Alcohol Sales Linked to Neighborhood Violence

May 13, 2008— -- Those living near stores selling alcohol may have an increased risk of being the victim of a violent assault, compared to those who do not,

So suggests a new study in which Canadian researchers report that the risk of being hospitalized from a violent assault increases during periods of higher alcohol sales near the victims' homes.

Researchers at the University of Toronto and the Institute for Clinical Evaluative Sciences, Canada, studied the link between alcohol sales and violent assaults in Canada's largest province, Ontario.

Unlike in the United States, most alcohol in Ontario is sold in government-run liquor stores, and the province is able to track these sales. In addition, Canada keeps detailed computerized medical records of people hospitalized as a result of violent assault.

The researchers identified 3,212 people over the age of 13 who had been hospitalized, because of a serious assault, over a 32-month period. They then looked at the amount of alcohol sold at the liquor store nearest to the victims' homes the day before the assault, as well as a control period a week before the assault occurred.

Researchers found that for every doubling in alcohol sales, the overall risk of being hospitalized for assault increased by 13 percent -- and the risk of assault was 41 percent higher at peak alcohol sale times than when sales were lowest.

A total of 1,150 assaults -- 36 percent of all assaults -- involved the use of a sharp or blunt weapon, and 1,532 -- 48 percent of all assaults -- rose during an unarmed brawl or fight.

According to Dr. Joel Ray, lead study investigator and clinician scientist in the divisions of endocrinology and metabolism and general internal medicine at St. Michael's Hospital University of Toronto, this research points to one common misuse of alcohol, not only in Canada, but worldwide.

"Alcohol is a chemical that almost certainly is commonly purchased, commonly enjoyed, but also commonly misused," said Ray. "One of its misuses is in the context of either someone who is angry or someone who is prone to being in a dangerous situation, and when either perpetrator or victim consumes alcohol, they often place themselves in a violent situation."

Moreover, because the study showed that young men between the ages of 13 and 20 were at highest risk for being involved in a violent assault, Ray said the study carries an important message for young male drinkers.

"If you mix testosterone with alcohol and an aggressive social context, then you probably create a situation where things escalate into an assault with a victim at the end of it," Ray explained.

Hitting Close to Home

However, some alcohol experts were more wary about translating the study's findings over to the situation in the U.S.

"I think we have to be careful in overinterpreting the results of this study," said Dr. Fred Berger, medical director of the Scripps McDonald Center for alcohol and drug treatment, and clinical professor of psychiatry at the University of California, San Diego. "The results are reporting a statistical association or correlation, and cannot, therefore, speak to causality."

Moreover, liquor is sold in far more locations in the U.S. than in Canada, and the link between alcohol sales and violent assault is much harder to pin down in the states.

Still, some experts say this study has implications for Americans living near stores selling alcohol.

"Living in close proximity to areas with high levels of alcohol sales increases the risk for assault that is sufficiently severe to require hospitalizations," said Dr. Michael Spigarelli, assistant professor of pediatrics and internal medicine division of adolescent medicine at Cincinnati's Children's Hospital Medical Center in Ohio.

And despite differences between the U.S. and Canada in the availability of liquor, experts were quick to point out that the effects of alcohol on the human psyche are fairly universal, making it a bit more difficult to downplay the link between alcohol consumption, aggressive behavior, and violent assault.

"In general, all other things being equal, alcohol disinhibits behavior, and certain individuals are more prone to violence under the influence of alcohol," Berger said.

Don't Drink and... Fight

And with this being the case for people in Canada as much as for people in the U.S., experts are left scratching their heads over one major problem with this study: since alcohol is a legal intoxicant in American and Canadian societies, what could we possibly do to curb this trend toward violent assault with increased alcohol sales?

According to Ray, one possibility is limiting the number of outlets selling alcohol in the U.S. in order to, likewise, limit the amount of consumption of alcohol -- and, therefore, the number of violent assaults.

But some experts believe such an approach here in the U.S. would be much more difficult.

"Seeing how alcohol sales are legal, it's hard to imagine that placing limits on the sale of alcohol -- other than laws already on the books, such as sales to minors -- would pass legislation," Berger said. "Prohibiting sales to obviously intoxicated individuals might be an interesting approach, [but] its enforcement would be difficult -- as opposed to sales to minors, which can be more easily proven."

Another possibility Ray offered was the creation of a general social intolerance toward combining alcohol and possibly volatile social situations, in much the same way the U.S. created a social intolerance for combining drinking with driving.

Most laws and penalties against drunk driving in the U.S. weren't fully enhanced and upheld until the 1970s, when pressure from groups like Mothers Against Drunk Driving (MADD) and Students Against Driving Drunk (SADD) led to a societal intolerance for combining the two activities.

Ray believes that if we can create a similar intolerance for drinking and aggression, or potentially turbulent social situations, we might see a reduction in the number of alcohol-related violent assaults.

"One possible solution is to create a societal intolerance to drinking in the context where one or two people are not working well together socially, so if there's a chance that something is already fuming, alcohol should not be consumed in that type of state," Ray explained.

"It sounds obvious and silly, but that's not so far away from drinking and driving, which we didn't use to think was very problematic until fairly recently."