Hazardous and Harmful Alcohol Use in the Northern Territory, Australia: The Impact of Alcohol Policy on Critical Care Admissions Using an Extended Sampling Period
Research article
Abstract
Aims
To describe the effect of alcohol policy on the incidence of intensive care unit (ICU) admissions associated with hazardous and harmful alcohol use in the Northern Territory (NT) of Australia.
Design, setting and participants
Before and after analysis of admissions to NT ICUs between April 2018 and September 2019, extending on both a descriptive study describing hazardous and harmful [high-risk and heavy] alcohol use and single‐centre analyses of harm minimization policies. After exclusions, 2281 (83%) admissions were analysed, 20.3% of which were associated with high-risk and heavy alcohol use.
Measurements
Primary outcome was the incidence of admissions associated with high-risk and heavy alcohol use in the 5 months preceding (baseline period) the introduction of new alcohol policies [full‐time stationing of Police Auxiliary Liquor Inspectors (PALIs) and minimum unit price (MUP)] compared with 12 months (post‐intervention) following. Secondary outcomes included measures of resource use [length of stay (LoS), need for mechanical ventilation] and mortality, stratified by site.
Findings
Overall, there was a 4.5% [95% confidence interval (CI) = 0.8–8.2%] absolute risk reduction between the time‐periods (95% CI = 23.4 versus 18.9% for baseline and post‐intervention, respectively, P = 0.01), predominantly due to a reduction in admissions associated with acute use (2.3%, 95% CI = −0.2 to 4.9% risk reduction, P = 0.06). There were regional differences, with a more marked relative risk reduction observed in Central Australia compared with the city of Darwin (27.0 versus 16.7% relative risk reduction, respectively).
Conclusions
Introduction of new alcohol harm minimization policies in the Northern Territory of Australia appears to have reduced the number of intensive care unit admissions associated with high-risk and heavy alcohol use. Strength of effect varies by geographical region and chronicity of hazardous and harmful alcohol use.
