Alcoholism in rural Australia

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Alcohol is the most frequently used drug by residents living in all isolated, remote and rural regions in Australia. [1] Alcohol consumption is particularly misused by individuals in these areas due to numerous factors distinctive of rural Australia. [1] These factors consist of the reduced access to education and health care professionals with alcohol treatment services, leading to higher rates of unemployment and economic disadvantage. [1] These characteristics promote increased levels of disease, injury and death as a result of the high alcohol-related harms that are substantial in rural communities across Australia. [1]

Contents

Consumption

The Australian Institute of Health and Welfare states that 80% of Australians regularly consume alcohol. [1] In Australia, a third of the population live in remote and rural areas, where a proportion of these adults engage in risk-taking behaviours such as excessive alcohol misuse which is significantly higher than in major cities of Australia. [1] In 2010, the National Drug Strategy Household Survey (NDSHS) reported 78% of regional Australia is consuming alcoholic beverages at extremely high-risk levels in which are harmful for life. [1] Unlike in major cities, only 19% of people are drinking alcohol at these life harming levels. [1]

Beer testing at Cheeky Monkey Brewery, Margaret River, 2016 2016 Margaret River Australia. Cheeky monkey brewery. Beer testing.jpg
Beer testing at Cheeky Monkey Brewery, Margaret River, 2016

The 2011 Australian Burden of Disease Study noted adults in rural and isolated regions are 1.4 times more probable to surpass the recommended amount of consuming alcohol in Australia, contrasting to adults living in major Australian cities. [2] The study also found that alcohol use in rural Australia significantly contributes to the overall Australian disease burden by 5.1%. [2] This is because alcohol consumption in Australia is correlated with pleasure and celebration, but in remote regions there's a limited variety of venues to socialise at, allowing for residents to engage in excessive drinking. [1] Men and young adults residing in rural communities are particularly liable to consume alcohol at high-risk levels due to them experiencing boredom at a higher rate, leading them to excessively drink. [1]

The prevalence of drought in Australia and the pressure of rising farm debt drives many farmers to drink as a form of self-medication. [3]

Indigenous alcohol consumption

Indigenous Australians in rural and isolated regions are the most susceptible to consuming disproportionate amounts of alcoholic drinks. Alcohol abuse is fueling high rates of domestic violence and youth crime in Indigenous communities. [4] As two-thirds of the population in remote Australia are Aboriginal and Torres Strait Islanders, these individuals are 1.5 times more likely to consuming alcohol at a risk-taking level. [1] This is as a result of numerous factors such as the “disconnection to culture, traditions and country, social exclusion, discrimination and isolation, trauma, poverty, and lack of adequate access to services”. [5] These factors further contribute to their low socio-economic status, which impacts the ability for young Indigenous people to access quality education. Without an education, young Indigenous Australians have limited opportunities for employment, and therefore are substantially influenced by their low socio-economic families to engage in risk-taking behaviour. However, in 2014 and 2015 the NATSISS discovered a decline by 4% in rural Indigenous people older than 15 years exceeding the guidelines for risky consumption of alcohol since 2008. [5] This decline was primarily due to the fact that people in urban areas were also reducing their large amount of alcohol consumption. [5]

More recently, in 2016 the NDSHS found that 1 in 5 Aboriginal and Torres Strait Islanders drank “11 or more standard drinks at least once a month”, which was 2.8 times the level of consumption for non-Indigenous Australians. [5] These excessive levels of drinking therefore are associated with numerous consequences such as chronic health conditions like coronary heart disease, cancer and diabetes, along with increasing levels of violence, assault, suicide and road accidents. [6] These “poorer health outcomes” subsequently lead to higher death rates for Indigenous Australians in rural areas due to their lack of access to quality healthcare and its professionals, and rehabilitation services. [5] Thus, if rural Australian areas had more of these health services for Indigenous Australians, their overall health disadvantage would decrease, as would their rates of astronomical drinking levels and mortality rates.

