DefinitionPercentage of adults 18 years of age and older who drank on 1 or more days during the past 30 days and responded 1 or more times on the [http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspx Behavioral Risk Factor Surveillance System (BRFSS)] to the question: "Considering all types of alcoholic beverages, how many times during the past 30 days did you have X (X = 5 for men, X = 4 for women) or more drinks on an occasion?"
NumeratorWeighted number of adults (18+) who reported binge drinking on the BRFSS based upon the following questions: "During the past 30 days, have you had at least one drink of any alcoholic beverage such as beer, wine, a malt beverage or liquor?" and "Considering all types of alcoholic beverages, how many times during the past 30 days did you have X (X = 5 for men, X = 4 for women) or more drinks on an occasion?"
DenominatorWeighted number of adults (18+) with complete and valid responses on the BRFSS to the questions on number of days drinking and times consuming multiple drinks on an occasion, excluding those with missing, "Don't know/Not sure" or "Refused" responses.
Data Interpretation IssuesThe Behavioral Risk Factor Surveillance System (BRFSS) is a source for estimating binge drinking prevalence for Alaska. The median of states, District of Columbia, and territories provides a comparison for the United States (U.S.). Information on background and methodology of the BRFSS managed by the Centers for Disease Control and Prevention (CDC) can be found at: [http://www.cdc.gov/brfss/]. The website for the Alaska BRFSS is: [http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspx].
Alaska data were obtained from the Standard AK BRFSS from 1991 through 2003, 2005 through 2007, and 2009 through 2014, and from the Standard and Supplemental AK BRFSS surveys combined in 2004, 2008 and 2015.
From 1991 through 2005 the following definition was used, adults (men and women) aged 18 years and older who consumed five or more drinks on one occasion within the past 30-day period. From 2006 and later, the definition of binge drinking has been men aged 18 years and older who consumed five or more drinks on one occasion or women aged 18 and older who consumed four or more drinks on one occasion within the page 30-day period.
Alaska Native people in analyses of the BRFSS refers to any mention of American Indian or Alaska Native heritage when enumerating racial and ethnic background. Individuals who indicate multiple races including American Indian/Alaska Native are considered Alaska Native in the data. When race and ethnicity are consider concurrently, Hispanic individuals with American Indian/Alaska Native heritage are combined into the Alaska Native (any mention) group and removed from the Hispanic class.
Post-stratification weights were used for Alaska prior to 2006; raking weights were used from 2007 onward. For more on this methodological change see: [http://dhss.alaska.gov/dph/Chronic/Pages/brfss/method.aspx].
Why Is This Important?Alcohol and substance abuse have a devastating impact on individuals, families and entire communities across Alaska. The effects of alcohol and other drug abuse include unintentional and intentional injuries, violence, high-risk sexual behaviors, cirrhosis, and alcohol poisoning.^1^ Alaska experiences a disparately high rate of alcohol-induced mortality compared to the United States. Alcohol and other drug use is common among adolescents and is a strong predictor of dependence in later life.^2^ [[br]]
1. Stahre M, Roeber J, Kanny D, Brewer RD, Zhang X. Contribution of Excessive Alcohol Consumption to Deaths and Years of Potential Life Lost in the United States. Prev Chronic Dis 2014;11:130293. DOI: [http://dx.doi.org/10.5888/pcd11.130293].
2. U.S. Department of Health and Human Services. The Surgeon General's Call to Action to Prevent and Reduce Underage Drinking-2007. [https://www.ncbi.nlm.nih.gov/books/NBK44360/pdf/Bookshelf_NBK44360.pdf]. Published 2007. Accessed October 10, 2016.
Healthy People Objective: Reduce the proportion of persons engaging in binge drinking during the past month--Adults aged 18 years and olderU.S. Target: 24.3%
Other ObjectivesHealthy Alaskans 2020 Indicator 15.a: Reduce the percentage of adults (age 18 and older) who report binge drinking in the past 30 days (based on the following criteria: 5 or more alcoholic drinks for men on one occasion; 4 or more alcoholic drinks for women on one occasion) to 20%
How Are We Doing?The percentage of adults who binge drink has fluctuated slightly over the past 2 decades, ranging from a high of 25% in 1994 to a low of 16% in 2008. The rate of binge drinking in 2017 of 19.4% for all Alaska adults was below the Healthy Alaskans goal of 20.0%. Alaska Native adults were above the Healthy Alaskans goal at 23.1%.
The prevalence of binge drinking in 2017 was higher among men (24.3%) than women (14.2%). Alaskans over the age of 64 were less likely to binge drink (6.5%) than Alaska adults in other age groups (17.3% to 22.6%). Asian adults had a lower binge drinking prevalence (12.2%) than Alaska Native adults (21.5%) and White non-Hispanic adults (19.2%) in Alaska for the 3-year average from 2015-2017.
Binge drinking prevalence rates from the BRFSS are initially presented for all Alaskans, Alaska Native people, and the median from states, District of Columbia, and territories for all available years. Subsequent analyses by demographic subpopulations (i.e., sex, age, race/ethnicity, ethnicity, marital status, education, employment status, income, and poverty status) are limited to 2010 and later to allow for ease of assessing recent trends.
