NM: Measures could curb alcohol-related deaths in New Mexico

Santa Fe New Mexican
By Ted Alcorn, New Mexico In Depth
August 18, 2022

At a 12-step meeting in Albuquerque’s foothills, one of hundreds held each week statewide, there were cowboys, Anglo women in golf shirts and Hispanic day laborers. A woman without housing asked around for a place to stay the night. A downcast man in nurse’s scrubs said he had relapsed but hoped to go home that night, if his wife would have him.

New Mexicans can’t ignore the state’s enormous alcohol problem even if they want to. Tens of thousands have to confront it each day in their roles as clinicians and cops and probation officers and teachers, as family of people dependent on alcohol, and in personal struggles with addiction.

Yet for years, the state’s political leaders have largely turned a blind eye, failing to take substantive, statewide action to curb the escalating crisis. Instead of reducing hazards for people who consume alcohol, they have improved the business climate for people who sell it. Last year, as the number of alcohol-induced deaths in the state hit record highs, legislators and Gov. Michelle Lujan Grisham made it easier to get alcohol in restaurants and via home delivery.

On more than half the measures recommended for reducing alcohol-related harms by the Community Preventive Services Task Force, an independent panel of scientific experts, the state Department of Health acknowledges the state “needs improvement” or is moving in the wrong direction.

Many people — including those who benefit from alcohol sales — view the challenge with fatalism.

“We do have an alcohol problem in New Mexico. We always have and always will,” said lobbyist Ruben Baca, who in 2017 helped kill one of the recommended measures, an increase in alcohol taxes.

In 1990, many thought the state’s elevated rate of intoxicated driving crashes couldn’t be changed — until lawmakers mustered a whole-of-government response and cut the rate of fatal crashes by two-thirds.

And overwhelmed by a wave of opioid overdose deaths long before it hit the nation as a whole, New Mexico developed policies that experts credit with preventing deaths from climbing higher.

Though not typically thought of as an innovator, New Mexico adopted laws that were the first of their kind that later spread across the country. The state required motorists convicted of intoxicated driving to install ignition interlocks and made it easier for people who inject drugs to report overdoses to emergency responders and access the medication naloxone to revive overdose victims.

Today, no state has a higher rate of alcohol-related deaths than New Mexico, including those that consume more alcohol and where more residents drink. “Drinking is more dangerous in New Mexico,” said Michael Landen, the state epidemiologist from 2012-20, so the state needs stronger safeguards than other places, too.

Potential for action

To significantly reduce alcohol’s harms would require efforts across New Mexican society — including by the governor, the Legislature, courts, clinicians, not to mention alcohol producers, sellers and drinkers. In interviews, state and national experts suggested necessary elements:

Set a measurable and meaningful goal, and lead: First, the state needs to acknowledge the problem and commit to addressing it, said Landen. Lawmakers could enshrine the clear, measurable goal of reducing alcohol-related deaths and empower a high-level task force to propel action — “to keep the recommendations coming and the evaluation moving forward.”

Renew the fight against DWI, and look beyond it: Thirty years ago, New Mexico’s campaign to reduce intoxicated driving significantly changed behaviors and saved lives — but in the last 15 years, those reductions bottomed out.

The state’s legal limit on blood alcohol concentration of 0.08 percent is lax — a 180-pound person might consume four drinks in an hour without exceeding it — and lawmakers could lower it to 0.05. This is already the standard in many middle- and high-income countries. In Utah, the first state to implement it, fatal crashes fell by 20 percent, faster than in neighboring states or nationwide.

But deaths caused by intoxicated driving represent only 1 in 10 of the state’s alcohol-related fatalities and are a facet of a much larger problem. The state has long funded Local DWI councils in each county to address intoxicated driving, but they focus on problem drinkers rather than populationwide strategies to reduce alcohol consumption. Landen said the Legislature could broaden its mandate to explicitly address all alcohol-related deaths with evidence-based approaches.

Raise the price of alcohol: Experts agreed the most important step New Mexico can take to reduce alcohol-related deaths is to make it less affordable to drink excessively by raising alcohol taxes.

“There are more studies of this than any other preventive intervention that we’ve done, and the findings are more consistent,” said Alex Wagenaar, a professor emeritus at the University of Florida College of Medicine. “As the tax goes up, alcohol problems go down.”

In New Mexico, Landen said an increase in alcohol taxes ought to be the “centerpiece” of any robust response to alcohol-related deaths, whether raised statewide or by empowering local counties to impose their own taxes, which McKinley County already does.

There are other ways of reducing the affordability of alcohol, such as setting a price floor for sellers. In Oregon, 750-milliliter bottles of 40-proof (20 percent alcohol) spirits must be priced at $8.95 or more. Ireland recently enacted a minimum unit price for alcohol, prohibiting sales per standard drink for less than the equivalent of $1.13, regardless of whether the beverage is beer, wine or liquor.

In contrast, the cheapest liquor sold at a Rio Rancho Walmart is priced at 30 cents per standard drink.

Measure alcohol sales: To curb rising opioid overdose deaths, New Mexico began monitoring the distribution of prescription drugs to help crack down on dangerous prescribing practices. Landen said the Legislature could create a comparable monitoring system for alcohol by authorizing the Tax and Revenue Department to use alcohol tax data from individual wholesalers and retailers to “track where alcohol has been purchased, in what settings, by what communities.”

Address the connection between alcohol and violence: More than 40 percent of New Mexico homicide victims were drinking at the time of their deaths, and alcohol is the most common intoxicant in violence in the state. Charlie Branas, the chairman of the epidemiology department at Columbia University, said “there are many untapped opportunities” for the state to prevent violence by tackling alcohol.

Research has recently demonstrated that handgun owners with a prior conviction for intoxicated driving are four to five times more likely to commit violent or firearm crimes. Lawmakers could prohibit them from possessing guns. Scientists have also repeatedly shown that businesses that sell alcohol influence crime rates in their proximity. New Mexico policymakers and law enforcement could study whether the number and concentration of alcohol outlets have contributed to the state’s alarming rates of violence.