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Community Preventive Services Task Force Finds Commercial Liability an Effective Strategy to Reduce Alcohol-Related Harms

Holding Alcohol Retailers Liable

Photo:  Wine glass and grapes Far too often, newspaper headlines tragically announce alcohol-related deaths. Excessive drinking kills more than 79,000 people in the U.S. each year; these deaths are preventable. One way to prevent excessive drinking, and related injuries and deaths, is to reduce binge drinking that occurs outside the home. Drinking in bars and restaurants is strongly associated with binge drinking and with alcohol-impaired driving. Managers and servers in retail alcohol establishments play a key role in the community by not serving intoxicated and underage customers. Laws that hold alcohol retailers liable for the injuries and damages caused by their intoxicated and underage customers help to encourage responsible service.

What is Dram Shop Liability and How Does it Work?

A dram shop is any retail establishment where alcohol is sold. Traditionally, it referred to a shop where spirits were sold by the dram, a small unit of liquid. Dram shop liability refers to laws that provide for the liability of retail establishments that sell alcohol for the injuries or harms caused by their intoxicated or underage customers. Dram shop liability laws have been shown to encourage more responsible beverage serving because managers and servers have an incentive to more closely manage their beverage service to intoxicated and underage customers, which can lead to penalties for retail establishments when this service leads to harms or damages.

The Community Preventive Services Task Force, an independent, nonfederal, volunteer body of public health and prevention experts, recommends dram shop liability as an effective intervention for reducing alcohol-related harms, based upon a state-of-the-art systematic review process of all available studies on the topic. The evidence review showed that areas with dram shop liability laws have reduced motor vehicle deaths, homicides, and alcohol-related medical conditions. Researchers further found that areas with dram shop liability had 6.4 percent fewer alcohol-related motor-vehicle deaths than comparable areas.

As of January 2009, 44 U.S. states and the District of Columbia have dram shop laws, although they vary by state in their scope and the evidence required for holding commercial hosts liable for their illegal, reckless and/or intentional service.

Overservice Law Enforcement Initiatives

The Task Force review showed that more research is needed to determine the effectiveness of enhanced enforcement of laws that prohibit overservice, or the service of alcoholic beverages to intoxicated customers. These strategies often involve police or state Alcohol Beverage Control personnel who make periodic visits to bars, clubs, and restaurants to enforce laws that prohibit illegal beverage service to intoxicated customers. They may also include training managers and servers how to recognize intoxicated customers and avoid overservice.

Creating a Safer Environment in Which Alcohol is Sold

States can preserve or strengthen their existing dram shop laws to prevent alcohol-related harms, especially motor vehicle deaths, and states without dram shop laws can consider this intervention to reduce alcohol-related harms. States, communities, territories, and tribes can also implement other strategies that are recommended by the Community Guide for reducing excessive alcohol use and related health and social problems. These strategies include regulating the number of places that sell alcohol in a given area, limiting the days and hours of alcohol sales, increasing alcohol taxes, and enforcing laws that prohibit alcohol sales to minors.

Excessive Alcohol Use

Excessive alcohol use, including binge and underage drinking, is the third leading cause of preventable death in the United States. For each death due to alcohol, on average, an individual’s life is cut short by 30 years. Excessive alcohol use costs the U.S. approximately $185 billion each year in health care and criminal justice expenses, as well as lost productivity.

The Community Guide

The Community Guide is an essential resource for people who want to know what works in public health. It provides evidence-based recommendations and findings about public health interventions and policies to improve health and promote safety. CDC staff in the Community Guide Branch systematically reviewed the scientific literature on the association between dram shop liability and alcohol-related harms, as well as the association between overservice law enforcement and alcohol-related harms. Eleven studies were analyzed on dram shop liability and two on overservice law enforcement using a state-of-the-art systematic review process. The results of the systematic reviews were published in the American Journal of Preventive Medicine. Full-text articles are available.

Visit Dram Shop Liability and Overservice Law Enforcement Initiatives to read more about these reviews. You can learn more about other Community Guide systematic reviews, including additional reviews specific to Preventing Excessive Alcohol Consumption by visiting Community Guide topics.