South's alcohol statistics worst

Dunedin Hospital emergency department staff (from left) Dr Nic Millar, Mike O'Brien, and Dr Tim Ritchie are concerned too many intoxicated people end up ''on our trolleys in ED''. Photo by Peter McIntosh.
Dunedin Hospital emergency department staff (from left) Dr Nic Millar, Mike O'Brien, and Dr Tim Ritchie are concerned too many intoxicated people end up ''on our trolleys in ED''. Photo by Peter McIntosh.

Public Health South's 2013 alcohol report paints an alarming picture of hazardous drinking in the South, prompting a call for tougher regulations over the sale and distribution of alcohol. Health reporter Eileen Goodwin talks to the people at the front line, in our Booze Control: Stop and Think series.

Judges are sending a ''powerful message'' about alcohol-related offending in the South, and local councils should take note, Queenstown-based medical officer of health Dr Derek Bell says.

Dr Bell is heartened by recently published comments of district court judges denouncing drink-fuelled offending.

''It's a pretty big thing when judges start commenting on social ills like that. What we're hoping is that local councils, when they're developing their local alcohol policies, will take note of those comments from the judiciary, as well as the comments [Public Health South] make.

''I think [the judges are] sick of it, and maybe they're aware of the opportunities that are coming up with the local alcohol policies, but maybe the issue is getting worse.''

The courts saw a ''fraction'' of alcohol related harm, but it was not possible to count or quantify its extent.

This led Public Health South to a different approach in a 2013 alcohol report aimed at helping councils navigate new liquor control law.

Rather than just reciting facts and figures, the public health unit asked health, community, and law enforcement workers for their on-the-job experiences.

The verbatim and blunt observations build a picture of hazardous drinking in the South, which the report describes as the country's worst.

A quarter of southern residents were hazardous drinkers, the 2011-12 New Zealand Health Survey found.

An initiative in emergency departments had been to take a ''constructive'' approach to the problem, Dr Bell said.

For the past six months, ED patients in Dunedin and Invercargill have been asked about their alcohol use, regardless of the reason for their attendance.

Women were asked how often they had more than four standard drinks in a sitting; men were asked how many times they had more than six.

If it happened on a monthly, weekly or daily basis, they were identified as being at risk of hazardous drinking.

''The idea is that their drinking habit is questioned.''

The person could then be referred to their GP or other support services.

Alcohol had become normalised, building an expectation it would be at every event or function.

''There is a normalisation, and in some sectors even a glamorisation, of alcohol-related harm where people think some quite major injuries are quite funny, because they happened as a result of alcohol.

''Like the kid who falls off a balcony and maybe gets away without serious injuries, but everyone has a good laugh about it.''

Prices should go up - ''alcohol has become extraordinarily cheap''.

More restrictions were needed - Dr Bell found the concept of personal responsibility fraught because alcohol was a dangerous substance that had become mainstream.

If introduced now, it would be subject to a very different set of controls.

''For us, as medical officers of health, we're responding to the population as if it was the patient, because that's what we do.

"The population is our patient, and the statistics are telling us that the population's got a bit of a problem.''

Dunedin Hospital emergency department specialist Dr Tim Ritchie also feels binge drinking is considered the norm, and is sick of people ''banging on'' about synthetic cannabis when alcohol and tobacco are far more harmful.

The Otago Daily Times visited the department on a Friday night shortly before Christmas.

Despite the festive season, the department was extremely quiet when the ODT visited about 10pm.

Dr Ritchie said the ''fairly dull'' night highlighted the impact of the students, most of whom had departed before the start of the festive season.

Drink was ''entrenched'' in New Zealand culture, and Dr Ritchie said he did not know the answer to that.

He was concerned that those presenting with alcohol intoxication were getting younger, and worried about the vulnerability of young women to sexual assault.

ED nurse Mike O'Brien said the drinking culture had to change.

Too many intoxicated people were ending up ''on our trolleys in ED'', and he found their level of incapacity distressing, considering what might have happened to them.

Where patients were disruptive, staff were skilled at communication, and physical assault was rare. Many were injured as well as intoxicated, which made clinical assessments difficult to perform.

It was crucial to plan for student events such as the Hyde St party.

The 2012 event had been a ''disaster'' in terms of preparedness and the department was overwhelmed by presentations, Dr Ritchie said.

ED staff relied on communication from organisers, particularly about newer events that might not be on the radar of hospital staff.

The new alcohol screening questions surprised some patients, especially those who disagreed with the suggestion they might be drinking too much, Mr O'Brien said.

eileen.goodwin@odt.co.nz 

Tomorrow: Why education programmes are not the answer

 

The real world

In response to  My point bars are not the problem here but supermarkets. Bbars have all sorts of restrictions imposed by the council: host responsibility, Liquor Licencing Authority etc. For instance a bar wants to run a promotion but they are told by the council  they are not allowed to run specials that incl prices below approx 4x what the same drinks cost at a off licence (council is very careful not to set prices but will say no no no until the bar owner raises the price to a certain level then they say yes).

They are not allowed to promote drinking , this is akin to a petrol station not being allowed to promote gas. They will have constant checks by police officers etc . I have yet to see a squad of Police enter a supermarket and check ID's and intoxication.

and the list goes on.

Supermarkets have no such restrictions. It's not uncommon for supermarkets to use alcohol as a loss leader , With big promotions any time an event or holiday occurs , they have no responsibilties toward their customers or what their customers do once they are out the door yet bars are held to account and demonised if a person who was there causes trouble once they have left. 

In fact even the Police have said in various articles that pre-loading is  is the cause of the majority of problems, Just Type "pre-loading" into the ODT search egine and read through the resulting articles.

[Abridged]

Truth and illogicality

There is both truth and illogicality involved with the statements by the doctors.


Drink was ''entrenched'' in New Zealand culture, and Dr Ritchie said he did not know the answer to that."

Drinking alcohol is entrenched in many cultures throughout the world. It is nothing new, and it appears that excess consumption appears to run in 100 year cycles. The Womens' Christian Temperance Union was formed in NZ in 1885 (part of a similar, worldwide movement) to challenge the drinking habits of the day.

Alcoholism is also a challenge in France - a nation often held up as an example of "civilised drinking". You do see rolling drunks in France, and in Germany and in just about every country in the world that consumes alcohol as part of its society. 


Dr Bell found the concept of personal responsibility fraught because alcohol was a dangerous substance that had become mainstream."

Yes it is a dangerous substance - it has always been mainstream. In spite of the over-work at the A&E, more than 80% of the adult population drink and of that majority, an internal majority drink sensibly and safely.


Dunedin Hospital emergency department specialist Dr Tim Ritchie also feels binge drinking is considered the norm, .........


Dr
Richie was once a medical student - a group not noted for their total temperance. I take it that he speaks with the certainty of personal experience. Binge drinking is not the norm in my social group (of adults) - the norm there being one or two glasses of beer at a sitting, wine (usually with food) and an occasional nightcap of a spirit. The young transgress social norms - as we all did. Most adults stay within bounds.

 

Responsibility and price

No, the whole community doesn't have a drinking problem - I certainly don't. Personal responsibility is the issue here. These people need to be held accountable for their own actions. The police need to be more active and charge these people for being drunk in public. They should also be charged for using ED. 

The bars that obviously serve these people need held to account - the penalties are pathetic. These bars flout the rules and serve drunks to make money. 

I enjoy having a drink, and why shouldn't I?  The medic states that alcohol is too cheap. Where is it cheap? Let me know please and  I'll shop there.

Prices have gone up lots, actually. Why should prices rise so that all are penalised, even those of us that can control ourselves?  

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