Alcohol risk and harm

Alcohol has a complex role in society. Consumption patterns reflect different attitudes towards alcohol. Harmful levels of consumption are a major health issue, associated with increased risk of chronic disease, injury and premature death. Most Australians drink alcohol at levels that cause few harmful effects. However, those who do drink at risky levels increase the risk of harm to themselves, their families, bystanders and the broader community (NHMRC 2009).

How many people consume alcohol?

The 2019 National Drug Strategy Household Survey (NDSHS) reported an estimated 4 in 5 (79%) people aged 18 and over had consumed alcohol in the previous 12 months; this is a decline from 81% reported in 2016 (AIHW 2017; AIHW 2020b). Similarly, results from the National Health Survey (NHS) 2017–18 showed that an estimated 4 in 5 (79%) Australians aged 18 and over had consumed alcohol in the previous 12 months (ABS 2019b).

Trends in alcohol consumption

The overall volume of alcohol available for consumption in Australia in 2017–18 was 191 million litres of pure alcohol—the equivalent of 9.51 litres per person aged 15 and over. This was a slight increase on the 9.48 litres available in the previous year, but the overall per capita trend over the last decade shows a decline of around 1.1% per year (10.8 litres per person in 2007–08). Over the last 50 years, the levels of apparent consumption of different alcoholic beverages have changed substantially, with a decrease in the proportion of beer and total alcohol consumed (per capita), and an increase in wine and spirits (Figure 1) (ABS 2019a).
 

Drinking behaviours

The NDSHS reported changes in drinking patterns between 2001 and 2019 including that:

• the proportion of adults abstaining from alcohol (not consuming alcohol in the previous 12 months) increased from 15.5% in 2001 to 19.5% in 2016 and rose to 21% in 2019 (Figure 2a)
• in 2019, just under 3 in 4 people aged 14–17 abstained from drinking alcohol—more than double the proportion in 2001 (32% in 2001, 73% in 2019) (Figure 2a). A similar pattern was seen for people in their 20s with the proportion of abstainers also more than doubling, from 8.9% in 2001 to 22% in 2019. In contrast, for people aged 70 and over, the proportion abstaining has declined (from 32% in 2001 to 28% in 2019)
• the proportion of adults aged 18 and over exceeding the lifetime risk guidelines declined from 21% in 2001 to 17.6% in 2019. The proportion exceeding the single occasion risk guidelines (at least once in the past year) also declined from 43% in 2001 to 38% in 2019. There was little change in the proportions exceeding either guideline between 2016 and 2019 (AIHW 2020b).

Similar changes to drinking patterns were reported by the NHS between 2014–15 and 2017–18 including that:

• fewer young people aged 15–17 were drinking alcohol and the proportion abstaining had increased, but this change was not statistically significant (66% in 2014–15 and 71% in 2017–18) (Figure 2b)
• the proportion of adults aged 18 and over abstaining from alcohol has remained relatively stable (11% in 2014–15 and 12% in 2017–18 after adjusting for age) (Figure 2b) (ABS 2019c).
   

In 2019, men aged 18 and over were at higher risk of alcohol-related harm than women from drinking at levels that exceed the lifetime risk guidelines (26% of men compared with 9.9% women)—this was similar to 2016 (26% and 10.4%, respectively). Men aged 18 and over were also at higher risk of injury than women from drinking at levels that exceed the single occasion risk guidelines at least once in the past year (48% of men compared with 29% of women)—this was similar to 2016 (49% and 29%, respectively) (AIHW 2020b).  

Results from the 2017–18 NHS similarly show that men were more likely than women to exceed the lifetime risky drinking guidelines (24% and 8.8%, respectively) and the single occasion risky drinking guidelines in the previous 12 months (54% and 31%, respectively) (ABS 2019b). These results were similar to those from the 2014–15 NHS (ABS 2018b).  

In 2019, 15.6% of people aged 18 and over reported drinking 11 or more drinks on 1 occasion at least once a year—this was similar to 16.2% in 2016 (AIHW 2020b). Similarly, based on data from the 2017–18 NHS, an estimated 19% of people aged 18 and over consumed 11 or more drinks on at least 1 occasion in the last 12 months (ABS 2019b).

Age

Since 2001, trends in single occasion risky drinking (at least once a month) have followed a similar pattern to lifetime risk, with risky drinking declining among younger age groups (18–39) but increasing among older age groups (40 and over). The proportion of people exceeding the lifetime risk guidelines has remained stable for older age groups since 2001, while for younger age groups, it has declined (Figure 3) (AIHW 2020b).

In 2019, young people aged 18–24 remained the group most likely to consume alcohol at levels which exceed single occasion risk guidelines at least once a month (41%). However, they were one of the least likely groups to drink at levels which exceed lifetime risk guidelines—this was highest among adults aged 40–49 and 50–59 (both 21%) (Figure 3) (AIHW 2020b).
 

Variation between population groups

See Health risk factors among Indigenous Australians for information on alcohol risk and harm among Aboriginal and Torres Strait Islander Australians.

Although there has been some reduction in risky drinking behaviour by some people, the harmful consumption of alcohol is more common in certain subsets of the population.

Some population groups drink alcohol in quantities that put them at risk of single occasion or lifetime harm more often than others. For example, analysis of the 2019 NDSHS showed that exceeding lifetime risk guidelines was more commonly reported by people living in Outer regional and Remote and very remote areas, people whose main language spoken at home is English, people living in the highest socioeconomic area and people who are employed (Figure 4). See also Health across socioeconomic groups and Rural and remote health.
 

