Alcohol-related ED presentations double over 10 years

The number of patients with alcohol-related injuries visiting one of New Zealand’s busiest hospital emergency departments has more than doubled over the past decade.

And a new University of Otago (Christchurch) study has found those presenting to ED with alcohol harm are predominantly older New Zealanders, rather than youths.

Lead researcher Christchurch Hospital emergency physician and University of Otago (Christchurch) senior lecturer Dr Laura Joyce said the ED study, published in today’s New Zealand Medical Journal, provided a detailed three-week "snapshot" of alcohol-related patient presentations to the Christchurch Hospital emergency department in 2013, 2017 and 2022.

Overall, the study found no "let-up" in the number of alcohol-related presentations emergency staff were treating over time, she said.

"Excess of alcohol as a reason for presentation to the Christchurch ED in our study rose, from just over 5% in 2013 to 11% in 2022.

"Alcohol harm is pervasive across Aotearoa New Zealand, leading to significant injury and chronic disease, causing more than 5% of all premature deaths.

"Alcohol-related presentations are preventable, contribute to ED overcrowding, impact other patients requiring care, put considerable stress on hospital staff and resources, and place a high financial burden on the entire health system."

People presenting to the ED were approached and consented to take part in the study if they had ingested alcohol in the four hours prior to presenting, or if their presentation was thought to be alcohol-related, Dr Joyce said.

Overall, 412 patients consented to take part.

Over the three waves, the median age of participants increased to 39 years.

Specifically, in the 25-54 age group, alcohol presentations rose from 29.9% (in 2013) to 40.1% (in 2022); and in the over-54 age group from 11.6% (in 2013) to 23.9% (in 2022).

In 2013, young people aged 25 and under made up 33.6% of presentations, but that dropped to 19.3% in 2022.

"Although media attention often focuses on young people drinking in pubs and bars on a Saturday night, this is not the case in terms of ED presentations in this study," Dr Joyce said.

"Our findings are in line with other research showing that over one-third of older New Zealanders are drinking at levels which may result in harm.

"This is concerning, as people in this age group are more likely to have additional co-morbidities and the potential for medication interactions."

A significant proportion of patients admitted to consuming 20 or more standard drinks on a single occasion, which showed binge-drinking was still prevalent in New Zealand.

Two-thirds of patients in the study had consumed alcohol in private locations, such as their home, she said.

"We feel this highlights the need for stronger local alcohol policies for off-license venues, particularly seeing they are a key supplier of large quantities of cheap alcohol and contribute to New Zealand’s drinking culture as a whole.

"With the recent passing of the Sale and Supply of Alcohol (Community Participation) Amendment Bill, councils can now implement strong controls on alcohol availability without the risk of alcohol industry appeals, particularly from alcohol retailers."

It was important that EDs in New Zealand systematically collected alcohol-related data, to help inform effective population-level alcohol policies to reduce excessive drinking, Dr Joyce said.