Set aside politics and posturing about gun violence in America and there is still one indisputable fact: Alcohol use plays a primary role in gun violence.

A startling 48 percent of homicide offenders were reportedly under the influence of alcohol at the time of the offense, and 37 percent were intoxicated, according to an analysis by University of North Carolina researchers who reviewed more than 23 independent studies examining 8,265 homicide offenders in nine countries. In the United States, guns are the leading cause of homicide and suicide.

"Both acute alcohol intoxication and chronic alcohol misuse are strongly associated with risk for committing firearm violence, whether that violence is directed at others or at oneself," said Garen J. Wintemute, founding director of the Violence Prevention Research Program at the University of California, Davis. He added that of the nearly 400,000 firearm-related U.S. deaths in 12 years, "it is probable that more than a third of these deaths involve alcohol."

Many states recognize the link. For example, Pennsylvania does not allow anyone with three DUIs to purchase guns. Federal law does not allow anyone who is "an unlawful user or addicted to any controlled substance to purchase or possess guns," but it exempts alcohol abuse.

Too often, discussions of gun violence focus on the reasons behind mass shootings. In the New Yorker recently, Malcolm Gladwell suggests that thresholds - and, more precisely, the lowering of them - are making mass shootings more prevalent and deadly. He wrote, "The problem is not that there is an endless supply of deeply disturbed young men who are willing to contemplate horrific acts. It's worse. It's that young men no longer need to be deeply disturbed to contemplate horrific acts."

In some ways, alcohol might have a similar impact, reducing the threshold for violence by lubricating behaviors that would be unimaginable for a sober public. This isn't to say that gun control isn't warranted. On the contrary, denying alcohol abusers access to firearms makes perfect sense. But it does point to another solution: the expansion of proven alcohol treatments, the kind that help alcohol abusers reclaim their self-respect and lives while reducing the risk of gun violence.

Right now, of 17.6 million alcohol abusers, only 7.9 percent have received treatment. Additionally, much of what's available fails to embrace the latest scientific research on what allows an individual to stop drinking and move into recovery.

We must change how we treat mental-health and substance-use disorders to effect a larger change toward a healthier, safer America. If we don't, we risk more bad outcomes not only for patients but for those working to overcome the pressing national issue of gun violence.

Deni Carise serves as chief clinical officer for Recovery Centers of America and is an adjunct professor at the University Pennsylvania School of Medicine. dcarise@recoverycoa.com