Legal purchasers of handguns with a prior DUI conviction have a greater risk of a future arrest for a violent offense


Legal purchasers of handguns with a prior DUI conviction have a greater risk of a future arrest for a violent offense — including murder, rape, robbery, and aggravated assault and for firearm-related violent crimes — a UC Davis Violence Prevention Program (VPRP) study has found.

The study publishes in the Sept. 30 issue of JAMA Internal Medicine.

“Alcohol use is a well-established risk factor for firearm violence,” said Rose Kagawa, assistant professor of emergency medicine and first author of the VPRP study.

“Our study suggests that handgun purchasers with a DUI conviction on their record at the time of purchase have a higher incidence of future violence and crime compared to purchasers without DUI convictions.”

For the study, the VPRP team used the California Department of Justice Dealer’s Record of Sale database to identify everyone aged 21 to 49 who legally purchased a handgun in California in 2001. The age range reflects the facts that handgun purchasers in California must be at least 21 years of age, and criminal behavior among persons aged 50 and older is relatively low.

Using records from the California Department of Justice Criminal History Information System, they identified arrests for violent crimes following the first purchase in 2001 (+10 days to account for California’s waiting period) until the end of 2013 or until they could no longer confirm the purchaser was alive and residing in California.

Those with at least one DUI conviction on their record at the time of purchase were compared to those without.

“Of the 78,878 handgun purchasers in California whose criminal records we tracked during 13 years, 9% of purchasers with pre-existing DUI convictions were later arrested for murder, rape, robbery or aggravated assault.

This is compared to 2% of purchasers with no prior criminal history at the time of purchase,” Kagawa said.

“When we compared purchasers who only had DUI convictions and no other arrests or convictions with those who had no criminal history, a DUI conviction was associated with more than double the risk of future arrest for a violent crime.”

California law prohibits individuals convicted of certain violent misdemeanors from legally purchasing a handgun within 10 years of conviction. As a result, they were not included in the study.

California law prohibits individuals convicted of certain violent misdemeanors from legally purchasing a handgun within 10 years of conviction. As a result, they were not included in the study.

The study expands on VPRP research published in 2018 that used data on handgun purchases in 1977 and tracked arrests for violent or firearm-related crimes through 1991.

While the sample size included only 4,066 purchasers, that study also associated risky alcohol use, mainly DUI offenses, with arrests for future violent crimes.

Funding: The research was funded by the National Institute of Alcohol Abuse and Alcoholism (1R01AA023551-01A1), California Wellness Foundation (2014-255), Heising-Simons Foundation (2016-219), and the Robertson Fellowship in Violence Prevention Research. Funding from the National Institutes of Health was not used in developing and describing the policy implications of the findings from this research.

Other authors of the study include Susan Stewart, Garen Wintemute, Mona A. Wright, Aaron B. Shev, Veronica A. Pear, Christopher D. McCort, Rocco Pallin, Rameesha Asif-Sattar, Sydney Sohl, Philip H. Kass, all from UC Davis; Magdalena Cerdá of New York University; Paul Gruenewald of the Pacific Institute for Research and Evaluation; and David M. Studdert of Stanford Law School and Stanford University School of Medicine.

The UC Davis Violence Prevention Research Program (VPRP) is a multi-disciplinary program of research and policy development focused on the causes, consequences and prevention of violence.

Studies assess firearm violence and the connections between violence, substance abuse and mental illness. VPRP is home to the University of California Firearm Violence Research Center, which launched in 2017 with a $5 million appropriation from the state of California to fund and conduct leading-edge research on firearm violence and its prevention.

Alcohol abuse is common in the USA. (We use ‘abuse’ in this article to refer to the gamut of alcohol-related or drug-related problems.) In the 2013 Behavioral Risk Factor Surveillance System survey, 16.8% of respondents reported binge drinking in the previous 30 days (≥5 drinks on an occasion for men, ≥4 drinks for women) and 6.2% reported heavy drinking (>60 drinks over 30 days for men, >30 drinks for women).1 

Acute alcohol intoxication and a history of alcohol abuse have well-established associations with violence, including firearm violence. For men, alcohol-attributable mortality from firearm violence approximates that for MVCs.2

Firearm ownership is also common in the USA; >50 million adults—approximately 35% of men and 11% of women—are estimated to own firearms.3 Firearm violence “poses a serious threat to the safety and welfare of the American public”,4 with 11 208 firearm homicides and 21 175 firearm suicides in 2013.5 The combined mortality rate from firearm suicide and homicide has changed little in more than a decade.6

Firearm owners may be more likely than others to abuse alcohol.7 Yet no longitudinal research has determined whether alcohol abuse is associated with risk for violence among firearm owners. This study will determine whether associations between individual alcohol abuse and community alcohol outlet density exist in a large population of legal purchasers of handguns.

Our principal hypotheses are as follows:

  • Among authorised purchasers of handguns in California, prior arrests and convictions for alcohol-related offenses, drug-related offenses and other non-violent misdemeanour crimes will each be associated with an increase in risk for violent and firearm-related criminal activity following handgun purchase.
  • Risk will increase both as the number of prior arrests or convictions associated with each of these three types of offense increases and as the number of types of offense that are present increases.
  • An increase in risk will persist after controlling for other known or potential individual risk factors (eg, demographics, firearm purchase history) and community characteristics (eg, demographics, socioeconomic status, firearm ownership, alcohol outlet density).
  • Alcohol outlet density will be independently associated with risk for violent and firearm-related criminal activity.

