Developing Surveillance for Alcohol Abuse, Dependence, and Related

Consequences in New Mexico

Sandra Woerle, MA

New Mexico Department of Health

Office of Epidemiology

Historical Background to Alcohol Epidemiology in New

Mexico• 1990 Substance Abuse Unit created within Office

of Epidemiology at NM Department of Health Primary funding through Centers for Substance Abuse

Treatment (CSAT) One State-funded Epidemiologist

• Spring 2002 entered into discussions with Centers for Disease Control and Prevention (CDC)

Alcohol Epidemiologist as of 12/2002

New Mexico Alcohol Epidemiology Cooperative Partners

• Behavioral Health Services Division• Office of Medical Investigator• Office of Vital Records and Health Statistics• Office of Epidemiology Injury and Survey Units• Family Health Bureau• Health Policy Commission• Alcohol Issue Consortium• UNM Division of Government Research• Centers for Disease Control and Prevention

Substance Abuse Indicator Assessment

• Mortality- Office of Vital Records and Health Statistics; Office of Medical

Investigator (OMI); Fatal Accident Reporting System (FARS)

• Morbidity- Hospital Impatient Discharge Database (HIDD)

• Behaviors- Behavioral Risk Factor Surveillance System (BRFSS); Youth Risk and

Resiliency Survey (YRRS); Pregnancy Risk Assessment Monitoring System (PRAMS)

• Services- Treatment Episode Data System (TEDS)

• Crime- Uniform Crime Report (UCR); Citation Tracking System (CTS);

Local DWI Grant Program Screening and Tracking

Alcohol-Related Deaths RatesNew Mexico, 1990-2000

468

1012141618202224

1990

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

Dea

ths

per

100

,000

per

son

s

NMUS

Sources: New Mexico Office of Vital Records and Health Statistics, CDC WonderICD9 291, 303, 305.0, 357.5, 425.5, 535.3, 790.3, 571.0-571.3, E860 Age-adjusted to US 2000 population

Alcohol-Related Deaths in the USTop State Rankings, 1990-1998

State Rank Rate per 100,000

Alaska 1 19.5

New Mexico 2 17.6

Nevada 3 16.7

Source: CDC Wonder

Alcohol-Involved Crash Fatalities New Mexico and US, 1995-2001

0

2

4

6

8

10

12

14

1995 1996 1997 1998 1999 2000 2001

Dea

ths

per

100,

000

pers

ons

NMUS

Source: UNM Division of Government Research

Alcohol-Related Deaths and Alcohol-Involved Crash Fatalities

New Mexico 1995-1999

0

5

10

15

20

25

30

35

1995 1996 1997 1998 1999

Dea

ths

Per

100

,000

NMUS

Source: BRFSS

Alcohol Behavior Patterns in New Mexico: Findings from

BRFSS

Prevalence of Binge Drinking*New Mexico and US, 1997-2001

02

46

810

1214

1618

1997 1999 2001 2002

Per

cent

USNM

Source: BRFSS

* 5 or more drinks on one occasion

Prevalence of Heavy Drinking* New Mexico and US, 1991-2001

0

1

2

3

4

5

6

1991 1993 1995 1997 1999 2001

Per

cent US

NM

Source: BRFSS* More than 2 drinks/day for males and more than 1 drink/day for females

Prevalence of Self-Reported Driving Under the Influence in New Mexico,

1998, 1999, 2000, and 2002

0

0.5

1

1.5

2

2.5

3

1998 1999 2000 2002

Per

cent

Source: BRFSS

Total Number of Self-Reported Driving While Under the Influence Episodes/Year

New Mexico 1998-2002

0100200300400500

600700800900

1000

1998 1999 2000 2002

Tot

al E

piso

des

in T

hous

ands

Source: BRFSS

Prevalence for Self-Reported Driving Under the Influence

Selected States, 1999

0 2 4 6 8 10

Maine

New Mexico

United States

Arizona

Colorado

Nevada

Percent

Source:CDC BRFSS Prevalence Tables

Prevalence for Self-Reported Driving Under the Influence by GenderNew Mexico 1999, 2000, 2002

