Using Environmental Strategies for Using Environmental Strategies for Using Environmental Strategies for Using Environmental Strategies for Using Environmental Strategies for Using Environmental Strategies for Using Environmental Strategies for Using Environmental Strategies for PreventionPreventionPreventionPreventionPreventionPreventionPreventionPrevention

Brenda A. MillerBrenda A. MillerPrevention Research CenterPrevention Research Center

PIREPIREBerkeley, CA, USABerkeley, CA, USA

Formal Regulationand Control of

Alcohol Sales/Drug distribution

Use

Legal/Illegal Production, Marketing

and Distribution

Social, Health, and Economic Consequences

Retail & Street Sales

Substance-involved Acute Mortality &

Morbidity

Community Economic Sector

Social and Health Services

Legal Action Drinking/Drug

UseSocial Control

and Communication

Addressing Community System of Alcohol/Drug Use

Community & PopulationCommunity & Population--based based

outcomesoutcomes

�� Reductions in substance related mortalityReductions in substance related mortality

�� Reductions in injuries/diseaseReductions in injuries/disease

�� Reduction in supplyReduction in supply

�� Change in community support/concernsChange in community support/concerns

�� Change in practicesChange in practices

�� Policy changesPolicy changes

CommunityCommunity--based approaches for based approaches for

alcohol/drugsalcohol/drugs——multimulti--tieredtiered

�� Reduce Access/availabilityReduce Access/availability

�� Control youth use/behaviorsControl youth use/behaviors

�� Responsible Establishment PracticesResponsible Establishment Practices

�� Address related problems (drinking & Address related problems (drinking &

driving, aggression, sexual risk taking)driving, aggression, sexual risk taking)

�� Change Community Values & ConcernsChange Community Values & Concerns

�� Changing Policies/lawsChanging Policies/laws

Reducing Access/AvailabilityReducing Access/Availability

�� AlcoholAlcohol

�� Density of outletsDensity of outlets

�� Government MonopoliesGovernment Monopolies

�� PricePrice

�� DrugsDrugs

�� Interdiction/enforcement Interdiction/enforcement

�� Reduce illegal prescription drug distribution Reduce illegal prescription drug distribution

�� Reduce access to legal products that can be Reduce access to legal products that can be abused (e.g. inhalants)abused (e.g. inhalants)

Control youth use and behaviorsControl youth use and behaviors

�� Limiting access in homesLimiting access in homes——both alcohol, both alcohol,

other abusable products, and prescription other abusable products, and prescription

drugsdrugs

�� Dispersion of knowledge about early age Dispersion of knowledge about early age

drinking and later life problemsdrinking and later life problems

�� Minimum purchase ageMinimum purchase age

Responsible Establishment PracticesResponsible Establishment Practices

�� AlcoholAlcohol

�� Trainings concerning over service in pubs, bars, Trainings concerning over service in pubs, bars, clubs, and restaurantsclubs, and restaurants

�� Liability on bars and serversLiability on bars and servers

�� Parent responsibility for hosting parties and Parent responsibility for hosting parties and underage drinkingunderage drinking

�� DrugsDrugs

�� Clubs and risksClubs and risks

�� Tolerance of useTolerance of use

�� Mixing of drugs and alcoholMixing of drugs and alcohol

Controlling alcohol and drug problemsControlling alcohol and drug problems

�� Overdose and PoisoningOverdose and Poisoning

�� Aggression & injuryAggression & injury

�� PhysicalPhysical

�� SexualSexual

�� Drinking/drug use and drivingDrinking/drug use and driving

�� Sexual risk takingSexual risk taking

�� Drinking/drug use and sexDrinking/drug use and sex

Changing Community Values & Changing Community Values &

ConcernsConcerns

�� Media campaigns & local newsMedia campaigns & local news

�� Enforcement campaignsEnforcement campaigns

�� Drug awarenessDrug awareness

�� AlcoholAlcohol--related problemsrelated problems——drinking and drivingdrinking and driving

�� Community OrganizingCommunity Organizing--utilizing existing utilizing existing infrastructuresinfrastructures

�� NGONGO’’s and community groups in partnershipss and community groups in partnerships

�� Parents & familiesParents & families

�� Governmental agencies & ministriesGovernmental agencies & ministries

AlcoholAlcohol--involved Trauma at the Community Level: involved Trauma at the Community Level:

Conceptual Model`````````Conceptual Model`````````MOBILIZATIONMOBILIZATIONMOBILIZATION DRINKING AND DRIVINGDRINKING AND DRIVINGDRINKING AND DRIVING

UNDERAGE DRINKINGUNDERAGE DRINKINGUNDERAGE DRINKING

ALCOHOL ACCESSALCOHOL ACCESSALCOHOL ACCESS

RESPONSIBLE BEVERAGE SERVICE

RESPONSIBLE BEVERAGE RESPONSIBLE BEVERAGE

SERVICESERVICE

NonNon--Traffic Risk ActivitiesTraffic Risk Activities

Local News about AlcoholLocal News about Alcohol

Problems & EnforcementProblems & Enforcement

Retail Alcohol Retail Alcohol

AvailabilityAvailability

(On and Off(On and Off--premise)premise)

Alcohol IntoxicationAlcohol Intoxication

or Impairmentor Impairment Alcohol-involved

Injury

AlcoholAlcohol--involvedinvolved

Injury Injury

Driving afterDriving after

DrinkingDrinking

Perceived Perceived

Risk of ArrestRisk of ArrestLocal LawLocal Law

EnforcementEnforcement

Social Access Social Access

to Alcoholto AlcoholAlcohol Alcohol

Serving and Serving and

Sales PracticesSales Practices

Local Regulation Local Regulation

of Alcoholof Alcohol

(Density. Hours (Density. Hours

of Sale)of Sale)

Holder

Examples of International Community Examples of International Community

Action Projects for Alcohol PreventionAction Projects for Alcohol Prevention

COUNTRYCOUNTRY GOALSGOALS STRATEGIESSTRATEGIES RESULTSRESULTS

•• Responsible Responsible

Beverage Service Beverage Service

.Joint parent/police .Joint parent/police

enforcement of sales enforcement of sales

to youth.to youth.

