The key to stemming alcohol-induced violence
WHEN used with amphetamines, ice and steroids, and often on its own, alcohol is a very dangerous mood-altering drug. In a large section of the population, alcohol all too readily fuels violence, including public and domestic violence and sexual assaults.
Yes, most people drink responsibly. But, as the liquor industry knows, it’s the top 10 per cent of heavy drinkers who account for 50 per cent of total alcohol consumption, and the top 20 per cent who account for 70 per cent of alcohol consumed. These are the individuals whose alcohol consumption accounts for most of the alcohol-fuelled violence and for most of the damage alcohol does to their own health and to the lives and wellbeing of others.
The key to reducing violence caused by alcohol (and to a lesser extent other drugs) is simple: cost and availability.
For example, research clearly shows that price (tax) increases reduce deaths from cirrhosis and deaths from car crashes. With regard to availability, a recent experiment in Newcastle, which reduced closing hours of clubs and pubs from 5am to 3am, with lockouts occurring at 1am instead of 3am, saw a 37 per cent reduction in alcohol-related violence.
Hence the question so far unanswered by NSW Premier Barry O’Farrell in relation to his proposed raft of “solutions” to alcohol-fuelled violence is, why not make this statewide?
As spokesman for the NSW/ACT Alcohol Policy Alliance Alex Wodak asks: “If, according to the best evidence we have, increasing the price and reducing the availability of alcohol means that my family and I are a little safer walking the streets of Sydney at night, why not implement these approaches?”
Wodak continues: “If reducing opening hours reduces violence by 20 per cent for each hour less trading, and the NSW public is screaming over the tragic deaths of many young men, why not reduce opening hours across the state rather than just Kings Cross and the Sydney CBD?”
But it is clear that, in relation to tackling the huge problems that alcohol represents, we need a distinctly national approach. In terms of federal governmental action there seem to be four parts to an Australia-wide solution.
The first is to raise the price of alcohol – for example by 1 or 2 per cent each year. As with reducing the smoking of cigarettes, a price rise is likely to result in significantly reduced consumption.
The second is that the Treasurer should estimate the actual costs and benefits of alcohol consumption in terms of the social wellbeing of the nation. At present, the costs of alcohol to the community far exceed the revenue generated. So what’s wrong with “user pays” for grog?
The third is to bar advertisements promoting alcohol consumption before 10pm and to break the nexus between alcohol marketing and sport. Currently the advertising of alcohol is entirely self-regulated – the drinks industry writes the rules and appoints its own judge and jury.
Fourth, there needs to be regular consultation between the federal government and the states and territories in setting alcohol tax. This should involve starting to base tax on actual alcoholic content rather than beverage class (volumetric taxing) and dedicating a small proportion of taxation raised from alcohol to improved prevention and treatment of people with alcohol problems.
But there still remain huge personal and political pressures preventing our politicians and advertisers and media from tacking the liquor industry head on.
As prolific US author Upton Sinclair wrote: “It is difficult to get a (person) to understand something when his salary depends on his not understanding it.”
If anything, I suspect that this applies, but even more so, to politicians who choose not to understand something (the realities about alcohol-fuelled violence) if they think their chances of being elected or re-elected depend on their not understanding it.
It is still debatable whether the citizens of NSW will get a good deal from O’Farrell’s recent announcements. We need to be told specifically just how much benefit taxpayers will get for how much expenditure. How many “killer punches” will be prevented by the extra 1000-2000 prisoners (costing more than $70,000 each a year) plus construction costs for an additional three to six new jails?
And in terms of personal responsibility, why should the drinker be the only person held responsible when things go wrong? What about the venue and the staff member who sells alcohol to someone who is already drunk? There is plenty of documentation to show that much alcohol is sold in Australia to people who are clearly legless.
And what about a premier who ignores a policy that reduced the problem by 37 per cent up the road (at Newcastle) but then introduces this policy only in 1 per cent of the state? Indeed, for far too many cities in Australia, what was supposed to be a “vibrant night-time economy” has turned into a very violent one.
A key problem in preventing the health, social and economic costs of alcohol is that there are no win-win options. There are, as Wodak says, only win-lose options. Either the liquor industry wins or the community wins.
Thus politicians who are serious about preventing alcohol problems can no more achieve their objective than they can make an omelette without breaking eggs. Those 10 per cent heaviest drinkers who consume half the alcohol drunk in the community (or the 20 per cent who account for 70 per cent) are critical to the economic and fiscal bottom line of the producers, wholesalers and retailers of alcohol.
Crucially, all of the above know that for many of their customers they are selling an addictive, highly damaging and violence-inducing drug.
And for all the liquor industry’s stress on individual liberty, it seems indisputable that one’s freedom to drink as much alcohol as possible diminishes the freedom of others who wish to walk safely around their communities.
Ross Fitzgerald was 44 years sober on Australia Day. His memoir, ‘My Name is Ross: An Alcoholic’s Journey’, is available as an e-book.