Binge drinking

Binge drinking five or more drinks in one sitting) in rural Australia is a severe problem as a result of the poor health determinants distinctive of these rural areas, including limited healthcare access, economic disadvantage, high unemployment levels and low levels of education. [1] 54% of young and Indigenous people in isolated areas of Australia are acutely high-level binge drinkers. [7] Binge drinking behaviour are “heavily shaped by prevailing cultural norms” such as the “acceptability of binge drinking”. [8] Binge drinking in rural areas of Australia have severe and problematic long-term impacts on individuals who perform these behaviours, not only to themselves but to the entire health outcome of rural Australia. In particular, as children and teenagers’ brains aren't properly developed yet, the immense level of binge drinking performed by these young individuals in rural Australia has a greater long-term impact for themselves both psychologically and physically, further adding to overall health disadvantage in rural communities. [7]

However, in 2016 the Australian Institute of Health and Welfare reported that younger adults were drinking less compared to 2013. 42% of individuals aged between 18 and 24 would binge drink a minimum of five alcoholic standard drinks per month, but this statistic was only a 5% decrease since 2013. [2] Overall, despite that young adults in rural areas decreased their levels of binge drinking from 31% in 2010 to 18.5% in 2016, this kind of behaviour remains a prominent and destructive issue in rural Australian society.

Alcohol abuse and mental health

The abuse and misconduct of alcohol in rural Australia is a crucial aspect and result of the excessive alcohol consumption in rural and remote communities in Australia. This can accordingly lead to individuals experiencing severe mental health issues or pursuing violence. As rural communities have less access to healthcare and its professionals, and rehabilitation services, depression, anxiety and suicide is much more prominent due to rural dwellers' extreme levels of alcohol consumption.

The National Alliance for Action on Alcohol reported that intentional and non-intentional deaths and injury are considerably greater in remote regions than in major cities, as a consequence of rural Australians abusing alcohol and becoming violent, depressed and/or suicidal. [1] Moreover, in these isolated areas, a third of young people aged between 14 and 24 have been physically abused by people who were highly intoxicated. [1] This severe misuse of alcohol inevitably contributes to the rapidly rising mortality rates in rural Australia, as well as the increased levels of disability amongst rural people who are victims of such abuse. [9]

The Australian Rural Mental Health Study examined the way in which unnecessary alcohol use can determine someone's psychological symptoms and damage their mental health in rural communities. [10] As evident in the graph, the study demonstrated that at least one individual in each age group consumed alcohol at a life-damaging level. [10] The youngest age group drinks alcohol in the most harmful category, substantially contributing to the high levels of psychological distress that 18-34 year olds experience in rural areas. [10]

Preventative strategies

Whilst excessive alcohol consumption is evidently a severe problem in rural communities, there are a number of strategies the Australian government has implemented to reduce these poor health behaviours:

The Ministerial Drug and Alcohol Forum

In 2015, the Council of Australian Governments decided it was vital to implement a new and innovative Ministerial Forum to endorse drug and alcohol preventative strategies in Australia. The Forum created a new policy, namely the National Drug Strategy, which aims to prevent and decrease harm facilitated by the excessive use of alcohol and drugs in Australia in 2017–2026. [11] The strategy is divided into more specific categories, whereby in 2018 the "National Alcohol and other Drug Workforce Development Strategy" illustrates the need for effective alcohol reduction strategies and specialised health services in rural, isolated and remote areas. [12]

The National Preventative Health Taskforce

This preventative strategy aims for Australia to be the "Healthiest Country by 2020" and recognises the inequities of health and alcohol misuse between rural and urban civilians in Australia. [13] The preventative health framework has numerous main aims to reduce the misuse of alcohol in rural regions of Australia. [1] Some of these include:

The National Alliance for Action on Alcohol

This national organisation was formed to raise awareness of healthy practice in Australia, particularly in rural regions, and simultaneously improve its policies to reduce alcohol harm and consumption in these areas. [14] The strategy has implemented an "Alcohol Policy Scorecard" across Australia, which tracks and benchmarks all state governments' movement of attempting to prevent and reduce harm that has been facilitated by significant alcohol consumption. [14] However, in 2018 the alliance stated that the Northwest Territory government's drug and alcohol strategy has still not been finalised, unlike in the Northern Territory which has made significant progress of reducing alcohol-facilitated harm by 68% since implementing the "Alcohol Harm Minimisation Action Plan". [14]

