The harm associated with the consumption of alcohol, particularly among young people, is an area of growing concern within the Australian community and presents a major challenge to all levels of government. Developing policies and initiatives that attempt to influence drinking behaviour is notoriously difficult, largely because the consumption of alcohol is both widely accepted as a significant part of Australian culture and at the same time responsible for a range of social and health-related problems. There is a well established drinking culture in Australia of 'drinking to get drunk', whereby the consumption of alcohol, frequently at excessive and harmful levels, is associated with many forms of entertainment and participation in social events.
However, the evidence relating to the range of individual and social harms associated with alcohol misuse is strong. The consumption of alcohol, especially at high levels, is a significant risk factor for violence. Alcohol-related crime and disorder can have a significant adverse impact upon the perceptions of safety among the broader community. This concern and perception extends well beyond those who have been directly involved in an incident of alcohol-related antisocial behaviour or harm (Nicholas 2006).
This issues paper provides a brief overview of the relationship between alcohol use and violence, the characteristics of alcohol-related violence and important risk factors that can be targeted by prevention strategies to reduce the social harms associated with alcohol use.
There is strong evidence of an association between the consumption of alcohol and violence (Graham & Homel 2008). Conservative estimates suggest that in 2004–05, the total costs attributable to alcohol-related crime in Australia was $1.7b; the social cost relating to alcohol-related violence (which excludes costs to the criminal justice system) was $187m; and the costs associated with the loss of life due to alcohol-related violent crime amounted to $124m (Collins & Lapsley 2007).
National surveys of alcohol use and victimisation provide further evidence of the impact of alcohol-related violence. According to the National Drug Strategy household Survey (NDSHS), in 2007 approximately:
- 1 in 4 Australians were a victim of alcohol-related verbal abuse
- 13 percent were made to feel fearful by someone under the influence of alcohol
- 4.5 percent of Australians aged 14 years or older had been physically abused by someone under the influence of alcohol (AIHW 2008).
The rates of physical and verbal abuse by a person affected by alcohol were more than twice the rate for other drug types. In addition, more than one-third of victims (38%) had consumed alcohol themselves at the time of the incident. This is consistent with evidence that shows that a significant proportion of violent offences are committed by and committed against people who have been drinking or are intoxicated (Plant, Plant & Thornton 2002).
Estimates regarding the extent of the involvement of alcohol in violent offences vary significantly across studies. These variations are largely the result of differences in the way in which the involvement of alcohol in crime is defined, whether the figure relates to incidents attended by police or total recorded crime, different data collection processes, problems relating to the accurate and reliable measurement of alcohol consumption and intoxication, and underreporting by victims. Nevertheless, Australian research estimates that a significant proportion of assaults involve alcohol; from 23 to as much as 73 percent of all assaults (Briscoe & Donnelly 2001a; Doherty & Roche 2003; Poynton et al 2005). Alcohol is also a significant contributor to serious injury from assault. In a NSW study, two-thirds of patients presenting at an emergency department with injuries from interpersonal violence reported having consumed alcohol prior to the incident and three-quarters of these patients stated that they had been drinking at license premises (Poynton et al 2005).
Self-reported alcohol use among offenders can help to provide more accurate and reliable evidence of the involvement of alcohol in violent offending. Findings from the AIC's Drug Use Monitoring Australia (DUMA) program indicate that in 2007, half of all offenders detained by police across Australia for disorder and violent offences had consumed alcohol in the 48 hours prior to their arrest (Adams et al 2008). Further analysis of DUMA data conducted specifically for this paper reveals that 52 percent of offenders charged by police for an assault had consumed alcohol in the previous 24 hours and 26 percent reported that the consumption of alcohol had contributed to their offending. An additional four percent of offenders detained for an assault were too intoxicated to be interviewed, which means that in total, approximately one-third (30%) of assault charges are likely to be attributable to alcohol. Around one-third of offenders detained for breaching an Apprehended Violence Order AVO) also reported that consuming alcohol had contributed to their offending.
