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Alcohol and health in Australia

Alcohol is responsible for a considerable burden of death, disease and injury in Australia. Alcohol-related harm to health is not limited to drinkers but also affects families, bystanders and the broader community.

Sources and reference

The material on this page apart from the research funding summary is taken directly from the chapter 'Background' in the guidelines.

Australians and alcohol

Most Australians have tried alcohol at some time in their lives. People use alcohol for a wide range of reasons and in different social and cultural contexts. They may drink for sociability, cultural participation, religious observance or as a result of peer influence. They may also drink for pleasure, relaxation, mood alteration, enhanced creativity, intoxication, addiction, boredom, habit, to overcome inhibitions, to escape or forget or to
‘drown sorrows’.

Most Australians who drink alcohol do so at levels that have few adverse effects. However, any level of drinking increases the risk of ill-health and injury.

The 2007 National Drug Strategy Household Survey (AIHW 2008) indicated that the majority of Australian adults have tried alcohol, and many continue to drink throughout life:

  • around 90 per cent have tried alcohol in their lifetime
  • over 83 per cent have consumed an alcoholic drink in the past 12 months.

This means that at one end of the range:

  • about 10 per cent of Australian adults have never had a full serve of alcohol
  • and about 17 per cent have not consumed alcohol in the past year.

While at the other end:

  • around 8 per cent drink daily
  • around 41 per cent drink weekly.

Both in terms of hours and places of sale, and in terms of price relative to income, alcohol has become much more readily available over the past two decades in Australia. This includes the greater availability of alcohol through new outlets such as supermarkets and via extended trading hours.

The mean volume of alcohol consumed has remained relatively stable since 1991, but there have been important changes in the patterns of consumption. Preferences in beverage type have shifted towards spirits and pre-mixed drinks, especially among younger drinkers, and there is an increased level of informality in drinking styles, such as drinking directly from the container.

Under-age drinking

A 2002 national survey on the use of alcohol by Australian secondary school students (White & Hayman 2004) found that experience with alcohol was high among secondary school students. Alcohol consumption became
more common as age increased:

  • by the age of 14, around 90 per cent of students had tried alcohol
  • at the age of 17, around 70 per cent of students had consumed alcohol in the month before the survey
  • the proportion of students drinking in the week before the survey increased with age from 19 per cent of 12-year-olds to a peak of 50 per cent among 17-year-olds.

Effects of alcohol on the body

Alcohol is a central nervous system depressant. The most obvious and immediate effects of alcohol are on the brain, beginning with feelings of relaxation, wellbeing and loss of inhibitions. However, as the intake of alcohol increases, these effects are counterbalanced by less pleasant effects, such as drowsiness, loss of balance, nausea and vomiting. Higher alcohol intakes can lead to life-threatening events such as unconsciousness and, eventually, inhibition of normal breathing. This may be fatal, particularly as the person may vomit and can suffocate if the vomit is inhaled.

Consumption of alcohol has both immediate and cumulative effects. Alcohol-related harm in individuals arises not only from the quantity of alcohol consumed but also from a complex interaction between their sex, body size and composition, age, experience of drinking, genetics, nutrition, individual metabolism, and social factors.

Cumulative effects

Alcohol consumption has been associated with a range of diseases that may cause death and adverse effects that reduce quality of life. Among these are:

