Restrict alcohol to help our hospitals

To prevent hospital overload from the Covid-19 crisis and beyond, alcohol sales hours should be cut and prices raised, argue Louise Delany and George Thomson of the University of Otago.

This is a time to immediately reduce the stresses for the health system. We must plan for scenarios where thousands of New Zealanders are sick – including many urgently hospitalised.

One way to reduce the stresses is to reduce injuries. A common thread for injuries is alcohol use, another is avoidable home accidents. In New Zealand more injuries happen at home than at work, on the roads or playing sport.

Increased alcohol prices, reduced sales hours or availability, and reduced or banned advertising of alcohol would make significant and valuable differences for hospital staff, medical centres and patients. Mass media campaigns by ACC to reduce preventable home accidents would also help.

While life is changing rapidly, one constant for an already overloaded health system is that alcohol-driven violence and injury creates an avoidable extra burden. This will continue, even with greatly reduced road traffic and even with bars closed.

Much of the crowding and stress at Emergency Departments (EDs) and other areas of the health system is directly related to injuries (often to non-drinkers) from alcohol use. Government policy needs to quickly reduce this type of health system stress. Reducing the volume of ED patients, particularly at high stress times, has beneficial flow-on effects through the health system – less urgent need for immediate beds in intensive care, and greater resilience of staff over longer periods.

As emergency doctors in Alberta, Canada have written recently, ‘system overload is not just about Covid-19. An overwhelmed system fails everyone: the trauma patients, the heart attacks, the cancer patients, the kids, all of us.’ 

What works best to prevent alcohol-related injuries? Research has found that ‘restricting trading hours at on- and off-licence premises was typically followed by decreases in the incidence of assault and hospitalisation’ and ‘making alcohol more expensive and less available, and banning alcohol advertising, are highly cost-effective strategies to reduce harm’. 

These alcohol policies will have net benefits for society, including reduced police work at disputes and fights, reduced violence to women and children, reduced alcohol-related offending (with effects for whanau, court time, prison space), reduced health inequalities, reduced time off work, improved productivity, improved mental health, reduced gambling, and more successful quitting from smoking. But most of all, we need to consider the policies in the context of inevitable major health system overload.

Further detail and research is given in our Public Health Expert blog ‘Avoidable hospitalisations: Helping our health system get through COVID-19’.

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