Today we'll be talking about alcohol and

drugs, and their role in violence,

which is an important public health issue.
But before we get started, let's talk
a little bit about what alcohol is.
Who uses it, and
what happens when people drink alcohol.
Especially when they binge drink or
drink a lot of alcohol.
And then we'll move on
to talk about how and
why alcohol facilitates
involvement in violence.
And which forms of violence seems
to be most impacted by alcohol use.
So what is alcohol?
We talk a lot about alcohol in general but
just to make sure we
are all on the same page.
Let's provide a little context.
The alcohol that people drink at home or
in bars or
at parties is called ethyl alcohol.
Or ethanol and
it is created by fermentation.
What people usually do not know,
is that all alcohol is made with
the same fermentation process.
So from the cheapest beer
to the most expensive wine,
it is basically the same process.
What differs in colors or
taste or potency and flavor.
Come from the different fruits or
vegetables that I used in the process
as well as any additives.
So intentionally fermented
beverages have been around for
a long time, even back to the stone age,
some 10,000 years BC.
But since then alcohol use in this
various forms have been noted
across ancient cultures such as Babylon,
China, Egypt, in Greece, India, Persia.
And, it's often referenced in
religious and celebratory context.
Now, alcohol use has evolved to
it's many modern forms that we
see in most societies, today.
However, the most intriguing part
of the historical context of
alcohol is the warnings associated
with excessive alcohol use.
That dates back thousands of years.
As such,
it's no surprise that alcohol use,
especially heavy use, has been found
to be problematic across cultures.
Across countries and over time and that
it's well-known to facilitate violence.
So what about alcohol and
the health burden in the US?
Based on findings from a recent study,
we have a better sense of the costs
of excessive drinking in the US.
Based on 2006 data, it was found
that excessive drinking caused.
Costs the United States
$223 billion that year.
And these costs largely results from
losses in workplace productivity,
healthcare expenses,
criminal justice expenses.
As well as motor vehicle crash costs for
impaired driving.
It is also estimated that
almost 3/4 of these costs were
due to binge drinking specifically.
So what is binge drinking?
Well binge drinking is the most
common pattern of excessive alcohol
use in the US.
And binge drinking is typically defined
as drinking five or more drinks for men.
And four or more drinks for women.
In one occasion.
And there are very important patterns
of binge drinking in the United States.
The Centers for Disease Control and
Prevention summarize many
data sources of the epidemiology
of alcohol use in the U.S..
Here are some facts.
More than half of the alcohol consumed
by adults in the US is in the form of
binge drinks.
Binge drinking also various
across the United States.
One in six US adults binge
drinks about four times a month,
consuming about eight drinks per binge.
And then prevalence of binge
drinking among men is twice
the prevalence among women.
And while binge drinking is more common
among young adults, aged 18 to 34 years.
Binge drinkers aged 65 years and
older report binge drinking more often.
An average of five to six times a month.
About 90% of the alcohol consumed
by youth, under the age of 21,
in the U.S., is in for
form of binge drinks.
Making underage drinking
a substantial problem.
So, what happens when people drink,
especially when they binge drink?
Well, there are many important
consequences of drinking too much alcohol.
That are outlined by the National
Institute on Alcohol Abuse and Alcoholism.
When alcohol enters the blood stream,
as soon as the person takes
their first sip of alcohol.
Immediate effects can actually
appear within 10 minutes.
So if a person continues to drink,
there will be an increase in their
blood alcohol concentration.
And the higher the concentration,
the more impaired the person will become.
So effects can include reduced
inhibitions, slurred speech,
motor impairment,
confusion, memory problems.
Concentration problems, coma,
breathing problems, and even death.
So because of the impact of alcohol.
In particular because of the reduced
inhibition, the confusion, and
concentration problems.
Excessive alcohol use is often associated
with different forms of violence.
So, let's transition to talk
a little bit about alcohol and
crime, or
the link between alcohol and crime.
