Alcohol in Iowa
A Response from the State Underage Drinking Task Force
Iowa Underage Drinking Plan
Introduction
To better address the issue of underage drinking in the
State of Iowa, a State Underage Drinking Task Force was formed to
research the problem and develop a strategic plan of action. The
Task Force was working on the development of goals and actions when
the Surgeon General’s Call to Action to Prevent and Reduce Underage
Drinking 2007 was released. Due to the similarity in the goals
outlined in the Call to Action with those they had developed, the
Task Force, along with the DPAC, is recommending that the document
be used as the basis for the plan to curb underage drinking. The
Call to Action is based on several overarching principles from
which its goals and the means for achieving them were derived.
These principles are:
1. Underage alcohol use is a phenomenon that is directly related to
human development. Because of the nature of adolescence itself,
alcohol poses a powerful attraction to adolescents, with
unpredictable outcomes that can put any child at risk.
2. Factors that protect adolescents from alcohol use as well as
those that put them at risk change during the course of
adolescence. Internal characteristics, developmental issues, and
shifting factors in the adolescent’s environment all play a
role.
3. Protecting adolescents from alcohol use requires a
comprehensive, developmentally based approach that is initiated
before puberty and continues throughout adolescence with support
from families, schools, colleges, communities, the health care
system, and government.
4. The prevention and reduction of underage drinking is the
collective responsibility of the Nation. Scaffolding the Nation’s
youth is the responsibility of all people in all of the social
systems in which adolescents operate: family, schools, communities,
health care systems, religious institutions, criminal and juvenile
justice systems, all levels of government, and society as a whole.
Each social system has a potential impact on the adolescent, and
the active involvement of all systems is necessary to fully
maximize existing resources to prevent underage drinking and its
related problems. When all the social systems work together toward
the common goal of preventing and reducing underage drinking, they
create a powerful synergy that is critical to realize the
vision.
5. Underage alcohol use is not inevitable, and parents and society
are not helpless to prevent it.
Alcohol Data
Alcohol Data for Iowa from the State Epidemiological
Profile, Key Findings:
Alcohol is the most frequently used substance in Iowa and across
the United States, 54.04% (approximately 1,328,000) of Iowa
residents 12 years of age or older are current alcohol users.
Alcohol is the most cited substance of choice by individuals
entering substance abuse treatment in Iowa.
Binge Alcohol use (five or more drinks of alcohol once or twice a
week) is viewed as less of a risk by Iowans than others in the
United States.
The rate of current alcohol use by Iowa adults is similar to the
national rate, whereas binge drinking rates in Iowa are
significantly higher.
Among youth, the Iowa rate of current alcohol use is similar to
the national rate.
Iowa reports a binge drinking rate among 12-to-17-year-old youth
that is about 30% higher than the national rate.
While there is a downward trend in alcohol use by youth over the
last few years, more than 15% of all students surveyed in 2005
reported using alcohol before turning 13. For every five
11th-graders in Iowa, two drank alcohol within the past month.
Approximately 115 Iowa deaths per year are caused by alcoholic
cirrhosis, a death rate hovering around 4 per 100,000 from 2003 to
2005.
The percentage of Iowans aged 12 or older who reported alcohol
dependence or abuse was significantly higher than the national
percentage.
One-quarter to one-third of all traffic fatalities involved a
driver with a Blood Alcohol Content (BAC) greater than 0.01.
Approximately 20,000 drunkenness and liquor law arrests were
recorded in 2005, the majority of these arrests involved 18-24 year
olds.
Operating While Intoxicated arrests per 100,000 Iowans neared 500
in 2004, the highest rate in at least 5 years. This may be due to
the change in the “legal limit” in Iowa, lowered from .10 Blood
Alcohol Content (BAC) to .08 BAC in 2003.
Alcohol Consumption
Alcohol is the substance most frequently used by adults and youth
in Iowa and across the United States. The National Survey on Drug
Use and Health (NSDUH) in 2004 found that 54.04% (approximately
1,328,000) of Iowa residents 12 years of age or older had used
alcohol during the past month. Of these Iowans, it was estimated
that more than one-half (699,000) consumed five or more drinks on
at least one occasion during the past month. Of Iowans 12 years of
age and older, 28.42% had binged on alcohol during the past month.
These figures demonstrate Iowa’s large problem with alcohol use.
