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by Cassandra Wright, Menzies School of Health Research; Beau Jayde Cubillo, Menzies School of Health Research; John Holmes, University of Sheffield; Mark Mayo, Menzies School of Health Research; Mark Robinson, The University of Queensland; Michael Livingston, Curtin University; Nicholas Taylor, Curtin University; Sarah Clifford, Menzies School of Health Research, and Tim Stockwell, University of Victoria*

The new Northern Territory government is planning a swathe of changes to alcohol policy.

If implemented, these changes fly in the face of what evidence shows works to reduce alcohol-related harms. Some are also out of step with the rest of Australia.

Among our concerns are plans that would lead to harmful alcohol products becoming cheaper, alcohol becoming more easily available, criminalising public drunkenness, and a particularly worrying type of mandatory alcohol treatment – all of which evidence suggests will cause more harms.

No one is downplaying the magnitude and complexities of alcohol-related issues in the NT. But we hope the territory government will pay more heed to the evidence and voices of those most impacted.

Alcohol-related harm in the NT is complex
Alcohol-related harms in the NT are significantly higher (for both Aboriginal and non-Aboriginal people) than elsewhere in Australia.

In the territory, these harms contribute to health and social outcomes costing at least A$1.4bn [US$1bn]  a year. Alcohol harms result in costs related to health care, deaths, crime, policing and child protection.

Aboriginal communities in the NT have for decades cried out for solutions and services that effectively respond to alcohol-related harm. Instead, they found their lives made part of a political football match on law and order. Policies have been reactive and mostly ineffective. They’ve been overturned at each election.

Now, the new NT government is discussing changes that promise to exacerbate the very issues it aims to address.

1. Cheap alcohol that contributes most harm would be on the market
The World Health Organisation recognises that raising the price of alcohol is one of the most effective ways for governments to reduce alcohol-related harm.

So some governments around the world, including in the NT, have set a price below which alcohol cannot be sold, known as the minimum or “floor price”. This targets cheap, high-strength alcohol associated with patterns of drinking that cause the most harm.

The new NT government plans to repeal this, despite evidence showing this works to reduce harms.

Since the NT alcohol floor price was set at A$1.30 per standard drink in 2018, there has been a:

• 14% reduction in alcohol-related assaults in Darwin and Palmerston

• 11% reduction in domestic and family violence assaults

• 21% reduction in domestic and family violence assaults involving alcohol

• 19% reduction in alcohol-related emergency department attendances.

Originally, experts recommended a A$1.50 floor price but this was reduced to A$1.30 after a backlash from alcohol industry lobbyists. Had the policy not been watered down, evidence suggests the impacts above would likely have been greater.

The floor price has likely also lost some of its initial impact as it has never been indexed for inflation.

The best available research shows the floor price has reduced alcohol-related harms with no evidence of unintended consequences or negative impacts on the alcohol industry, despite claims otherwise.

Researchers and experts from around the world have been writing to NT ministers urging them to reconsider repealing this effective policy.

This includes researchers from the United Kingdom and Canada, who have coauthored this article. In these countries, evidence on the effectiveness of minimum pricing has been used to increase the floor price by 30%, not abolish it.

2. Bottle shops could be open longer
There are also proposals to repeal current restrictions on bottle shop trading hours. Such restrictions are highly effective in reducing alcohol harms, including violence.

Our paper from earlier this year found that in the town of Tennant Creek, restrictions to reduce trading hours and introduce purchase limits at bottle shops resulted in a 92% reduction in alcohol-involved domestic and family violence assaults.

Preliminary analyses of the reduced trading hours introduced in Alice Springs following Prime Minister Anthony Albanese’s visit in early 2023 also suggest a clear reduction on violence rates.

3. New public drunkenness offence
Ministers were also set to pass laws to create a new offence for “nuisance” public intoxication (also known as public drunkenness). This would allow police officers to arrest people and fine them up to A$925, in addition to current powers to seize and tip out alcohol from people drinking in prohibited areas.

This is at the time when nearly every other jurisdiction in Australia is in the process of decriminalising public drunkenness, making the NT out of step with the rest of the nation.

The NT’s proposed new laws on public drunkenness would criminalise more people who are already locked out from our society, placing them at risk of the negative, intergenerational and preventable impacts that often arise from contact with the justice system.

4. Mandatory rehab
Mandatory alcohol treatment was also an election commitment.

In its previous term of government, mandatory alcohol treatment was focused on people with a public intoxication offence rather than providing quality care to people with alcohol dependence in life-saving circumstances. If the same model is reintroduced, this is potentially harmful and at best ineffective.

In the NT, this model of mandatory alcohol treatment had no better outcomes than for those who may not have received any treatment at all. But it cost the taxpayer three times as much.

Where to from here?
Researchers, health professionals and partner organisations have urged the NT government to reconsider these decisions, as we have well-founded concerns these may worsen the very issues the government aims to address.

There’s no need to guess the outcomes of changing, repealing or introducing alcohol policies. We can draw on robust evidence, including extensive research from the NT, on what works in our communities.

*This piece is republished from The Conversation under a Creative Commons license. Read the original piece. ■

[Read more…] about Guest post: Why Northern Territory alcohol reforms would be a disaster, according nine experts

One in 25 cancers is linked to alcohol consumption, with men accounting for three quarters of cases, according to a global study in Lancet Oncology.