Effective interventions

Apart from the many preventative strategies that the Australian government has implemented to reduce alcohol misuse in rural Australia, there are also a number of programs that can assist with this reduction. Such interventions include "partial or complete bans on promotion of alcohol, measures to reduce drink driving, and targeted advice in the primary care setting". [1]

Related Research Articles

<span class="mw-page-title-main">Alcoholism</span> Problematic excessive alcohol consumption

Alcoholism is the continued drinking of alcohol despite negative results. Problematic use of alcohol has been mentioned in the earliest historical records, the World Health Organization (WHO) estimated there were 283 million people with alcohol use disorders worldwide as of 2016. The term alcoholism was first coined in 1852, but alcoholism and alcoholic are stigmatizing and discourage seeking treatment, so clinical diagnostic terms such as alcohol use disorder or alcohol dependence are used instead.

<span class="mw-page-title-main">Harm reduction</span> Public health policies which lessen negative aspects of problematic activities

Harm reduction, or harm minimization, refers to a range of intentional practices and public health policies designed to lessen the negative social and/or physical consequences associated with various human behaviors, both legal and illegal. Harm reduction is used to decrease negative consequences of recreational drug use and sexual activity without requiring abstinence, recognizing that those unable or unwilling to stop can still make positive change to protect themselves and others.

<span class="mw-page-title-main">Alcohol abuse</span> Misuse of alcoholic beverages resulting in negative consequences

Alcohol abuse encompasses a spectrum of unhealthy drinking behaviors which range from consuming more than 2 drinks per day on average for men, or more than 1 drink per day on average for women, to binge drinking or alcohol use disorder.

Alcohol education is the practice of disseminating information about the effects of alcohol on health, as well as society and the family unit. It was introduced into the public schools by temperance organizations such as the Woman's Christian Temperance Union in the late 19th century. Initially, alcohol education focused on how the consumption of alcoholic beverages affected society, as well as the family unit. In the 1930s, this came to also incorporate education pertaining to alcohol's effects on health. For example, even light and moderate alcohol consumption increases cancer risk in individuals. Organizations such as the National Institute on Alcohol Abuse and Alcoholism in the United States were founded to promulgate alcohol education alongside those of the temperance movement, such as the American Council on Alcohol Problems.

Brief intervention can often be referred to as screening and brief intervention (SBI) or, in England, identification and brief advice (IBA). Brief interventions are a technique used to initiate change for an unhealthy or risky behaviour such as smoking, lack of exercise or alcohol misuse. This page primarily describes brief interventions as applied to alcohol. As an alcohol intervention it is typically targeted to non-dependent drinkers, or drinkers who might be experiencing problems but are not seeking treatment. It is an approach which aims to prevent the acceleration or impact of alcohol problems, and/or to reduce alcohol consumption. It can be carried out in a range of settings such as in primary care, emergency or other hospital departments, criminal justice settings, workplaces, online, university/college settings, and other settings.

Alcohol has a number of effects on health. Short-term effects of alcohol consumption include intoxication and dehydration. Long-term effects of alcohol include changes in the metabolism of the liver and brain, several types of cancer and alcohol use disorder. Alcohol intoxication affects the brain, causing slurred speech, clumsiness, and delayed reflexes. Alcohol consumption can cause hypoglycemia in diabetics on certain medications, such as insulin or sulfonylurea, by blocking gluconeogenesis. There is an increased risk of developing an alcohol use disorder for teenagers while their brain is still developing. Adolescents who drink have a higher probability of injury including death.

Recommendations for consumption of the drug alcohol vary from recommendations to be alcohol-free to daily or weekly drinking "safe limits" or maximum intakes. Many governmental agencies and organizations have issued guidelines. These recommendations concerning maximum intake are distinct from any legal restrictions, for example countries with drunk driving laws or countries that have prohibited alcohol. These recommendations are (often) also distinct from the scientific evidence, such as the short-term effects of alcohol consumption and long-term effects of alcohol consumption.

The Australian National Council on Drugs (ANCD) describes itself as "the principal advisory body to Government on drug policy and plays a critical role in ensuring the voice of the community is heard in relation to drug related policies and strategies." The Council occupies a unique position by virtue of its role in enhancing the partnership between the government and the community. It has pivotal advisory, advocacy and representative functions, with a significant role to provide government Ministers with independent, expert advice on matters related to licit and illicit drugs.

