New emergency department data exposes more harm from alcohol to our communities and the urgent need for governments and policy makers to take action, according to the peak body for emergency medicine in Australia.
Australasian College for Emergency Medicine (ACEM) President Dr Simon Judkins said: "While alcohol companies continue to line their pockets with profits from the sale and consumption of alcohol, our members – specialist emergency physicians – are working on the frontline dealing with the consequences of widespread alcohol use and the harm it inflicts on local communities across Australia.
"We desperately need our federal and state governments to step up and adopt preventive public health measures to reduce the harm fuelled by alcohol that we see at work in our emergency departments every day."
ACEM supports the advocacy efforts of partner groups such as The Foundation for Alcohol Research and Education (FARE) and the Alcohol Policy Coalition, which call for better government regulation of the alcohol industry and alcoholic products.
Last drinks among alcohol related presentations to emergency departments
The Driving Change project is a collaboration between ACEM and nine participating hospitals in Melbourne, Geelong, Sydney, Canberra and Warrnambool, and Deakin University, Central Queensland University, the University of New South Wales, Australian National University and Cardiff University (Wales). The project is funded by the National Health and Medical Research Council and St Vincent's Health Australia. More details are on the Driving Change project website.
Monash Health Emergency Departments
New figures show that in the last three months of 2018, up to 6% of all patients attending Monash Health's Clayton, Casey and Dandenong Hospital Emergency Departments reported consuming alcohol in the 12 hours before their emergency department presentation. In other words, in the lead up to the New Year one in every 16 to 20 patients attending hospital in Melbourne's south eastern suburbs were there in relation to alcohol.
There was a broad range of diagnoses among presentations, with patients having neck, ankle, and head injuries, brief psychotic episodes, and sedative or anxiolytic disorders where alcohol consumption was a comorbidity (the co-occurrence of one or more diseases or disorders in an individual).
On weekends, harm fuelled by alcohol dramatically increased, with one patient in every seven to 10 attendances to Monash Health's Emergency Departments there because of alcohol.
Overall, the data showed that more than six in 10 patients with an alcohol related presentation purchased their alcohol from packaged liquor outlets (i.e. bottle shops, both large chains and smaller shops). This proportion is likely to be much higher, but some patients didn't disclose.
"The alcohol industry uses liquor outlets to target and exploit vulnerable communities – we know that packaged liquor licences, particularly large chain bottle shops, are concentrated in disadvantaged areas throughout Victoria, which has the highest level of packaged liquor outlets in the country. Victorian research has shown that the more concentrated packaged liquor outlets are, the more alcohol harm we see from assaults and family violence.
"We call on regulators, and the federal and state governments, to do their job by ensuring they have appropriate planning and policy controls in place that prevent alcohol harm. One way that is proven to work is by preventing packaged liquor outlets from trading after 10 pm. We also need better regulation of licensing for new online alcohol delivery services, and trading for these businesses should be capped at 9 pm," Dr Judkins said.
Males were twice as likely as females to have an alcohol related attendance, which was consistent across all age brackets. Risky drinking – defined by the National Health and Medical Research Council as consuming more than two standard drinks in a setting – was widespread across all ages, except among patients aged 75 years and over.
Data was collected from Clayton, Casey and Dandenong Hospital Emergency Departments between 1 October 2018 and 31 December 2018.
St Vincent's Hospital Melbourne Emergency Department
New data shows one in 10 patients presented to Melbourne's St Vincent's Hospital Emergency Department during the 2018 winter after using alcohol. On weekends, the inner city emergency department sees the harm from alcohol steeply rise, with two in every seven patients attending St Vincent's Hospital because of the drug.
The most common presentations to the emergency department in winter last year included injuries to the head related to assaults, glassing, and violence resulting in head injuries and bite wounds. Other attendances were related to alcohol poisoning, chest pain, and alcohol-attributed mental health presentations.
Overall, the data showed that seven in 10 patients purchased their alcoholic products from packaged liquor outlets (i.e. supermarkets, large chains and smaller bottle shops).
The leading licensed venues at which patients had last been served alcohol before presenting to St Vincent's Hospital Melbourne Emergency Department were:
1. Crown Casino.
2. The Melbourne Cricket Ground.
3. Yah Yah's on Smith Street.
4. Billboard on Russell Street.
Venues the Arbory Bar and Eatery on the Yarra River and house music club Tramp Bar dropped from the list.
Males attended the emergency department more frequently than females, which was consistent across all age brackets. At the inner Melbourne hospital, male patients aged 45 to 54 years and 55 to 64 years were the most common risky drinkers. Risky drinking was most common among female patients aged 45 to 54 years and 18 to 24 years.
Data was collected from the middle of June to the start of September 2018 from more than 11,000 presentations to Melbourne's St Vincent's Hospital Emergency Department.
Background
ACEM is the peak body for emergency medicine in Australia and New Zealand, responsible for training emergency physicians and advancement of professional standards. www.acem.org.au
