Blunting the legacy of alcohol abuse in Western Australia

Abstract

Fitzroy Crossing, an isolated town with approximately 2500 residents in Australia’s remote northwest, was typical of such communities, with a large Indigenous population (around 60%), high rates of harmful alcohol use, and depressingly high rates of alcohol-related violence and crime. A tipping point came in 2007 when there were 55 deaths in the community, 13 being suicides. Alcohol was a factor in most deaths. After much consultation, community elders took what at the time was unthinkable action: proposing that all stores selling take-away alcohol be restricted only to low-strength beverages, with a maximum of 2·5% alcohol by volume. Take-away sales of stronger beers or ciders, wine, and spirits were prohibited, meaning these could only be bought in the bar of the town’s two licensed premises that were prohibitively expensive to many residents. The nearest town selling take-away high strength alcohol is 250 km away. Despite stern opposition and personal threats to those leading the reform, there was sufficient community support to implement a trial of the restrictions. 12 months after their introduction, independent assessment showed a 28% reduction in alcohol-related incidents attended by police, a 42% reduction in alcohol-related hospital presentations, and a 14% increase in school attendance. Fitzroy Crossing suddenly became a more pleasant place to live and work. Local police could engage proactively with the community, rather than responding to incidents over which they had no control. So successful were the restrictions that the West Australian Liquor Licensing authorities extended them indefinitely. Alcohol can cause a range of permanent physical and neurocognitive abnormalities known as fetal alcohol spectrum disorders (FASD), including specific diagnoses of fetal alcohol syndrome (FAS), partial FAS, and neuro developmental disorder—alcohol exposed (ND-AE). “Alcohol consump tion during pregnancy can cause birth defects, growth restriction, and a range of lifelong developmental,