Characteristics of alcohol-related violence
Preventing alcohol-related violence requires an understanding of the characteristics of violent incidents to effectively target interventions. A growing body of evidence from both Australian and overseas studies has explored the association between alcohol and violence and identified a range of areas that can be targeted. Factors that have been identified as important predictors of alcohol-related violence include a mixture of individual and situational factors. Key findings relating to the characteristics of alcohol-related violence include:
- being young, single and male are the most significant predictors of self-reported alcohol-related victimisation (Teece & Williams 2000). In 2007, males (6%) were twice as likely as females (3%) to report being physically abused by someone under the influence of alcohol (AIHW 2008)
- rates of self-reported victimisation are particularly high among young people living in rural areas, with one-third of people aged 14–19 years and two-thirds of those aged 20–24 living in rural areas having reported being victims of alcohol-related physical abuse (Williams 1999)
- a significant proportion of perpetrators of alcohol-related social disorders are also victims (Williams 2000)
- males are more likely to be involved in incidents of physical abuse in pubs and clubs or in the street, whereas for females, these incidents are more likely to be in their own home (AIHW 2008)
- alcohol consumption among young people is typified by frequent episodes of binge drinking and heavy drinking has been shown to be associated with aggression and violence (Wells & Graham 2003)
- female victims of physical abuse by someone under the influence of alcohol or illicit drugs are more likely than males to know their abuser (AIHW 2008)
- alcohol-related violence in which both the victim and offender have consumed alcohol are more likely to be spontaneous or opportunistic and more likely to involve strangers (Finney 2004; Plant, Plant & Thornton 2002)
- alcohol-related assaults most commonly occur between 9 pm and 3 am on Friday and Saturday nights (Briscoe & Donnelly 2001a)
- a significant proportion of offenders and victims of sexual assault have consumed alcohol and alcohol consumption increases the risk of sexual assault, as victims become less able to detect dangerous situations (Corbin et al 2001; Testa, Vanzile-Tamsen & Livingston 2001)
- there is a relationship between seasonal changes, calendar events and major sporting events and the rate of reported incidents of violence, which can in part be explained by the increased level of alcohol consumed on these days (Marcus & Braaf 2007).
Alcohol and homicide
Alcohol is also involved in a significant number of homicides. Recent research using the AIC's National Homicide Monitoring Program's (NHMP) database concluded that around half (47%) of all homicides in Australia between 2000 and 2006 were alcohol related (Dearden & Payne 2009). In this study, a homicide was classified as alcohol related if police had recorded the offender as having been drinking or drunk or toxicology reports showed the victim had consumed alcohol. In the majority of these homicides (60%), both the offender and victim had consumed alcohol. Other findings include:
- male victims of homicide are significantly more likely than females to have consumed alcohol
- alcohol-related homicides most frequently involvea male offender and victim who will likely know one another
- almost half (44%) of all intimate partner homicides, and the majority (87%) of intimate partner homicides involving Indigenous people, are alcohol related
- homicides occurring on weekends and in the hours between 6 pm and 6 am are more likely to involve alcohol
- homicides in recreational settings are more likely to involve alcohol, although those incidents that occur in residential locations or on the street account for a greater proportion of alcohol-related homicides
- alcohol is most frequently associated with those deaths involving physical altercations, blunt force injuries and stab wounds (Carcach & Conroy 2001; Darke & Duflou 2008; Dearden & Payne 2009).
Cost to police
Police in Australia devote a significant amount of resources to responding to incidents involving people who are intoxicated. Recent research estimated that around 10 percent of police time was dedicated to dealing with alcohol-related incidents, of which the most common was responding to assaults (Donnelly et al 2007). Dealing with each assault takes an average of more than two hours and as such, places a significant burden on police resources (Donnelly et al 2007). The total cost to policing across Australia from crime attributable to alcohol is around $747m annually (Collins & Lapsley 2007).
Underreporting of violent crime
A relatively small proportion of incidents involving alcohol-related violence are reported to police. As a result, many violent offences involving alcohol go unrecorded, making it difficult to determine the full extent of alcohol-related violence. According to one study, among those people who were physically abused by someone under the influence of alcohol or other drugs within a 12 month period, nearly three-quarters (70%) did not report the incident to police (Bryant & Williams 2000). This figure is even higher for assaults that occur in pubs and clubs, with approximately 85 percent of assaults not reported to police (Doherty & Roche 2003). One of the major reasons for this is that the incident is perceived as being too trivial for police involvement; but other common reasons include a belief that the police could not, or would not, do anything (Bryant & Williams 2000).
