ANCD Issues Paper: Alcohol Action Plan
20 November 2013
National Plan to Address Alcohol Concerns for Communities
The Australian National Council on Drugs (ANCD) has today released an action plan it has developed to address the continuing and at times escalating problems caused by alcohol in communities around the country.
The plan has been designed with recommendations for communities, governments at all levels and corporations and to consider stemming the unacceptable levels of crime, violence, health harms and family disturbance caused by alcohol.
Alcohol use and harm affect a significant proportion of our population. This includes not just the minority of heavy drinkers but a significant number of people who occasionally drink in a risky way. There are also many people who are negatively affected by other people’s drinking, directly through having to deal with intoxicated people and reduced public opportunity for enjoyment, or indirectly through the higher costs imposed on health services and policing.
The ANCD recognises that alcohol consumption is a regular part of social life for many Australians. However, levels and patterns of consumption are frequently risky or unhealthy and create serious problems for everyone in our communities. Some of the issues of concern considered by the ANCD in developing this plan included research showing:
• 60% of all police attendances, including 90% of late-night calls, involve alcohol
• 20% of Australians drink at levels that put them at risk of lifetime harm from injury or disease
• 36% of drinkers say their primary purpose when drinking is ‘to get drunk’
• 25% of Australians report having been a victim of alcohol-related verbal abuse
• 21% of Australians under the age of 18 report having been harmed by another’s drinking
• 8% of Australians report having been a victim of alcohol-related physical abuse
• 3.2% of the total burden of disease in Australia is related to alcohol use
• Alcohol has been causally linked to at least 60 different medical conditions
• Hazardous and harmful alcohol consumption results in costs of more than $15.3 billion a year
• It is estimated that local governments spent nearly $800 million on public order and safety
• Insurance administration costs related to alcohol were at least $185 million in 2004–05
Dr Herron, Chairman of the ANCD, said “The level of alcohol related damage occurring in our communities is simply appalling and the Council has responded by developing a plan for action; for governments and communities to address the situation. The health, social and economic costs associated with alcohol use simply cannot be allowed to continue at the current level. We all understand that the culture of drinking and intoxication has a long history in Australia and we all agree that these levels of harm are unacceptable, however whenever we speak of culture change the industries that profit most from this culture run the same old fear campaign of a nanny state takeover. Seatbelts, random breath tests and gun laws do not represent a nanny state and nor do sensible alcohol policies and programs.”
Alcohol consumption among young people is a significant concern for the ANCD given that while many young people typically engage in fewer episodes of drinking overall, they are more likely to consume at higher risk levels each time. They are also more likely to specifically drink to become intoxicated; and more likely to experience acute alcohol-related harms. Some of the data reviewed by the ANCD included:
• 60% of students aged 12–17 reported consuming alcohol in the past year, and 23% in the past week
• 61% of 18–29 year olds reported they drank specifically to get drunk
• 22% of hospitalisations and 13% of deaths of young people are attributed to alcohol
• 52% of alcohol-related road injuries and 32% of alcohol-related hospital admissions for injuries from violence involve 15–24 year olds
ANCD Member Prof Steve Allsop noted that “There is hardly an Australian community or family that has not been affected by alcohol problems – whether that has been from their own use, a family member or that of a stranger - our safety on the road, the costs to our hospitals and police services, our concern about young people all demand investment in effective responses.”
The ANCD also wants to highlight that although the focus on alcohol-related concerns almost invariably means a focus on young people it is important to realise that Australians over the age of 65 years had:
• over 10,000 deaths attributed to alcohol between 1994 and 2003
• over 110,000 hospitalisations attributed to alcohol between 1993 and 2001
• liver cirrhosis, haemorrhagic stroke, heart problems and falls as the most common causes of alcohol-related hospitalisations and death
ANCD Executive Prof Margaret Hamilton concluded that “As someone with decades of experience in reviewing and developing alcohol policies I know that if we are to deal with alcohol better it is critical that all of us are involved; not just governments. Research tells us what can work but until we share that information with more people, we will not see an effective mix of evidenced informed measures that result in the right balance of access to and availability of alcohol with responses at the Federal, State and local level. It will also require a serious commitment to rein in the almost saturation level of alcohol promotion and advertising that we, and especially our children are exposed to each and every day. Of course far better access to help for experiencing personal difficulties with alcohol is also essential.”