Health impact

Deaths

Alcohol-induced deaths are defined as those that can be directly attributed to alcohol use, as determined by toxicology and pathology reports (ABS 2018a).

In 2017, the alcohol-induced death rate was 5.1 per 100,000 population (1,366 deaths) and it has remained stable since a low of 4.5 deaths per 100,000 in 2012. In 2017, alcohol was mentioned as a contributory cause in an additional 2,820 deaths. This demonstrates that people were twice as likely to have alcohol certified at death as a contributory factor rather than to have died from an alcohol-induced death (ABS 2018a).

Burden of disease

Alcohol was the fifth-highest risk factor contributing to disease burden in Australia in 2015. Alcohol use was estimated to be responsible for 4.5% of the total burden of disease and injury, based on estimates from the Australian Burden of Disease Study 2015.

For adolescents and young adults, non-fatal burden was the main contributor to alcohol attributed burden, while for those aged 55 and over fatal burden was the main contributor.

The burden from alcohol disorders was higher in males (2.0%) than females, ranking 13th in total male burden and outside the top 20 for females. Alcohol use was the leading risk factor contributing to disease burden for males aged 15–24 (13%) and 25–44 (12%) (AIHW 2019a). See Burden of disease.

Hospitalisations

The number of hospitalisations in Australia with a drug-related principal diagnosis of alcohol use increased from 64,200 hospitalisations in 2013–14 to 72,300 in 2017–18 (or from 275.8 to 291.9 hospitalisations per 100,000 population). As a proportion this equates to a decline from 55% of drug-related hospitalisations in 2013–14 to 53% in 2017–18 (AIHW 2019b). The decrease in proportion of alcohol-related hospitalisations is due to an increase in non-alcohol drug-related hospitalisations in 2017–18.

See Illicit drug use for information on drug-related hospitalisations where alcohol was not the drug.

Treatment

The number of closed treatment episodes provided in publicly funded alcohol and other drug treatment agencies across Australia for a person’s own drug use (where alcohol was the principal drug of concern) fell between 2012–13 and 2016–17 (from 63,800 to 62,400) but increased between 2017–18 and 2018–19 (from 70,900 to 74,700). As a proportion this equates to a decline from 41% of total episodes of treatment in 2012–13 to 36% in 2018–19 (AIHW 2020a). See Alcohol and other drug treatment services.

Social impact

Alcohol misuse was estimated to cost Australia around $14 billion in 2010 ($6.0 billion in lost productivity), followed by traffic accidents ($3.7 billion), the criminal justice system ($2.9 billion) and costs to the health system ($1.7 billion) (Manning et al. 2013). However, these costs do not include the negative impacts on others associated with someone else’s drinking (such as violence, poor productivity, disturbing the peace), estimated at $6.8 billion in 2008 (Laslett et al. 2010).

Where do I go for more information?

For more information on alcohol risk and harm, see:

• Alcohol, tobacco & other drugs in Australia
• National Drug Strategy Household Survey 2019
• Alcohol and other drug treatment services in Australia 2018–19
• Australian Burden of Disease Study 2015: Interactive data on risk factor burden
• Australian Bureau of Statistics National Health Survey: First Results, 2017–18

Visit Alcohol for more on this topic

References

ABS (Australian Bureau of Statistics) 2018a. Causes of death, Australia, 2017. ABS cat. no. 3303.0. Canberra: ABS.

ABS 2018b. National Health Survey: First Results, 2014–15. ABS cat. no. 4364.0.55.001. Canberra: ABS.    

ABS 2019a. Apparent consumption of alcohol, Australia, 2017–18. ABS cat. no. 4307.0.55.001. Canberra: ABS.

ABS 2019b. National Health Survey: First Results, 2017–18. ABS cat. no. 4364.0.55.001. Canberra: ABS.

ABS 2019c. National Health Survey, 2017–18. Customised report. Canberra: ABS.

AIHW (Australian Institute of Health and Welfare) 2017. National drug strategy household survey 2016: Detailed findings. Drug statistics series no. 31. Cat. no. PHE 214. Canberra: AIHW.

AIHW 2019a. Australian Burden of Disease Study: impact and causes of illness and death in Australia 2015. Cat. no. BOD 22. Canberra: AIHW.

AIHW 2019b. Alcohol, tobacco and other drugs in Australia report. Web Report. Cat no. PHE 221. Canberra: AIHW.

AIHW 2020a. Alcohol and other drug treatment services in Australia 2018–19. Web report. Cat. No. HSE 243. Canberra: AIHW. 

AIHW 2020b. National drug strategy household survey 2019. Drug statistics series no. 32. Cat. no. PHE 270. Canberra: AIHW.

Laslett A, Catalano P, Chikritzhs T, Dale C, Doran C, Ferris J et al. 2010. The range and magnitude of alcohol’s harm to others. Fitzroy, Victoria: AER Centre for Alcohol Policy Research, Turning Point Alcohol and Drug Centre, Eastern Health.

Manning M, Smith C & Mazerolle P 2013. The societal costs of alcohol misuse in Australia. Trends & issues in crime and criminal justice no. 454. Canberra: Australian Institute of Criminology.

NHMRC (National Health and Medical Research Council) 2009. Australian Guidelines to Reduce Health Risks from Drinking Alcohol. Canberra: NHMRC.