A recent report from from The Johns Hopkins Center for Gun Violence Solutions found that about a third of U.S. gun homicides involved heavy drinking — on the part of the perpetrator, the victim, or both — and a quarter of suicides also involved alcohol misuse. Heavy use of alcohol is also a strong predictor of future violence, researchers found.
While prior research has established a solid link between alcohol and other forms of violence, its connection to gun violence has gone largely unexplored and is not widely addressed in public policy or violence prevention programs.
“That was shocking to me,” said Silvia Villarreal, director of research translation at the Hopkins Center and lead author of the report. “People don’t put these two things together.”
According to the report, gun owners are more likely to misuse alcohol than those who don’t own guns, and over 15 million gun owners are estimated to misuse alcohol, which researchers describe as a range of behaviors from binge drinking to alcoholism.
People who misuse alcohol are also more prone to engage in risky firearm behavior, such as carrying guns in public, threatening others with a gun or storing guns unsafely, the report found. Individuals with alcohol use disorder were over 2.4 times as likely to report impulsive angry behavior and carry their guns in public.
The Hopkins team used data generated by collaborators at the Violence Prevention Research Program at the University of California at Davis, one of the only academic centers to have examined the link, to explain it and make policy recommendations that aim to curb gun violence.
The recommendations focus on restricting access to firearms by people with a record of alcohol misuse and prohibiting carrying guns in settings where alcohol is consumed, or while someone is intoxicated.
“If the policy context reduces availability of alcohol under a risky situation, you’re gonna have less violence,” said Daniel Webster, professor at the Johns Hopkins Bloomberg School of Public Health and distinguished research scholar at the Center for Gun Violence Solutions.
The connection between alcohol and violence is undeniable. Not only have most people witnessed it with their own eyes — when a fistfight breaks out in an alcohol-saturated setting, for example — it’s born out by a large body of research. For decades, studies have shown a strong link between alcohol misuse and domestic violence, child and elder abuse and violent crime, including sexual assault.
Heavy drinking creates the conditions for violence to flourish — judgement is compromised, inhibitions are down and impulsivity is up, making people more likely to do something rash in the moment they’d think twice about when sober.
The report’s researchers said the widespread social acceptance of alcohol use — even when heavy — helps drive the failure to connect it to gun violence in prevention research, policy and programs.
Alcohol use is “all about good times, right? And not acknowledging harms,” said Webster, even though the potential for such harms is widely known.
Despite the many interconnected forces behind gun violence, some groups choose to focus — perhaps for practical reasons — “on one aspect of causes,” he said, with access to guns perhaps being the most common. Public health researchers also tend to stay in one lane, he said, with those who study alcohol often not paying attention to what violence researchers are doing, and vice versa.
Local policymakers tend not to address the connection at all, Webster said, noting that when Baltimore Mayor Brandon Scott or other officials talk about gun violence, “how often are they mentioning alcohol? My hunch is almost never.”
In a statement, the Mayor’s Office of Neighborhood Safety and Engagement said “alcohol is undeniably a risk factor for increased violence” and emphasized its connection to intimate partner violence and sexual assault, but not to gun violence in particular.
“Ultimately, reducing access to firearms must be a priority, particularly when there is evidence suggesting that an individual is prone to consistent violence,” the statement said.
In Baltimore, gun-related deaths have hovered around 300 for the last eight years. In 2022, 293 of 335 total homicides involved a gun — a rate of 87%. On average, injuries from firearms occur at roughly twice the rate of deaths nationwide; this also holds true in Baltimore where 688 nonfatal shootings happened in 2022. In Maryland, 796 people die by guns each year on average, with communities of color in Baltimore disproportionately impacted. Maryland is ranked eighth among states for the strength of its gun laws.
“Alcohol is definitely connected to violence,” said Freedom Jones, director of community violence interventions at the Center for Hope, who oversees six community sites operated by Safe Streets, a Baltimore gun violence prevention program.
Her staff’s primary role, though, is to interrupt conflict in the moment it’s happening, and “to defuse the situation as best you can so that there’s no violence,” she said. It’s generally not effective — and could be dangerous — to try to reason with someone when they’re angry and intoxicated, she said.
But, her staff are also skilled at building relationships in the communities they serve and could play a more preventive role with regard to alcohol, she said. She noted that Safe Streets is working on a staff training program on violence-related issues such as trauma and substance use. The program also hosts community events which could be opportunities to have conversations about the relationship between alcohol and gun violence, she said.
“Alcohol, trauma, both of those things [that] are in communities of color are things that are not really addressed from a place of violence prevention,” but they should be, she said.
Substance use is discussed both individually and in groups as part of a harm-reduction curriculum through Roca, a Baltimore gun violence prevention program targeting young men aged 16 to 24 who are at “the highest risk in the city,” said Andrea Harrison, assistant director of programming. Alcohol use is not singled out, though. Young men in the program who use substances tend to prefer marijuana or pills; alcohol is “just not their thing” and doesn’t come up a lot, Harrison said.
But she estimates “4 out of 10” Roca participants were exposed to family members’ chronic alcohol abuse or dependency in their homes growing up.
Villarreal, of the Hopkins Center, said it would help if policy change came first, so that community organizations “wouldn’t have to do the heavy lifting of convincing people that this is important.”
“I think with the report, we are breaking through,” she said, and “just creating awareness that this connection is strong and that it exists and we need to consider it when we talk about gun violence.”