Alcohol health promotion utilising a harm minimisation approach PREVENTIVE HEALTH MATTERS WEBINAR

Alcohol health promotion utilising a harm minimisation approach PREVENTIVE HEALTH MATTERS WEBINAR

ALCOHOL IS A DRUG Drinking alcohol is the most common type of drug use in Australia Despite, Ice epidemic, alcohol still remains the highest used drug in Australia Causes the highest amount of harms 2

AUSTRALIA AND DRINKING CULTURE Alcohol is a major part of the Australian culture. Foundation for Alcohol Research (FARE) found in the 2016 Australian poll that of the1,825 respondents: 78% of people believe that Australia has a problem with excess drinking or alcohol abuse. 73% of people believe that alcohol-related problems in Australia will either get worse or remain the same over the next five to ten years. 35% of Australians consider alcohol to be the drug that causes the most harm, behind illegal drugs (44%) and ahead of tobacco (10%) and pharmaceuticals (5%). Australians are most concerned about alcohol-related violence (79%), road traffic accidents (76%) and child abuse and neglect (64%). 3

MONEY Income Alcohol tax generates approx. $7 billion per year Costs Financial: approx. $15 billion per year Personal: approx. $6.4 billion The societal costs of alcohol misuse in Australia, Australian Institute of Criminology, 2013 4

CURRENT TRENDS IN AUSTRALIA Data from the National Drug Strategy Household Survey 2013 6.5% of Australians aged 14yrs + drank on a daily basis Almost 1 in 5 people aged 14yrs + consumed more than two standard drinks per day on average 1 in 3 people yearly and 1 in 4 people monthly had consumed alcohol at a level placing them at risk of injury 1 in 5 recent drinkers put themselves or someone else at risk of harm while under the influence of alcohol Around 1 in 6 people aged 12yrs + had consumed 11 or more standard drinks on a single drinking occasion in the past 12 months 5

THEORY BASED APPROACH The ecological framework (McLeroy et al., 1988) 6

NEW THINKING Vic Health s- Alcohol Cultures Framework; https://www.vichealth.vic.gov.au/media-andresources/publications/alcohol-cultures-framework The Framework defines alcohol cultures and provides a lens for designing and implementing programs. Alcohol culture is defined as the way people drink including the formal rules, social norms, attitudes and beliefs around what is and what is not socially acceptable for a group of people before, during and after drinking. 7

THEORY BASED APPROACH Use of alcohol contributes substantially to the burden of disease and harm in society. Some evidence suggests it can be reduced through applying a combination of regulatory, early-intervention, and harm-reduction approaches. 8

WHAT ARE ALCOHOL RELATED HARMS? The National guidelines talk about lifetime risk of harm from alcohol-related disease or injury and the risk of alcohol related injury arising from that occasion The 2009 Guidelines focus on the health risks that accumulate over a lifetime from alcohol, and the understanding that these risks increases progressively the more you drink, the greater the risk. Alcohol related harms can be broken down into short and long term harms. 9

WHAT ARE ALCOHOL RELATED HARMS? Short-term harm is what may occur as a result of one (single) drinking occasion. Alcohol increases the likelihood of a person being involved in anti-social behaviour conflict, that can lead to fights and violence including domestic injury due to falls, burns, car crashes etc unprotected or unwanted sexual encounters problems that occur with friends and family. 10

WHAT ARE ALCOHOL RELATED HARMS? There are a significant number of alcohol-related diseases and health problems caused by alcohol consumption in Australia, including cancer (bowel, breast, throat, mouth, liver) liver disease cardiovascular disease stroke dependence mental health problems. 11

HARM MINIMISATION Harm minimisation aims to address alcohol and other drug issues by reducing the harmful effects of alcohol and other drugs on individuals and society. (ecological model) Harm minimisation considers the health, social and economic consequences of AOD use on both the individual and the community as a whole. It has been a key policy of Australian state and federal governments since the 1985 launch of the National Campaign against Drug Abuse and the subsequent National Drug Strategy. 12

HARM MINIMISATION The harm minimisation approach is based on the following Drug use, both licit and illicit, is an inevitable part of society Drug use occurs across a continuum, ranging from occasional use to dependent use A range of harms are associated to different types and patterns of AOD use A range of approaches can be used to respond to these harms. Harm Minimisation is consistent with a comprehensive approach to reducing drug-related harm, and involves harm reduction, supply reduction and demand reduction strategies 13

HARM REDUCTION Strategies that aim to reduce the harm from drugs for both individuals and communities. These strategies do not necessarily aim to stop drug use. Examples include needle syringe services, methadone maintenance, brief interventions and peer education. 14

