Introduction
DEFINITION
For the purposes of this discussion, we will adopt the definition of violence offered by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), which describes violence “as behavior that intentionally inflicts, or attempts to inflict, physical harm.” i
In addition, the following discussion refers to moderate versus heavy and problem drinking. Although definitions of what is considered to be “moderate” vary in the scientific literature, there are government-issued guidelines around the world which establish levels of drinking considered to be “safe” or “low-risk.” The levels identified range from no more than four 10g drinks per day for men/two per day for women (Australia) to no more than five 12g units per day for men/three for women (France) to no more than two 14g drinks per day for men/one per day for women (United States per the NIAAA). A complete table of these guidelines has been compiled by the International Center for Alcohol Policies at www.icap.org/policyissues/drinkingguidelines/guidelinestable/tabid/204/default.aspx.
Also for the purposes of this discussion, “moderate drinking” will be considered to be drinking which falls into the range of no more than four 14g drinks per day for men (not to exceed 14 per week), no more than three per day for women (not to exceed seven per week). “Heavy” drinking will be considered to be drinking which exceeds those levels of consumption—more specifically, as outlined by the NIAAA, five or more drinks per day for men/four or more drinks per day for women.ii “Problem” drinking will be considered to be heavy drinking or what is commonly referred to as binge drinking. (For more on binge drinking, see The Issues Forum entry on Binge Drinking.)
BACKGROUND AND THE ISSUE
While it is largely agreed that drinking and violence sometimes coexist, the precise nature of the relationship between alcohol consumption and violence remains open to debate. In addition, violence in and of itself is known to have a number of possible contributing causes, ranging from psychology and biology to culture and family influence.iii
Research supports the assertion that there is a relationship between some forms of violence and certain drinking patterns. However, there is no research evidence that drinking causes violence.iv
iSee: http://alcoholism.about.com/cs/alerts/l/blnaa38.htm.
iiSee:http://www.niaaa.nih.gov/NewsEvents/NewsReleases/NIAAANewCliniciansGuide.htm.
iiiMoss, H.B., & Tarter, R.E. Substance abuse, aggression and violence. Am J Addict 2(2):149-160, 1993. White, H. R., & Gorman, D. M. (2000). Dynamics of the drug-crime relationship. In G. LaFree (Ed.), Criminal justice 2000 The nature of crime: Continuity and change (pp. 151–218). Washington, DC: U.S. Department of Justice.
ivInternational Center for Alcohol Policies, Blue Book, Module 7. See: http://icap.org/portals/0/download/all_pdfs/blue_book/Module_07_Drinking_and_Violence.pdf.
The Research
The Association between Alcohol and Violence
Research shows that higher rates of drinking, heavy drinking, and alcohol abuse are reported by violent offenders than the general population. The percentages of violent offenders reported to be drinking at the time of their offenses varies from study to study, but the association is reported consistently for crimes including homicide, assault, sexual assault, and domestic violence.i (In addition, it has been pointed out that violent criminals who drink heavily are more likely than less intoxicated offenders to be apprehended and consequently may be over represented in samples of convicted criminals or arrestees.ii )
Research evidence also establishes that violence is more likely to be associated with heavy drinking and alcohol abuse (versus light or moderate drinking).iii In particular, domestic violence, sexual assaults, and suicide are often associated with heavy drinking and alcohol abuse.iv
Explanations of Behavioral Patterns Involving Alcohol and Violence
Violent behavior is rooted in an array of possible contributing factors. Neurotransmitters, genetics, hormones, demographic factors, parenting and parental behaviors, personality disorders, and social and cultural factors have all been documented as playing a role in violent behavior or tendencies for violent behavior.v
Studies consistently show that alcohol may be related to violence among only certain individuals and only under some conditions or in certain situations.vi Thus research has tended to focus on why this is the case.
