You are not permitted to download, save or email this image. Visit image gallery to purchase the image.
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.
• Tomorrow: Why education programmes are not the answer