ANCD Alcohol Action Plan Recommendations
1. Increase informed public engagement with the harms associated with alcohol, by:
1.1. Promoting public understanding of the range of evidence-based options to prevent and respond to alcohol-related harm.
1.2. Promoting better public understanding of the harms to others caused by alcohol consumption to ensure informed community debate about effective responses, especially harms to children and the costs of individual alcohol use borne by communities.
2. Obtain data on alcohol consumption and harms essential to informing effective responses that have currency and are sensitive to change, by:
2.1. Encouraging each State and Territory to collect and report alcohol sales data that allow local- level analysis.
2.2. Implementing policies in each jurisdiction to increase the collection of information about alcohol’s involvement with police incidents, and to standardise such reporting nationally.
2.3. Initiating procedures to collate and analyse data on alcohol-related emergency department admissions across Australia.
2.4. Including questions on the concurrent use of alcohol with other drugs in future National Drug Strategy Household Surveys.
3. Support local-level interventions in alcohol-related harms, by:
3.1. Encouraging States and Territories to ensure that liquor licensing legislation across all jurisdictions gives prominence to public health and safety considerations.
3.2. Ensuring that there is opportunity for local government and other local community stakeholders to be involved in decision-making processes without undue difficulty, and that communities are aware of their rights in these regards.
3.3. Ensuring access to local relevant data on alcohol consumption and related harm.
3.4. Building the capacity of local community stakeholders (e.g. local government) to respond effectively to prevent alcohol-related harm.
4. Recognise the critical role of regulating the availability of alcohol in reducing alcohol- related harms, by:
4.1. Give further consideration to implementing the recommendations regarding alcohol taxation made in the Australia’s Future Tax System review.
4.2. Developing liquor licensing procedures that consider outlet density, closing hours, and related risks and harms, drawing on local evidence and with the input of the local community.
4.3. Monitor and enforce compliance with responsible service of alcohol laws with meaningful penalties.
5. Regulate alcohol advertising, promotions and sponsorship, by:
5.1. Initiating a parliamentary review of the impact of alcohol advertising, promotions and sponsorship on young people.
5.2. Give further consideration to establishing an independent or government body to review, adjudicate and regulate alcohol advertising and promotions.
6. Enhance treatment responses for the whole population and for specific high-risk groups, by:
6.1. Basing funding decisions on a system that identifies local needs and resources, and identifies and responds to service gaps for high-risk populations, with a view to developing access to a range of evidence-based treatment options.
6.2. Considering approaches for drinkers not currently engaged with the treatment system, such as opportunistic and brief interventions within the primary healthcare system or in other health and welfare services where higher rates of alcohol-related problems have been noted (such as homelessness, child protection and mental health).
6.3. Developing and implementing online or other e-health promotions incorporating self- monitoring, provision of information on personal strategies for reducing consumption, and referral to treatment where appropriate; with particular attention to reaching those who would not normally access treatment.
6.4. Promoting awareness of, and where indicated adoption of, pharmacotherapy treatments for alcohol dependence.
6.5 Expanding the availability of police and court diversions into treatment for minor offences committed when intoxicated or in association with harmful alcohol use.
6.6. Enhancing availability of and access to child- and youth-friendly services as well as services to support and assist parents seeking help in relation to their children’s alcohol use.
7. Address alcohol-related problems among older Australians, by:
7.1. Undertaking further research into alcohol use among Australians aged over 65, including identifying patterns of use, age-specific risks and harms, and implications for prevention and treatment.
7.2. Developing an evidence base that enables the development of alcohol consumption guidelines for older Australians.
7.3. Introducing strategies to alert health professionals and older Australians themselves to the risks associated with alcohol among older people as well as appropriate interventions.
8. Address alcohol consumption and harms among young people, by:
8.1. Evaluating the impact of secondary supply legislation.
8.2. Encouraging informed community debate on the minimum legal purchase age for alcohol.
8.3. Encouraging broad prevention strategies such as increasing school engagement and awareness of the role families and parents can have in reducing alcohol-related harm, and investing in strategies consistent with this role.
8.4. Developing and evaluating the impact of specific treatments for young people experiencing alcohol-related problems.