Latest information and statistics on alcohol

Drinking too much alcohol, both on single drinking occasions (binge drinking) and over a person’s lifetime can lead to harms including chronic diseases, injury and transport accidents, mental health disorders, intergenerational trauma and violence [40728][33425]. This affects individuals, families and the wider community. Many factors influence why people may drink too much alcohol, for example, socioeconomic disadvantage, stress and negative early life experiences [39347][39351]. With regard to Aboriginal and Torres Strait Islander people, as noted elsewhere in the Overview, it is important to understand the historical and social contexts of colonisation, the effects of dispossession of land and culture, economic exclusion and how these factors have influenced alcohol use [33425][30136][34063].

Extent of alcohol use among Aboriginal and Torres Strait Islander people

Aboriginal and Torres Strait Islander people are less likely to drink alcohol than non-Indigenous people, but those who do drink are more likely to at levels that cause harm [33725][42101].

Abstinence or no consumption of alcohol in the last 12 months

The 2022-2023 National Drug Strategy Household Survey (NDSHS) found that 28% of Aboriginal and Torres Strait Islander people aged 14 years and over had not consumed alcohol in the previous 12 months [48574].

The 2018-19 National Aboriginal and Torres Strait Islander Health Survey (NATSIHS) found that 26% of Aboriginal and Torres Strait Islander people aged 18 years or older reported they had never drank alcohol or had not done so for more than 12 months (26% of Aboriginal people and 23% of Torres Strait Islander people) [39231]. The proportion was higher for females (31%) than males (19%). The proportion was lowest in younger age-groups, 18-24 years (19%) and 25-34 years (18%), and highest in people aged 55 years and over (42%). Across the jurisdictions, the proportion of respondents who had not consumed alcohol in the past 12 months ranged from 44% in the NT, followed by SA (28%), WA and Qld (both 25%), with the lowest proportion in the ACT (10%). It was higher for people living in very remote areas (43%) than major cities (19%).

Not at risk

In the 2022-2023 NDSHS, 39% of Aboriginal and Torres Strait Islander people aged 14 years and over reported not exceeding the 2020 guidelines for drinking at risk in the previous 12 months (see highlighted box above, guideline 1) [48574].

Single occasion risk

In the 2022-2023 NDSHS, 30% of Aboriginal and Torres Strait Islander people aged 14 years and over reported not exceeding the 2020 guidelines for drinking at risk on a single occasion[1] in the previous 12 months [48574]. Thirteen percent (13%) reported exceeding the single occasion risk guideline in the past year, but not monthly; and 30% reported exceeding the single occasion risk guideline in the past year at least monthly.

In the 2018-19 NATSIHS[2], 18% of Aboriginal people and 22% of Torres Strait Islander people aged 18 years and over reported not exceeding the 2009 guidelines for drinking at risk on a single occasion[3] [39231]. Just over half (54%) of Aboriginal and Torres Strait Islander people reported exceeding the single occasion risk guideline, a decrease from 57% since the 2012-13 survey [39231][26500]. In 2018-19, a greater proportion of males (65%) exceeded the guideline than females (43%). A higher proportion of respondents in the younger age-groups exceeded the guideline (18-24 years: 65% and 25-34 years: 62%) than those in older age-groups, and the 55 years and over age-group had the lowest proportion of respondents who exceeded the guideline (34%). In 2018-19, WA reported the highest proportion of respondents exceeding the guideline (61%) and the NT the lowest (42%) [39231]. The proportion exceeding the guideline was similar for people living in remote areas (53%) and non-remote areas (54%).

Lifetime risk

In the 2018-19 NATSIHS, 26% of Aboriginal and Torres Strait Islander people aged 18 years and over reported not exceeding the 2009 guideline for drinking at lifetime risk[4] (Aboriginal people: 26% and Torres Strait Islander people: 21%) [39231]. In the survey, 20% of Aboriginal people and 24% of Torres Strait Islander people reported exceeding the guideline. The proportion of Aboriginal and Torres Strait Islander males exceeding the guideline for lifetime risk (30%) was higher than that of females (10%), and higher across all age-groups. Qld reported the highest proportion of people exceeding the guideline (25%) among the jurisdictions and the NT the lowest (13%). The proportion was higher in non-remote areas (21%) compared with remote areas (17%).

The 2022-2023 NDSHS reported the risky consumption of alcohol among Aboriginal and Torres Strait Islander people aged 14 years and over. Half of respondents (50%) reported consuming 10 standard drinks per week or less and 22% reported consuming more than 10 standard drinks per week [5].