Psychopharmacological Effects
One model used to explain the relationship between alcohol and violence focuses on its psychopharmacological effects—the way chemicals interact with an individual’s brain and affect thinking and behavior. If an individual’s cognitive processes are impaired by alcohol, his or her perception of interpersonal cues, behavioral inhibitions, awareness of consequences, and overall judgment could be affected. For example, someone who has been drinking heavily might overreact to a perceived threat, and fail to soundly assess the possible consequences of acting on a violent impulse.vii
Physiological Factors
Individual brain chemistry may provide an explanation for why excessive alcohol consumption is associated with aggression in some people, but not in others. For instance, serotonin essentially functions as a behavioral inhibitor in terms of brain chemistry, and lower serotonin activity is associated with increased impulsivity and aggressiveness. In experiments conducted with animals, monkeys with low serotonin activity consumed alcohol at elevated rates and demonstrated impaired impulse control, resulting in excessive and inappropriate aggression.viii
Hormones may also play a role in an association between certain individuals’ alcohol consumption and aggression. For example, in experiments with monkeys already known to have high levels of testosterone and aggression, the administration of alcohol has been associated with increased levels of aggressive behavior.ix Conversely, in experiments with monkeys already known to have lower levels of testosterone and aggression, alcohol intake was not associated with increased levels of aggressive behavior.x
Social Factors and Expectancies
Another model used to explain the relationship between alcohol and violence focuses on expectations, and the possibility that alcohol consumption may be associated with aggression because people expect they might become violent. In research studies using both mock and real alcohol beverages, people who believe they have consumed alcohol began to act more aggressively, whether the beverage they consumed actually had alcohol content or not.xi
In addition, social researchers have described some bars and drinking establishments as locations which may be more likely (than, say, retail stores) to bring together potential offenders (heavy and problem drinkers) and possible targets of violence (other individuals who are drinking and may be impaired).xii
Cultural Factors
Researchers have identified cultural views as playing “an important role in defining drinking patterns and attitudes.”xiii Studies confirm that “cultures in which alcohol use is well-integrated into everyday functions—as in Mediterranean countries—have much lower rates of alcohol-related violence than cultures where alcohol is not well-integrated—as in Nordic countries—or cultures that are ambivalent about the roles of alcohol in society, as in the United States.”xiv
In cultures where heavy drinking is less common, the association between drinking and violence tends to be lower. In cultures where heavy drinking is more common, we see higher levels of association between drinking and violence.xv
Drinking Environment
An increasing body of scientific evidence shows that the relationship between alcohol consumption and aggressive and violent behavior is not a direct causal link, but rather a complex interaction of biochemical, psychological, situational, and cultural factors.xvi The evidence that alcohol does not appear to lead to aggression under non-provocative conditionsxvii provides additional support for the importance of measures designed to improve the management of drinking environments to avoid provocation to violence.
The benefits of modifying the drinking context are supported by an increasing range of evidence, for example, the “Safer Bars” intervention in Toronto, which introduced constructive design principles such as padded furniture and compartmentalized space—resulting in a significant reduction in severe and moderate alcohol-related aggression.xviii Other measures that have been recommended to reduce the likelihood of alcohol-related problems include: ensuring a clean, well-maintained environment; encouraging eating with drinking; toughened safety glass; and hiring and training bar staff capable of communicating effectively with people.
iMartin, S. E. (Ed.). (1993). Alcohol and interpersonal violence: Fostering multidisciplinary perspectives. Rockville, MD: National Institute of Health.
iiCook, P.J., & Moore, M.J. Economic perspectives on reducing alcohol-related violence . In: Martin, S.E., ed. Alcohol and Interpersonal Violence. NIAAA Research Monograph No. 24 NIH Pub. No. 93-3496.
iiiInternational Center for Alcohol Policies, Blue Book, Module 7. See: http://icap.org/portals/0/download/all_pdfs/blue_book/Module_07_Drinking_and_Violence.pdf.
See also http://pubs.niaaa.nih.gov/publications/aa38.htm.
ivInternational Center for Alcohol Policies, Blue Book, Module 7. See: http://icap.org/portals/0/download/all_pdfs/blue_book/Module_07_Drinking_and_Violence.pdf.
vVolvaka, J., M.D., Ph.D., Neurobiology of Violence, Second Edition. American Psychiatric Publishing. ISBN 9781585620814. See also:http://www.psychologymatters.org/violence.html.
viSee: http://icap.org/portals/0/download/all_pdfs/blue_book/Module_07_Drinking_and_Violence.pdf.
See also: http://pubs.niaaa.nih.gov/publications/aa38.htm.
viiMiczek, K.A., et al. Alcohol, BAGAA-benzzodiazepibe receptor complex, and aggression. In: Galanter, M., ed. Recent Developments in Alcoholism. Vol. 13. New York: Plenum Press, 1997, pp.139-171. See also: http://pubs.niaaa.nih.gov/publications/aa38.htm.
viiiVirkkunen, M., & Linnoila, M. Serotonin and glucose metabolism in impulsively violent alcoholic offenders. In: Stoff, D.M., & Cairns, R.B., eds. Aggression and Violence. Mahwah, NJ: Lawrence Erlbaum, 1996. pp. 87-100. Higley, J.D., & Linnoila, M. A nonhuman primate model of excessive alcohol intake: Personality and neurobiological parallels of type I- and type II-like alcoholism. In: Galanter, M., ed. Recent Developments in Alcoholism. Vol. 13. New York: Plenum Press, 1997. pp. 192-219.