“Public health strategies, such as reduced alcohol availability, labelling alcohol products with a health warning, and marketing bans could reduce rates of alcohol-driven cancer,” says Harriet Rumgay of the International Agency for Research on Cancer, also recommending higher taxes and minimum pricing.

The estimates would mean 740,000 cancer cases globally were linked to alcohol last year, with heavy drinkers contributing bar far the most. But there is no risk-free level of alcohol drinking and cancer. Low-level drinkers were one-in-seven of alcohol-linked cancer cases.

“It is safest not to drink alcohol, but if you do, you should stick to the UK Chief Medical Officers’ low-risk guidelines which is to drink no more than 14 units a week [or 140ml of alcohol] on a regular basis,” said Professor Sir Ian Gilmore, Chair of the UK’s Alcohol Health Alliance.

Cancers of the oesophagus, liver, and breast accounted for most of the cases. Alcohol damages DNA and affects hormone production, which can contribute to cancer development, as well as worsen the cancer-causing effects of substances like tobacco.

In the UK the alcohol-lined cancer rate was the global average of 4%, with 16,800 cases; The US, 3%, with 52,700 cases; China 6%, 282,300; Germany 4%, 21,500 cases; and France 5%, 20,000 cases. The percentage of alcohol-linked cancer cases were reckoned to be highest in Mongolia, at 10%, from 560 cases, and lowest in Kuwait, where it was 0%, with just a few cases.

The study made its estimate by looking at alcohol intake in 2010 and the number of cases of cancers known to be linked to alcohol last year. Some suspect the research may underestimate alcohol’s contribution to cancer cases, because a quarter of alcohol purchases are not captured by government figures. ■

Western culture makes a fetish of strenuous effort. Put in lots of effort, we are told, and we can reliably expect cracking results. I, like a lot of people, was brought up to believe it. Media reinforce the idea. But it is not true.

Many of us often work extremely hard and get very limited results in return. What we invariably get, however, is fatigue. Over the long term we often get chronic fatigue. We also increase our chances of injury and becoming jaded.

We also boost the chances we crave relief from the pain and strain we have induced. Enthusiastic efforts to improve our health can lead us to look for relief using alcohol or in other counterproductive ways.

I was brought up to be a firm believer in the try hard ethos. Whether it was memorising irregular foreign verbs or running round a playing field until we puked. It was all quite unpleasant, but rest assured the pain would have a pay off.

There is something to be said for seeing where our limits are and experiencing what happens when we reach them. It is instructive, but constantly pushing our gauges into the red is a flawed long-term strategy.

Real achievements typically emerge from steady, sustainable and enjoyable effort. Bodies strengthen, but they take time. Books, academic papers and brick walls take shape, but not thanks to an afternoon of frantic exertion.

Willing ourselves to regularly hit our pain thresholds can induce endorphins that soothe strain and stress. But over the long term this can backfire when we no longer want to endure discomfort simply for a painkilling payoff.

My own experience was that I became tired of the satisfaction and reward of enduring things as an end in itself. Eventually I found what Chinese philosophy calls wu wei, a slippery idea one might say means “never pushing”.

The idea is to never strain oneself. One should look at ways to sail rather than row to a destination. Rather than giving oneself a pat on the back for labouring, one should focus on technique, reducing effort and enhancing enjoyment.

It is an approach that can be well embodied in some tai chi classes. If you feel any pain or strain you are told to stop moving quite so much. The lesson for an inveterate try-harder is stop trying so hard, progress will come anyway.

I did no more than the tai chi basics, but “never pushing” works with anything. I swam this way for three years. I was never injured, tired or stressed and was able to enjoy every minute. I emerged far stronger and with technique improved. 

The ultra low intensity meant there was no pain or discomfort during or after. This meant there was not the slightest temptation to self-medicate with alcohol or anything else. Swimming itself became a longed-for stress relief.

Making never pushing and enjoyment the key parameters of success make activities themselves the rewarding relaxation it should be.  Well-being not effort is the most reliable basis for progress. ■

Updated 28.8.2024 to include response from Men’s Sheds.

The UK Men’s Sheds Association acknowledged concerns from health experts and shed users about its partnership with alcohol giant Diageo, while highlighting the benefits of the controversial deal.

“It is genuinely a response to harmful drinking especially in the 50-70 age group,” Men’s Shed chief executive Charlie Bethel told Alcohol Review. The 18-month pilot of the DrinkIQ-branded co-created product will allow the charity to assess its impact. One shed which closed now meets at a Wetherspoons, Bethel noted.

Bethel said some shed users have objected to the deal, but he said it is comparable to other charities taking money from National Lottery scratch cards. He said he could not speak for Diageo’s motives, but noted the success of its alcohol free beers. There is currently no evidence alcohol-free beer cuts harm.

“It’s prob too late but worth having a read of the evidence on partnerships with harmful product industries They don’t have men’s health–or women’s, for that matter–as a strategic aim,” said Greg Fell, President of the The Association Of Directors of Public Health (UK), on X at the time of the announcement in late July.

“There are other places to get your information about alcohol harm to help with recovery, addiction and mental health regarding alcohol than those that make it profit from it,” commented alcohol harm reduction campaigner Mick Unwin.

“This is a very unfortunate move by UK Men’s Sheds,” said Sheila Gilheany head of Alcohol Action Ireland, echoing the similar concerns about the expertise an alcohol company might have in offering information on alcohol harm.

“Very sad to see this corporate capture of Men’s Sheds,” said another commenter who sits on the board of a harm reduction charity. ■