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First published: 27 February 2020
Background and aims: In February 2014, pubs and bars in Kings Cross (KX) and the central business district (CBD) of Sydney, Australia were required to stop serving alcohol by 3 a.m. and operate a ‘lockout’ from 1.30 a.m. We studied changes in the incidence of assault during the following 5 years, including possible displacement.
Measurements: We compared change in non‐domestic assault in KX and the CBD with adjacent areas, other city areas, and outer suburbs, adjusting for the trend in the rest of the state during three periods: 6 p.m.–1.29 a.m. (‘pre‐lockout’), 1.30 a.m.–2.59 a.m. (‘lockout’) and 3 a.m.–6 a.m. (‘after last‐drinks’). We constructed interrupted time‐series models with terms for secular trend and season, producing incidence rate ratios (IRR) for step and slope parameters. We performed sensitivity analyses on impacts of missing location data.
Findings: After the intervention, assaults fell 38% in KX (IRR for step change = 0.62, 95% CI = 0.49, 0.79) and 10% in the CBD (IRR = 0.90, 95% CI = 0.80, 0.99). Assaults continued declining in KX (IRR for slope = 0.990, 95% CI = 0.982, 0.998) and later increased in adjacent areas (IRR for slope = 1.006, 95% CI = 1.001, 1.011) and earlier in the evenings in both KX and the adjacent areas. The net reduction was 627 assaults over 60 months post‐intervention, i.e. 10 fewer per month. Estimates were robust to extreme assumptions about missing data.
Conclusions: The 2014 alcohol supply restrictions for pubs and bars in Kings Cross (KX) and the central business district (CBD) of Sydney, Australia were followed by a substantial reduction in the incidence of assault in KX and to a lesser extent in the CBD, possibly displacing some cases to adjacent areas and earlier in the evening
Alcohol sales have spiked during the past month. It has long been acknowledged that Scotland has an ‘unhealthy relationship with alcohol’. Too much drinking carries with it heavy personal, economic, health and societal costs. The combination of being home-bound, feeling extraordinary stress or fear, as well as the cultural tendency to turn to both sex and alcohol for comfort and relief makes increasingly risky behaviour a near certainty.
One example of predictable ‘collateral damage’ from the current pandemic will be a significant rise in the cases of Fetal Alcohol Spectrum Disorders (FASD) across Scotland.
Alcohol exposure in utero is the world’s leading cause of neurodevelopmental (brain and nervous system) damage, learning disabilities and behavioural problems. FASD cannot be cured, reversed or outgrown, as it permanently compromises lives and life chances, e.g. by school failure, substance abuse, as well as being troubled and in trouble.
In fact, FASD is invisible in 90 per cent of the people affected and can be difficult to confirm, which means it is often misdiagnosed or simply overlooked – for instance, while the Scottish Government estimates that approximately 172,000 children, young and adults across Scotland are currently affected, there are between 500 and 1,000 undiagnosed FASD cases for every one officially confirmed.
There is no risk-free time during pregnancy, no safe type of alcohol or risk-free amount - which is why all four UK Chief Medical Officers advise that no alcohol should be consumed during pregnancy or if likely to conceive (including in the weeks/months before pregnancy is confirmed). Yet FASD is preventable in either of two ways: by not drinking during pregnancy - or by not getting pregnant while continuing to drink.
Is anything being said - or, better still, being done - to help prevent this specific ‘collateral damage’? Since most people are riveted on new information about what can be done to avoid harm during this pandemic, there is a great opportunity in this moment to prevent FASD.
Alcohol is known to be harmful to health in general, and is well understood to increase the risk of injury and violence, including intimate partner violence, and can cause alcohol poisoning. At times of lockdown during the COVID-19 pandemic, alcohol consumption can exacerbate health vulnerability, risk-taking behaviours, mental health issues and violence. WHO/Europe reminds people that drinking alcohol does not protect them from COVID-19, and encourages governments to enforce measures which limit alcohol consumption.
Busting myths on alcohol and COVID-19 As part of its public health response to COVID-19, WHO has worked with partners to develop a factsheet which addresses myths and provides guidance during the pandemic: “Alcohol and COVID-19: what you need to know”. Fear and misinformation have generated a dangerous myth that consuming high-strength alcohol can kill the COVID-19 virus. It does not. Consuming any alcohol poses health risks, but consuming high-strength ethyl alcohol (ethanol), particularly if it has been adulterated with methanol, can result in severe health consequences, including death.
Expert fears shift to home drinking may fuel increases in violence, fires and dependence
The UN agency acknowledged that many turn to drugs and alcohol in times of crisis, as a new survey suggested the pandemic has caused nearly two thirds of adults in the UK to feel anxious or worried.
But using substances to cope “can make things worse”, cautioned Dr Aiysha Malik, a technical officer at WHO Europe’s mental health and substance abuse department.
Dr Piper warned that “with routines out of the window we might well find ourselves reaching for a drink more often”.
Initial reports of supermarkets running out of alcohol and online retailers being overwhelmed with orders may point to a possible increase in consumption, but experts say it is too early to tell the overall impact that coronavirus will have on the nation’s drinking habits.
But it is logical to predict that alcohol only being available for home consumption may lead to rises in domestic violence, fires and potential increases dependence, according to James Morris of South Bank London University’s centre for addictive behaviours research.