Introduction: Statement of the Problem

The cost of alcohol-related harm to society is enormous, both in human and economic terms:

  • At least 85,000 Americans die each year from alcohol-related causes, making alcohol-related problems the third-leading cause of death in the United States (Mokdad, et al., 2004).

  • Drinking and driving is a significant cause of injuries and fatalities in the United States. Alcohol was involved in 40 percent of traffic crash fatalities and in 7 percent of all crashes in 2003, resulting in 17,013 fatalities and injuring an estimated 275,000 people (NHTSA, 2004).

  • Almost one in four victims of violent crime report that the perpetrator had been drinking prior to committing the violence. Alcohol was involved in 32 to 50 percent of homicides (Spunt, et al., 1995; Goldstein, et al., 1992; Greenfeld, 1998).

  • Thirty-nine percent of accidental deaths (including drowning, poisonings, falls, and fires) and 29 percent of suicides in the United States are linked to the consumption of alcohol (Smith, et al., 1999).

  • The total monetary cost of alcohol-attributable consequences (including health care costs, productivity losses, and alcohol-related crime costs) in 1998 was estimated to be $185 billion (USDHHS, 2000).

The problems listed above are often associated with the over-consumption of alcohol in episodes of heavy drinking. Studies that show that up to 50 percent of people driving under the influence had their last drinks at licensed establishments are a strong indication the enforcement and prosecution of laws governing the consumption and distribution of alcohol should have a significant impact on the reduction of injuries and fatalities resulting from the consumption of alcohol (O’Donnell, 1985; Anglin, 1997; Gallup, 2000). This report examines the following problem: There are existing laws regulating the service of alcohol that are designed to prevent the over-consumption of alcohol by either:
(1) Prohibiting the sale and service of alcohol to intoxicated people, or (2) prohibiting sales practices (including happy hours, drink specials, and other drink promotions) that effectively reduce the price of drinks and encourage excessive consumption of alcohol. Yet the research conducted in preparation for this report indicates that enforcement of these laws is often given a low priority relative to the magnitude of the problems resulting from over-consumption of alcohol. At least three factors contribute to the lack of adequate enforcement:

  • alcohol enforcement agencies face diminishing budgets and resources;

  • there is an absence of public and government support for the enforcement of such laws; and

  • in the case of laws governing sales to intoxicated people, the statutes are difficult to enforce and adjudicate.

This report begins with a review of previous research documenting the association between over-consumption and serving practices. This research suggests that interventions and enforcement of laws regulating serving practices can increase compliance and reduce alcohol-related problems. The report then presents findings from original research conducted pursuant to a contract with the National Highway Traffic Safety Administration1. The findings include:

  • an analysis of State laws addressing service to intoxicated people and restrictions on happy hours and related serving practices;

  • a review of the current status of enforcement and adjudication of these laws; and

  • a presentation of promising enforcement strategies being implemented by State and local enforcement agencies.

The report concludes with a summary of the problem and proposed intervention strategies designed to improve compliance rates with laws restricting sales to intoxicated people and happy hour and other reduced-price promotions.


1NHTSA contract IQC DTNH22-98-D-35079.