Drinking a lot of alcohol is bad for the drinker’s health, both in the short and in the long run. But drinking often affects others adversely, too. This is well recognised for drink driving, and once the size of the problem was established, policies were put in place that successfully drove down rates of drink-driving deaths and injuries.
But there are a range of harms to others from drinking. These include effects on family life and members – sometimes just a bad moment, sometimes very serious. The drinker may spoil a family holiday, or may fail to pick up a child from preschool. Drinking is often implicated in family violence and in child neglect.
There are effects on friends and on work life – friendships broken off, injuries in a drunken fight, work time spent filling in for a drinker or getting help for him or her. And there are adverse effects on people who don’t know the drinker – annoyances like late-night street noise, and more serious impacts, such as injury from trying to break up a drunken fight, or the cost of fixing or replacing broken furniture or torn clothing when someone had a bit too much.
These kinds of effects are immediately recognised when they’re mentioned. But they mostly haven’t been quantified – we don’t have the kind of routine statistics even for serious events that we have for drink-driving. And usually, a social problem needs to be quantified to focus our attention on it.
In 2010, we published a report doing just this for problems from others’ drinking – laying out how many different types of problems there are, and quantifying them. We looked at how common the problems are, and the costs to people other than the drinker.
Commissioned by the Foundation for Alcohol Research and Education, the report looked at the problems through two windows. One window is the case records of the agencies that are the front line of response to problems in our society – the police, the ambulances, the hospitals, the child protection services. This window shows us the more serious problems, the ones that come to official attention.
The other window is what people in the population at large tell an interviewer in a survey about problems they’ve had in the recent past with others’ drinking.
What we found is that, from both perspectives, the problem is large – that there are many serious cases and events, and that the experience of problems from others’ drinking is widespread in the population at large.
At the most serious end, we found that in a given year, 367 Australians die because of another’s drinking, and 13,660 are hospitalised. An estimated 19,443 substantiated child protection cases involve a carer’s drinking and 24,581 assaults on family members reported to the police involve drinking, as do 44,852 assaults on the street and elsewhere.
In terms of the broader picture, most of us – 73% of adults - have experienced some kind of adverse effect in the last year from someone else’s drinking. Of these, 5% were negatively affected in our work by a co-worker’s drinking, 16% by a relative’s or household member’s drinking, 11% by a friend’s and 43% when a stranger’s drinking resulted in abuse, threat, property damage or worse.
But though adverse effects of strangers’ drinking were more widely reported, the adverse effects in the household and family were more likely to be substantial, whether measured in terms of seriousness or of out-of-pocket costs and lost time from work.
Our report attracted a lot of interest internationally. Quoting it, the World Health Organization decided to measure alcohol’s harm to others as a major strand in its Global Strategy the Reduce Harmful Alcohol Consumption. Over a dozen countries, from every inhabited continent, are now conducting studies using the approaches in our report.
And we have continued to do research on the issue, including a forthcoming study of patterns over time – what determines who is repeatedly adversely affected by others’ drinking over a period of years.
But what should we do with this knowledge of substantial adverse harms from others’ drinking? One option is to deny or discount it – maybe they didn’t measure it right. The alcohol industry’s reaction was to pay some economics consultants to do a throw-everything-at-it critique of our report. But we could and did answer the criticisms in detail.
Or, we should find those responsible and punish or treat the problems away – maybe if we can get all the alcoholics into treatment or gaol, the problem will go away. Alcohol-related violence has nothing to do with nightclubs or liquor barns pushing booze, it’s argued, it’s just a problem of the “bad-apple” drinker. But, as police leaders have have repeatedly pointed out, we can’t arrest our way out of these problems.
The alternative is to decide that we need to do what was done with drink-driving – take the problem seriously, and take measures that actually have an effect. Australia has been doing this with second-hand smoking, even though the proportion of the problems borne by others around the user is much smaller for tobacco than it is for alcohol.
Taking the problem seriously has to include rethinking policies of a free market in alcohol, with slabs or casks available around the clock and clubs and pubs open until five in the morning. It will require addressing the constant alcohol ads playing to our children while they watch sports on television. If we find that there are too many costs and sorrows, we need to start a serious policy discussion about how to reduce these harms.
Maybe if it were just the drinker’s health at stake, you could argue that he or she should be left alone to drink to oblivion. But the stakes are higher and the impact broader than that. In decisions about alcohol policy, the effects on others, and not just on the drinker, need to be taken into account.
This is the third part of our series looking at alcohol and the drinking culture in Australia. Click on the links below to read the other articles:
Part Seven: Big Alcohol and Big Tobacco – boozem buddies?
Part Eight: Explainer: foetal alcohol spectrum disorders