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The drift to individualised control of drinkers: where are we headed?
 

The drift to individualised control of drinkers: where are we headed?

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Presentation by Robin Room, Centre for Alcohol Policy Research, Turning Point Alcohol & Drug Centre, School of Population Health, University of Melbourne. Presented at the DrugInfo seminar on crime ...

Presentation by Robin Room, Centre for Alcohol Policy Research, Turning Point Alcohol & Drug Centre, School of Population Health, University of Melbourne. Presented at the DrugInfo seminar on crime and disorder at Melbourne Exhibition Centre, 5 September, 2012.

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    The drift to individualised control of drinkers: where are we headed? The drift to individualised control of drinkers: where are we headed? Presentation Transcript

    • The drift to individualised control of drinkers: where are we headed? Robin Room Centre for Alcohol Policy Research, Turning Point Alcohol & Drug Centre; School of Population Health, University of MelbourneFor presentation at a DrugInfo Seminar: Alcohol and Other DrugRelated Crime and Disorder, Australian Drug Foundation, at theMelbourne Convention and Exhibition Centre, 5 September, 2012
    • Individualised controls• Bans on individual drinkers purchasing or being on premises (in the past, also individualised rations)• 20 years ago, a forgotten measure from the past; now a rising wave in the UK & Australia• The prehistory: individualised controls in the 1920s-1960s, and what happened to them• Evidence on effects and effectiveness?• The relevance for alcohol policy today
    • Current events: 1. private banning schemes• Late 1980s onward – UK: PubWatch – Australia: Community Liquor Accords – Encouraged and often stimulated by the police – Banning misbehaving individuals for a time from all participating bars as a common tactic – Supposedly private voluntary associations, so no possibility of legal review of decisions – But limited effectiveness – e.g., the “problem places” often don’t participate
    • Current events: 2. civil-law banning orders• UK: Drinking Banning Orders (DBOs) –Partially implemented: 313 issued by November 2011• Australia: –New South Wales: “self-exclusion agreement” – unclear if used –Victoria: 24-hour bans by police – 2144 in Melb. CBD by Jan. 2010 –Western Australia – new “barring notices” by police – appealable if > 1 month – 15 by Dec, 2011 –Northern Territory – Katherine & Alice Springs: court prohibition notices enforced by electronic photo ID check • Groote Eylandt: permit required for purchase: – ~900 permits issued to most of the white population – 45 in Aboriginal population of ~1500 – 39 permits revoked in two years
    • Current events: 3. NT “Enough is Enough” alcohol reforms• 1 Oct. 2010: first “liquor banning notice” in Darwin under new legislation – Up to 48 hours from entertainment district after an offense• New laws in 2011, “fully operational” 1 Jan., 2012: – Banning Alcohol and Treatment orders from police for 6 months if picked up drunk 3 times in 3 mo., etc. – Special tribunal can give BAT order for 1 year or more – Banned Drinker Register (BDR); 2491 on it by end of June 2012: • 959 because of police BAT Notice after protective custody for drunkenness; • 614 because of police BAT Notice after an offence • 756 because of court orders, parole or bail conditions – Electronically scannable photo ID required to purchase alcohol to take away, has to be checked by seller against electronic BDR
    • The prehistory• Strict alcohol controls as alternative to or after prohibition, 1915-1960s – Population-level measures (taxes, opening hours, number of stores, etc.) – But also individualised controls: • Permits for purchasing alcohol in all Canadian provinces – Ontario: 4000 banning orders (“drunk list”) each year in 1940s • in five USA states • Sweden: Individualised rationing (motbok); of males 25+, motbok refused or withdrawn for 10%, rights reduced or restricted for another 11.4% • Finland: buyer surveillance (enforced by staff of 215): 15,000 with purchase permits revoked
