Suicide was the tenth leading cause of death in the United States in 2013. There is clear evidence that intoxication and chronic, heavy drinking are often associated with suicide. While alcohol policies are known to be effective in reducing excessive drinking, this review undertakes a critical look at the literature on the relationship between alcohol policies and suicide.
The authors summarize the associations between various types of alcohol policies and suicide, both in the U.S. and internationally, as found in English-language literature published between 1999 and 2014. Overall, a number of studies suggest that restrictive alcohol policies have a protective effect on reducing suicide at a general population level. Due to substantial between-states variation in alcohol policies, U.S.-based studies contributed substantially to the literature. The findings highlight the importance of population-based alcohol policies in suicide prevention.
Better implementation of effective alcohol policies can reduce alcohol availability at a population level, which in turn, reduces the average risk of suicide, especially in those cases where alcohol is involved. This is consistent with the prevention paradox, which posits that the majority of cases of a health condition arise from members at low or moderate risk of the disease, while members at high risk only contribute a minority of cases. This population-based approach is likely to maximize public health benefits and have a long-lasting influence on reducing suicide. This is because this population-based approach is likely to shift the distribution of population suicide risk in a favorable (lower) direction.
The authors point out that the literature has a number of methodological limitations, such as measurement and selection bias, and a restricted focus, in which the effects of a limited number of alcohol policies are considered without accounting for other alcohol policies.
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