<span class="mw-page-title-main">Binge drinking</span> Form of excessive alcohol intake

Binge drinking, or heavy episodic drinking, is drinking alcoholic beverages with an intention of becoming intoxicated by heavy consumption of alcohol over a short period of time, but definitions vary considerably.

<span class="mw-page-title-main">Alcohol in Australia</span> Public health issue in Australia

Alcohol is commonly consumed and available at pubs and liquor stores in Australia – all of which are private enterprises. Spirits can be purchased at liquor stores and pubs, whereas most grocery stores do not sell them, although they may have separate liquor stores on their premises. Alcohol consumption is higher, according to WHO studies, than in most European countries and several Central Asian and African countries, although consumption is just as high in Australia as in North America. After tobacco, alcohol is the second leading preventable cause of death and hospitalisation in Australia.

<span class="mw-page-title-main">Substance use disorder</span> Continual use of drugs (including alcohol) despite detrimental consequences

Substance use disorder (SUD) is the persistent use of drugs despite substantial harm and adverse consequences as a result of their use. The National Institute of Mental Health (NIMH) states that "Substance use disorder (SUD) is a treatable mental disorder that affects a person's brain and behavior, leading to their inability to control their use of substances like legal or illegal drugs, alcohol, or medications. Symptoms can be moderate to severe, with addiction being the most severe form of SUD". Substance use disorders (SUD) are considered to be a serious mental illness that fluctuates with the age that symptoms first start appearing in an individual, the time during which it exists and the type of substance that is used. It is not uncommon for those who have SUD to also have other mental health disorders. Substance use disorders are characterized by an array of mental/emotional, physical, and behavioral problems such as chronic guilt; an inability to reduce or stop consuming the substance(s) despite repeated attempts; operating vehicles while intoxicated; and physiological withdrawal symptoms. Drug classes that are commonly involved in SUD include: alcohol (alcoholism); cannabis; opioids; stimulants such as nicotine, cocaine and amphetamines; benzodiazepines; barbiturates; and other or unknown substances.

Binge drinking is the practice of consuming excessive amounts of alcohol in a short period of time. Due to the idiosyncrasies of the human body, the exact amount of alcohol that would constitute binge drinking differs among individuals. The definitions of binge drinking are also nuanced across cultures and population subgroups. For example, many studies use gender-specific measures of binge drinking. The epidemiology of binge drinking likewise differs across cultures and population subgroups.

The legal drinking age varies from country to country. In the United States, the legal drinking age is currently 21. To curb excessive alcohol consumption by younger people, instead of raising the drinking age, other countries have raised the prices of alcohol beverages and encouraged the general public to drink less. Setting a legal drinking age of 21 is designed to discourage reckless alcohol consumption by youth, limiting consumption to those who are more mature, who can be expected to make reasonable and wise decisions when it comes to drinking.

Drunkorexia is a colloquialism for anorexia or bulimia combined with an alcohol use disorder. The term is generally used to denote the utilization of extreme weight control methods to compensate for planned binge drinking. Research on the combination of an eating disorder and binge drinking has primarily focused on college-aged women, though the phenomenon has also been noted among young men. Studies suggest that individuals engage in this combination of self-imposed malnutrition and binge drinking to avoid weight gain from alcohol, to save money for purchasing alcohol, and to facilitate alcohol intoxication.

<span class="mw-page-title-main">Indigenous health in Australia</span> Medical condition

Indigenous health in Australia examines health and wellbeing indicators of Indigenous Australians compared with the rest of the population. Statistics indicate that Aboriginal Australians and Torres Strait Islanders are much less healthy than other Australians. Various government strategies have been put into place to try to remediate the problem; there has been some improvement in several areas, but statistics between Indigenous Australians and the rest of the Australian population still show unacceptable levels of difference.

Alcohol is a liquid form substance which contains ethyl alcohol that can cause harm and even damage to a person's DNA. "Alcohol consumption is recognized worldwide as a leading risk factor for disease, disability, and death" and is rated as the most used substance by adolescences. Adolescence is a transitional stage of physical and psychological changes, usually a time in a person life in which they go through puberty. Combining these transitional stages and the intake of alcohol can leave a number of consequences for an adolescent.

