Objective: Alcohol can result in harm (including injury) not only to the drinker but also to others; however, little research exists on the additional proportion of violence-related injuries that can be attributed to the perpetrator.
Method: Data are reported from emergency department studies in 14 countries on the prevalence of patients' self-report of drinking within the 6 hours before the violence-related injury event, patients' belief that the event would not have happened if they had not been drinking at the time, and patients' perception that the perpetrator had been drinking. Alcohol-attributable fraction was calculated based on the patients' perception that their own drinking was causally related to the event and on their perception that the perpetrator had been drinking.
Results: Across all countries, 62.9% of the violence-related injuries involved alcohol use on the part of the victim, the perpetrator, or both. Rates of others definitely drinking, as perceived by the victim, ranged from 14% to 73% across countries and was positively associated with patients' own drinking in the event and with attributing a causal association between their drinking and the event. Estimates of alcohol-attributable fraction were 38.8% when the victim and perpetrator were considered together compared with 23.9% when only the patient was considered and varied by country-level drinking pattern.
Conclusions: These findings suggest adjustments that could be made to global burden of disease estimates because of violence-related injury morbidity to better reflect alcohol-attributable fraction when drinking by others and country-level drinking patterns are taken into account.