A global review of the impact on women from men's alcohol drinking: the need for responding with a gendered lens

BACKGROUND

Global evidence shows that men's harmful alcohol use contributes to intimate partner violence (IPV) and other harms. Yet, interventions that target alcohol-related harms to women are scarce. Quantitative analyses demonstrate links with physical and verbal aggression; however, the specific harms to women from men's drinking have not been well articulated, particularly from an international perspective.

AIM

To document the breadth and nature of harms and impact of men's drinking on women.

METHODS

A narrative review, using inductive analysis, was conducted of peer-reviewed qualitative studies that: (a) focused on alcohol (men's drinking), (b) featured women as primary victims, (c) encompassed direct/indirect harms, and (d) explicitly featured alcohol in the qualitative results. Papers were selected following a non-time-limited systematic search of key scholarly databases.

RESULTS

Thirty papers were included in this review. The majority of studies were conducted in low- to middle-income countries. The harms in the studies were collated and organised under three main themes: (i) harmful alcohol-related actions by men (e.g. violence, sexual coercion, economic abuse), (ii) impact on women (e.g. physical and mental health harm, relationship functioning, social harm), and (iii) how partner alcohol use was framed by women in the studies.

CONCLUSION

Men's drinking results in a multitude of direct, indirect and hidden harms to women that are cumulative, intersecting and entrench women's disempowerment. An explicit gendered lens is needed in prevention efforts to target men's drinking and the impact on women, to improve health and social outcomes for women worldwide.

Harm from the drinking of people you know: A range of effects from different relationships

AIMS

To describe the range of effects experienced due to the drinking of people respondents know and analyze risk and protective factors for harm from the drinking of partners and household members, other relatives and friends and co-workers.

DESIGN, SETTING AND PARTICIPANTS

Surveys of 2574 participants' experiences were obtained from two samples: 1000 people responded to random digitally dialled Australian mobile calls and 1574 participants responded from the Life in AustraliaTM panel survey.

MEASUREMENTS

Respondents were asked whether they had been negatively affected in the previous 12 months by the drinking of persons they knew who were 'a heavy drinker or drank a lot sometimes' and the nature of these harms. Weighted logistic regressions were used to analyze differences in rates of key negative outcomes from known others' drinking by gender, age and socio-economic status.

FINDINGS

Almost two thirds [60.2%; 95% confidence interval (CI) = 57.7%-62.7%] of participants reported having heavy drinkers in their lives and 21.8% (95% CI = 19.8%-23.9%) reported being negatively affected by the drinking of people they knew well in some way. Participants reported a gamut of effects, including, most commonly, adverse social effects: having to transport relatives and friends who had been drinking, role failure and faults, being emotionally hurt or neglected, serious arguments, family problems, having to care for drinkers and verbal abuse. Less commonly, respondents reported physical or sexual harm, property damage, financial stress and threats from others' drinking. Women (odds ratio = 1.49; 95% CI = 1.13-1.95), younger people, rural, Australian-born (vs. respondents born overseas in non-English speaking countries) and more frequent drinkers were more likely to report harm from a drinker they knew than their counterparts after adjusting for other variables in the model.

CONCLUSIONS

Australians appear to be commonly adversely affected by the drinking of people they know. Harms from known drinkers are more likely to be experienced by women than men, particularly from the people they live with and other relatives.

The burden of alcohol-related caring for others in Australia in the 2021 pandemic period

OBJECTIVE

The magnitude of caring for others due to excessive alcohol use is unclear in Australia and internationally. This study explores the prevalence, sociodemographic predictors, and consequences of informal care for others due to alcohol use.

METHOD

A survey on harm from others' drinking was conducted among 2,574 Australian adults in November 2021 from national random digit dial and "Life in Australia" panel samples to elicit representative data. Respondents who indicated they had "heavy drinker/s" in their lives (n= 1,585), were asked about their experience of caring for these drinkers and their dependents in the last 12 months. Weighted logistic and linear regressions examined a) sociodemographic factors associated with informal care due to others' drinking, and b) the impact of the caregiving burden on caregiver's financial status, overall health, and quality of life.

RESULTS

Overall, 20% of participants reported caregiving responsibilities arising from others' drinking. Older age, unemployment, residing in capital cities and reporting birth in a non-English speaking background country were associated with a reduced likelihood of caregiving, whereas higher education and more frequent risky drinking were associated with an increased likelihood. Caregivers reported significantly higher financial disadvantage, a lower quality of life and poorer overall health.

CONCLUSIONS

One in five adults reported caring for drinkers in the previous 12 months, with this associated with negative consequences for those providing care. Service providers, health promotion practitioners and policy makers should focus upon younger age groups, those who live in regional areas, and those born in Australia who are at greater risk of being burdened by caregiving due to others' alcohol use.

Associations Between Heavy Episodic Drinking, Drinking While Gambling, and Risky Gambling

INTRODUCTION

Understanding how patterns of drinking are associated with risky gambling in Australia is needed to inform an effective approach to minimise harm.

METHODS

This cross-sectional questionnaire study reports on 2,704 subsampled participants who completed survey questions about their patterns of drinking. With logistic regressions, we examined whether frequency of heavy episodic drinking (HED) and alcohol use while gambling were associated with risky gambling while controlling for sociodemographic variables.

RESULTS

Occasional HED and monthly HED were associated with any gambling (versus no gambling), but frequent HED was not significantly associated with gambling. The opposite pattern was found when predicting risky gambling. Occasional HED (i.e. less than monthly) was not significantly associated, but a higher frequency of HED (at least weekly) was associated with a higher likelihood of risky gambling. Drinking alcohol while gambling was associated with risky gambling, over and above HED. The combination of HED and use of alcohol while gambling appeared to significantly increase the likelihood of risky gambling.

CONCLUSIONS

The association of HED and alcohol use while gambling with risky gambling highlights the importance of preventing heavy alcohol use among gamblers. The links between these forms of drinking and risky gambling further suggests that individuals who engage in both activities are specifically prone to gambling harm. Policies should therefore discourage alcohol use while gambling for example by prohibiting serving alcohol at reduced prices or to gamblers who show signs of being affected by alcohol and informing individuals of the risks associated with alcohol use while gambling.

