Unsafe Alcohol Use

Workgroup meeting summary

August 29, 2007

Attending: Eddie Edwards, Bill Butynski, Laura Davie, Tricia Lucas, John Bunker, Aviva Meyer, Nicola Whitley, Michael Dumond, and Ned Helms

1)  An overview was provided regarding the stumbling blocks we found in using the framework outlined in the first meeting and the results of the July 6th meeting. During the July 6th meeting we identified four areas to explore further: Public awareness campaign, support appropriate data collection on health and cost of unsafe alcohol use, server trainer and last drink policy, and brief intervention initiatives.

2)  Provided information on the Public Health Improvement Assessment Plan specifically the Public Health Communications work plan and the Monitoring Health Status work plan. Please visit http://www.dhhs.state.nh.us/DHHS/DPHS/iphnh.htm for more information on the project.

3)  Looked back on plans and research which support the four areas identified on the July 6th meeting:

  1. “Overcoming the Impact of Alcohol and Other Drug Problems: A Plan for New Hampshire” (April 2007)
  2. “Current Research on Alcohol Policy and State Alcohol and Other Drug Systems” (August 2006) by NASADAD
  3. “Traffic Safety and Alcohol Regulations: Transportation Research Board/National Research Council (January 2007)
  4. Ensuring Solutions to Alcohol Problems (GWU and Dr. Eric Goplerud)

4)  The group then discussed each area identified during the July 6th meeting, providing an update on current efforts in NH, the importance to the unsafe alcohol use problem, and the cultural/policy/legislative issues.

Public Health Awareness Campaign

  1. Concerns
  2. Capacity of state to fund
  3. Complexity of issue
  4. IOM is still working on recommendations in this area
  5. Evidence does not necessarily support the effectiveness of campaigns by themselves.
  6. Current efforts
  7. PHIAP process has public health awareness issue as a priority
  8. NHPHA is working on a communications plan
  9. Joe Diament is a resource for NH efforts- he’s pulling resources together.
  10. Partner with NH efforts
  11. The state plan does include public education.
  12. SAMSA does have a mandatory reporting outcome measure regarding the % of youth who listen to a prevention measure.
  13. Added Resources
  14. Look into Office of National Drug Control Policy- they may have research determining effectiveness.
  15. For advertising spending in NH, look at Marin Institute, Center for Science and Public Interest, Center on Alcohol Marketing and Youth. John to share contact information.
  16. Group decision: Group agreed that this would not be at the top priority however coordinating with other state efforts in this area is important. Also, continued research into effect programs would be beneficial.

Support appropriate data collection on health and cost of unsafe alcohol use

  1. Concerns
  2. No one place collects all the various data sets.
  3. Health cost data is very different then what is generally collected.
  4. Currently arrests are voluntary reporting, by arrests, do not know if the store robber was drunk.
  5. Need to keep focus on health care costs. Difficult to do with such as social issue.
  6. Current efforts
  7. SAMSA collection mandates cost band analysis/cost prevention service per person
  8. Jeff Metzer- data group as part of task force which is working on what is missing- Alcohol epidemiology work group- Data group as part of Governors Task force
  9. Steve Norton has conducted mental health research looking at hospital discharge data/insurance claims- Laura to inquire about if/how alcohol showed up.
  10. Liquor Commission has hired analyst to answer some of the questions.
  11. Laura is connecting with the PHIAP workgroup on data.
  12. Resources
  13. Lewin Group- however analysis may be 10 years old, looking for funding to update the analysis. The methodology is challenging. Worth a call to find out if this was just health costs or if it included criminal justice, work place, etc.
  14. Group decision: This is a priority area, falling above a public awareness campaign but below the next two recommendations listed. It was recommended to pull together a one page of data currently collected and one page on what we don’t have but need. Third page is what we need to do to get that information. .

Server trainer and last drink policy

  1. Concerns
  2. Hospitality Association wants credit for their server training programs- Liquor Commission is looking into the viability.
  3. Need combination of server training and last drink policy.
  4. Focus of restaurants, bars, and stores is sales not prevention.
  5. Current efforts
  6. DOT has workgroup looking at DWI, reckless driving- study groups looking at education and enforcement (includes AG, Safety, Liquor Commission, and others) Eddie Edwards can keep us updated.
  7. NH’s enforcement is the largest in the nation per capita however there is not enough focus on prevention. Regular enforcement different than criminal enforcement. Need reporting to increase.
  8. There was a bill about two years ago (Senator Foster) which failed that required district courts and police departments to report to Liquor Commission anyone arrested and convicted of DWI if came from liquor establishment. Needs support. Senator is reluctant to put bill back out there.
  9. Initiative to have Liquor Investigates at every sobriety check point to interview those arrested- Last Drink Initiative. Follow up with restaurants that have problems. Needs support.
  10. Review problem statement- make statement specific to programs- People working in server training are not aware of, or enforcing, the laws which exist. Enforcement at the State level is an issue.
  11. Group decision: This is a high priority and should be coupled with enforcement- last drink initiative. Can work on reintroducing and supporting the previous bill. Eddie Edwards has more information on the bill. Also partner with public awareness campaign.

Brief intervention initiatives

  1. Concerns
  2. PCP and ED settings should be a focus. We should not look into other settings for may be another five years. Do PCP and ED well first. Three to five years on PCP offices and ED.
  3. This may have the most effect directly on health care costs. And has the best evidence for effectiveness.
  4. Current efforts
  5. New Futures is looking into a possible alcohol exclusion case law to see if it is still in place.
  6. SAMSA is offering funding around training on brief interventions in the PCP setting- Recommended that NH apply. John Bunker will pass along info.
  7. Group decision: This is a priority area. Probably the highest priority area in terms of fitting with the Citizens Health Initiative over all objectives (reducing health care costs).

5)  Next steps:

  1. Laura will follow up with Jeff Metzer, Steve Norton, Eddie Edwards, and others as noted through out the summary.
  2. Laura will send a draft of the recommendations that will be presented to the Health Promotion and Disease Prevention Policy Team to the group to verify the messaging is correct.
  3. The recommendations will be presented to the full Health Promotion and Disease Prevention Policy Team meeting: PLEASE NOTE THE NEW DATE AND TIME: October 11th 1-3 at the Community Health Institute in Bow. All workgroup participants are welcome to attend this meeting.
  4. A summary of the Policy Team meeting will be sent out to all unsafe alcohol use workgroup participants.
  5. Draft copies of the recommendation report will be sent to workgroup members for comment this fall.
  6. Further meetings will be scheduled as needed.