The 2004 NSDUH estimated that more than one-third (33.78%) of
Iowans aged 12 years or older felt that five or more drinks of
alcohol once or twice a week was a great risk. The national rate
for people 12 or older was 41.30%. This difference shows that
alcohol use is not deemed as high a risk in Iowa as across the
nation.
Alcohol is the most cited substance of choice by individuals on
admission to Iowa substance abuse treatment services, reinforcing
alcohol as the primary substance of choice in Iowa. Marijuana,
methamphetamine, and cocaine are the next most cited
substances.
Adults
Current Use
In 2004, more than one-half of Iowa adults had consumed alcohol
in the past month as reported in the Behavior Risk Factor
Surveillance System (BRFSS) and the NSDUH. More Iowa men than women
reported past 30-day alcohol use, similar to the national rates.
Estimates based on the 2005 BRFSS show no significant difference
between usage rates of men or women at the national and Iowa
levels. There is no significant difference in Iowa men’s and
women’s usage rates from year to year.
Binge Drinking
Iowa binge drinking rates, estimated by the 2005 BRFSS for
women (9.6%) and men (28.1%), are higher than the respective
national figures. In 2005, adult men in Iowa had a significantly
higher rate of heavy drinking than the national rate. There was no
real difference between the heavy drinking rate for Iowa women and
women nationally. Fewer Iowans over age 12 view the consumption of
five or more drinks of alcohol once or twice a week as a great
risk, compared with the national rate. The lower perception of
great risk in Iowa versus the United States echoes the difference
between Iowa and United States binge drinking rates.
Youth
Underage drinking is a critical issue in Iowa. Iowa
places in the top fifth of the states for both underage use of
alcohol and underage binge drinking. The social culture in many of
Iowa’s rural areas and college towns accepts underage drinking as a
rite of passage. Many community events and activities center on or
include drinking alcohol, glorifying drinking, and may even promote
underage drinking.
Use before the Age of 13
The reported rate of alcohol use before age 13 has fallen from
1999 to 2005. However, over 15% of all students surveyed in 2005
reported using alcohol before turning 13.
Current Use
Past 30-day use of alcohol has also fallen for each grade
reported in the Iowa Youth Survey (IYS) since 1999. The downward
trend is positive, but the overall number of youth reporting past
30-day use is still alarming. For every five 11th graders in Iowa,
two drank alcohol in the past month. Even though the IYS shows a
downward trend in past 30-day alcohol use, Iowa teens continue to
use alcohol at a similar rate as teens nationally. According to the
2004 NSDUH, there is no real difference in the rate of past 30-day
alcohol use by 12- to 17-year-olds in Iowa (19.60%) and nationwide
(17.65%).
Binge Drinking
Binge drinking by 6th, 8th, and 11th graders over the past 30
days as reported on the IYS has decreased since 1999. Iowa reports
a significantly higher binge drinking rate among youth than the
national rate. According to the 2004 NSUDH, 14.08 percent of 12-to
17-year-old Iowans versus 10.86% of 12- to 17-year-olds nationally
had at least one episode of binge drinking in the past 30 days.
This finding reflects Iowa’s above-average adult binge drinking
rate.
Drinking and Driving
As with other measures of youth alcohol use, the reported
percentage of youth driving after using any amount of alcohol or
other drugs has decreased from 1999 to 2005. Although the rate of
youth driving after using alcohol or other drugs has decreased,
many Iowa youth still place their lives at risk by driving after
using alcohol or other drugs.
Perceived Risk of Drinking
The majority of 6th-, 8th-, and 11th-graders in Iowa feel there
is great or moderate risk associated with drinking a considerable
amount of alcohol on a regular basis. Female respondents perceived
greater risk of alcohol use than males. The gender difference
remained relatively stable from 1999 to 2005.
Alcohol
Consequences
The consequences of alcohol use in Iowa are severe and
multi-faceted. They include: injury and loss of life; lost wages
and loss of employment; increased insurance rates and
hospitalization charges; costs associated with the legal system;
incarceration; and property damage. Because of the higher levels of
alcohol consumption compared with tobacco or illicit drugs, the
adverse consequences of alcohol use may outweigh those associated
with tobacco or illicit drugs.
Legal
Approximately 20,000 drunkenness and liquor law arrests were
recorded in 2005, the majority involving 18-24 year olds. These
numbers were similar to those reported in 2004. The number of
convictions for alcohol-related offenses in Iowa has remained
relatively stable between 2003 and 2005.