Can alcohol policy prevent harms to women and children from men's alcohol consumption? An overview of existing literature and suggested ways forward

The World Health Organization's list of cost-effective alcohol control policies is a widely-used resource that highlights strategies to address alcohol-related harms. However, there is more evidence on how recommended policies impact harms to people who drink alcohol-such as physical health problems caused by heavy alcohol use-than on secondhand harms inflicted on someone other than the person drinking alcohol, i.e., alcohol's harms to others. In this essay, we describe evidence of impacts of alcohol policy on harms to women and children resulting from men's alcohol consumption, as well as options for making policies more relevant for reducing intimate partner violence and child abuse. We begin with an overview of harms to women and children resulting from men's alcohol consumption and review cost-effective alcohol policies with potential to reduce these harms based on likely mechanisms of action. Next, we present a rapid review of reviews to describe existing evidence of impacts of these policies on the outcomes of physical violence, sexual violence, and child abuse and neglect. We found little evidence of systematic evaluation of impacts of these important alcohol policies on harms to women and children. Thus, we advocate for increased attention in evaluation research to the impacts of alcohol policies on harms experienced by women and children who are exposed to men who drink alcohol. We also argue for more consideration of a broader range of policies and interventions to reduce these specific types of harm. Finally, we present a conceptual model illustrating how alcohol policies may be supplemented with other interventions specifically tailored to reduce alcohol-related harms commonly experienced by women and children as a result of men's alcohol use.

Trends in alcohol expenditure in Australia from 1984 to 2015-2016: An exploratory study

INTRODUCTION

Excessive alcohol use is associated with non-communicable diseases and social problems, such as work absence, financial problems and family violence. Expenditure and expenditure shares on alcohol are valuable measures to monitor financial activities on this risk behaviour. The aim of this paper is to report trends in alcohol expenditure in Australia over the last two decades.

METHODS

Data are from six waves of Australian Household Expenditure Surveys from 1984 to 2015-2016. We explored trends of alcohol expenditure among Australians and in different socio-demographic groups in the last 30 years. We further examined changes of expenditure on different on- and off-premises beverages over time.

RESULTS

Absolute alcohol expenditure has remained the same between the 1980s and 2016, after accounting for inflation. However, a declining trend in relative alcohol expenditure as a proportion of total household expenditure was found across nearly all demographic groups (e.g., sex, age, employment, household income), except for women aged 45-54, who showed an increasing trend of alcohol expenditure after 1998-1999.

DISCUSSION AND CONCLUSIONS

The current study shows declines in relative alcohol expenditure, which may reflect declines in alcohol's relative importance within the elements of the person's lifestyle they need to pay for and/or increased awareness of alcohol's health and social harms. Further longitudinal analysis should explore additional predictors of household expenditure on alcohol. Results suggest that current bi-annual indexation increases in alcohol tax should account for increases in income to ensure the effectiveness of pricing. Moreover, attention is needed to address drinking among middle-aged females.

High Intensity Drinking (HID) Assessed by Maximum Quantity Consumed Is an Important Pattern Measure Adding Predictive Value in Higher and Lower Income Societies for Modeling Alcohol-Related Problems

Adjusting for demographics and standard drinking measures, High Intensity Drinking (HID), indexed by the maximum quantity consumed in a single day in the past 12 months, may be valuable in predicting alcohol dependence other harms across high and low income societies. The data consisted of 17 surveys of adult (15,460 current drinkers; 71% of total surveyed) in Europe (3), the Americas (8), Africa (2), and Asia/Australia (4). Gender-disaggregated country analyses used Poison regression to investigate whether HID (8-11, 12-23, 24+ drinks) was incrementally influential, beyond log drinking volume and HED (Heavy Episodic Drinking, or 5+ days), in predicting drinking problems, adjusting for age and marital status. In adjusted models predicting AUDIT-5 for men, adding HID improved the overall model fit for 11 of 15 countries. For women, 12 of 14 countries with available data showed an improved fit with HID included. The results for the five Life-Area Harms were similar for men. Considering the results by gender, each country showing improvements in model fit by adding HID had larger values of the average difference between high intensity and usual consumption, implying variations in amounts consumed on any given day. The amount consumed/day often greatly exceeded HED levels. In many societies of varying income levels, as hypothesized, HID provided important added information on drinking patterns for predicting harms, beyond the standard volume and binging indicators.

Exclusion of the non-English-speaking world from the scientific literature: Recommendations for change for addiction journals and publishers

Background: While English is only the native language of 7.3% of the world's population and less than 20% can speak the language, nearly 75% of all scientific publications are English. Aim: To describe how and why scientific contributions from the non-English-speaking world have been excluded from addiction literature, and put forward suggestions for making this literature more accessible to the non-English-speaking population. Methods: A working group of the International Society of Addiction Journal Editors (ISAJE) conducted an iterative review of issues related to scientific publishing from the non-English-speaking world. Findings: We discuss several issues stemming from the predominance of English in the scientific addiction literature, including historical drivers, why this matters, and proposed solutions, focusing on the increased availability of translation services. Conclusion: The addition of non-English-speaking authors, editorial team members, and journals will increase the value, impact, and transparency of research findings and increase the accountability and inclusivity of scientific publications.

Programme responses for men who perpetrate intimate partner violence in the context of alcohol or other drugs: a scoping review

Purpose

Substance use plays a significant role in the perpetration of much intimate partner violence (IPV). However, responses to these two issues are rarely integrated. Single focus programme responses can lead to poor outcomes for men as well as their families experiencing these intersecting issues. This scoping paper aims to establish the current state of knowledge on contextual factors influencing the development and implementation of combined programmes.

Design/methodology/approach

Four electronic databases were systematically searched in May 2021 and December 2021. Twenty-one peer-reviewed studies reporting on ten programmes were included.

Findings

This scoping review revealed that combined programme responses are an underdeveloped area of research and evaluation. The limited evidence base indicated systemic barriers hindering services’ capacity to expand this field of work, affecting implementation and outcomes. Support is required from the wider service systems to intervene in men’s perpetration of IPV in the context of substance use.

Practical implications

Findings in this scoping review demonstrate the importance of fostering a coordinated and collective response to IPV in the context of substance use. Combined programmes have the potential to reduce siloed practices, enabling more holistic responses for men with intersecting issues. However, researchers and policymakers must also address contextual issues hindering or enabling combined programmes’ implementation and development.

Originality/value

Mapping the evidence based on combined programmes provides direction for further development and research to expand this field of inquiry.

The relationship between fathers' heavy episodic drinking and fathering involvement in five Asia-Pacific countries: An individual participant data meta-analysis

BACKGROUND

This study aims to increase understanding of the relationship between heavy episodic drinking (HED) and fathers' involvement in parenting in five countries. The potential moderating effect of fathers' experiences of childhood trauma is also studied, controlling for the possible confounding of the effect of HED by father's attitudes toward gender equality, father's age and father's education.