ixMiczek, K.A., et al. Alcohol, drugs of abuse, aggression, and violence. In: Reiss, A.J., & Roth, J.A., eds. Understanding and Preventing Violence. Vol. 3. Washington, DC: National Academy Press, 1994. pp. 377-570.
xMiczek, K.A., et al. Alcohol, GABAA-benzodiazepine receptor complex, and aggression. In: Galanter, M., ed. Recent Developments in Alcoholism. Vol. 13. New York: Plenum Press, 1997. pp. 139-171.
xiBushman, B.J. Effects of alcohol on human aggression: Validity of proposed explanations. Galanter, M., ed. Recent Developments in Alcoholism. Vol. 13. Chicago: Univ. of Chicago Press, 67.
xiiRoncek, D. W., & Maier, P. A. (1991). Bars, blocks, and crimes revisited: Linking the theory of routine activities to the empiricism of “hot spots.” Criminology, 29, 725–753.
xiiiInternational Center for Alcohol Policies, Blue Book, Module 6. See: http://icap.org/Publication/ICAPBlueBook/tabid/148/Default.aspx.
xivInternational Center for Alcohol Policies, Blue Book, Module 7. See: http://icap.org/portals/0/download/all_pdfs/blue_book/Module_07_Drinking_and_Violence.pdf.
xvGrant, M., & Litvak, J. (Eds.). (1998). Drinking patterns and their consequences. Washington, DC: Taylor & Francis.
xviInserm. See: http://ist.inserm.fr/basispresse/DP/DPanglais/25february2003.pdf.
xviiNIAAA, See http://pubs.niaaa.nih.gov/publications/aa38.htm.
xviiiSee: http://www.camh.net/Publications/CAMH_Publications/safer_bars_program.html.
Policy Considerations
Given the numerous factors which help to explain an association between alcohol and violence, a variety of approaches warrant consideration in policy development.
Intervention Strategies for Individuals and Groups with Risk Factors
There is evidence which supports the position that drinking heavily and behaving violently are related behaviors because they share common risk factors such as parental modeling of heavy drinking and aggression, genetic or psychological traits, disorders such as antisocial personality disorder, and cultural or sub-cultural (e.g. gang) influences.i These insights are persuasive in asserting a need for targeted interventions in schools, local communities, and the population at large, with a particular focus on individuals and groups with known risk factors. Such programs range from social norms marketing (aimed at correcting peer misperceptions) to server training programs and life skills programs in schools and communities.ii For example, the international Strengthening Families Program (SFP) targets high-risk families and is designed to prevent youth substance abuse and other negative behaviors. (See www.strengtheningfamiliesprogram.org.)
Better Social Controls
Some level of violent crime tends to occur in or around certain establishments such as bars, pubs, and night clubs—where heavy drinking is more likely to take place. Because of this association between drinking and violence, communities have launched collective approaches to discourage heavy drinking and violence in and around such locations. For example, the “Alcohol. Go Easy.” campaign in Australia targets sports and recreation locations and encourages responsible serving of alcohol, offers guidelines for dealing with intoxicated customers, and enforces “dry areas” within and around the targeted establishments. (See www.alcohol.sa.gov.au/site/page.cfm?u=86.)
Responsible Serving of Alcohol
Appropriate training of hospitality staff and retailers is an important component of violence prevention efforts. Programs developed with this in mind include “RSA”(Responsible Serving of Alcohol) in Ireland, ServeWise in Scotland, and “Think Before You Serve” in the Netherlands.
When it comes to consumption within the home, modifying the drinking environment generally entails ensuring that the host knows how to ensure a safe environment for guests. Examples of programs which offer guidance on responsible hosting include the “Host” initiative in Canada and the “Good Host Checklist” in the U.K.iii
iFergusson, D. M., Lynskey, M. T., & Horwood, L. J. (1996). Alcohol misuse and juvenile offending in adolescence. Addiction, 91, 483–494. White, H. R., & Gorman, D. M. (2000). Dynamics of the drug-crime relationship. In G. LaFree (Ed.), Criminal justice 2000 The nature of crime: Continuity and change (pp. 151–218). Washington, DC: U.S. Department of Justice.
iiFor a complete listing of targeted intervention examples worldwide, see the International Center for Alcohol Policies, Blue Book, Module 12. See: http://www.icap.org/Publication/ICAPBlueBook/tabid/148/Default.aspx.
iiiSee: http://www.icadts.org/T2004/pdfs/O116.pdf.