Alcohol Excessive Consumption: Overservice Law Enforcement Initiatives

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Findings and Recommendations

The Community Preventive Services Task Force (CPSTF) finds insufficient evidence to determine whether overservice law enforcement initiatives reduce excessive alcohol consumption and alcohol-related harms.

The full CPSTF Finding and Rationale Statement and supporting documents for Alcohol Excessive Consumption: Overservice Law Enforcement Initiatives are available in The Community Guide Collection on CDC Stacks.

Intervention

Overservice law enforcement initiatives are proactive community efforts to increase the enforcement of laws that prohibit the service of alcoholic beverages to intoxicated customers. Alcohol Beverage Control personnel or plainclothes or uniformed police carry out enforcement, which may include fines or licensing actions.

Overservice law enforcement initiatives often involve two more components.

  1. Notify alcohol beverage outlets of enforcement plans in order to foster awareness essential for effective deterrence.
  2. Provide information or training to help outlet managers and staff comply with overservice laws. Help them learn how to better recognize intoxicated customers and offer strategies to prevent overservice.

Because overservice laws are not actively enforced in many communities, these initiatives often involve increases in enforcement from low baseline levels.

Not all U.S. states provide definitions of intoxication in their overservice regulations, and the definitions in use are inconsistent. Law enforcement officers and servers may recognize intoxication by tracking the number of alcoholic beverages served or by looking for physiological and behavioral characteristics that become more apparent as alcohol consumption increases (e.g., bloodshot eyes, flushed face, slurred speech, lack of balance and coordination).

About The Systematic Review

The CPSTF finding is based on evidence from a systematic review of two studies (search period through October 2007).

The review was conducted on behalf of the CPSTF by a team of specialists in systematic review methods, and in research, practice, and policy related to preventing excessive alcohol consumption.

Study Characteristics

  • Studies were conducted in Washington and Michigan.
  • Both studies provided information about efforts to raise awareness about the initiative and its enforcement.
  • The studies used pre post designs, with concurrent comparisons.

Summary of Results

The systematic review included two studies.

  • One study (with a greater intensity of enhanced enforcement) found substantial and statistically significant benefits of the overservice enforcement initiative on all of the outcomes assessed (Michigan). When compared with control settings:
    • Service to individuals pretending to be intoxicated customers decreased 28.5%
    • People arrested for DUI who reported consuming their last drink in a bar or restaurant decreased 26.5%
  • The other study found inconsistent and statistically nonsignificant results for outcomes assessing overservice and alcohol-impaired driving (Washington state).
  • Overall, several results pointed in a comparable direction. The estimated effects on the most reliable health outcomes those related to alcohol-impaired driving showed beneficial effects in both studies.

Summary of Economic Evidence

An economic review of this intervention was not conducted because CPSTF did not have enough information to determine if the intervention works.

Applicability

Applicability of this intervention across different settings and populations was not assessed because CPSTF did not have enough information to determine if the intervention works.

Evidence Gaps

  • How effective is enhanced enforcement of overservice regulations in reducing excessive alcohol consumption and related harms?
  • What are barriers to effective enforcement?
  • What is the role of the media in publicizing enhanced enforcement?
  • What is the potential role of responsible beverage service training programs in reducing overservice and enhancing the effectiveness of enforcement? Multicomponent server intervention programs may prove beneficial in decreasing excessive alcohol consumption and related harms in on-premises retail alcohol settings.
  • What are the best methods for identifying patrons who are intoxicated, underage, or both?
  • Are there other methods to avoiding overservice, such as counting drinks or spacing out the frequency of drink service with food or nonalcoholic drinks?
  • What is the economic value of enforcement?

Implementation Considerations and Resources

CPSTF did not have enough evidence to determine whether the intervention is or is not effective. This does not mean that the intervention does not work, but rather that additional research is needed to determine whether or not the intervention is effective.