METHOD

United Nations Multi-Country Study on Men and Violence (UNMCS) survey data from 4562 fathers aged 18-49 years from Cambodia, China, Indonesia and Papua New Guinea (PNG) and Sri Lanka were used to assess the relationship between fathering involvement (e.g., helping children with their homework) and self-reported HED of 6+ drinks in one occasion vs. non-HED and abstaining. Moderating effects of a 13-item fathers' childhood trauma (FCT) scale were tested and analyses were adjusted for gender-inequitable attitudes using the Gender-Equitable Men scale score. Bivariate and adjusted individual participant meta-analyses were used to determine effect estimates for each site and across all sites.

RESULTS

Fathers' HED was associated with less positive parental involvement after adjusting for gender-equitable attitudes, FCT, age and education. No overall interaction between HED and FCT was identified. Gender equitable attitudes were associated with fathering involvement in some countries but not overall (p = 0.07).

CONCLUSIONS

Heavy episodic drinking was associated with reduced positive fathering involvement. These findings suggest that interventions to increase fathers' involvement in parenting should include targeting reductions in fathers' HED. Structural barriers to fathers' involvement should be considered alongside HED in future studies of fathers' engagement with their children.

Community-Level Alcohol Availability and Child Maltreatment: A Statewide Panel Analysis Over 13 Years

OBJECTIVE

Parental or caregiver alcohol use, particularly heavy regular or episodic use, can increase the risk of child maltreatment within individual families. At the national level, higher per capita alcohol consumption has been associated with increased child injury mortality in Australia. This study aimed to investigate whether an association exists between substantiated child maltreatment cases, numbers of licensed outlets, and average alcohol sales volumes at the community level (local government area [LGA]) over a 13-year period across Western Australia (WA).

METHOD

Annual panel data were obtained for 132 WA LGAs over the period 2001-2013. Bayesian conditional autoregressive Poisson regression was applied to test associations between numbers of substantiated child maltreatment cases and per-population densities and mean sales volumes of off-trade and on-trade alcohol outlets. Associations were adjusted for the presence of local alcohol restrictions and mandatory reporting; density of on-trade outlets; and their sales, demographic, and socioeconomic variables.

RESULTS

Comprehensive area-level alcohol bans and policies restricting alcohol sales reduced child maltreatment by 9.6% and 38.5%, whereas mandatory reporting of child maltreatment increased substantiations by 15.3%. Counterintuitively, for each additional 1,000 L of ethanol sold per off-premise outlet, there was a 3.7% decline in child maltreatment.

CONCLUSIONS

Local government alcohol restrictions predicted reduced child abuse and neglect. Findings that increases in off-trade outlets predicted a decreased risk of child maltreatment at a local level are seemingly at odds with these findings, but outlet density may be acting as a measure of less disorganization. Alcohol policy that affects alcohol availability can reduce child maltreatment in at-risk areas. Local area alcohol bans and interventions reducing hours of sale should be further evaluated to confirm these findings.

Beyond the Drinker: Alcohol's Hidden Costs in 2016 in Australia

OBJECTIVE

Drawing on a study of the range and magnitude of harms that alcohol caused to specific others in Australia, and on social and health agency statistics for collective costs, this article produces an analysis of the economic cost of alcohol's harm to others (AHTO) in Australia.

METHOD

This study used a general population survey and routinely collected social response agencies' data to quantify different costs of AHTO, using methods consistent with International Guidelines for Estimating the Costs of Substance Abuse. This approach estimates costs for health care and social services, crime costs, costs of productivity loss, quality of life-year loss and other expenses, including both tangible costs (direct and indirect) and intangible costs of loss of quality of life (respondents' self-reported loss of health-related quality of life).

RESULTS

The cost of AHTO in Australia was AUD$19.81 billion (95% CI [11.99, 28.34]), with tangible costs accounting for 58% of total costs ($11.45 billion, which is 0.68% of gross domestic product in 2016) and intangible costs of $8.36 billion. The costs to private individuals or households ($18.1 billion and 89% of total costs of AHTO) are greater than the costs to the government or society because of others' drinking in Australia.

CONCLUSIONS

This study presents an estimation of the economic cost of harm from others' drinking. The economic costs from others' drinking are large and of much the same magnitude as the costs that drinkers impose on themselves, as found in previous studies. Preventing harm to others from drinking is important as a public health goal for both economic and humane reasons.

Beyond the Drinker: Alcohol's Hidden Costs in 2016 in Australia

OBJECTIVE

Drawing on a study of the range and magnitude of harms that alcohol caused to specific others in Australia, and on social and health agency statistics for collective costs, this article produces an analysis of the economic cost of alcohol's harm to others (AHTO) in Australia.

METHOD

This study used a general population survey and routinely collected social response agencies' data to quantify different costs of AHTO, using methods consistent with International Guidelines for Estimating the Costs of Substance Abuse. This approach estimates costs for health care and social services, crime costs, costs of productivity loss, quality of life-year loss and other expenses, including both tangible costs (direct and indirect) and intangible costs of loss of quality of life (respondents' self-reported loss of health-related quality of life).

RESULTS

The cost of AHTO in Australia was AUD$19.81 billion (95% CI [11.99, 28.34]), with tangible costs accounting for 58% of total costs ($11.45 billion, which is 0.68% of gross domestic product in 2016) and intangible costs of $8.36 billion. The costs to private individuals or households ($18.1 billion and 89% of total costs of AHTO) are greater than the costs to the government or society because of others' drinking in Australia.

CONCLUSIONS

This study presents an estimation of the economic cost of harm from others' drinking. The economic costs from others' drinking are large and of much the same magnitude as the costs that drinkers impose on themselves, as found in previous studies. Preventing harm to others from drinking is important as a public health goal for both economic and humane reasons.

KODY, an all-of-family response to co-occurring substance use and domestic violence: protocol for a quasi-experimental intervention trial

Background

The co-occurrence of domestic violence with alcohol and other drugs significantly increases the severity of abuse and violence experienced by family members. Longitudinal studies indicate that substance use is one of few predictors of men’s continued use of, or desistance from, violence. Recent developments in men’s behaviour change programs have focused on men’s attitudes and behaviour towards their children, and the exploration of interventions that address the needs of all family members. However, the research evidence is limited on the most effective elements of men’s behaviour change programs in promoting the safety and wellbeing of child and women victim survivors.

This study aims to build on the existing evidence by trialling the KODY program which addresses harmful substance use by men who also perpetrate domestic violence; the safety and wellbeing of women and children; the needs of children in their own right, as well as in relationship with their mothers; and the development of an ‘all-of-family’ service response. The evaluation of these innovations, and the ramifications for policy development to support less fragmented service system responses, provide the rationale for the study.

