September 2013 – Page 3 – Matters of Substance

Commonly seen and heard navigating down the corridor of an entertainment district are staggering patrons and their escalating aggression levels. When witnessed, incidents of alcohol-fueled violence may seem insignificant numerically; however, over the course of time the offences amount to substantial trauma and related legal costs. For example, a Canadian inmate study estimated that 28% of violent crimes reported to police are alcohol-associated¹. In British Columbia, this translates to 17,888 offences in 2012 and a startling figure of 211,683 police-reported incidents over the ten years previous². To see a striking visual illustration, visit the Victoria Police crime mapping portal and observe the concentration of assaults around the downtown entertainment district.

Behind these statistics, the alcohol-violence connection is complex and shaped by multiple factors: individual personalities, drinking environments, and social norms each having variable effects on human behaviour and drinking cultures. At the individual level it is hard to deny alcohol’s ability to impair judgement. Arguably this is the euphoric feeling (and the associated loss of fear or “Dutch Courage”) consumers seek. The same decrease in cognitive function also leads to increased risk of physical violence and victimization when intoxicated patrons interact (i.e., around bars, nightclubs, or liquor outlets). In fact, a research article considering 11, 563 injury cases from 45 different hospitals across 16 different countries found that intoxicated patients had a higher likelihood of violence-related injury than any other catalyst. Many studies have also linked decreases in the price of alcohol, increases in trading hours, and high alcohol outlet densities (on and off premise alcohol retailers per unit area or roadway) to greater rates of homicides, assaults, and domestic violence independent of demographic and socio-economic status³^&⁴. The only positive note is the consistently insignificant effect of restaurant liquor licenses on violence rates inferring that drinking with a meal and a small social group is mostly low risk.

Preventative measures to reduce the burden of alcohol-related violence are not out of reach for British Columbians. In fact, we have already come a long way in accepting evidence- based limits on pressing matters such as driving rights and public intoxication. Should we not consider the expediency of introducing fair pricing of higher alcohol content products, limiting late night sales of alcohol, and restricting alcohol outlet densities since these have been shown to reduce alcohol-related violence⁵^&⁶? Allowing alcohol prices to keep pace with inflation⁶, shortening the 9:00am to 4:00am hours of on-premise liquor sales, and creating population based restrictions on liquor establishment densities removing the pressure on municipal governments to assess and approve liquor licenses⁷ seem reasonable steps toward harm reduction.

Armed with this knowledge, what alcohol availability restrictions are we willing to accept in order to decrease related harms?

Author: Jessica Fitterer

The BC government is the sole wholesaler and leading retailer of alcohol in the province and government revenue from alcohol is carefully tracked year after year. The social costs of alcohol, however, are not reported by government even though they contribute significantly to health care and enforcement costs. This begs the question: How can we make informed decisions about the supply of alcohol if we do not meaningfully include costs in our analyses?

Alcohol is implicated in a host of health and social harms from violence to injuries to many types of cancer to better known ailments such as liver cirrhosis and alcohol dependence (addiction). While the sheer breadth of these harms makes monitoring them difficult, careful methods for assessing the costs of alcohol were developed right here in Canada, and have been applied in several countries around the world. The costs of alcohol are divided into direct costs (mainly for health and enforcement), and indirect costs which account for losses in productivity associated with alcohol-related disability and deaths.

The on-going assessment of alcohol-related costs and harms could help enhance the management of alcohol in several ways. For example, such information could help the government assess the impact of its policies and programs and gauge the impact of changes to policy over time. Yearly estimates of alcohol-related costs and harms could be compared to the revenue and other benefits from alcohol sales, and this could help the government achieve its stated goal of balancing the benefits and costs of alcohol in society. On this point it is worth noting that some policies have the potential to maintain revenue while at the same time reducing risky alcohol consumption. Chief among these are minimum price policies which target heavy and risky drinkers who tend to gravitate toward low cost alcohol.

And just how balanced is the current approach to managing alcohol in BC? The answer is, we don’t know, because recent cost estimates are not available. However, in 2002 (the last year for which data is available) direct revenue from alcohol totaled $852 million and direct costs were estimated at $925 million. Big ticket costs included $550 million for health care and $359 million for alcohol-related enforcement. So the best available data suggests that when direct revenue and direct costs are compared, the province is running a deficit of $73 million dollars.

There are, of course, other benefits besides revenue related to alcohol, and there are many other costs and harms besides provincial budget costs. But given that we do know the direct costs of alcohol outstrip the direct revenue government gains from the sale of alcohol, wouldn’t the ongoing monitoring and reporting of costs be an important part of modernizing BC’s approach to managing alcohol?

Author: Gerald Thomas

Month: September 2013

What contributes to alcohol-related violence and how can we prevent it?

Let’s talk about alcohol-related benefits AND COSTS