A managed alcohol program is a program meant to reduce harm for chronic alcoholics. The program involves providing a regular dose of alcohol to individuals with alcohol addiction, typically at a shelter-based harm reduction centre.

Alcoholism in Ireland is a significant public health problem. In Ireland, 70.0% of Irish men and 34.1% of Irish women aged 15+ are considered to be hazardous drinkers. In the same age group, there are over one hundred and fifty thousand Irish people who are classified as 'dependent drinkers'. According to Eurostat, 24% of Ireland's population engages in heavy episodic drinking at least once a month, compared to the European average of 19%.

Many students attending colleges, universities, and other higher education institutions consume alcoholic beverages. The laws and social culture around this practice vary by country and institution type, and within an institution, some students may drink heavily whereas others may not drink at all. In the United States, drinking tends to be particularly associated with fraternities.

<span class="mw-page-title-main">Alcohol in the United Kingdom</span>

Alcohol in the United Kingdom is legal to buy, sell and consume. Consumption rates within the country are high among the average of OECD nations however average among European countries but consistently ranks highest on binge drinking culture. An estimated 29 million people in the United Kingdom drank alcohol in 2017.

References

  1. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 "Alcohol Use in Rural Australia" (PDF). National Rural Health Alliance. 2014.
  2. 1 2 3 "Rural & remote health, Access to health services". Australian Institute of Health and Welfare. Retrieved 2019-05-17.
  3. ↑ Claughton, David (18 August 2019). "Sober in the Country: Rural health advocate Shanna Whan fights to save farmers from self-medicating with alcohol". ABC News. Retrieved 15 February 2024.
  4. ↑ O'Connor, Ted; Lucas, Jarrod (14 February 2024). "Police add remote and outback residents to WA's re-worked Banned Drinkers Register". ABC News. Retrieved 17 February 2024.
  5. 1 2 3 4 5 "Alcohol, tobacco & other drugs in Australia, Aboriginal and Torres Strait Islander people". Australian Institute of Health and Welfare. Retrieved 2019-05-17.
  6. ↑ Miller, P (2010). "Review of Rural and Regional Alcohol Research in Australia". Australian Journal of Rural Health. (18)3: 110–117.
  7. 1 2 Powers, Jennifer; Duffy, Luke; Burns, Lucy; Loxton, Deborah (April 2016). "Binge drinking and subsequent depressive symptoms in young women in Australia". Drug and Alcohol Dependence. 161: 86–94. doi:10.1016/j.drugalcdep.2016.01.019. hdl: 1959.13/1322160 . ISSN   0376-8716.
  8. ↑ Beard, John R.; Tomaska, Nola; Earnest, Arul; Summerhayes, Richard; Morgan, Geoff (February 2009). "Influence of socioeconomic and cultural factors on rural health". Australian Journal of Rural Health. 17 (1): 10–15. doi:10.1111/j.1440-1584.2008.01030.x. ISSN   1038-5282.
  9. ↑ Pacileo, Guglielmo; Fattore, Giovanni (2009-11-05). "Alcohol abuse prevention in young people: An economic simulation". Journal of Substance Use. 14 (6): 385–392. doi:10.3109/14659890802695865. ISSN   1465-9891.
  10. 1 2 3 Inder, Kerry J; Handley, Tonelle E; Fitzgerald, Michael; Lewin, Terry J; Coleman, Clare; Perkins, David; Kelly, Brian J (2012-08-01). "Individual and district-level predictors of alcohol use: cross sectional findings from a rural mental health survey in Australia". BMC Public Health. 12 (1). doi: 10.1186/1471-2458-12-586 . ISSN   1471-2458. PMC   3491021 .
  11. ↑ "Ministerial Drug and Alcohol Forum (MDAF)". Australian Government Department of Health. 2019-02-05. Retrieved 2019-05-17.
  12. ↑ "National Alcohol and other Drug Workforce Development Strategy 2015–2018". Australian Government Department of Health. 2019-02-06. Retrieved 2019-05-17.
  13. ↑ "Australia: The Healthiest Country by 2020" (PDF). National Preventative Health Strategy - Overview. 2009.
  14. 1 2 3 "National Alliance for Action on Alcohol – National Alliance for Action on Alcohol" . Retrieved 2019-05-17.
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