DefinitionAlcohol-related death is defined as the total number of deaths attributed to alcohol per 100,000 population, age-adjusted to the U.S 2000 Standard Population. The alcohol-related death rates reported here are based on definitions and alcohol-attributable fractions from the CDC's Alcohol-Related Disease Impact (ARDI) website [http://apps.nccd.cdc.gov/ardi/Homepage.aspx].
NumeratorNumber of alcohol-related deaths in New Mexico
DenominatorNew Mexico Population
Data Interpretation IssuesAccording to the CDC's Alcohol-Related Disease Impact (ARDI) website [http://apps.nccd.cdc.gov/ardi/Homepage.aspx], there are 54 causes of death considered to be at least partially attributable to alcohol. These include 35 alcohol-related chronic diseases (e.g., liver cirrhosis, alcohol dependence); and 19 alcohol-related injuries (e.g., motor vehicle crashes, poisonings, falls, homicide, suicide).
Alcohol-related deaths are estimated by multiplying the total number of deaths in a cause-of-death category by the percent of deaths in that category that are considered to be caused by alcohol. This percent, the so-called alcohol attributable fraction (AAF), can vary from 100% for causes of death that are completely related to alcohol use (e.g., alcoholic liver disease, alcohol poisoning); to less than 100% for causes that are only sometimes related to alcohol use. For example, per CDC ARDI, the AAF for portal hypertension is 40%. This means that 40% of deaths from portal hypertension are considered to be caused by alcohol use. The AAF for homicide is 47% and for suicide is 23%. The AAF for alcohol-related motor vehicle crashes is age- and gender-specific, ranging from 49% for males ages 25-34 to 8% for females ages 65 and over. For more information on the AAFs used here see the CDC ARDI Methods webpage [http://apps.nccd.cdc.gov/ardi/AboutARDIMethods.htm].
Why Is This Important?The consequences of excessive alcohol use are severe in New Mexico. New Mexico's total alcohol-related death rate has ranked first, second, or third in the US since 1981; and 1st for the period 1997 through 2010 (the most recent year for which state comparison data are available). The negative consequences of excessive alcohol use in New Mexico are not limited to death but also include domestic violence, crime, poverty, and unemployment, as well as chronic liver disease, motor vehicle crash and other injuries, mental illness, and a variety of other medical problems. Nationally, one in ten deaths among working age adults (age 20-64) is attributable to alcohol. In New Mexico this ratio is one in six deaths.
Healthy People Objective: SA-20, Decrease the number of deaths attributable to alcoholU.S. Target: 71,681 deaths
Other ObjectivesSubstance Abuse Epidemiology Report Indicator, New Mexico Community Health Status Indicator (CHSI)
Evidence-based PracticesThere is a large body of evidence on effective strategies to prevent excessive alcohol use and alcohol-related harm. In the past decade, this evidence base has been the subject of numerous systematic expert reviews to assess the quality and consistency of the evidence for particular strategies; and to make recommendations based on this evidence. These expert reviews have recently been summarized by the NMDOH. The following list summarizes the evidence-based prevention strategies that are well-recommended by experts; and that could be more widely or completely implemented in New Mexico to reduce our alcohol-related problems: [http://ibis.health.state.nm.us/docs/Evidence/EvidenceBasedExcessiveAlcoholUsePrevention.pdf].
The following is a bit more information on prevention in general, and alcohol-related prevention in particular.
Primary prevention attempts to stop a problem before it starts. In New Mexico, primary prevention of alcohol-related health problems has focused on regulating access to alcohol and altering the alcohol consumption behavior of high-risk populations. Regulatory efforts have included increasing the price of alcohol (shown to be effective in deterring alcohol use among adolescents), establishing a minimum legal drinking age, regulating the density of liquor outlets, and increasing penalties for buyers and servers of alcohol to minors. DWI-related law enforcement (e.g., sobriety checkpoints), when accompanied by media activity, can also be an important form of primary prevention, increasing the perceived risk of driving after drinking among the general population.
Secondary prevention efforts try to detect and treat emergent cases before they cause harm. Screening and brief interventions (SBI) for adults in primary care settings is an evidence-based intervention to address problem drinking before it causes serious harm. Implementing this intervention more broadly in New Mexico primary care settings could help reduce our serious burden of alcohol-related chronic disease and injury.
Tertiary prevention involves the treatment of individuals diagnosed with alcohol use disorders so they can recover to the highest possible level of health while minimizing the effects of the disease and preventing complications. According to the most recent estimates from the National Survey on Drug Use and Health (NSDUH), [http://oas.samhsa.gov/2k7State/NewMexico.htm#Tabs], roughly 130,000 New Mexicans report past-year alcohol dependence or abuse, indicating an acute need for treatment.
However, fewer than one in ten people in need of treatment receives it.
Nationally, the most common reasons that people who need and seek treatment do not receive it are because: they have no health insurance and cannot afford the cost; they are concerned about the possible negative effect on their job; or they are not ready to stop using.