New emergency department data exposes the scale of harm from alcohol in Melbourne and the need for the Victorian government to take action, according to the peak body for emergency medicine in Australia.
The Australasian College for Emergency Medicine (ACEM) has released findings from the emergency departments in St Vincent's Hospital and three Monash Health campuses (Clayton, Casey and Dandenong), collected over three months as part of the Driving Change project. Driving Change asks all adults who present to the ED whether they drank alcohol before their attendance, where they bought the alcohol, and the location of the last drink.
The Driving Change data showed that the main reasons for attending the emergency department were for alcohol intoxication, dependence, withdrawal, physical injuries, and suicide ideation. Data shows that dangerous levels of drinking (more than two standard drinks on each occasion) is pervasive across the communities served by the participating hospitals, regardless of age and gender, although men and women aged 45 to 54 were more likely to drink at dangerous levels.
More concerning, almost half of patients (44%) at St Vincent's, and over half (67%) of patients at Monash Health campuses who reported consuming alcohol in the preceding 12 hours had purchased alcohol from packaged liquor outlets such as supermarkets and bottle shops. This is an issue because it enables pre-loading, when drinks can be bought ahead of time while a person is sober, and consumed to excess when no 'safe service' levels apply. This number is also likely to be under-reported because of the number of people who were unable to recall the purchase location, or who were unconscious or refused to respond.
Monash Health
Over a three month period earlier this year at the 3 participating Monash Health campuses, data collected shows that on Friday and Saturday nights, around 1 in 10 patients were there due to alcohol consumption (compared to an average of almost 1 in 20 over the whole week). All told, 7 out of every 10 patients in the ED reported consuming alcohol in the 12 hour period beforehand. These findings continue the trend observed in previous years.
St Vincent's
Over a three month period late last year at St Vincent's ED, data collected shows that on Friday and Saturday nights, over 1 in 4 patients were there due to alcohol consumption (compared to an average of almost 1 in 10 over the whole week). All told, almost half of patients in the ED who reported consuming alcohol in the 12 hour period beforehand had purchased the alcohol from packaged liquor outlets such as supermarkets and bottle shops.
The mostly commonly reported venues from St Vincent's for last drinks before needing to go to an ED were concentrated among major venues in Melbourne:
- Crown Casino
- Flemington Racecourse
- Melbourne Cricket Ground
- The Forum
Spring racing carnival
All reports from Flemington Racecourse date from the period around the Spring Carnival in the first half of November 2018. The findings reveal that contrary to most trends that show males are heavier drinkers, over three quarters of presentations from Flemington Racecourse were female.
Call for action against alcohol harm
ACEM President Dr Simon Judkins said: "Emergency physicians regularly manage the devastating effects of excessive alcohol consumption on individual health, as well as assaults or verbal and physical threats from drunk patients. It is incredibly stressful and confronting to see and have to manage this every weekend. The NT government has demonstrated that alcohol reforms, including setting a minimum floor price, can dramatically reduce ED presentations."
"What is clear is that Australia needs to undertake a cultural shift in its relationship with alcohol. With alcohol being promoted at sporting events, heavy drinking around major events will continue to be a big cause of the problem that contributes to the alcohol harm we see in the ED every day. Regulation is required to tackle the way alcohol is heavily promoted.'
The Driving Change project is led by Professor Peter Miller at Deakin University, with funding from the National Health and Medical Research Council. In addition to the two EDs in Canberra, there are participating hospitals in Melbourne, Geelong, Sydney and Warrnambool. Central Queensland University, the University of New South Wales, Australian National University and Cardiff University (Wales) are also partners in the project.
More details: Last Drinks