We next briefly review some of the most salient studies providing the foundation and context for our proposed research. A more detailed review has been published elsewhere.2

Alcohol abuse and risk for violence

Acute intoxication

In Bureau of Justice Statistics (BJS) surveys, approximately 37% of inmates convicted of violent crimes reported being under the influence of alcohol when those crimes were committed.8,9 Acute alcohol use or intoxication among homicide offenders ranges from 33% to 60% in toxicology studies.10,11 Acute alcohol use is associated with a substantial, dose-dependent increase in risk for suicide,1214 which appears to be greatest for firearm suicide.15,16

History of abuse

Large-scale survey studies have found an association between prior alcohol abuse and an increased risk of violence against others generally, and intimate partner violence, child abuse and child neglect.1719 In a multicity case–control study, persons who committed suicide were more likely to have had alcohol-related trouble at work or hospitalisations for complications of alcohol use.20 Prior alcohol abuse is associated with increased risk for a first suicide attempt.21

Driving under the influence offenses

Driving under the influence (DUI) is the most common of the alcohol-related offenses we will study.22 One persistent finding of DUI research is the relationship between the number of DUI offenses and the prevalence of other risk behaviours, including drug use and other criminal activity.2326 One such study used military police records to identify arrests. Repeat DUI offenders were more likely than first offenders (or non-offenders) to have been arrested for a violent crime, concealed weapon carrying or drug possession.27

Alcohol outlet density

Alcohol outlet density affects both the quantity and circumstances of individual alcohol consumption.28 Alcohol outlet distribution, particularly of on-premise establishments like bars, taverns and pubs, is an independent predictor of the rate and distribution of violence in communities.2932 

Alcohol outlet density is also associated with other conditions related to crime and violence, such as neighbourhood social disorganisation and residential instability, and its effects must be assessed with these conditions in mind.31

Other key exposures

Drug abuse

In a 2004 BJS survey, >25% of inmates incarcerated for violent crimes reported committing those crimes while under the influence of drugs; >50% reported use in the preceding month.33 Homicide offenders have rates of acute drug use or intoxication of 33–38% in toxicology studies.10 In National Violent Death Reporting System suicide data for 2010, opiates, marijuana and cocaine were identified in 20.0%, 10.2% and 4.6%, respectively, of those tested.12

Large-scale surveys have found that, as with alcohol, pre-existing drug abuse is associated with an increased risk of violence against others, intimate partner violence, child abuse and child neglect.17,19 In surveys and a systematic review, drug abuse has been associated with increases in risk for subsequent suicide attempts and self-directed non-fatal violence.13,17,21

Criminal history

Risk for new criminal activity, including violence, is greatly increased among persons with a criminal history.4,3442 A dose–response relationship exists; the more extensive the prior criminal record, the greater the risk of subsequent offending.43 Risk for violence is highly concentrated, with 6–10% of offenders committing >50% of violent offenses.37 After an index offense, risk for reoffending is highest initially and declines exponentially thereafter, approaching that for non-offenders after 10–20 years.4446

Other factors

Risk for violence is strongly related to male sex and (for interpersonal violence) younger age.4,3437,47 Community characteristics such as concentrated poverty and residential segregation are associated with risk for violence and are believed to operate by multiple mechanisms.36,4851

Co-occurrence of key exposures

Our principal exposures will likely co-occur but have been demonstrated to be statistically separable in previous research; each may act directly and modify risk associated with the others.

Mental illness research is particularly informative on this point. In a nationally representative survey, the probability of incident violent behaviour was low for persons reporting neither substance abuse nor violence in the past, increased for those reporting only substance abuse or violence, and increased still further for those reporting both.52 

In a case–control study of suicide, alcohol abuse was associated with a far greater increase in suicide risk among persons with a history of violence than among persons with no such history.53

Findings specific to firearm owners

Alcohol abuse

No study has examined associations between alcohol abuse and future violence among firearm owners. While alcohol abuse has been linked to homicide and suicide risk when firearms are in the home, such studies are not restricted to firearm owners and do not assess risk for committing interpersonal violence.20,5356

Firearm ownership itself may be associated with alcohol abuse, including binge drinking and heavy drinking.7,5763 Moreover, firearm owners who abuse alcohol are more likely than others to engage in firearm-related risk behaviours, including behaviours likely to be associated with violence.7,62,63

Demographics and criminal history

Longitudinal studies of violent and non-violent criminal activity among handgun purchasers in California have shown large increases in risk for men, a direct relationship between risk and the extent of any criminal history, and an inverse relationship between risk and age.6467

Firearm ownership

Firearm ownership itself has been associated with an increased risk of arrest57,68 or ‘trouble with the police.’60 Carrying a firearm in public has also been linked to arrest for a non-traffic offense62,68 and aggressive or hostile driving behaviour.69,70

UC Davis
Media Contacts:
Kelly Quigley – UC Davis
Image Source:
The image is in the public domain.

Original Research: Closed access
“Association of prior convictions for driving under the influence with risk of subsequent arrest for violent crimes among handgun purchasers”. Rose M. C. Kagawa, PhD, MPH; Susan Stewart, PhD; Mona A. Wright, MPH; Aaron B. Shev, PhD; Veronica A. Pear, MPH; Christopher D. McCort, MS; Rocco Pallin, MPH; Rameesha Asif-Sattar, BS; Sydney Sohl, BS; Philip H. Kass, DVM, MPVM, MS, PhD; Magdalena Cerdá, DrPH; Paul Gruenewald, PhD; David M. Studdert, LLB, ScD, MPH; Garen J. Wintemute, MD, MPH.
JAMA Internal Medicine doi:10.100/jamainternmed.2019.4491.


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