# Assessing the Effects of State Alcohol Exclusion Laws on Alcohol-Related Behaviors and Outcomes

> **NIH NIH R01** · UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH · 2020 · $305,259

## Abstract

Project Summary/Abstract
Alcohol use disorders (AUDs) are highly prevalent in the U.S., and impose a substantial burden on individuals,
families and society. Public understanding of AUD and the disease of addiction has evolved as a result of
advances in science demonstrating the neurobiological basis of addiction and the fact that it is a treatable
condition. Nonetheless, individual and institutional discrimination against people with AUD persists. For
example, in contrast to shifts in public awareness, many states still have Alcohol Exclusion Laws (AELs).
These laws (which are part of the Uniform Accident and Sickness Policy Provision Law) allow insurance
companies of various types (accident, auto, disability, health) to deny coverage for injuries sustained by those
impaired by alcohol. There are concerns that such laws prevent or create disincentives to healthcare providers
testing blood alcohol levels of injured patients, screening and identifying those with alcohol-related problems,
and making referrals for treatment. As a result, over the past 20 years, 16 states and the District of Columbia
have repealed AELs. However, the impact of repeal has not been assessed scientifically. In response to
NIAAA PA-17-135, the proposed study will address this critical knowledge gap by conducting the first rigorous
analyses of how the repealing of AELs has affected alcohol treatment-seeking behavior, practice patterns of
healthcare providers, and how behavioral responses to these laws might be influenced by payment source.
Additionally, we will examine an important potential unintended consequence of repealing these laws--whether
doing so increases problem drinking. We propose a quasi-experimental design, exploiting variation across
state laws over time as a natural experiment. We will use data from five large national surveys and
administrative sources: the Treatment Episode Data Set, State Inpatient Databases, State Emergency
Response databases, the National Survey on Drug Use and Health, and the Behavioral Risk Factor
Surveillance System. We will also use NIAAA's Alcohol Policy Information System supplemented by original
legal research and other policy data sources. This project addresses a highly understudied area of high public
health significance: the potential of a state healthcare system-level factor--insurance exclusionary laws--to be a
barrier to treatment for AUDs—a question that is especially critical at a time when the prevalence of AUDs is
increasing and use of treatment services is low. This research will enhance our understanding of the
relationships between insurance exclusionary laws and substance-related behaviors and outcomes. In
response to PA-17-135, this project proposes innovative research into policies and policy effects that are not
well understood. We anticipate that the proposed study will provide an evidence base to inform future
legislative actions at both the state and national levels, thereby having a meaningful positive imp...

## Key facts

- **NIH application ID:** 9976404
- **Project number:** 5R01AA026666-03
- **Recipient organization:** UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH
- **Principal Investigator:** Sunday Azagba
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $305,259
- **Award type:** 5
- **Project period:** 2018-09-01 → 2022-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9976404

## Citation

> US National Institutes of Health, RePORTER application 9976404, Assessing the Effects of State Alcohol Exclusion Laws on Alcohol-Related Behaviors and Outcomes (5R01AA026666-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9976404. Licensed CC0.

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