Alcohol in Australia

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Alcohol abuse: involves using alcohol in harmful manner, but doesn't involve dependence

- drinker goes for extended periods of time without drinking, e.g. binging

Alcohol dependence: involves using alcohol on daily basis for extended periods of time

- compulsion to drink; feel less comfortable if not drinking

Symbolic uses of alcohol

To define social situations or events - all cultures tend to have specifically designated places for drinking alcohol

Indicator of social status

As statement of affiliation

As gender differentiator

Societal/Cultural Differences in Alcohol Consumption

Important differences in behaviour of people who drink in different societies

Aus, UK, USA - alcohol use and intoxication associated with anti-social behaviour

Greece, Italy - alcohol doesn't lead to violent behaviour

Efforts to prohibit sale or consumption of alcohol have been universally unsuccessful, with possible exception of strict religious prohibitions in some cultures

Distribution of Alcohol Consumption in Australia, 2010

Top 1% of drinkers consume 11.8% of all alcohol

Top 5% of drinkers consume 30.5% of all alcohol

Bottom 50% of drinkers consume 8.8% of all alcohol

Males consume about 65% of all alcohol consumed

Females consume about 35% of all alcohol consumed

Males consume 58.8 standards/mth (on average)

Females consume 21.1 standards/mth (on average)

Annual number of deaths in Aus by drug, NDSHS 2007

Alcohol - 3000

Cannabis - 0

Ecstasy - 0-10

Amphetamines - 50-60

Annual number of hospital separations in Aus

Alcohol - 43 003

Cannabis - 3095

Ecstasy - very few/no numbers available

Amphetamines - 2192

Million Women's Study

Million Women's Study

Why do people drink alcohol? - Why drink at all; age and circumstances associated with first consumption; heavy/excessive consumption; binge drinking, drunkenness, alcohol use disorders

Alcohol has long history of being associated with social activity - most (all?) societies have social rules about drinking alcohol and context in which alcohol is consumed

460-320BC - Grecian scholars issued advisories on drunkenness and moderate drinking

Plato: alcohol shouldn't be used under age 18, between 18-30 in moderation, no restrictions for use by older than 40

11th c. AD, Simeon Seth (physician in Constantinople) wrote that drinking wine to excess caused inflammation of liver

Alcohol and Mood

Alcohol impacts on reaction times, short and medium term memory, time it takes to do tasks, paretic. those involving coordination

Impact of alcohol on mood and emotional scale less predictable and results of experimental research aren't conclusive

Why do people use drugs/drink alcohol?

Structural explanations: cost, availability, acceptability

Indiv. explanations: genetic, psychological, social

Kids from families where there are marital problems or where mum is smoker and consumes alcohol are more likely to drink

Kids with early life history of delinquent behaviour (smoke and drink) are much more likely to have alcohol use problem when they grow up

Aggression/delinquency > alcohol use and misuse > aggression/crime

Medications e.g. Naltrexone

in 1 important clinical trial, 19/20 placebo patients relapsed; 8/16 Naltrexone patients relapsed

Counselling

Review of best clinical trials suggests modest reduction of drinking at follow-up

Support groups

E.g. AA

Possibly most effective treatment

Ineffective yet popular strategies

Voluntary industry codes; e.g. of bar service

Alcohol education in schools

Public service messages

Non-specific warning labels

Promoting alternatives - alcohol free activities

Designated drivers and ride services

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10 best practices, based on international evaluation literature

Alcohol control policies: minimum legal purchase age; gov. monopoly of retail sales; restrictions on hours of day sales; outlet density restrictions; alcohol taxes

Drink-driving countermeasures: sobriety checkpoints; lowered BAC level; administrative licence suspension; graduated licensing for novice drivers; brief interventions for hazardous drinkers

M

More aggressive gov. action to reduce alcohol consumption

Increase in tax on alcohol

Increased control of alcohol advertising

Tobacco use prevalence in Aus is now at 17% (v. low in global context) - due to successful gov. action?

Taxation options

Volumetric taxation

Minimum pricing

General increase in taxation level

Alcopops

1990s, intro of "designer" drinks

Alcohol soda, ciders, coolers

Spirits mixed with soft drink or milk

Beer with sugar, colour flavourings

Increased advertising and branding to appeal to lifestyle and image characteristics

Use of names associated with recreational drugs

Appeal to young people (15yrs -) who prefer sweet flavours which mask taste of alcohol

Pre-mixed canned party beverages

Malt-liquor energy drink called Four Loko that contains caffeine, guarana, taurine

Combining high-potency caffeinated drinks with alcohol is risky

These drinks allow someone to drink for longer period of time

This combination can increase drinking

Definitions; Society; Symbolic

Stats

Treatment

Alcohol on the Market