Fiction on alcohol

IT may be an inconvenient truth but the fact is that, in terms of its harm, alcohol is by far Australia’s most dangerous drug.

I pointed this out way back in 2003, when I was keynote speaker at the NSW Alcohol Summit.

But since I gave my blunt assessment about the dire situation with regard to alcohol in Australia, little seems to have changed. Indeed alcohol abuse is rife and alcohol-related violence is clearly on the increase, especially among the young.

One disturbing trend seems to be an exponential increase, among Australians aged 15 to 25, in out-of-control drinking, and especially in binge drinking among teenagers of both sexes. As we know all too well, the nightly news often features some personal and family tragedy that is the result of this national dysfunction.

In our society there is still enormous social and peer-group pressure on those who wish to avoid alcohol. Not surprisingly, this pressure is extremely strong in relation to the young, for whom drinking – or, more accurately, drunkenness – is a rite of passage.

In a society like ours, with such an entrenched drinking culture and with such a politically powerful liquor industry, significant pressure is applied to those, young as well as old, who need to remain abstinent in order not to harm others and themselves, let alone to live productive lives.

The reality is alcohol is a very dangerous mood-altering drug. In a large section of the population, the booze 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 the NSW city of 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 recent, and very welcome so called “solutions” to alcohol-fuelled violence is, why not make this statewide?

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 state-wide?

As Dr Alex Wodak, spokesperson for the NSW/ACT Alcohol Policy Alliance says, “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 people, why not reduce opening hours across each state rather than just a selected area?”

It is clear that, in relation to tackling the huge problems that alcohol represents, we need a distinctly national approach. In terms of meaningful action there seem to me 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 on the type of beverage consumed, 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.

American 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, even more so, to politicians who choose not to understand something (in this instance, the realities about alcohol-fuelled violence) if they think their chances of being elected or re-elected depend on their not understanding it.

And in terms of personal responsibility, why should the out-of-control 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 Dr Alex 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, the producers, wholesalers and retailers of alcohol 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 to me indisputable that a person’s freedom to drink as much alcohol as possible diminishes the freedom of others who wish to walk safely around their communities.

These are the speaking notes from Professor Ross Fitzgerald’s  address at the Queensland Coalition for Action on Alcohol (QCAA) Forum Preventing alcohol-related harms in Queensland: The need for reform at Queensland Parliament House on 19 March 2014.