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More Than 1 in 4 People Who Died Violently Had a High BAC

Alcohol and public health: www.cdc.gov/alcohol. National Center for Chronic Disease Prevention and Health Promotion, Division of Population Health, CDC

April 5, 2021

Gaps and Disparities in Alcohol Testing Among People Who Die Violently

A new study conducted by members of the Council for State and Territorial Epidemiologists (CSTE) Alcohol Subcommittee and the CDC Alcohol Program found that about 2 in 5 people who died violently (e.g., homicide or suicide) had unknown or missing information on alcohol testing. However, among the people who died violently with a reported a blood alcohol concentration (BAC) level, 41% had a positive BAC and 28% had a BAC ≥ 0.08 g/dL.


The authors looked at data from more than 95,000 people who died violently in states that participated in the National Violent Death Reporting System during 2014–2016 and found variation in alcohol testing rates by state.

  • The percent of violent deaths with a BAC test ranged from 10% in Georgia to 96% in Utah.
  • Overall, people who were aged 21–44 years, non-Hispanic American Indian/Alaska Native or Hispanic, died by poisoning, died by undetermined intent, or were investigated by a state medical examiner were most likely to receive BAC testing.
  • Increased testing and reporting of alcohol among violent deaths could better document the role of alcohol in violent deaths and inform the development and use of evidence-based prevention strategies (e.g., increasing alcohol taxes, regulating alcohol outlet density) for reducing violent deaths.

Spotlight: Assessing Alcohol Use in Acute Care Facilities

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Only 1 in 6 ED Physicians Screen Their Patients for Excessive Drinking

A new study of emergency department physicians, conducted by the Council for State and Territorial Epidemiologists’ Alcohol Subcommittee, found that only 1 in 6 consistently screened their patients for excessive drinking. Only a fraction of those who screened their patients used a recommended screening tool. Respondents identified lack of time and a lack of services for those who screened positive as barriers to screening. The U.S. Preventive Services Task Force recommends alcohol screening and behavioral counseling in clinical settings for all adults to effectively reduce excessive alcohol consumption. Learn more about this effective clinical strategy for reducing excessive drinking.

Blood Alcohol Levels Taken After Death Underestimate Alcohol Involvement in Fatal Injuries

A study published in the American Journal of Drug and Alcohol Abuse assesses the variability in blood alcohol concentration levels taken before and after death among fatally injured adults admitted to one shock trauma center in Baltimore, Maryland. Blood alcohol concentration levels taken after death were generally, though not consistently, lower than blood alcohol concentration levels taken before death. The findings emphasize the usefulness of routine testing and recording of blood alcohol concentration levels in acute care facilities.

The Council of State and Territorial Epidemiologists (CSTE) Alcohol Subcommittee, in partnership with the CDC Alcohol Program, published a how-to guide on estimating hospitalizations related to alcohol consumption in the United States, using ICD-10-CM codes. This guide is designed for state and local epidemiologists who want to monitor the burden of excessive alcohol use on the hospital system or enhance the surveillance of alcohol-related harms in their jurisdiction.


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