.Club policy & and .Club policy & and

security drug security drug

recognition.recognition.••

Reduce local Reduce local

alcohol and alcohol and

drug problemsdrug problems

Reduction in sales to intoxicatedpatrons (5% to 47%)

��������

��������

Violent crime down by 29%

•• Community Forum & Community Forum &

alcohol safety auditalcohol safety audit

•• Model House PoliciesModel House Policies

•• Increased enforcement of Increased enforcement of

alcohol licensed premisesalcohol licensed premises

AustraliaAustralia

Surfers Surfers

Paradise Paradise

Safety Safety

Action Action

ProjectProject

Lower Lower

alcohol alcohol

involved involved

violenceviolence

Violent events: Violent events: ----

original siteoriginal site from from

9.8 to 4.79.8 to 4.7

��������

Refusals of drug Refusals of drug

impaired patrons impaired patrons

increased by 300%increased by 300%

��������

replication sitesreplication sitesfrom 12.2 to 3.0from 12.2 to 3.0

��������

SwedenSweden

STAD Project

Stockholm

Holder

Examples of Community Action Projects Examples of Community Action Projects

for Environmental Preventionfor Environmental Prevention

COUNTRYCOUNTRY GOALSGOALS STRATEGIESSTRATEGIES RESULTSRESULTS

•• local news

•• Alcohol service Alcohol service

(RBS) (RBS)

•• Underage sales Underage sales

enforcementenforcement

•• Drunk patron Drunk patron

enforcementenforcement

United StatesUnited States

Sacramento,Sacramento,

CaliforniaCalifornia

Reduce drinking Reduce drinking

and problems for and problems for

1515--29 youth and 29 youth and

young adultyoung adult

3.9% reduction in 3.9% reduction in

reported assaultsreported assaults��������

��������

��������

43% reduction in 43% reduction in

violenceviolence

33.7% Lower 33.7% Lower

emergency care emergency care

•• News coverageNews coverage

•• DUI enforcementDUI enforcement

•• Alcohol outletAlcohol outlet

surveillancesurveillance

MassachusettsMassachusetts Reduce alcohol Reduce alcohol

crashescrashes25% reduction in 25% reduction in

fatal crashesfatal crashes��������

•• community community

mobilizationmobilization

•• Local sales policies Local sales policies

and enforcementand enforcement

MinnesotaMinnesota Reduce youth Reduce youth

drinkingdrinkingLower alcohol Lower alcohol

sales to youthsales to youth

RReduced traffic educed traffic

crashescrashes

��������

��������

Holder

Holder

EXAMPLES OF COMMUNITY ACTION

PROJECTS FROM AROUND THE WORLD

Western AustraliaWestern Australia

IsraelIsrael

Florence, ItalyFlorence, Italy

LahtiLahti, Finland, Finland

Stockholm, SwedenStockholm, Sweden

Massachusetts, USAMassachusetts, USA

South Carolina, USASouth Carolina, USA

Minnesota, USAMinnesota, USA

California, USACalifornia, USA

MalmoMalmo, Sweden, Sweden....

New ZealandNew ZealandWestern AustraliaWestern AustraliaWestern Australia

IsraelIsraelIsrael

Florence, ItalyFlorence, ItalyFlorence, Italy

LahtiLahtiLahti, Finland,, FinlandFinland

Stockholm, SwedenStockholm, SwedenStockholm, Sweden

Ontario, CanadaOntario, Canada

Massachusetts, USAMassachusetts, USAMassachusetts, USA

South Carolina, USASouth Carolina, USASouth Carolina, USA

Minnesota, USAMinnesota, USAMinnesota, USA

California, USACalifornia, USACalifornia, USA

MalmoMalmoMalmo....

New ZealandNew ZealandNew Zealand

PAKKA, FinlandPAKKA, FinlandPAKKA, FinlandPAKKA, FinlandPAKKA, FinlandPAKKA, FinlandPAKKA, FinlandPAKKA, Finland6 Community Trial, Sweden6 Community Trial, Sweden6 Community Trial, Sweden6 Community Trial, Sweden6 Community Trial, Sweden6 Community Trial, Sweden6 Community Trial, Sweden6 Community Trial, Sweden

QueenslandQueensland

IrelandIreland

6 community trial, Norway

U K

Diadema & Paulinia,

Brazil

Holder

High Impact Areas for Environmental High Impact Areas for Environmental

StrategiesStrategies

�� Acute mortality, violence & injuriesAcute mortality, violence & injuries

�� Control of legal and abusable productsControl of legal and abusable products

�� Controls on outlets and distributionsControls on outlets and distributions

�� Drinking and drivingDrinking and driving

�� Club strategiesClub strategies