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Using Environmental Strategies for Using Environmental Strategies for Using Environmental Strategies for Using Environmental Strategies for Using Environmental Strategies for Using Environmental Strategies for Using Environmental Strategies for Using Environmental Strategies for PreventionPreventionPreventionPreventionPreventionPreventionPreventionPrevention
Brenda A. MillerBrenda A. MillerPrevention Research CenterPrevention Research Center
PIREPIREBerkeley, CA, USABerkeley, CA, USA
Formal Regulationand Control of
Alcohol Sales/Drug distribution
Use
Legal/Illegal Production, Marketing
and Distribution
Social, Health, and Economic Consequences
Retail & Street Sales
Substance-involved Acute Mortality &
Morbidity
Community Economic Sector
Social and Health Services
Legal Action Drinking/Drug
UseSocial Control
and Communication
Addressing Community System of Alcohol/Drug Use
Community & PopulationCommunity & Population--based based
outcomesoutcomes
�� Reductions in substance related mortalityReductions in substance related mortality
�� Reductions in injuries/diseaseReductions in injuries/disease
�� Reduction in supplyReduction in supply
�� Change in community support/concernsChange in community support/concerns
�� Change in practicesChange in practices
�� Policy changesPolicy changes
CommunityCommunity--based approaches for based approaches for
alcohol/drugsalcohol/drugs——multimulti--tieredtiered
�� Reduce Access/availabilityReduce Access/availability
�� Control youth use/behaviorsControl youth use/behaviors
�� Responsible Establishment PracticesResponsible Establishment Practices
�� Address related problems (drinking & Address related problems (drinking &
driving, aggression, sexual risk taking)driving, aggression, sexual risk taking)
�� Change Community Values & ConcernsChange Community Values & Concerns
�� Changing Policies/lawsChanging Policies/laws
Reducing Access/AvailabilityReducing Access/Availability
�� AlcoholAlcohol
�� Density of outletsDensity of outlets
�� Government MonopoliesGovernment Monopolies
�� PricePrice
�� DrugsDrugs
�� Interdiction/enforcement Interdiction/enforcement
�� Reduce illegal prescription drug distribution Reduce illegal prescription drug distribution
�� Reduce access to legal products that can be Reduce access to legal products that can be abused (e.g. inhalants)abused (e.g. inhalants)
Control youth use and behaviorsControl youth use and behaviors
�� Limiting access in homesLimiting access in homes——both alcohol, both alcohol,
other abusable products, and prescription other abusable products, and prescription
drugsdrugs
�� Dispersion of knowledge about early age Dispersion of knowledge about early age
drinking and later life problemsdrinking and later life problems
�� Minimum purchase ageMinimum purchase age
Responsible Establishment PracticesResponsible Establishment Practices
�� AlcoholAlcohol
�� Trainings concerning over service in pubs, bars, Trainings concerning over service in pubs, bars, clubs, and restaurantsclubs, and restaurants
�� Liability on bars and serversLiability on bars and servers
�� Parent responsibility for hosting parties and Parent responsibility for hosting parties and underage drinkingunderage drinking
�� DrugsDrugs
�� Clubs and risksClubs and risks
�� Tolerance of useTolerance of use
�� Mixing of drugs and alcoholMixing of drugs and alcohol
Controlling alcohol and drug problemsControlling alcohol and drug problems
�� Overdose and PoisoningOverdose and Poisoning
�� Aggression & injuryAggression & injury
�� PhysicalPhysical
�� SexualSexual
�� Drinking/drug use and drivingDrinking/drug use and driving
�� Sexual risk takingSexual risk taking
�� Drinking/drug use and sexDrinking/drug use and sex
Changing Community Values & Changing Community Values &
ConcernsConcerns
�� Media campaigns & local newsMedia campaigns & local news
�� Enforcement campaignsEnforcement campaigns
�� Drug awarenessDrug awareness
�� AlcoholAlcohol--related problemsrelated problems——drinking and drivingdrinking and driving
�� Community OrganizingCommunity Organizing--utilizing existing utilizing existing infrastructuresinfrastructures
�� NGONGO’’s and community groups in partnershipss and community groups in partnerships
�� Parents & familiesParents & families
�� Governmental agencies & ministriesGovernmental agencies & ministries
AlcoholAlcohol--involved Trauma at the Community Level: involved Trauma at the Community Level:
Conceptual Model`````````Conceptual Model`````````MOBILIZATIONMOBILIZATIONMOBILIZATION DRINKING AND DRIVINGDRINKING AND DRIVINGDRINKING AND DRIVING
UNDERAGE DRINKINGUNDERAGE DRINKINGUNDERAGE DRINKING
ALCOHOL ACCESSALCOHOL ACCESSALCOHOL ACCESS
RESPONSIBLE BEVERAGE SERVICE
RESPONSIBLE BEVERAGE RESPONSIBLE BEVERAGE
SERVICESERVICE
NonNon--Traffic Risk ActivitiesTraffic Risk Activities
Local News about AlcoholLocal News about Alcohol
Problems & EnforcementProblems & Enforcement
Retail Alcohol Retail Alcohol
AvailabilityAvailability
(On and Off(On and Off--premise)premise)
Alcohol IntoxicationAlcohol Intoxication
or Impairmentor Impairment Alcohol-involved
Injury
AlcoholAlcohol--involvedinvolved
Injury Injury
Driving afterDriving after
DrinkingDrinking
Perceived Perceived
Risk of ArrestRisk of ArrestLocal LawLocal Law
EnforcementEnforcement
Social Access Social Access
to Alcoholto AlcoholAlcohol Alcohol
Serving and Serving and
Sales PracticesSales Practices
Local Regulation Local Regulation
of Alcoholof Alcohol
(Density. Hours (Density. Hours
of Sale)of Sale)
Holder
Examples of International Community Examples of International Community
Action Projects for Alcohol PreventionAction Projects for Alcohol Prevention
COUNTRYCOUNTRY GOALSGOALS STRATEGIESSTRATEGIES RESULTSRESULTS
•• Responsible Responsible
Beverage Service Beverage Service
.Joint parent/police .Joint parent/police
enforcement of sales enforcement of sales
to youth.to youth.