0

0.5

1

1.5

2

2.5

3

3.5

4

4.5

1999 2000 2002

Per

cent Male

Female

Prevalence of Self-Reported Driving Under the Influence by Race/Ethnicity

New Mexico 1998-2000

0

0.5

1

1.5

2

2.5

3

3.5

White Hispanic AmericanIndian

Other

Per

cent

Source: BRFSSP value= .03

Prevalence of Self-Reported Driving Under the Influence by Age

New Mexico 1998-2000

00.5

11.5

22.5

33.5

44.5

5

18-20 21-30 31-40 41-50 51-60 61+

Per

cent

Source: BRFSS

Prevalence of Self-Reported Driving Under the Influence by Marital Status

New Mexico 1998-2000

0

1

2

3

4

5

6

7

Married Divorced Separated Single

Per

cent

Source: BRFSS

Prevalence of Self-Reported Driving Under the Influence by Employment

New Mexico 1998-2000

0

1

2

3

4

5

6

Employed Unemployed Student Other

Per

cent

Source: BRFSS

Prevalence of Self-Reported Driving Under the Influence by Income

New Mexico 1998-2000

0

0.5

1

1.5

2

2.5

3

3.5

<$10K <$15K <$20K <$25K <$35K <$50K <$75K >$75K

Per

cent

Source: BFRSSP value= .08

Prevalence of Self-Reported Driving Under the Influence by BHSD Region

New Mexico 1998-2000

0

0.5

1

1.5

2

2.5

3

3.5

Region 1 Region2 Region 3 Region 4 Region 5

Per

cent

Source: BRFSS

Prevalence of Alcohol DependenceNew Mexico 2002

• Alcohol dependence obtained by state-added questions to BRFSS.

• Prevalence rate for past 12 months of 1.7

• 7.2 percent of binge drinkers are alcohol dependent

• National Household Survey on Drug Abuse showed alcohol dependence at 4.0

• 82% of self-reported DUI also report binge-drinking in past 30 days

Summary of Risk Behaviors• Alcohol risk behavior indicators vary:

- State binge drinking prevalence has remained stable;although significant changes occur within and between specific groups

- Heavy drinking has increased - Self-reported DUI has declined- Significant risk factors for DUI are male, younger,

never married, and student status or employed- BRFSS identified “problem” drinkers are not alcohol

dependent- There is an association between self-reported DUI

and binge drinking

Treatment Admissions by Primary Substance by Sex

New Mexico, 2000-2002

0 10 20 30 40 50 60 70

Alcohol

Marijuana

Cocaine

Heroin

Meth

FemaleMale

Source: TEDS July 2000-April 2002

ConclusionsAlcohol surveillance in New Mexico is a complex picture

Alcohol-related mortality rate is well above the national rate and is increasing

• Alcohol-related risk behaviors are stable or decreasing

• Patterns of alcohol use within sub-populations are crucial to understanding burden of alcohol in New Mexico

• Future work needs to address New Mexico specific issues

A Comparison of BRFSS to Screening & Tracking Using Santa Fe County, 2000

BRFSS• 70% Male• 47% Hispanic• 42% Married• 74% Employed• 26% Earn $25,000 to

$35,000/Year• 36% H.S. Grad and

36% College Grad

S & T• 78% Male• 69% Hispanic• 42% Never Married• 66% Employed• 65% Earn <$20,000• 44% H.S. Grad

Putting It All Together

• Multiple sources may reveal gaps in services or programming.

• Multiple data sources allow for comparisons to evaluate existing policies and plan for future program development

• BRFSS 2004 will include binge drinking module to obtain more information regarding type of alcoholic beverage and where last obtained alcohol.

Contact Information

Judith Harmon, MAManagement Analyst

Office of Epidemiology

1190 St. Francis Drive

Santa Fe, NM 87502

(505) 476-3576