Perceptions of alcohol-related violence and feelings of safety
Alcohol-related crime and disorder can have an adverse impact upon perceptions of crime and safety among the broader community. According to a national survey, more than two-fifths (43%) of respondents perceived physical assault in a public place to be a problem in their neighbourhood and 84 percent believed it to be a problem in their state or territory (SCRCSP 2009). A similar proportion of respondents (86%) perceived drunken or disorderly behaviour as a problem in their state or territory. Another national survey found that of all drug types, around one-third of people identify the excessive consumption of alcohol as the most serious concern to the community (AIHW 2008). Public perceptions of the seriousness of alcohol-related violence, while likely to overestimate the true extent of offending, are not totally unfounded. Recent research suggests that the rate of assaults has increased markedly over the past decade (Ringland & Baker 2009). Alcohol-related assaults have also increased during this time (McIlwain & Homel 2009).
Alcohol-related violence in Indigenous communities
While the proportion of Indigenous people who consume alcohol is lower than the rest of the population, those who do consume alcohol do so at far more harmful levels (NDRI 2007). As a result, the excessive consumption of alcohol and alcohol-related conflict continue to be a significant problem within Indigenous communities, particularly in rural and remote areas (Delahunty & Putt 2006). Self-reported victimisation or physical abuse by someone under the influence of alcohol has been shown to be much higher among Indigenous Australians (Hennessy & Williams 2001). Intimate partner homicides involving an Indigenous offender and victim are 13 times as likely to be alcohol related than other intimate partner homicides (Dearden & Payne 2009). A survey of police found that four in five officers in both urban and non-urban areas perceive the use of alcohol by Indigenous people as a serious problem (Delahunty & Putt 2006). Research in remote Indigenous communities in Queensland concluded that while alcohol consumption was a common contributing factor in fights, it should be viewed as an important situational factor that exacerbates the seriousness of conflict, rather than a cause of violence (Memmott et al 2001). Research has also shown that Indigenous people do not underestimate the significance of problems associated with alcohol (Hennessy & Williams 2001).
Alcohol and family violence
Alcohol is also an important risk factor for both domestic violence and child abuse and neglect. The high rate of alcohol involvement in intimate partner homicide has already been reported. The consumption of alcohol, either by the offender or victim or both, is also a significant contributing factor in incidents of non-fatal domestic violence, with research demonstrating that women whose partners consume alcohol at excessive levels are more likely to experience domestic violence (Marcus & Braaf 2007). The involvement of alcohol in domestic violence is also a significant issue within Indigenous communities (Memmott et al 2001).
There is also a considerable body of research that suggests that alcohol abuse is an important risk factor for child abuse, maltreatment and neglect (Dawe, Harnett & Frye 2008). Research has shown that the excessive consumption or misuse of alcohol is associated with poor quality or inconsistent parenting, which can lead to a child experiencing a range of emotional or psychological problems (Dawe, Harnett & Frye 2008). Children whose parent (or parents) misuse or abuse alcohol are also more likely to be subjected to various forms of physical and verbal abuse (Dube et al 2001). Victims of child abuse (particularly physical abuse) and neglect are more likely to offend later in life, with research suggesting a direct causal link between child maltreatment and juvenile offending, including violent offending (Stewart, Dennison & Waterson 2002).
The relationship between alcohol and violence
Despite this strong body of evidence, the relationship between alcohol and violence, like many other complex social phenomena, is not a simple or straightforward one. Research shows that heavy drinking and intoxication are associated with physical aggression (Plant, Plant & Thornton 2002; Wells & Graham 2003). However, the majority of people who drink alcohol do not become offenders or victims of violent crime and consuming alcohol does not necessarily act as a precursor to violent behaviour (Plant, Plant & Thornton 2002).
Instead, research suggests that the association between alcohol and aggression is the result of a complex interaction of a number of variables, including:
- the pharmacological effects of alcohol on the cognitive, affective or behavioural functioning of the drinker which can lead to increased risk-taking, reduced anxiety regarding possible sanctions for their behaviour, heightened emotionality, impulsive behaviour, 'liquid courage', a distorted interpretation of events and an inability to resolve incidents verbally
- individual characteristics including age, gender, personality traits, predisposition to aggression, deviant attitudes and expectations of the drinker about the effects of alcohol and their behaviour while intoxicated
- effects of the drinking environment including situational factors such as crowding, permissiveness of violent behaviour, the management of licensed premises and the role and behaviour of venue staff (including managers and security)
- societal attitudes and values, including a culture of drinking to deliberately become intoxicated, using alcohol as an excuse for behaviour not normally condoned and for holding individuals less responsible for their actions (Graham et al 2006; 1998).
Therefore, the relationship between alcohol and violence is influenced by the interaction effects of alcohol along with personal, environmental and cultural factors. The prevention of violence and aggression must therefore be based upon a clear understanding of these interacting processes and risk factors, drawing upon the evidence base with respect to the most effective interventions to address these factors, and customising these strategies to suit the specific circumstances of local communities (Graham & Homel 2008).