The number of Operating While Intoxicated (OWI) arrests per 100,000
Iowans neared 500 in 2004, the highest rate in at least 5 years.
The change in the legal BAC limit may be responsible for the
notable increase in the OWI arrest rate per 100,000 Iowans from
2003 to 2004. Other possible reasons for the increase could be
improved law enforcement or zero tolerance policies toward motor
vehicle-alcohol offenses. Iowa recorded more than 14,000 OWI
arrests during 2004.
The number of Iowa domestic violence cases where alcohol was
present has remained stable from 2003-2005, hovering around 1,200
and comprising 15-18% of the total number of domestic violence
cases.
Fatal
A recent study found that, of suicide victims who were tested
for alcohol or drugs, approximately 33.3% were positive for alcohol
and 16.4% were positive for opiates. Adjusted for population, the
overall suicide rate in Iowa has climbed steadily since 2000. The
suicide rate for Iowans under age 19 fell, while the suicide rate
for adults rose, since 2000. The 2004 suicide rate was 11.5 per
100,000.
Approximately 115 Iowa deaths per year are caused by alcoholic
cirrhosis (ICD 10 code K70), for a death rate hovering around 4 per
100,000 from 2003-2005. This rate is quite low compared with the
lung cancer death rate of approximately 65 per 100,000 Iowans from
2003-2005.
Between 2000 and 2005, approximately one-quarter to one-third of
Iowa traffic fatalities involved an “alcohol-involved driver,”
defined as having a Blood Alcohol Content (BAC) greater than 0.01.
The rate of alcohol-related traffic fatalities has remained
relatively constant since 2000.
PROPOSED IOWA PLAN
2007 – 2010
Year 1
Goals are taken from the Call to Action. The action steps and
strategies were developed by the Task Force
Goal 1: Foster changes in Iowa that facilitate healthy adolescent
development and that help prevent and reduce underage drinking.
Year 1 Action Step: Increase resources available to address
underage drinking.
Strategy 1: Research the current legislation that relates to the
automatic transfer of all funds from the Alcohol and Beverage
Division (ABD) of the Department of Commerce to IDPH for substance
abuse services. Make recommendations for future actions.
Strategy 2: To explore the current use of funds generated by
alcohol-related civil penalties
Strategy 3: To explore sources for funding alcohol compliance
checks
Strategy 4: To research and enhance best practices to reduce
underage drinking at the community level, such to support the
statewide Alliance of Coalitions 4 Change (AC4C)
Strategy 5: To explore an increase in the beer tax (currently $.19
per gallon) as a way to create a stable funding source for
substance abuse prevention, treatment and law enforcement
programs.
Goal 2: Engage parents and other caregivers, schools, communities,
all levels of government, all social systems that interface with
youth, and youth themselves in a coordinated state effort to
prevent and reduce underage drinking and its consequences.
Year 1 Action Step: Engage state level and community partners
Strategy 1: Identify potential partners and collaborators
Strategy 2: To seek support and endorsement from the partners and
collaborators for the underage drinking plan
Strategy 3: To request from the partners and collaborators input
regarding the action steps and strategies for years 2 and 3.
Goal 3: Promote an understanding of underage alcohol consumption in
the context of human development and maturation that takes into
account individual adolescent characteristics as well as
environmental, ethnic, cultural, and gender differences.
Year 1 Action Step: Make available research-based information on
the impact of alcohol on adolescent development
Strategy 1: Involve the Iowa Substance Abuse Information Center
(ISAIC) and AC4C in the dissemination of materials for social
marketing.
Goal 4: Conduct additional research on adolescent alcohol use and
its relationship to development.
This is not currently a state level function
Goal 5: Work to improve public health surveillance on underage
drinking and on population based risk factors for this
behavior.
Year 1 Action Step: Ensure the availability of consistent data on
underage drinking
Strategy 1: Institutionalize the Iowa Youth Survey (IYS) with a
state funding source.
Strategy 2: To conduct the Iowa Youth Survey on no less than a
triennial basis
Strategy 3: To update the State Epidemiological Substance Abuse
Profile on a yearly basis.
Strategy 4: To explore the gap in consistent data on college age
youth.
Goal 6: Work to ensure that policies at all levels are consistent
with the state goal of preventing and reducing underage alcohol
consumption.
ODCP/DPAC will coordinate this function in Iowa.
