Alcohol-related harms ‘not just an Indigenous problem’
Dr Richard Chenhall's years of research into alcohol have convinced him that some Indigenous communities could teach mainstream communities a thing or two about how to address the problems caused by alcohol.
Dr Chenhall is a Senior Lecturer in Medical Anthropology at the School of Population and Global Health’s Centre for Health and Society, at the University of Melbourne. One of the few Australian researchers who have examined alcohol management plans (AMPs) in depth, his latest timely contribution is to a paper by the Indigenous Justice Clearinghouse (IJC). The IJC makes research about Indigenous justice available to policymakers.
"Alcohol-related harms are not just an Indigenous problem – alcohol is everyone's problem and we have a lot to learn from the Indigenous community from their ability to come together and try to enforce change," he says. Alcohol Management Plans have their genesis in Aboriginal community activism dating back to the 1970s, he says, when communities themselves tackled the devastating harms caused by alcohol. Yet more than 35 years later, the harms from alcohol consumption continue in Indigenous communities. While there is a greater percentage of Indigenous people who abstain from alcohol compared to non-Indigenous people, the Australian Institute of Health and Welfare reports that a significantly higher proportion of Indigenous people aged between 25 and 44 years drink at high risk, long-term levels compared to non-Indigenous people. Alcohol management plans are a relatively recent policy approach, first introduced in Northern Queensland in 2002 and subsequently in the Northern Territory in 2005. In broad terms, an AMP involves strategies designed to empower communities in reducing alcohol-related harms, using measures that are appropriate for specific communities. The types of communities (remote versus regional town, for example) and social, political, resourcing and practical factors all influence the development, implementation and effectiveness of AMPs.AMPs in various forms are spreading to urban centres like the City of Yarra and Darebin Council, in Melbourne, as recognition grows of the damaging impacts of alcohol, including violence, chronic health problems and reduced workplace productivity. The Centre for Health and Society’s Professor Robin Room and colleagues at Turning Point alcohol and drug centre have estimated the annual, national costs of harm to others from drinking to be $20.6 billion.
The IJC's paper, Alcohol Management Plans and Related Alcohol Reforms, (due to be published in early 2013) was drafted in 2012 amid concerns that the newly elected governments of Queensland and the Northern Territory might ease restrictions on access to alcohol in Aboriginal communities.
Dr Chenhall says having State and Territory governments reviewing AMPs would be "a good thing" for a host of reasons that the IJC's literature review highlights. "Often AMPs start off with a very broad strategy, including looking at supply issues, such as where and when and how you can buy alcohol, through to looking at demand reduction and harm minimisation.
"But when it comes to implementation, often the cheapest thing is to look at just restrictions. And while there is a very good body of evidence to demonstrate that restrictions can reduce alcohol sales and alcohol-related harms, often they can be very contentious within the community itself because people who want to sell or drink alcohol may see it as curbing their freedom and their economic interests."
Community support and engagement in developing, implementing and maintaining AMPs are essential to their success, the IJC paper concludes."The paper found that more work needs to be done on defining what AMPs are and how an effective AMP could and should work in a community," he says. Vested interests – including consumers, the alcohol industry and the governments that collect taxes from alcohol sales – are powerful voices in these debates. But independent researchers also need to need to be heard. "We have to return to the fact that alcohol is a drug – just as tobacco is a drug," Dr Chenhall says. "And it took a long time for people to see that tobacco is dangerous for health."
Caption: Dr Richard Chenhall