Violence and the drinking environment
Australian Government policy directed towards reducing the incidents of alcohol-related victimisation has been primarily concerned with regulatory responses that target entertainment precincts, licensed premises and liquor outlets (Loxley et al 2005). Licensed premises are a high risk setting for alcohol-related violence, with a significant proportion of assaults occurring in or within close proximity to hotels and nightclubs (Haines & Graham 2005). Drinking establishments have been linked (both as the location of assaults and for the consumption of alcohol) with much higher rates of alcohol-related aggression and violence, particularly among males, than any other setting (Poynton et al 2005; Teece & Williams 2000; Wells et al 2005). Australian research indicates that over 40 percent of all assaults occur in or around licensed premises (McIlwain & Homel 2009). Both patrons and staff of licensed premises are at heightened risk of becoming involved in a violent incident when compared to other locations (Graham & Homel 2008).
Research demonstrates a strong correlation between liquor outlet density and the incidence of multiple forms of social disruption including homicide, assault and child abuse and neglect (Chikritzhs et al 2007). Outlet density is also related to neighbourhood perceptions of drunkenness as a problem (Donnelly et al 2006). However, not all licensed venues are problematic. Research has also shown that in any given area, a small number of outlets can be responsible for a disproportionate number of incidents of alcohol-related harm (Briscoe & Donnelly 2001b). Hotels and nightclubs are the most problematic licensed venues for violence, particularly those with extended or 24 hour trading (Briscoe & Donnelly 2001b; Chikritzhs & Stockwell 2002).
Understanding why certain licensed venues are more problematic than others is important. There is evidence that the characteristics of venue patrons, such as young males who drink heavily, are associated with increased likelihood of violence. However the strongest predictor of violence in licensed premises is the characteristics of the venue itself (Quigley, Leonard & Collins 2003). Premises that fail to discourage aggressive behaviour while exhibiting particular physical and social characteristics that are more conducive to aggressive behaviour will more frequently attract patrons who are most likely to become involved in aggressive behaviour (Quigley, Leonard & Collins 2003). There is strong evidence for adopting strategies to create a positive physical and social environment to attract patrons that are more likely to be well behaved.
Table 1 outlines the risk factors for licensed premises relating to the characteristics of patrons, the venue, social environment, staff behaviour and the wider environment. Many of these factors have been linked not only to the frequency of aggression, but to the severity of violence when it occurs. Understanding and addressing the range of factors associated with violence in and around licensed premises is critical to the development of effective interventions.
The broader social and regulatory context in which licensed premises operate must also be considered. In Australia, as with many other countries, there has been a general trend towards the liberalisation of liquor licensing legislation, deregulation of the sale of alcohol and growth in the night-time economy (Chikritzhs et al 2007; Graham & Homel 2008). Licensed premises are popular venues for entertainment and the consumption of alcohol, and an important location for socialising, particularly among young people (McIlwain & Homel 2009). This has important implications for the development of strategies that aim to reduce alcohol-related problems in and around entertainment precincts. It influences the types of premises that are established in these areas, the characteristics of the clientele and the culture and community within which premises operate (Graham & Homel 2008).