    • Limited evidence on effectiveness: In the past• Sweden at end of motbok: – consumption up 25%, DT deaths up fourfold – Rationing, not banning, probably the main factor holding down consumption of heavy drinkers• Finland: – only small differences in consumption in 1952 between alcohol abusers with & without intervention (some bans) in 1949 – Recording purchases in permit book did affect misusers’ purchases (small study 1954-55)• Ontario: No study (but looking back, some correlation?)
    • Limited evidence on effectiveness: Now• Groote Eylandt: an island with limited access: – After rationing scheme requiring permit to purchase: • Incidents in police records dropped substantially ; • “a marked improvement in community harmony and reduction in fighting and other alcohol-related harms” in Indigenous communities (Conigrave et al., 2007)• Northern Territory “Enough is Enough”: – “Alcohol Reform Progress Report” issued before 2012 election: • 6% drop (120) in public assault statistics from previous year • But 8% rise (200) in domestic assaults – Reflecting more police attention to domestic violence? – Or policy “creating conflict between banned drinkers and their partners” – women “expected to provide alcohol or transport to purchase alcohol”?
    • The turn 50 years ago against individualised controls• Sociology: labelling theory, secondary deviance• Moves to decriminalise “status offenses”• More attention to discrimination in enforcement  attraction of the total consumption model (TCM) – Foundation documents of the TCM flew the flag of public health, but written mostly by sociologists: • TCM measures more effective and cheaper to implement than individualised “social handling” • But also ethically preferable (Bruun et al., Alcohol Control Policies in Public Health Perspective, 1975)
    • Back to the future?• The politician’s dilemma: – Sharp rise in public attention to alcohol problems in the nighttime economy and in clubbing and festivals – Continuing dominance of free-market ideology • locked in by competition policy in Australia and EU single- market rules in UK • strong political influence of alcohol industries & allied trades• With intervention in the market blocked, political attention is directed to the drinker: catch and punish the “bad apples”
    • The NT as a case in point: 1• NT reform proposal originally included measures affecting bars, e.g., giving police power to close pubs if they feared trouble.• The pub owners (AHA) had a negative view; the focus of reform changed to targeting anti-social behaviour.• The architect of the original proposals resigned: – “When you take that view of the world, you target and even stigmatise a group of people. [Whereas] risky drinking cuts across the whole territory”. -- Peter Jones, quoted in R. Callinan, NT grog reform ‘shelved to placate hotels’, The Australian, 19 March 2011.
    • The NT as a case in point: 2• In 25 August election, Country Liberal Party ran on a platform to dismantle the Banned Drinkers Register, substitute two mandatory 3-month rehabilitation prison farms for those who don’t “volunteer” for treatment after being picked up 3 times in 6 months• Chief Minister-elect: “I got to work on day one and that was to remove the Banned Drinkers Register and set in play the decommissioning of that machinery so we can focus on the real problems.... Then we begin to remove some of those measures around supply.” 27 August, ABC radio; http://www.abc.net.au/worldtoday/content/2012/s3576478.htm
    • Difficulties ahead?• Individualised controls as the answer to the dilemma: the problems are defined in terms of “bad apples”• But: – unclear how effective and what effects • little political interest in actual effects • if the measures are effective, they will affect the market – NT election results: whether effective or not, individual- oriented solutions which interfere with the market will face opposition – Potentially costly to implement (but compared to what?) – And what about stigmatisation, discrimination in application – the ethical issues which killed the schemes in the 1960s?
    • Acknowledgements• Thanks for help on Finland: Klaus Mäkelä; on NT: Peter d’Abbs and Sarah MacLean• Professorship supported by Victoria Department of Health and Foundation for Alcohol Research & Education• Based on and updated from: Room, R. “Individualized control of drinkers: Back to the future?”, Contemporary Drug Problems, in press, Summer 2012.
    • •Centre for Mental Health and Wellbeing Research
    • Centre for Mental Health and Wellbeing Research
    • Centre for Mental Health and Wellbeing Research