Methods/Design

A quasi-experimental design will be used to assess the primary outcomes of improving the safety and wellbeing of mothers and children whose (ex)partners and fathers respectively participate in KODY (the trial program), when compared with ‘Caring Dads standard’ (the comparison group). Psychometric tests will be administered to fathers and mothers at baseline, post-program and at 3-month follow up. Data collection will occur over three years.

Discussion

By building the evidence base about responses to co-occurring domestic violence and substance use, this study aims to develop knowledge about improving safety outcomes for women and children, and to better understand appropriate support for children in families living at the intersection of domestic violence and substance use. It is anticipated that study findings will point to the ramifications for policy development to support less fragmented service system responses.

Trial registration

An application for registration with the Australian and New Zealand Clinical Trials Registry (https://www.anzctr.org.au/) was lodged on 20 December 2021 (Request number: 383206)—prospectively registered.

A multi-country analysis of informal caregiving due to others' drinking

The burden of caring for drinkers is seldom articulated as a social concern, or integrated in service planning or alcohol policy. This study aims to examine prevalence and predictors of informal caregiving due to others' drinking cross-nationally by surveying 20,728 respondents (18-64 years) in 11 countries. The outcome variable was respondent-reported informal caregiving due to others' drinking, analysed by socio-demographic factors and drinking pattern using logistic regression and meta-analysis. Estimated overall prevalence of informal caregiving due to others' drinking ranged from 9% in Nigeria to 47% in Thailand. In most countries, females reported a higher rate than males of caring for children and other dependents, but males reported a higher rate of driving family or friends somewhere or picking them up. Logistic regression analysis found differences between high-income countries and low- and middle-income countries in the relationship of caregiving with employment and household composition. Respondent's own drinking was positively correlated with the prevalence of caregiving in 10 out of 11 countries. In general, younger adults and those who are themselves risky drinkers are more likely to have had caring responsibilities. Although problematic drinking is concentrated in specific subpopulations, the burden of care for others' drinking extends widely across the population.

Does drinking modify the relationship between men's gender-inequitable attitudes and their perpetration of intimate partner violence? A meta-analysis of surveys of men from seven countries in the Asia Pacific region

BACKGROUND AND AIMS

Although men's alcohol misuse and less gender-equitable attitudes have been identified as risks for perpetration of intimate partner violence (IPV), less is known about how men's gender-equitable attitudes and drinking act together to increase risk of IPV. This study aimed to assess the independent relationships of lower gender-equitable attitudes and drinking to perpetration of IPV and their interaction among men in seven countries.

DESIGN

Secondary analysis of the United Nations Multi-Country Study on Men and Violence (UNMCS) and Nabilan Study databases consisting of (1) unadjusted and adjusted logistic regression to measure the association of perpetration of IPV with gender-equitable men (GEM) scale score and regular heavy episodic drinking (RHED) and (2) meta-analyses of prevalence and effect estimates adjusted for country-level sites and countries.

SETTING AND PARTICIPANTS

A total of 9148 ever-partnered 18-49-year-old men surveyed in 2011-15 from 18 sites in Bangladesh, Cambodia, China, Indonesia, Papua New Guinea, Sri Lanka and Timor Leste.

MEASUREMENTS

The outcome variable is reported perpetration of physical or sexual IPV in the previous year.

INDEPENDENT VARIABLES

GEM scale scores; RHED, defined as six or more drinks in one session at least monthly (compared with other drinkers and abstainers).

FINDINGS

Pooled past-year prevalence of perpetration of IPV was 13% [95% confidence interval (CI) = 9-16%]. GEM scores and RHED were independently associated with perpetration of IPV overall and in most sites. Pooled odds ratios (ORs) for perpetration of IPV with less equitable GEM scores were 1.07 (95% CI = 1.04, 1.09) and with RHED were 3.42 (95% CI = 2.43, 4.81). A significant interaction between GEM score and RHED (P = 0.001) indicated that RHED increased the relationship of less gender-equitable attitudes and perpetration of IPV.

CONCLUSION

Both gender-inequitable attitudes and drinking appear to be associated with perpetration of intimate partner violence by men, with regular heavy episodic drinking increasing the likelihood of intimate partner violence among men with less equitable gender attitudes.

Beyond 'drinking occasions': Examining complex changes in drinking practices during COVID-19

Introduction

‘Drinking occasions’ are commonly used to capture quantities of alcohol consumed. Yet this standardised terminology brings with it numerous assumptions and epistemological limitations. We suggest that social changes brought on by COVID‐19 restrictions have influenced routines, patterns of time use and drinking practices, highlighting the need to re‐examine how we conceptualise drinking and ‘drinking occasions’ in alcohol research.

Methods

This analysis draws on data gathered from 59 qualitative interviews conducted during the second half of 2020 with Australian drinkers aged 18 and over. The interviews explored how COVID‐19 restrictions impacted daily practices and alcohol consumption patterns.

Findings

Participants spoke about their work, study and social routines changing, which influenced the times, timing and contexts of their drinking practices. We separated these shifts into four overarching themes: shifting of structures shaping drinking; the permeability of drinking boundaries; the extension of drinking occasions; and new contexts for drinking.

Discussion and Conclusion

COVID‐19 restrictions have led to shifts in the temporal boundaries and contexts that would otherwise shape people's drinking, meaning drinking practices may be less bound by structures, norms, settings and rituals. The drinking occasions concept, although a simple tool for measuring how much people drink, has not been able to capture these complex developments. This is a timely consideration given that COVID‐19 may have enduring effects on people's lifestyles, work and drinking practices. It may be useful to examine drinking as practice, rather than just an occasion, in order to better contextualise epidemiological studies going forward.

Disclosures of harming others during their most recent drinking session: Findings from a large national study of heavy-drinking adolescents

INTRODUCTION

The extant Alcohol's Harms to Others (AHTO) literature is largely comprised of reports from victims. We investigated AHTO from perpetrators' perspectives, including how harms were associated with individual characteristics, and alcohol quantities consumed during the perpetration incident.

METHODS

Participants (N = 2932) were 14-19 years old, recruited primarily through social media and screened as risky drinkers. They completed face-to-face (n = 594) or self-administered (n = 2338) surveys. They self-reported whether during their last risky drinking session (LRDS) they had perpetrated any verbal abuse, physical abuse or property damage. A multinomial logistic regression examined whether nine factors were associated with perpetrating zero, one or 2+ categories of AHTO.

