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A New Approach to Alcohol in Australia

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A New Approach to Alcohol in Australia e s torin� a new approach to alcohol in Australia St Vincent’s Health Australia’s Alcohol-Related Harm and Violence Policy St Vincent’s Health Australia has a plan to reduce alcohol-related harm and violence. From what we see in our hospitals and treatment services, we know the damage alcohol can do and what needs to be done to reduce its impact. Alcohol harm can’t be reduced through a single policy initiative or individual campaign. To achieve our goal will take constructive dialogue between A new approach governments, businesses, the community and health sectors, and the broader public, along with an integrated It’s time for Australia to take a new approach to alcohol to reduce its negative approach over many years. effects on our community. We recognise that alcohol has deep cultural and social significance in Australia and is of major economic importance. Yet all the evidence points overwhelmingly to the fact Australia has an alcohol problem – one that is not restricted to a small proportion of heavy and/or dependent drinkers, and which is greater than that posed by any Reduce alcohol-related illness and injury illegal drug – and requires our urgent intervention. in Australia by 20% by 2025, including: Unfortunately, alcohol policy has become the product of competing interests, values and ideologies. Alcohol-related emergency department presentations. Achieving our targets will require Australians and their governments to start thinking differently about alcohol and the way we interact with it. Hospital admissions for alcohol use disorders. It will require Commonwealth and state and territory governments to display the same level of commitment commonly shown towards tackling other major health issues, by embracing the reforms and providing the Alcoholic liver disease deaths. resources necessary to reduce its harm. This is our primary aim. Background St Vincent’s Health Australia is one of the nation’s largest not-for-profit health and aged care organisations. It has a 176 year heritage of providing compassionate healthcare to Australians from all walks of life, but most notably vulnerable members of the community, including homeless people, people with mental illness, prisoners, urban Aboriginal and Torres Strait Islanders, and people struggling with alcohol and drug addiction. Our two major tertiary public hospitals – St Vincent’s in Our Alcohol-Related Harm and Violence Policy is built on an Melbourne’s Fitzroy and St Vincent’s in Sydney’s Darlinghurst extensive environment scan and interviews with more than 80 – have long catered to the entire spectrum of alcohol-related experts – many of them national and international leaders in harm and violence, and by virtue of their locations, the horrific their field – on the social and health effects of alcohol. alcohol-fuelled injuries that occur in the entertainment Our goal is to prevent and reduce alcohol-related harm, in the precincts of both cities. same way efforts such as seat belts, plain cigarette packaging, Australia’s first medically-based clinical and academic program random breath testing, immunisation, sun protection, and for the treatment and study of alcohol dependence was HIV awareness have prevented and reduced harms in other established at St Vincent’s, Melbourne in 1964. St Vincent’s areas. Public health policy has played a significant role in all of Sydney followed with its own similar program in 1971. these areas and has become a growing asset in recalibrating our culture, attitudes and beliefs. St Vincent’s Sydney’s Alcohol and Drug Service is a recognised leader in the management of alcohol and drug-related health Over time we are confident our voice, research and problems including hospital inpatient, an outpatient Wellness experience will result in our recommendations being accepted Clinic, multidisciplinary care hospital liaison services, and a by governments, business and the broader community. 20-bed non-medical residential withdrawal unit, Gorman House. St Vincent’s Melbourne’s Department of Addiction Medicine offers a combination of in and outpatient services including the 12 bedroom DePaul House, a medical residential withdrawal We believe it’s our responsibility, unit, consultation liaison services, drink driving education, counselling and research. knowing what we know as one More recently, St Vincent’s Health played a lead role of the nation’s largest healthcare supporting measures to reduce the availability of alcohol in Sydney’s inner city – advocacy that was an important factor groups, to stand up and say... in the NSW Government’s introduction of a suite of reforms, known commonly as the ‘lockout laws’, in February 2014. The success of this advocacy was a catalyst to bring our resources, expertise and experience together to address alcohol-related harm and violence more broadly across Australia. Alcohol is second only to tobacco as the leading preventable cause of death and hospitalisation in Australia.1 As a health