Alcohol misuse, firearm violence perpetration, and public policy in the United States

• Alcohol misuse and firearm access are common and associated with one another.
• In an average month, 8.9 to 11.7 million firearm owners binge drink.
• Alcohol misuse and firearm access increase risk of committing homicide and suicide.
• Enforceable restrictions on firearm access because of alcohol misuse are uncommon.
• Restrictions based on other risk factors appear to be effective.

ObjectiveFirearm violence is a significant public health problem in the United States, and alcohol is frequently involved. This article reviews existing research on the relationships between alcohol misuse; ownership, access to, and use of firearms; and the commission of firearm violence, and discusses the policy implications of these findings.MethodNarrative review augmented by new tabulations of publicly-available data.ResultsAcute and chronic alcohol misuse is positively associated with firearm ownership, risk behaviors involving firearms, and risk for perpetrating both interpersonal and self-directed firearm violence. In an average month, an estimated 8.9 to 11.7 million firearm owners binge drink. For men, deaths from alcohol-related firearm violence equal those from alcohol-related motor vehicle crashes. Enforceable policies restricting access to firearms for persons who misuse alcohol are uncommon. Policies that restrict access on the basis of other risk factors have been shown to reduce risk for subsequent violence.ConclusionThe evidence suggests that restricting access to firearms for persons with a documented history of alcohol misuse would be an effective violence prevention measure. Restrictions should rely on unambiguous definitions of alcohol misuse to facilitate enforcement and should be rigorously evaluated.