|Patron characteristics||Venue characteristics||Social environment||Staffing characteristics||Wider environment|
Greater proportion of males
Presence of males in groups, especially strangers to one another
Younger patrons, including those that are underage
Greater proportion of unkempt patrons and patrons from marginal groups
Patrons exhibiting signs of being less agreeable, more impulsive and angry
Queues or line ups outside the building
Patrons hanging around outside venue at closing
Queues for public transport
Venues with larger capacity
Poorly maintained and unpleasant decor
Unclean or messy
Poor or low levels of lighting
Crowding that inhibits movement around the venue, including around the bar
Frequent patron movement
Higher noise level
Poor ventilation and high temperature
Inadequate or uncomfortable seating
Inconvenient access to the bar
Heavy drinking and high levels of intoxication
Generally permissive environment with high levels of rowdy behaviour
Expectation that aggression will be tolerated
Presence of competitive games
Sexual activity, contact and competition
Limited availability of food
Other illegal activities, such as drug dealing
High proportion of male staff
Low staff-to-patron ratio
Lack of responsible serving practices
Refusing service to already intoxicated patrons
Drinking by staff
Greater number of staff adopting confrontational approach to venue management
Aggressive security staff
Poor coordination of staff
Poor monitoring and control of minor incidents
Limited ability to control or defuse situations
Lack of professionalism by security staff
Serving several drinks to patrons at closing
Younger security staff
High density of licensed premises
High levels of movement in and out of premises
Entry and ejection practices for aggressive patrons
Unfair or confrontational entry practices
Conflict between social groups emerging from or congregating around venues
Poor management of cluster points such as bus stations, taxi ranks, food outlets
Congestion points as crowds leave venues (especially at closing time)
Source: Graham et al 2006; Graham & Homel 2008; Quigley, Leonard & Colllins 2003
Alcohol-related violence in residential locations
Despite the attention that is often given to licensed premises, not all alcohol-related violence occurs within a public area. In fact, a significant proportion of alcohol-related assaults occurred within a private setting (Chikritzhs et al 2007). According to an analysis of NSW recorded crime data, more than one-third of assault incidents (38%) that were flagged as being alcohol related took place in residential locations, compared to 28 percent of assaults in outdoor locations (which can include those assaults that take place within the vicinity of licensed venues) and 26 percent of assaults inside licensed premises (Briscoe & Donnelly 2001a). Similarly, among those respondents to the NDSHS who reported being physically abused by someone under the influence of alcohol or illicit drugs in the previous 12 months, 34 percent of respondents reported having experienced physical abuse in their own home (AIHW 2008). While around 40 percent of homicides in residential locations are alcohol related, more than half (54%) of all alcohol-related homicides take place in someone's home (Darke & Duflou 2008; Dearden & Payne 2009). Individuals involved in violent incidents also frequently report having consumed an excessive amount of alcohol in residential locations, rather than in licensed premises, prior to the incident, including those incidents where the violence took place in or around a licensed premise (Hughes et al 2007).
There is also a relative dearth of research into alcohol-related violence (particularly non-domestic violence) that occurs outside of licensed premises and entertainment precincts. Greater attention needs to be given to preventing violence in residential settings and targeting the excessive consumption of alcohol at home. Given the practical difficulties associated with preventing alcohol-related violence in the home, it is important that there are mechanisms in place to identify and work with both perpetrators and victims to prevent repeat offending. This highlights the importance of improving reporting by victims, particularly given that a person of interest will be identified in 91 percent of recorded assaults that take place in the home (Briscoe & Donnelly 2001a).
Implications for policy and practice
There is a growing body of evidence that outlines a range of effective interventions to reduce the harms associated with alcohol, ranging from universal strategies to reduce the availability of alcohol to small scale, community-based projects to modify environmental conditions (eg see NDRI 2007). Regardless of the approach adopted, it is important that interventions target key risk factors for alcohol-related violence. This summary paper has highlighted several areas that should be targeted to reduce violence associated with the consumption of alcohol. These findings suggest that strategies should aim to:
- identify and target those venues associated with the greatest number of problems
- create a positive physical and social drinking environment to attract patrons that are more likely to be well behaved by setting and maintaining high standards for both venue operators and clientele
- target multiple contributing factors rather than any single cause of alcohol-related violence
- encourage and facilitate the reporting of victimisation
- address alcohol-related violence in a range of settings, not just in entertainment precincts
- be developed at the community level, where practical and appropriate, and adapted to suit local circumstances
- be based on effective partnerships between all levels of government, non-government, private business, academia and the community
- be supported by effective enforcement of existing liquor licensing laws.
To be effective in reducing alcohol-related violence, prevention efforts must aim to influence the relationships between individuals and the environment in which alcohol is consumed (Holder, Treno & Levy 2005). Environmental conditions (including social, physical and cultural factors) can be manipulated to influence individual drinking behaviours and related problems, including alcohol-related violence (Holder, Treno & Levy 2005). Particularly important is the need for a range of partners within the community to work together to set appropriate standards for the consumption of alcohol and set formal and informal controls on the misuse of alcohol and the problem behaviours that result (Graham & Homel 2008; Holder et al 2005).
As is the case with any community, interventions aimed at reducing the negative effects of alcohol and alcohol-related violence in Indigenous communities must attempt to address the factors that contribute to alcohol abuse.
In conclusion, it is important that the existing evidence base is used to inform policy and practice and is customised to suit local problems and circumstances. Further research and evaluation of violence prevention programs is required to continue to develop our understanding of what works in reducing alcohol-related violence and why, and to identify important lessons for successful implementation.
This summary paper was funded by the WA Office of Crime Prevention.
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