RESULTS

Eleven percent (n = 323) reported perpetrating at least one form of AHTO (7.5% verbal, 1.9% physical and 4.6% property). Perpetration of AHTO at LRDS was uniquely associated with: younger age, male gender, experiences of childhood physical punishment, greater perpetration incident-specific drinking, concurrent illicit drug use, and less frequent use of safety strategies while drinking in the past 12 months. Controlling for the other variables, an increase of six Australian standard drinks (60 g of alcohol) increased the odds of perpetration by 15% [95% confidence interval (CI) adjusted odds ratio (AOR) 1.08, 1.23], and an increase of 15 Australian standard drinks increased the odds by 42% (95% CI AOR 1.20, 1.69).

DISCUSSION AND CONCLUSIONS

Individual characteristics, larger quantities of alcohol consumed, and a disinclination to practice harm reduction amplified risk of AHTO perpetration. This has implications for health promotion and risk prevention/reduction strategies.

Children, Parental Alcohol Consumption, and Intimate Partner Violence: A Multicountry Analysis by Perpetration Versus Victimization and Sex

Both living with children and alcohol consumption are positively associated with intimate partner violence (IPV). We assessed their combined relationship with physical IPV (P-IPV) victimization and perpetration, and explored possible moderating roles of sex and culture. Data included 15 surveys of 13,716 men and 17,832 women in 14 countries from the GENACIS (Gender, Alcohol, and Culture: An International Study) collaboration. P-IPV was measured as victim of physical aggression by an intimate partner (Vic-Only), perpetrator of physical aggression toward a partner (Perp-Only), or both victim and perpetrator (i.e., bidirectional) (Bi-Dir). Participants reported whether they lived with children below 18 years of age, whether the participant was a drinker/abstainer, and, among drinkers, usual frequency and quantity of alcohol consumed. Multilevel multinomial logistic regression, controlling for age and nesting of data within countries, indicated that Vic-Only, Perp-Only, and Bi-Dir (compared with no P-IPV) were positively associated with living with children, being a drinker, and quantity/frequency of drinking among drinkers (especially higher quantity). The positive association of P-IPV with living with children and being a drinker was evident within most countries. Significant interactions with sex were found, with (a) living with children more strongly associated with Perp-Only for men and Vic-Only for women, and (b) Perp-Only and Bi-Dir more strongly associated with being a drinker for men but with quantity consumed for women. Also, alcohol consumption was more strongly related to Perp-Only and Bi-Dir than with Vic-Only. In conclusion, higher risk of P-IPV with alcohol consumption is compounded when living with children-putting children who live with drinkers, especially drinkers who consume large amounts per occasion, at special risk of exposure to P-IPV. This is an important area for future research and prevention.

Harms to children from the financial effects of others' drinking

BACKGROUND

Many children live with parents who drink and experience little impact, but risky or heavy drinking by caregivers can result in a range of harms to children. Alcohol-related financial harms which directly impact children's needs in general populations have been seldom studied.

OBJECTIVE

The study aims to identify the prevalence and correlates of financial harms from others' drinking affecting children's needs in nine lower- and middle-income (LMICs) and high-income countries (HICs).

METHODS

Participants (n = 7,669) from Brazil, Chile, Ireland, Lao PDR, Nigeria, Sri Lanka, Thailand, USA and Viet Nam were aged 18-64 years and living with children. Logistic regression and meta-analyses explored differences in financial harm affecting children among LMICs and HICs, adjusting for gender, education, rurality and drinking pattern.

RESULTS

In around one-tenth to a third of households in the nine countries, children lived with people who drank riskily. Less than 1% to 8% of respondents reported that their children's needs had not been met because of financial harm from others' drinking. Women reported significantly greater harm to children due to the financial effects of others' drinking than men in the USA, Nigeria and Viet Nam. When the participant reported drinking riskily, and particularly when families included someone who drank heavily, increased odds of financial harm from others' drinking affecting children were identified.

CONCLUSION

That children's needs were not met due to financial harm from others' drinking was reported by three percent (<1 to 8%) of caregivers across the nine countries, representing a problem for large numbers of children, particularly in the low and middle-income countries studied. When a person's drinking was reported to be heavy or harmful within the family, the risk that children's needs were affected by the financial impacts of others' drinking was significantly greater.

Exploiting motherhood: Do mummy drinking sites offer real support or are they mainly alcohol marketing?

Even as women's roles have expanded substantially beyond traditional sex stereotypes, women are still commonly portrayed as uncomplaining caregivers, long-suffering intimate partners and in control of family matters, all while maintaining a sexualised femininity. Nowhere are these stereotypes and expectations more apparent than for mothers. However, some social media are exploiting mothers by inappropriately offering alcohol consumption as a solution to the challenges of parenting. This is a very timely topic, given the impacts of COVID-19 on family and home life, and potential for an increase in alcohol-related problems and health harms. We address these issues and offer alternatives to alcohol consumption as an easy solution to countering challenges of parenthood.

Parental risk constellations and future alcohol use disorder (AUD) in offspring: A combined HUNT survey and health registries study

OBJECTIVE

We examined the risk of developing a future alcohol use disorder (AUD) among offspring of families with different constellations of parental risk factors.

METHOD

We analyzed a sample of 8,774 offspring (50.2% male) from 6,696 two-parent families who participated in the Nord-Trøndelag Health Study in Norway when offspring were 13-19 years old in 1995-1997 or 2006-2008. Based on population registry information and parental Nord-Trøndelag Health Study self-reports, families were classified via Latent Profile Analysis into fiver risk constellations reflecting parents' education, drinking quantities and frequencies, and mental health. Information about AUD-related diagnoses, treatments, and prescriptions for all offspring in the period between 2008 and 2016 was obtained from 3 national health registries and pooled to reflect any AUD. The likelihood of AUD in offspring was examined with a set of nested logistic regression models.

RESULTS

Registry records yielded 186 AUD cases (2.1%). Compared with the lowest-risk constellation, offspring from two constellations were more likely to present with AUD in unadjusted analyses. After adjusting for all covariates, including offspring's alcohol consumption and witnessing parental intoxication during adolescence, AUD risk remained elevated and statistically significant (adjusted odds ratio = 2.34, 95% confidence interval = 1.14, 4.85) for offspring from the constellation characterized by at least weekly binge drinking, low education, and poor mental health in both parents.

