2005;11(3):191. - PMC - PubMed
    1. Branas CC, Elliott MR, Richmond TS et al. Alcohol consumption, alcohol outlets, and the risk of being assaulted with a gun. Alcohol Clin Exp Res. 2009;33(5):906–915. - PMC - PubMed
    1. Branas CC, Richmond TS, Ten Have TR et al. Acute alcohol consumption, alcohol outlets, and gun suicide. Subst Use Misuse. 2011;46(13):1592–1603. - PMC - PubMed
    1. Center for Behavioral Health Statistics and Quality. Table 2.41B In: 2013 National Survey on Drug Use and Health: Detailed Tables. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2014:694.

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