‘The Weekend Australian’, February 1-2, 2014, INQUIRER, p 18
Cheap grog to blame
TO buy a beer or spirit in a hotel or nightclub these days leaves little change out of $10 or $15 (“The key to stemming alcohol-induced violence lies in sweeping curbs on access to grog”, 1-2/2).
The 10 to 20 per cent of people responsible for most of the alcohol consumption Ross Fitzgerald refers to are in the main from poor backgrounds. It is impossible for them to consume those quantities of alcohol in hotels and nightclubs. So where do they get the alcohol? Big supermarket chains and their associated bottle shops, which sell cheap beer, wine and spirits in far greater quantities than hotels and nightclubs. Hoteliers and club owners would agree that most of their clients arrive at their venues having already consumed cheap alcohol from these outlets. The problems do not begin or end with the hotel or club but with the cheap alcohol and drugs consumed before entering a venue.
Tony Neale, McCracken, SA
The Australian, February 3, 2014, p 11.
The readers of The Australian have had a chance (The key to stemming alcohol-induced violence) to read a rarely put perspective on our favourite drug.
The deaths, disease, physical and sexual violence and huge economic cost of alcohol to the community are usually carefully airbrushed from the picture.
But it is disappointing to read the assertion that amphetamine and steroids are very important in violence. Drugs other than alcohol may make a small contribution to violence by it is clear to clinicians and researchers that the major problem is alcohol, alcohol, alcohol.
There is no evidence at present to estimate the proportion of violence that can be attributed to drugs other than alcohol.
On the other hand there is plenty of evidence that the self-regulation of alcohol advertising and promotion does not work and exacerbates the problems.
As has been said ‘self regulation is to regulation as self-importance is to importance’.
Dr Alex Wodak AM
Darlinghurst, NSW 2010
Ross Fitzgerald (The key to stemming alcohol-induced violence ,The Weekend Australian, 1-2 February 2014, INQUIRER, p 18) is spot on: the freedom to market a product is matched by the responsibility to market it safely. It makes great sense to apply a health and safety levy of 30% to all alcohol sales to provide extra resources to the police, ambulance and hospital emergency services. After all, it is not the alcohol industry that cops it when it fails to deliver its products only to those who drink responsibly. The least they can do is to pick up some of the tab for cleaning up after themselves.
Dr P. A. Smith, Mount Archer, Qld
Australia is credited with giving the word â€˜selfieâ€™ to the world. Ross Fitzgerald ( 1/2) has provided us with a written â€˜selfieâ€™ of the distress caused by alcohol and the challenges involved in trying to reduce its damaging influence. Fitzgerald correctly notes that legislative solutions and taxation policies run the risk of being either piecemeal or unco-ordinated in our Federal system. As another Monday morning brings more news of alcohol fuelled violence in our homes and on our streets, not to forget alcoholâ€™s link to the road toll, Australians must recognise that these events are no accident. They are the by-product of the behaviours we allow to occur, all too often in the pursuit of the ubiquitous â€œgood timeâ€ that Australians consider their birthright. It is often said that â€œculture always beats strategyâ€. Until more Australians accept the truth of our alcohol saturated culture our legislators will always struggle to devise strategies that effectively manage our greatest drug problem.
Julian Dowse, Mullaloo, WA.
Ross Fitzgerald is absolutely right (The key to stemming alcohol-induced violence, The Weekend Australian, February 1-2, 2014) that missing from the recent NSW Governmentâ€™s plans to contain alcohol-fuelled violence is a state-wide approach.
More important is the missing national approach through price (sensible taxes on alcohol), controls on advertising and promotion to vulnerable groups and steps to stem easy availability and wide-spread distribution.
In 2009 the then NSW Health Minister, John Della Bosca, took the issue of alcohol advertising, the exposure of minors and the links of alcohol to sport to Australian Council of Health and Police Ministers, but the Commonwealth would not back the NSW proposals.
It is disappointing that in an otherwise excellent piece, Fitzgerald starts by referring to the mixture of alcohol with other drugs (amphetamines and steroids, which have their undoubted problems) as historically and universally alcohol is far more important in promoting impulsive and aggressive actions resulting in violence and harm to others than the other substances combined. For every one case of amphetamine aggression seen in a busy city ED there are at least 30 alcohol-caused cases. However, I acknowledge that the real thrust of the article is the harm from alcohol.
Three days ago the BBC reported research published in the Lancet describing the massive male mortality in Russia from alcohol (mainly vodka) in which “deaths from fighting” and suicides are a major component: 25% of Russian males die before the age of 55. There are similar patterns in other countries with high alcohol consumption.
While steroids and amphetamines cause serious problems, the alcohol industry will use this as a way of distancing itself from responsibility. For them it is all a question of personal responsibility not effective public health measures
Ian W Webster, Physician
Shoalhaven Memorial Hospital
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