CONCLUSION

Weekly binge drinking by both parents was associated with future AUD risk among community offspring in Norway when clustered with additional parental risks such as poor mental health and low educational attainment. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Purchasing, consumption, demographic and socioeconomic variables associated with shifts in alcohol consumption during the COVID-19 pandemic

INTRODUCTION AND AIMS

Restrictions introduced to reduce the spread of COVID-19 have had major impacts on the living circumstances of Australians. This paper aims to provide insight into shifts in alcohol consumption and associated factors during the epidemic.

DESIGN AND METHODS

A cross-sectional convenience sample of 2307 Australians aged 18 and over who drank at least monthly was recruited through social media. Respondents were asked about their alcohol consumption and purchasing in 2019 prior to the epidemic plus similar questions about their experiences in the month prior to being surveyed between 29 April and 16 May 2020.

RESULTS

Reports of average consumption before (3.53 drinks per day [3.36, 3.71 95% confidence interval]) and during (3.52 [3.34, 3.69]) the pandemic were stable. However, young men and those who drank more outside the home in 2019 reported decreased consumption during the pandemic, and people with high levels of stress and those who bulk-bought alcohol when restrictions were announced reported an increase in consumption relative to those who did not.

DISCUSSION AND CONCLUSIONS

A reported increase in consumption among those experiencing more stress suggests that some people may have been drinking to cope during the epidemic. Conversely, the reported decrease in consumption among those who drank more outside of their home in 2019 suggests that closing all on-trade sales did not result in complete substitution of on-premise drinking with home drinking in this group. Monitoring of relevant subgroups to assess long-term changes in consumption in the aftermath of the epidemic is recommended.

Relationship trajectories of women experiencing alcohol-related intimate partner violence: A grounded-theory analysis of women's voices

RATIONALE

The association between male partner alcohol use and increased risk and severity of their perpetration of intimate partner violence (IPV) is well-established in quantitative research. However, few studies have explored the nature and trajectory of relationships involving partner drinking and abuse, and how women find pathways to safety.

OBJECTIVE AND METHOD

We conducted in-depth interviews with a community sample of 18 Australian women (aged 20-50 years) who reported feeling afraid when their male partner drank alcohol. Using a constructivist grounded theory approach, we identified key processes underpinning women's experience of alcohol-related IPV and mapped these over four relationship phases.

RESULTS

Partner alcohol use played a key role in how women interpreted and dealt with IPV victimisation. In early relationships, women spoke of not seeing or dismissing early warning signs of problem drinking and aggression in settings that normalized men's heavy drinking. Later, women identified patterns of inter-connected drinking and aggression, leading to questioning their reality, trying to 'fix' their partner's drinking to stop the abuse, and in the absence of change, learning to manage daily life around the drinking and abuse. In the third phase, giving up hope that the partner would stop drinking, women ended the relationship. Finally, after leaving the abuser, women attempted to reset normal around drinking behaviour but continued to experience trauma associated with others' drinking in social settings.

DISCUSSION AND CONCLUSION

For women who have experienced partners' alcohol use intertwined with violence in their relationship, changing their partners' drinking plays a central role in their journey to safety, possibly obscuring recognition of abuse and complicating their ability to leave. Greater understanding of the stages of the alcohol-IPV relationship can help health providers support women as they navigate these complex relationships, and provide appropriate support depending on the needs of women in their relationship trajectory.

Cross-sectional surveys of financial harm associated with others' drinking in 15 countries: Unequal effects on women?

INTRODUCTION AND AIMS

That physical, emotional and social problems occur not only to drinkers, but also to others they connect with, is increasingly acknowledged. Financial harms from others' drinking have been seldom studied at the population level, particularly in low- and middle-income countries. Whether financial harm and costs from others' drinking inequitably affect women is little known. The study's aim is to compare estimates and correlates of alcohol's financial harm to others than the drinker in 15 countries.

METHODS AND MATERIALS

Cross-sectional surveys of Alcohol's Harm To Others (AHTO) were conducted in Australia, Brazil, Chile, Denmark, India, Ireland, Lao PDR, New Zealand, Nigeria, Sri Lanka, Sweden, Switzerland, Thailand, the US and Vietnam.

PARTICIPANTS

17,670 men and 20,947 women.

MEASUREMENT

The prevalence of financial harm in the last year was assessed as financial trouble and/or less money available for household expenses because of someone else's drinking.

ANALYSIS

Meta-analysis and country-level logistic regression of financial harm (vs. none), adjusted for gender, age, education, rurality and participant drinking.

RESULTS

Under 3.2 % of respondents in most high-income countries reported financial harm due to others' drinking, whereas 12-22 % did in Thailand, Sri Lanka and India. Financial harm from others' drinking was significantly more common among women than men in nine countries. Among men and women, financial harm was significantly more prevalent in low- and middle- than in high-income countries.

CONCLUSIONS

Reports of financial harm from others' drinking are more common among women than among men, and in low- and middle-income than in high-income countries.

Do gender differences in the relationship between living with children and alcohol consumption vary by societal gender inequality?

INTRODUCTION AND AIMS

To better understand the relationship between alcohol consumption and living with children, we assessed whether the association varied for men and women across diverse countries and whether this relationship was moderated by country-level gender inequality.

DESIGN AND METHODS

We used Hierarchical Linear Modelling to analyse data from 32 surveys conducted in 27 countries. Measures included whether the participant was a drinker versus abstainer in past 12 months, annual number of drinks consumed, whether the respondent lived with children, gender (male/female) and age of respondent, and country-level gender inequality measured using the Gender Inequality Index.

RESULTS

Annual drinks consumed was significantly lower for women living with children. Men living with children were generally more likely to be drinkers, and the relationship between annual consumption and living with children was moderated by cultural gender equality: specifically, men in countries with higher gender equality drank less if they lived with children while the association for men in lower equality countries was nonsignificant.

DISCUSSION AND CONCLUSIONS

Although lower alcohol consumption was found generally for women living with children, this relationship was found only for men in countries where there was more gender equality. Given the high risk of harm to children from heavy consumption by adults with whom they live, prevention efforts need to strengthen prevention of heavy consumption by parents and other who live with children, especially for men who live with children in low gender equality countries.

Cross-National Comparisons and Correlates of Harms From the Drinking of People With Whom You Work

BACKGROUND

While research in high-income countries (HICs) has established high costs associated with alcohol's harm to others (AHTO) in the workplace, scant attention has been paid to AHTO in the workplace in lower- or middle-income countries (LMICs).

AIM

To compare estimates and predictors of alcohol's impacts upon coworkers among workers in 12 countries.

