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]
''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
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
Prices should go up - ''alcohol has become extraordinarily
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
"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
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
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.
• Tomorrow: Why education programmes are not the