.Club policy & and .Club policy & and
security drug security drug
recognition.recognition.••
Reduce local Reduce local
alcohol and alcohol and
drug problemsdrug problems
Reduction in sales to intoxicatedpatrons (5% to 47%)
��������
��������
Violent crime down by 29%
•• Community Forum & Community Forum &
alcohol safety auditalcohol safety audit
•• Model House PoliciesModel House Policies
•• Increased enforcement of Increased enforcement of
alcohol licensed premisesalcohol licensed premises
AustraliaAustralia
Surfers Surfers
Paradise Paradise
Safety Safety
Action Action
ProjectProject
Lower Lower
alcohol alcohol
involved involved
violenceviolence
Violent events: Violent events: ----
original siteoriginal site from from
9.8 to 4.79.8 to 4.7
��������
Refusals of drug Refusals of drug
impaired patrons impaired patrons
increased by 300%increased by 300%
��������
replication sitesreplication sitesfrom 12.2 to 3.0from 12.2 to 3.0
��������
SwedenSweden
STAD Project
Stockholm
Holder
Examples of Community Action Projects Examples of Community Action Projects
for Environmental Preventionfor Environmental Prevention
COUNTRYCOUNTRY GOALSGOALS STRATEGIESSTRATEGIES RESULTSRESULTS
•• local news
•• Alcohol service Alcohol service
(RBS) (RBS)
•• Underage sales Underage sales
enforcementenforcement
•• Drunk patron Drunk patron
enforcementenforcement
United StatesUnited States
Sacramento,Sacramento,
CaliforniaCalifornia
Reduce drinking Reduce drinking
and problems for and problems for
1515--29 youth and 29 youth and
young adultyoung adult
3.9% reduction in 3.9% reduction in
reported assaultsreported assaults��������
��������
��������
43% reduction in 43% reduction in
violenceviolence
33.7% Lower 33.7% Lower
emergency care emergency care
•• News coverageNews coverage
•• DUI enforcementDUI enforcement
•• Alcohol outletAlcohol outlet
surveillancesurveillance
MassachusettsMassachusetts Reduce alcohol Reduce alcohol
crashescrashes25% reduction in 25% reduction in
fatal crashesfatal crashes��������
•• community community
mobilizationmobilization
•• Local sales policies Local sales policies
and enforcementand enforcement
MinnesotaMinnesota Reduce youth Reduce youth
drinkingdrinkingLower alcohol Lower alcohol
sales to youthsales to youth
RReduced traffic educed traffic
crashescrashes
��������
��������
Holder
Holder
EXAMPLES OF COMMUNITY ACTION
PROJECTS FROM AROUND THE WORLD
Western AustraliaWestern Australia
IsraelIsrael
Florence, ItalyFlorence, Italy
LahtiLahti, Finland, Finland
Stockholm, SwedenStockholm, Sweden
Massachusetts, USAMassachusetts, USA
South Carolina, USASouth Carolina, USA
Minnesota, USAMinnesota, USA
California, USACalifornia, USA
MalmoMalmo, Sweden, Sweden....
New ZealandNew ZealandWestern AustraliaWestern AustraliaWestern Australia
IsraelIsraelIsrael
Florence, ItalyFlorence, ItalyFlorence, Italy
LahtiLahtiLahti, Finland,, FinlandFinland
Stockholm, SwedenStockholm, SwedenStockholm, Sweden
Ontario, CanadaOntario, Canada
Massachusetts, USAMassachusetts, USAMassachusetts, USA
South Carolina, USASouth Carolina, USASouth Carolina, USA
Minnesota, USAMinnesota, USAMinnesota, USA
California, USACalifornia, USACalifornia, USA
MalmoMalmoMalmo....
New ZealandNew ZealandNew Zealand
PAKKA, FinlandPAKKA, FinlandPAKKA, FinlandPAKKA, FinlandPAKKA, FinlandPAKKA, FinlandPAKKA, FinlandPAKKA, Finland6 Community Trial, Sweden6 Community Trial, Sweden6 Community Trial, Sweden6 Community Trial, Sweden6 Community Trial, Sweden6 Community Trial, Sweden6 Community Trial, Sweden6 Community Trial, Sweden
QueenslandQueensland
IrelandIreland
6 community trial, Norway
U K
Diadema & Paulinia,
Brazil
Holder
High Impact Areas for Environmental High Impact Areas for Environmental
StrategiesStrategies
�� Acute mortality, violence & injuriesAcute mortality, violence & injuries
�� Control of legal and abusable productsControl of legal and abusable products
�� Controls on outlets and distributionsControls on outlets and distributions
�� Drinking and drivingDrinking and driving
�� Club strategiesClub strategies
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