METHODS

Cross-sectional surveys from 9,693 men and 8,606 women employed in Switzerland, Australia, the United States, Ireland, New Zealand, Chile, Nigeria, Lao PDR, Thailand, Vietnam, India, and Sri Lanka. Five questions were asked about harms in the past year because of coworkers' drinking: Had they (i) covered for another worker; (ii) worked extra hours; (iii) been involved in an accident or close call; or had their (iv) own productivity been reduced; or (v) ability to do their job been affected? Logistic regression and meta-analyses were estimated with 1 or more harms (vs. none) as the dependent variable, adjusting for age, sex, rurality of location, and the respondent worker's own drinking.

RESULTS

Between 1% (New Zealand) and 16% (Thailand) of workers reported that they had been adversely affected by a coworker's drinking in the previous year (with most countries in the 6 to 13% range). Smaller percentages (<1% to 12%) reported being in an accident or close call due to others' drinking. Employed men were more likely to report harm from coworkers' drinking than employed women in all countries apart from the United States, New Zealand, and Vietnam, and own drinking pattern was associated with increased harm in 5 countries. Harms were distributed fairly equally across age and geographic regions. Harm from coworkers' drinking was less prevalent among men in HICs compared with LMICs.

CONCLUSIONS

Workforce impairment because of drinking extends beyond the drinker in a range of countries and impacts productivity and economic development, particularly affecting men in LMICs.

Children's experience of physical harms and exposure to family violence from others' drinking in nine societies

AIM

To study caregiver reports of children's experience of physical harm and exposure to family violence due to others' drinking in nine societies, assess the relationship of harm with household drinking pattern and evaluate whether gender and education of caregiver affect these relationships.

METHOD

Using data on adult caregivers from the GENAHTO (Gender and Alcohol's Harm to Others) project, child alcohol-related injuries and exposure of children to alcohol-related violence (CAIV) rates are estimated by country and pooled using meta-analysis and stratified by gender of the caregiver. Households with and without heavy or harmful drinker(s) (HHD) are compared assessing the interaction of caregiver gender on the relationship between reporting HHD and CAIV, adjusting for caregiver education and age. Additionally, the relationship between caregiver education and CAIV is analysed with meta-regression.

RESULTS

The prevalence of CAIV varied across societies, with an overall pooled mean of 4% reported by caregivers. HHD was a consistent correlate of CAIV in all countries. Men and women in the sample reported similar levels of CAIV overall, but the relationship between HHD and CAIV was greater for women than for men, especially if the HHD was the most harmful drinker. Education was not significantly associated with CAIV.

CONCLUSION

One in 25 caregivers with children report physical or family violence harms to children because of others' drinking. The adjusted odds of harm are significantly greater (more than four-fold) in households with a heavy or harmful drinker, with men most likely to be defined as this drinker in the household.

Harm from Known Others' Drinking by Relationship Proximity to the Harmful Drinker and Gender: A Meta-Analysis Across 10 Countries

BACKGROUND

Drinking is a common activity with friends or at home but is associated with harms within both close and extended relationships. This study investigates associations between having a close proximity relationship with a harmful drinker and likelihood of experiencing harms from known others' drinking for men and women in 10 countries.

METHODS

Data about alcohol's harms to others from national/regional surveys from 10 countries were used. Gender-stratified random-effects meta-analysis compared the likelihood of experiencing each, and at least 1, of 7 types of alcohol-related harm in the last 12 months, between those who identified someone in close proximity to them (a partner, family member, or household member) and those who identified someone from an extended relationship as the most harmful drinker (MHD) in their life in the last 12 months.

RESULTS

Women were most likely to report a close male MHD, while men were most likely to report an extended male MHD. Relatedly, women with a close MHD were more likely than women with an extended MHD to report each type of harm, and 1 or more harms, from others' drinking. For men, having a close MHD was associated with increased odds of reporting some but not all types of harm from others' drinking and was not associated with increased odds of experiencing 1 or more harms.

CONCLUSIONS

The experience of harm attributable to the drinking of others differs by gender. For preventing harm to women, the primary focus should be on heavy or harmful drinkers in close proximity relationships; for preventing harm to men, a broader approach is needed. This and further work investigating the dynamics among gender, victim-perpetrator relationships, alcohol, and harm to others will help to develop interventions to reduce alcohol-related harm to others which are specific to the contexts within which harms occur.

Child injury deaths linked with adult alcohol consumption: A time series analysis

OBJECTIVE

This paper aims to quantify the population-level associations between child injury deaths and adult (aged 15+ years) per capita alcohol consumption (PCC) and between child injury deaths and the impact of major alcohol and safety policy changes in Australia.

METHODS

All child deaths due to external causes during 1910-2013, and child deaths due specifically to road crashes, assaults, suicide and other external causes, were obtained from the Australian Institute of Health and Welfare. Child (0-14 year) mortality rates were analysed in relation to PCC using an Autoregressive Integrated Moving Average model.

RESULTS

A positive association between PCC and overall child external mortality was identified. The estimated coefficient was 0.326 (p = .002), indicating that a 10% decrease in PCC was associated with a 3.3% reduction in child injury mortality. A positive association was identified for road traffic and other child injury mortality, but not assault injuries. The introduction of compulsory seatbelt legislation in combination with random breath testing was associated with a reduction in overall injury and road traffic child mortality. Decreasing the legal drinking age was associated with an increase in the rate of other external-cause child mortality.

CONCLUSION

Reducing PCC in Australia is likely to result in a small but significant reduction in the injury mortality rate of children aged 0-14 years.

Addiction research centres and the nurturing of creativity: The Centre for Alcohol Policy Research (CAPR), Melbourne: a decade on

Established in 2006, the Centre for Alcohol Policy Research (CAPR) is Australia's only research centre with a primary focus on alcohol policy. CAPR has four main areas of research: alcohol policy impacts; alcohol policy formation and regulatory processes involved in implementing alcohol policies; patterns and trends in drinking and alcohol problems in the population; and the influence of drinking norms, cultural practices and social contexts, particularly in interaction with alcohol policies. In this paper, we give examples of key publications in each area. During the past decade, the number of staff employed at CAPR has increased steadily and now hovers at approximately 10. CAPR has supported the development of independent researchers who collaborate on a number of international projects, such as the Alcohol's Harm to Others study which is now replicated in approximately 30 countries. CAPR receives core funding from the Foundation for Alcohol Research and Education, and staff have been highly successful in securing additional competitive research funding. In 2016, CAPR moved to a new institutional setting at La Trobe University and celebrated 10 years of operation.

A Multi-Country Study of Harms to Children Because of Others' Drinking

OBJECTIVE

This study aims to ascertain and compare the prevalence and correlates of alcohol-related harms to children cross-nationally.