Which has not really received
the same level of attention as
say driving while under
the influence of alcohol.
However there are lots of studies that
show that alcohol is often involved in
both perpetrators and victims of violence.
So we have substantial amount of research
by the US department of justice for
example that shows several
important factors.
So for example, 5.3 million adult,
or 36% of those under correctional
supervision at the time were drinking at
the time of their conviction offense.
And the majority of criminal
offenders were under the influence of
alcohol alone when they
committed their crimes.
And another fact is for
the 40% of convicted murderers that are
being held in their jail or state prison.
Alcohol use was a factor in that homicide.
About three million violent
crimes occur each year
which victims perceive the offender
to have been drinking.
And such crimes include rape,
sexual assault, robbery, aggravated and
simple assault.
According to the national
crime victimization survey.
In 2007 there were 5.2 million
violent victimizations of
residents aged twelve and
over in the United States.
And victims of violence were
asked to describe whether they
perceived the offender to be drinking or
using drugs.
About 26% of the victims
of violence reported.
Reported that the offender
was using drugs or alcohol.
And based on victim's report,
alcohol by the offender was a factor
in 37% of rapes and sexual assaults.
15% of robberies.
27% of aggravated assaults.
And 25% of simple assaults.
In fact, alcohol is more likely to be a
factor in violence where the attacker and
the victim know each other.
In fact, two-thirds of victims
who were attacked by an intimate,
including a current or former spouse.
Boyfriend or girlfriend,
reported that alcohol had been involved.
70% of alcohol-related incidents
of violence occur in the home.
The reason why we focus mostly on
the link between alcohol and violence.
Rather than drugs and
violence, is because it seems that
alcohol has a specific substance.
It's just much more strongly and
more easily linked to violence.
Also, among violent crimes,
the offender is far more likely to
have been drinking alcohol than being
under the influence of other drugs.
With the exception of robberies
where other drugs are used.
Because there's so many different drugs.
And because they have different
psychopharmacoligcal properties.
It's very difficult to generalize
their effect on the human body, and
its link to violence.
Also, from the violence
prevention perspective.
We're less interested in
drug defined offenses.
Or those that merely are linked to
a lifestyle that involve illicit drug use,
and other deviant behaviors.
Instead, we are specifically
interested in drug related violent.
Crimes that are committed because of
this psychopharmacological effect on
the person involved.
One of the reasons that use of
drugs contributes to violence is
the impact some drugs have on the brain.
And the National Institute on
Drug Abuse has made this area of
research a key priority.
As an example, the repeated use of
addictive drugs eventually changes how
the brain functions.
Resulting brain changes which can
accompany the transition from voluntary to
compulsive drug use.
Effect the brain's natural inhibition and
reward centers.
Causing the addicted person to use drugs,
in spite of the adverse health,
social, and legal consequences.
In the 2004 survey of inmates in state and
federal correction facilities,
32% of state prisoners.
And 26% of federal
prisoners said that they
had committed their offense while
under the influence of drugs.
Among federal prisoners 32% of
drug offenders, and 24% of violent
offenders were the most likely to report
drug use at the time of their crimes.
So as you can see, there are many data
points to examine when we want to
understand the role of alcohol and
drugs and violence.
And as Public Health Researchers,
we can approach this complicated issue
using data from the general population.
We can examine it from a medical and
health perspective.
If as an example we can look at
people who's a treatment from
their injuries from violence.
Or we can look at data among arrested or
retained for
having committed a violent crime.
All these approaches are needed so that we
get a better sense of how common it is for
alcohol or
drugs to be involve in violence.
And also to better understand how to
prevent alcohol or drug related violence.
We also need this information to
determine who maybe at increase risk for
either perpetration or
victimization of these forms of violence.
So clearly balance prevention is
an important public health priority.
And as we have just outlined, alcohol and
drugs are an important factor in violence
and really needs more attention.