organisation we are faced daily The harms associated with alcohol and the with the outcomes of the harmful consumption increasing scientific evidence regarding the of alcohol across the lifespan. health outcomes influenced by alcohol is persuasive to anyone involved in health care This may be harm caused by alcohol-related and clearly indicates that action must be taken. road trauma or violence treated in our emergency departments, trauma wards, operating theatres The effects of alcohol-related harm, however, or intensive care units. It may also be through the extend beyond the individual and the health care of our patients with mental illness or chronic system and include social and economic disease brought about by harmful alcohol costs of harm to families, communities and consumption over the longer term. Or it may be society at large. through dealing with developmental problems Alcohol abuse or intoxication is implicated arising from alcohol use in pregnancy, including in violence – both domestic and public, foetal alcohol spectrum disorders. unemployment, financial problems and poverty, drink driving, traffic accidents, industrial and work accidents, fires, falls, homelessness, and suicide. 1 National Health and Medical Research Council (2009). Australian guidelines to reduce health risks from drinking alcohol. Commonwealth of Australia. {cited 2011 February 2} Available from: www.nhmrc.gov.au In Australia, 3.2 per cent of the total burden 3.2% of disease is related to alcohol use.1 total burden of disease Hurts deaths every day 15 In Australia, alcohol kills 15 Australians every day, 5,554 each year (3,467 male deaths 2 increase in off-licence /5,554 and 2,087 female deaths). 10% liquor outlets deaths each year A 10 per cent increase in off-licence liquor outlets is associated /3.3% with a 3.3 per cent increase in domestic violence.7 hospitalisations every day increase in domestic violence 430 Alcohol hospitalises 430 Australians every day, 157,132 each year (101,425 for males and 55,707 for females).3 For every 10,000 additional litres of pure alcohol sold at a packaged liquor outlet, the risk of violence experienced /157,132 in a residential setting increases by 26 per cent.8 hospitalisations each year 26% increased risk of violence in residential setting Alcohol’s harm to others costs Australians more than $20.6 billion, including $14.3 billion in tangible costs (eg: out-of-pocket costs, forgone wages or productivity, hospital and child protection costs) and Studies have shown that 60 per cent of people presenting with $ $6.4 billion in intangible costs (the costs assigned injuries to emergency wards had consumed alcohol bought cost of alcohol’s 4 to pain and suffering, and diminished quality of life). 9 20.6 harm to other australians 60% from a store in the hours leading up to their injuries. people admitted to hospital BILLION consumed alcohol more Ambulances are more commonly called to neighbourhoods One-in-12 of all presentations to hospital emergency near bottle shops, with areas near larger chain stores reporting of all presentations to hospital emergency 10 departments in Australia and New Zealand departments in Australia and New Zealand are alcohol- ambulances even higher injury rates. iN are alcohol-related related, equating to more than half a million people called to neighbourhoods each year. In peak times (6pm Friday night to 6am near bottle shops 1 Sunday morning) the rate increases to one-in-eight.5 There were almost 30,000 police reported incidents of alcohol-related domestic violence in 2011 1 Begg S, Vos T, Barker B, Stevenson C, Stanley L & Lopez AD (2007). The Burden of Disease 7 Livingstone, M. (2011) A longitudinal analysis of alcohol outlet density and domestic violence. Addiction. and Injury in Australia 2003. Canberra: Australian Institute of Health and Welfare. (excluding Queensland, South Australia, Tasmania and 8 Liang, W., Chikritzhs, T. (2011) Revealing the link between licensed outlets and violence: counting 6 2 Gao, C., Ogeil, R.P., & Lloyd, B. (2014). Alcohol’s burden of disease in Australia. venues versus measuring alcohol availability. Australasian Professional Society on Alcohol and the Australian Capital Territory). Given less than half of Canberra: FARE and VicHealth in collaboration with Turning Point. other Drugs. 30,000 3 ibid. 9 Miller, P. (2015). Last drinks: A study of rural emergency department data collection to identify and target community alcohol-related violence. Deakin University on behalf of Australasian College of incidents are reported to police – and are often the most 4 Foundation for Alcohol Research and Education and Centre for Alcohol Policy Research, Emergency Medicine. 12 The range and magnitude of alcohol’s harm to others, Summary, 2nd Edition, February 2015. police reported incidents of severe cases – this figure likely under-represents the full 10 Morrison, C., & Smith, K. (2015) Disaggregating relationships between off-premise alcohol outlets 5 Australasian College for Emergency Medicine (2015). and trauma. Canberra: Foundation for Alcohol research and Education (FARE).
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