SUPPLY REDUCTION Aims to disrupt production and distribution of illicit drugs. Examples include legislation and law enforcement. 1.30am lockouts and 3am last drinks laws are in force in NSW and Qld. Trials of the laws took place in SA, Vic and WA The laws have been rejected in ACT and Tasmania Calls for the laws to take place in NT 15

DEMAND REDUCTION Prevent the uptake and delay onset of drug use Reduce the number of children and young people using drugs Reduce the uptake of drugs in the broader Queensland community Focus on those communities with the highest rates and at greatest risk. Reduce the use of drugs Change Queensland s drinking culture Improve access to treatment and support services. 16

DEMAND REDUCTION Support people to recover from dependency and reconnect with the community Promote social inclusion and reduce stigma and discrimination. Alcohol problems, education measures, and treatment Restricting advertising/marketing, increase prevention programs, early intervention programs for people exhibiting alcohol issues 17

THE ALCOHOL RISK CONTINUUM Supply Demand Harm Community Prevention Counselling/Rehab Primary Secondary Tertiary Prevention Prevention Prevention Rehabilitation 18

PREVENTION DOCUMENT http://www.druginfo.adf.org.au/attachments/1507_preve ntionresearch_engagingcommunities_final_web.pdf Add the document title 19

HOW TO REDUCE THE RISK OF HARM FROM ALCOHOL? INDIVIDUAL While there is no safe level of drinking, the Australian guidelines for low-risk drinking recommend 1. For healthy men and women, drinking no more than two standard drinks on any day reduces the lifetime risk of harm from alcohol-related disease or injury. 2. For healthy men and women, drinking no more than four standard drinks on a single occasion reduces the risk of alcohol-related injury arising from that occasion. 20

HOW TO REDUCE THE RISK OF HARM FROM ALCOHOL? 3. For children and young people under 18 years of age, not drinking is the safest option. Parents and carers are advised that children under the age of 15 are at greatest risk of harm from drinking and it is especially important that they do not drink alcohol. https://www.youtube.com/watch?v=g2gvzvibc_g Turning Point, Under Construction: Alcohol and the Teenage Brain 4. For women who are pregnant, are planning a pregnancy or are breastfeeding, not drinking is the safest option 21

WHAT IS A STANDARD Different types of alcoholic drinks contain different amounts of alcohol, and a single 'drink' is often much more than a standard drink. A standard drink is exactly 10 grams of pure alcohol. 22

WHAT IS A SERVE OF ALCOHOL? 23

WHAT IS A SERVE OF ALCOHOL? 24

WHAT IS A SERVE OF ALCOHOL? 25

ASSESSMENT TOOLS World Health Organisation Risk assessment Tool Thomas F. Babor, John C. Higgins-Biddle, John B. Saunders, and Maristela G. Monteiro (2001) AUDIT: The Alcohol Use Disorders Identification Test Guidelines for Use in Primary Care. Second Edition. 10 questions, can be used as self assessment or as brief intervention 26

AUDIT TOOL Domains and Item Content of the Audit Domains Question number Item Content Hazardous Alcohol Use 1 2 3 Dependence Symptoms Harmful Alcohol use 4 5 6 7 8 9 10 Frequency of drinking Typical quantity Frequency of heavy drinking Impaired control over drinking Increased salience of drinking Morning drinking Guilt after drinking Blackouts Alcohol-related injuries Others concerned about drinking 27

COMMUNITY CAPACITY BUILDING Working under Demand reduction we take a Community capacity building approach to reduce alcohol related harms Community capacity-building approaches attempt to increase a given community's capacity to solve its collective problems. Community also being a part of the ecological model 28

COMMUNITY CAPACITY BUILDING Community Capacity Building should focus on Community needs "Bottom-up" or "grassroots" practice Strengths-based approach Inclusive practice Investment in community capacity Aim for sustainability 29

KEY ALCOHOL PREVENTION ORGANISATIONS IN AUSTRALIA ADF- Alcohol and Drug Foundation (previously the Australian Drug Foundation, http://www.adf.org.au/ CDAT- Community Drug Action Teams (NSW) Drug Info- http://druginfo.adf.org.au/ Good Sports Grog watch- http://grogwatch.adf.org.au/ Alcohol Think Again- WA, http://alcoholthinkagain.com.au/ FARE- Foundation for Alcohol Research and Education National Alliance for Action on Alcohol- NCAA 30

KEY DOCUMENTS National Drug Strategy Draft format 2015 Australian guidelines to reduce health risks from drinking alcohol 31

THANK YOU 32