Crosstabulations were also conducted for three-year averages by body mass index, current smoking, sexual orientation, disability, and history of adverse childhood experiences (ACEs). Significant differences were evident in contrasts by current smoking, sexual orientation, and disability. The prevalence rate of binge drinking increased with the level of ACEs exposure, with those who experienced 2 or more ACEs having significantly higher prevalence than those adults with no exposure.
Binge drinking prevalence by regions of Alaska is presented for the most recent time period allowing reporting for all Alaskans and Alaska Native people: 1) single-year for the 6 Alaska Public Health Regions, 2) three-year averages by the 7 Metropolitan and Micropolitan Statistics Areas and rural remainder, 3) single-year for the 10 behavioral health assessment regions based upon aggregations of 20,000 population, 4) three-year averages for 29 boroughs and census areas, and 5) five-year averages for the 12 tribal health organization regions. These time intervals match those for the InstantAtlas health profiles for each of the geographic regionalizes of Alaska for those desiring longer time series.
How Do We Compare With the U.S.?The Alaska adult binge drinking rate has consistently been slightly higher than the median for the United States, which was 16.9% in 2016.
What Is Being Done?Before ending in June 2015, the two primary objectives chosen by the Alaska Strategic Prevention Framework State Incentive Grant (SPF SIG) Advisory Committee were to reduce youth alcohol use (e.g., lifetime, current, heavy and binge drinking) and adult alcohol abuse (e.g., heavy and binge drinking). The SPF SIG Strategic Plan identified four key strategies: (1) Enhance the Alaska prevention workforce; (2) Develop regional/community capacity to promote prevention principles and strategies; (3) Increase the understanding and use of community coalitions and environmental strategies to accomplish sustainable community change; and (4) Increase regional/community understanding and use of data to drive decision-making, implementation, evaluation and continuous quality improvement of strategies and interventions.
Evidence-based PracticesAs part of the Healthy Alaskans 2020 health improvement process, groups of Alaska subject matter experts met over a period of months in a rigorous review process to identify and prioritize strategies to address the 25 health priorities. Public health partners around the state are aligning work around these approaches adapted to Alaska's unique needs.
[[br]]Integrate electronic Screening, Brief Intervention, and Referral to Treatment (SBIRT) into strategic healthcare settings throughout Alaska. SBIRT is an early intervention approach that targets those with nondependent substance use to provide effective strategies for intervention prior to the need for more extensive or specialized treatment.
[[br]]SBIRT is a model listed in the SAMHSA'S National Registry of Evidence-based Programs and Practices that focuses on delivering early intervention and treatment services for people with substance use disorders, or those at-risk for developing substance use disorders.
[[br]][http://www.nrepp.samhsa.gov/ViewIntervention.aspx?id=222 Project ASSERT]
[[br]]Expand therapeutic courts throughout Alaska. These courts provide an alternative justice model in which a collaborative court team made up of a supervising judge, district attorney, defense counsel, probation officer and/or substance abuse or mental health treatment provider who oversees and closely monitors participants who chose the treatment program in lieu of incarceration.
[[br]]Therapeutic courts have been shown to increase treatment retention rates and decrease rates of rearrests and reconvictions compared to conventional prosecution.
[[br]]Center for Court Innovation - Best Practices in Adult Drug Courts: What Does the Research Tell Us? [http://www.courtinnovation.org/research/best-practices-adult-drug-courts-what-doesresearch-tell-us]
Carns TW, Cohn L, Martin S. Recidivism in Alaska's Therapeutic Courts for Addictions and
Department of Corrections Institutional Substance Abuse Programs. [http://www.ajc.state.ak.us/reports/2012programrecid.pdf]. 2012.
[[br]]Fund Strategic Prevention Framework Grants that address local needs and reduce substance abuse problems.
[[br]]This initiative comes from SAMHSA and is being used by the State of Alaska. It is a five-step planning process to guide the work of states and communities in their prevention activities. The framework allows communities to identify and select evidence based interventions that address local needs to reduce substance abuse problems. The framework is to be used in a comprehensive strategic plan. The 5 steps are:
[[br]]1. Assess population needs, the resources required to address the problem, and the readiness to act;
[[br]]2. Build capacity at state and community levels to address needs and problems identified in Step 1;
[[br]]3. Develop a comprehensive strategic plan. At the community level, the comprehensive plan articulates a vision for organizing specific prevention programs, policies, and practices to address substance abuse problems locally;
[[br]]4. Implement the evidence-based programs, practices, and policies identified in Step 3; and
[[br]]5. Monitor implementation, evaluate effectiveness, sustain effective activities, and improve or replace those that fail.
[[br]]Center for Substance Abuse Prevention. Identifying and Selecting Evidence-Based Interventions Revised Guidance Document for the Strategic Prevention Framework State Incentive Grant Program. Rockville, MD: Center for Substance Abuse Prevention, Substance Abuse and Mental Health Services Administration, 2009.
A listing of strategies, actions, and key partners on this measure can be found at: [http://hss.state.ak.us/ha2020/assets/Actions-Partners_15_BingeDrinking.pdf].