METHOD

National and regional sample surveys of randomly selected households included 7,848 carers (4,223 women) from eight countries (Australia, Chile, Ireland, Lao People's Democratic Republic [PDR], Nigeria, Sri Lanka, Thailand, and Vietnam). Country response rates ranged from 35% to 99%. Face-to-face or telephone surveys asking about harm from others' drinking to children ages 0-17 years were conducted, including four specific harms: that because of others' drinking in the past year children had been (a) physically hurt, (b) verbally abused, (c) exposed to domestic violence, or (d) left unsupervised.

RESULTS

The prevalence of alcohol-related harms to children varied from a low of 4% in Lao PDR to 14% in Vietnam. Alcohol-related harms to children were reported by a substantial minority of families in most countries, with only Lao PDR and Nigeria reporting significantly lower levels of harm. Alcohol-related harms to children were dispersed sociodemographically and were concentrated in families with heavy drinkers.

CONCLUSIONS

Family-level drinking patterns were consistently identified as correlates of harm to children because of others' drinking, whereas sociodemographic factors showed few obvious correlations.

Conceptual and Methodological Issues in Studying Alcohol's Harm to Others1

While there is a longer history of concern about alcohol's harm to others, researchers' interest has intensified in the last few years. The background of variation in concern over time in different societies is outlined. Three main traditions of research have emerged: population survey studies of such harm from the perspective of the ‘other’; analysis of register or case-record data which includes information on the involvement of another's drinking in the case; and qualitative studies of interactions and experiences involved in particular harms from others' drinking. In the course of the new spate of studies, many conceptual and methodological issues have arisen, some of which are considered in the paper. The diverse types of harms which have been studied are discussed. The social and personal nature of many of the harms means they do not ft easily into a disability or costing model, raising questions about how they might best be counted and aggregated. Harm from others' drinking is inherently interactional, and subject to varying definitions of what counts as harm. The attribution to drinking, in the usual situation of conditional causation, is also subject to variation, with moral politics potentially coming into play. For measurement and comparison, account needs to be taken of cultural and individual variations in perceptions and thresholds of what counts as a harm, and attribution to alcohol. The view from the windows of a population survey and of a response agency case register are often starkly different, and research is needed, as an input and spur to policy initiatives, on what influences this difference and whether and how the views might be reconciled.

Alcohol's involvement in an array of harms to intimate partners

Introduction

Harms from intimate partners' (IP) drinking range from frustration because the partner has not performed their role to assault.

Aim

To describe the prevalence and persistence of alcohol‐related harms to IPs and assess which respondents are more likely to report discontinuation of this harm.

Design and methods

Cross‐sectional (n = 2649) and follow‐up (n = 1106) alcohol's harm to others telephone surveys in 2008 and 2011 (response rates of 35% and 15% of the original sample respectively) were used to elicit harms to respondents from their IP's drinking (by gender and relationship). To examine discontinuation, a sub‐sample of 83 respondents was analysed in detail.

Results

A total of 6.7% of Australians were negatively affected by an IP's drinking in 2008. Women were more likely to report harm than men from an IP's drinking. Of the 1106 respondents who completed both surveys, the majority (90%) reported no harm from IPs although 3% reported harm in both surveys. No significant correlates of discontinuation of harm were identified.

Discussion

Many Australian relationships are affected in a range of ways because of the drinking of their IPs. A minority of respondents were affected by their IP's drinking, yet over half (57%) of those harmed in 2008 continued to experience harm in 2011. Additionally, half (46.9%) of those who were not harmed in 2008 but did live with a heavy drinking IP did go on to be harmed in 2011. More research on the role of alcohol‐related harm from IPs with larger samples is required to examine predictors of change. [Laslett A‐M, Jiang H, Room R. Alcohol's involvement in an array of harms to intimate partners. Drug Alcohol Rev 2017;36:72–79]

Substance misuse, mental health problems and recurrent child maltreatment

Purpose

– The purpose of this paper is to determine whether the diagnosis of both carers’ mental health problems and substance misuse increase the likelihood of recurrent child maltreatment over and above the individual effects of these factors.

Design/methodology/approach

– Retrospective secondary data analysis of 29,455 children where child maltreatment was confirmed in the Victorian child protection system between 2001 and 2005. Recorded mental health, alcohol misuse and other drug misuse variables were entered into multivariate logistic regression models predicting repeated child maltreatment. Interactions and a range of other child, carer and socio-economic factors were included in these models.

Findings

– Carer alcohol misuse, other drug misuse and mental ill health all independently predicted recurrent child maltreatment. The presence of both other drug misuse and mental ill health increased the likelihood that recurrent child abuse was recorded over the likelihood that mental health alone predicted recurrent child maltreatment, and while alcohol misuse had an effect when there was no mental health condition recorded it did not have an additional effect when there was evidence of mental health problems.

Research limitations/implications

– Children in families where there is both mental health problems and other drug use problems are at greater risk of repeated maltreatment than where there is evidence of mental health problems or other drug use alone. Where there was evidence of carer mental health problems, alcohol misuse did not add to this likelihood. However, the effect of mental health and other drug use was similar in size to the effect of alcohol misuse alone.

Originality/value

– These findings add to understandings of the effects of co-occurring mental health problems and substance misuse on recurrent child maltreatment and differentiate between cases that involve alcohol and other drug misuse.

Seeking help because of others' drinking

INTRODUCTION AND AIMS

Many individuals contact and are assisted by community and emergency services because of someone else's drinking. Previous studies have focused on family members accessing services, such as Alcoholics Anonymous due to significant others' drinking; however, little is known about service use in the broad community. This paper aims to estimate the prevalence of contacting the police and seeking help from health services because of others' drinking and to compare the profiles of individuals seeking services with those who did not contact a service.

DESIGN AND METHODS

A total of 2649 adult Australians were surveyed about their experience of harm from others' drinking, including use of emergency and community services.

RESULTS

In the 12 months prior to the survey, 13% of respondents had contacted the police and 5% had sought help from a health-related service. Using logistic regression, being older and having a secondary school education were associated with a decreased likelihood of contacting police because of others' drinking, whereas residing in a non-metropolitan location was positively associated with using health-related services. Having a partner was negatively associated with use of health-related services. The extent of self-reported harm from others' drinking was the only factor associated with use of both police and health-related services.

DISCUSSION AND CONCLUSION

Results suggest differences in the profile of respondents who call the police and those who seek health-related services due to others' drinking. This supports the need for tailored services to support and address the needs of people experiencing harm from others' drinking.