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A randomised controlled feasibility trial of alcohol consumption and the ability to appropriately use a firearm
  1. B G Carr1,2,3,4,
  2. D J Wiebe2,3,4,
  3. T S Richmond3,4,5,
  4. R Cheney3,
  5. C C Branas2,3,4
  1. 1
    Department of Emergency Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
  2. 2
    Department of Biostatistics & Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
  3. 3
    The Firearm & Injury Center at Penn, University of Pennsylvania, Philadelphia, Pennsylvania, USA
  4. 4
    The Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
  5. 5
    University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
  1. Correspondence to Dr B G Carr, University of Pennsylvania, School of Medicine, 929 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104-6021, USA; carrb{at}


Objective: To show the feasibility of using a controlled trial to investigate the effect of alcohol on firearm use.

Methods: Randomised, blinded, placebo-controlled trial in the Firearm Usage and Safety Experiments (FUSE) Lab. Treatment subjects (male, 21–40-year-old, non-habitual drinkers, with no professional firearms training) received alcohol; control subjects received placebo alcohol. The AIS PRISim Firearm Simulator, including real pistols retrofitted to discharge compressed air cartridges that simulate firearm recoil and sound, was used to measure firearm performance. Accuracy and speed for target shooting, reaction time scenarios, and scenarios requiring judgement about when to use a gun were measured.

Results: 12 subjects enrolled in the trial, completing 160 training scenarios. All subjects in the alcohol arm reached target alcohol level. 33% of placebo subjects reported alcohol consumption. Mechanical malfunction of the simulator occurred in 9 of 160 (5.6%) scenarios. Intoxicated subjects were less accurate, slower to fire in reaction time scenarios, and quicker to fire in scenarios requiring judgement relative to controls.

Conclusions: The feasibility of a randomised, controlled trial exploring the relationship between alcohol consumption and firearm use was shown. The hypothesis that alcohol consumption worsens accuracy and retards judgement about when to use a gun should be tested. Larger trials could inform policies regarding firearm use while intoxicated.

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  • See Policy forum, page 425

  • i With regard to the latter group, criminal gun users found to be intoxicated during their crimes may be assigned lesser penalties given their impaired state and the resultant inability for prosecutors to demonstrate criminal intent or “malice aforethought” to commit the crime in question, up to and including crimes such as first-degree murder.

  • Contributorship The trial was conceived by CCB. The design of the trial was a collaborative effort by all authors. The data were collected by BGC and CCB, and interpretation was performed by BGC, DJW, and CCB. The article was drafted by BGC and critical revision of the article for important intellectual content was performed by all authors. All authors read and approved the final version that is being submitted. BGC and CCB are the guarantors of the paper, had full access to the data, controlled the decision to publish, and accept full responsibility for the work.

  • Funding The University Research Foundation of the University of Pennsylvania.

  • Competing interests None declared.

  • Ethics approval The trial was approved by the institutional review board (IRB) at the University of Pennsylvania. The IRB did not request that the ethics committee review the proposal.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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