Collateral damage from alcohol abuse: the enormous costs to Australia: Curtailing the rippling effect of irresponsible drinking

Alcohol abuse is a problem that could affect any member of society, including the majority who are abstinent or use alcohol in moderation. Although much has been written about alcohol abuse and its effects on the drinker, there has been less emphasis on the deleterious effects on innocent bystanders, such as the physical, emotional and/or financial loss or damage. The spectrum of this "collateral damage" includes alcohol-related violence, road accidents, family problems, adverse pregnancy outcomes, consequences of alcohol abuse by doctors, and the resultant financial burdens incurred by society. Past studies have found that alcohol abuse plays a significant role in violent crime.' It is estimated that about 13% of Australians aged 14 years and over (well over one million people) have been physically abused at least once by someone affected by alcohol, while 16% have had their property damaged at least once.> Alcohol has also been implicated in about one-third of sexual assault cases.' In 1992, 294 people died from alcohol-related assaults in Australia.' Drunk drivers put not only their own lives in peril, but also pose a significant risk to other road users. In NSW in 1995, of the 620 people killed in road accidents, 141 (including 37 passengers and pedestrians) died in alcohol-related accidents. In addition, 298 non-drivers were seriously injured." Even more dramatic examples of alcohol-related transport accidents have been recorded internationally, such as the tragic Exxon Valdez oil spill in Alaska in 1989. At least 1% of the population (about 180000 people) have a close family member with a serious alcohol problem. Isolation, neglect, aggression and disruption within the family, particularly spouse abuse, are frequent. S Sexual and financial problems, stress, verbal and physical abuse, separations and divorce are also common between couples where at least one partner abuses alcohol. 6 A Victorian report in 1988 found that alcohol was definitely or possibly involved in 53% of several thousand reported incidents of family violence." Children are particularly affected by having an alcoholic parent and they are more likely to become depressed," have lower IQ,8 and be alcohol dependent themselves in the future." In 1992, there were 226 hospital episodes resulting from alcohol-related child abuse in Australia.' However, the extent of family problems is probably underestimated because there is underreporting of alcohol-related domestic violence. Maternal alcohol abuse is associated with adverse perinatal outcomes. These include the fetal alcohol syndrome, pseudo-Cushing's syndrome, alcohol withdrawal in the newborn, and increased risk of perinatal mortality.!? The incidence of fetal alcohol syndrome has been estimated to be