  • Cardiovascular disease — high blood pressure, arrhythmias, shortness of breath, some types of cardiac failure, haemorrhagic stroke and other circulatory problems.
  • Cancers — alcohol is carcinogenic to humans, being causally related to cancers of the oral cavity, pharynx, larynx, oesophagus, liver, colorectum and female breast.
  • Diabetes — the relationship between alcohol consumption, insulin sensitivity, and type 2 diabetes mellitus is not clear. However, alcohol affects the management of diabetes in a number of ways.
  • Nutrition-related conditions — alcohol consumption is linked to malnutrition, Wernicke-Korsakoff syndrome, folate deficiency, Vitamin A depletion and pellagra.
  • Overweight and obesity — alcohol adds kilojoules to the normal diet and may increase energy intake and fat storage further by increasing appetite and displacing fat and carbohydrate oxidation.
  • Risks to unborn babies — alcohol enters the bloodstream of the fetus when the mother drinks and can cause a range of birth defects and growth and developmental problems, comprising Fetal Alcohol Spectrum Disorder (FASD), which may persist into adulthood. Alcohol also enters the breast milk.
  • Liver diseases — alcohol consumption is the most common cause of cirrhosis of the liver, and drinking alcohol over many years can cause cirrhosis in the absence of other causes.
  • Mental health conditions — there is growing evidence that alcohol increases the risk of highly prevalent mental health conditions such as depression and anxiety in some people, and may affect the efficacy of antidepressant medication.
  • Tolerance — the immediate effects of alcohol on the brain are often less apparent in people who drink regularly, as they acquire a degree of tolerance. Despite this tolerance, the long-term effects remain damaging, particularly as the drinkers who have greater tolerance for alcohol are likely to be those who experience higher blood alcohol levels more frequently.
  • Dependence — alcohol is an addictive drug and regular use can result in alcohol dependence.
  • Long-term cognitive impairment — drinkers who consume alcohol at harmful levels exhibit negative structural and metabolic brain changes, and have an increased risk of dementia.
  • Self-harm — harmful drinking is a major risk factor for suicide and suicidal behaviour in both males and females across the lifespan.

Potential health benefits of drinking

Recent studies have suggested that low levels of alcohol consumption may slightly reduce the risk of some cardiovascular and cerebrovascular disease. The body of evidence suggests that most of the potential cardiovascular benefit of alcohol may be achieved by drinking within the levels recommended in Guideline 1.

It should also be noted that the potential cardiovascular benefits from alcohol can also be gained from other means, such as exercise or modifying the diet.

Burden of alcohol related disease and injury

Alcohol consumption accounted for 3.3 per cent of the total burden of disease and injury in Australia in 2003; 4.9 per cent in males and 1.6 per cent in females.

In Australia:

  • Alcohol is second only to tobacco as a preventable cause of drug-related death and hospitalisation
    • between 1992 and 2001, more than 31,000 deaths were attributed to risky or high-risk alcohol consumption
    • in the eight years between 1993–94 and 2000–01, over half a million completed hospital episodes were associated with alcohol
  • While the number of emergency department presentations caused by alcohol is unknown, it is likely to account for a large proportion of all presentations
  • Alcohol accounts for 13 per cent of all deaths among 14–17-year-old Australians — it has been estimated that one Australian teenager dies and more than 60 are hospitalised each week from alcohol-related causes
  • Alcohol is also a significant contributor to premature death and hospitalisation among older Australians — among 65-74-year-olds, almost 600 die every year from injury and disease caused by drinking above the NHMRC 2001 guideline levels, and a further 6,500 are hospitalised.
  • Although most surveys show that Aboriginal and Torres Strait Islander people are less likely than the general population to drink, alcohol attributable injury and disease are particularly high among this group.
  • The rate of alcohol-attributable death among Indigenous Australians is about twice that for the non-Indigenous population, with a particularly strong association apparent between alcohol use and suicide among some Aboriginal and Torres Strait Islander people.

Socioeconomic consequences

The effects of alcohol consumption go beyond diseases, accidents and injuries to a range of adverse social consequences, both for the drinker and for others in the community. These consequences include harm to family members (including children) and to friends and workmates, as well as to bystanders and strangers.

Concerns to the community that are associated with alcohol use include noise, litter, offensive behaviour, vandalism, aggression, petty crime, assault and road safety issues. Many of these social consequences can result in affront, violence or injury to others.

Alcohol is significantly associated with crime, with studies suggesting that alcohol is involved in up to half of all violent crimes (including domestic violence) and a lesser but substantial proportion of other crimes.

It has been estimated that alcohol cost the Australian community about $15.3 billion in 2004–05, when factors such as crime and violence, treatment costs, loss of productivity and premature death were taken into account. These figures are recognised to be conservative, as the cost of alcohol related absenteeism alone has recently been estimated at $1.2 billion per year, using self-report data from the 2001 National Drug Strategy Household Survey (AIHW 2002).

NHMRC funding for alcohol research

Apart from the development of the Guidelines, NHMRC has invested over $19.7 million into research related to alcohol from 2000 to 2008.

Year

Funding ($m)

2000

0.9

2001

1.0

2002

1.3

2003

1.4

2004

2.3

2005

2.2

2006

3.0

2007

3.4

2008

4.3

Total 115.0

 

Page reviewed: 19 May, 2014