In 2022-23, 18% of people aged 10 years and over who accessed publicly funded alcohol and other drugs (AOD) treatment services for their own substance use identified as being Aboriginal and/or Torres Strait Islander [43453]. Alcohol was the main drug of concern for 37% of Aboriginal and Torres Strait Islander clients who sought treatment for their own AOD use. A study conducted in 2019 among 775 Aboriginal and Torres Strait Islander people in SA (aged 16 years and over) found that 2.2% were likely dependent on alcohol (self-reported two or more dependence symptoms via the Grog Survey App) [42836].

Alcohol and pregnancy

Drinking alcohol in pregnancy may affect the unborn baby leading to Fetal alcohol spectrum disorder (FASD), a diagnostic term that describes a range of conditions including central nervous system dysfunction, poor growth, characteristic facial features and developmental delay [26090][31432]. In 2021, 92% of pregnant Aboriginal and Torres Strait Islander women self-reported not consuming alcohol during the first 20 weeks of pregnancy[6] [43321]. After 20 weeks of pregnancy, this increased to 97% of women.

Hospitalisation

In 2017-19, the crude rate of alcohol-related hospitalisations for Aboriginal and Torres Strait Islander people was 7.0 per 1,000 [42101]. The rate was higher for males than females (8.1 per 1,000 and 5.8 per 1,000 respectively). The highest crude rate of hospitalisations related to alcohol use for Aboriginal and Torres Strait Islander people was for mental and behavioural disorders at 6.3 per 1,000 (males: 7.3 per 1,000 and females: 5.3 per 1,000). Acute intoxication was the leading mental and behavioural disorder, with a crude hospitalisation rate of 4.2 per 1,000.

Across age ranges, the highest age-specific alcohol-related hospitalisation rates among Aboriginal and Torres Strait Islander people in 2017-19 were for the 45-54 years age-group (22 per 1,000), followed by the 35-44 years age-group (17 per 1,000), 55-64 years age-group (15 per 1,000), 25-34 years age-group (7.3 per 1,000), 65 years and over age-group (4.6 per 1,000), 15-24 years age-group (3.0 per 1,000) and 0-14 years age-group (0.2 per 1,000) [42101]. The rankings by age-group were the same among females and males, except males in the 55-64 years age-group who had a higher hospitalisation rate than males in the 35-44 years age-group (20 per 1,000 and 19 per 1,000 respectively).

By jurisdiction, crude rates of alcohol-related hospitalisations in 2017-19 for Aboriginal and Torres Strait Islander people were highest in the NT (16 per 1,000), followed by SA (9.1 per 1,000), WA (8.6 per 1,000), Qld (7.6 per 1,000), the ACT (4.8 per 1,000), NSW (4.0 per 1,000), Vic (3.7 per 1,000) and Tas (2.8 per 1,000) [42101]. Males had higher crude rates of alcohol-related hospitalisation than females across all states and territories, except the NT (males: 15 per 1,000 and females: 17 per 1,000).

Hospitalisation rates related to alcohol use in 2017-19 varied by level of remoteness [42101]. Aboriginal and Torres Strait Islander people living in remote areas[7] had the highest crude rates of hospitalisation related to alcohol use (15 per 1,000), followed by those in very remote areas (11 per 1,000). People in inner regional areas (3.1 per 1,000) and major cities (5.3 per 1,000) had the lowest crude rates of hospitalisation related to alcohol use.

Mortality

In 2018, 350 deaths among Aboriginal and Torres Strait Islander people (9.7% of all deaths) were attributable to alcohol use [44827]. For 2015-2019 in NSW, Qld, WA, SA and the NT, the crude rate for Aboriginal and Torres Strait Islander deaths related to alcohol use was 13 per 100,000 [42101]. The alcohol-related death rate for Aboriginal and Torres Strait Islander males was 2.1 times higher compared with females (17 per 100,000 and 8.1 per 100,000 respectively). The main cause of alcohol-related deaths was from alcoholic liver disease with a crude rate of 8.0 per 100,000.

Burden of disease

In 2018, alcohol use was the second leading risk factor contributing to the total burden of disease among Aboriginal and Torres Strait Islander people, accounting for 11% of the burden [44827]. For non-fatal burden of disease among Aboriginal and Torres Strait Islander people, 9.2% was attributable to alcohol use, the most of any risk factor.

Alcohol use disorders were the fourth leading group of diseases causing burden among Aboriginal and Torres Strait Islander people in 2018 (4.4% of total DALY) [44827]. Alcohol was a key contributor to burden of disease among males in particular, with alcohol use disorders ranked as the third leading cause of total burden, accounting for 6.2% of total DALY. Alcohol use was the leading risk factor contributing to the burden of disease for males in both the 15-24 years and 25-44 years age-groups, accounting for 26% and 23% of total disease burden respectively. For females, alcohol use disorders ranked 10^th among the causes of total burden (2.4% of total DALY). Alcohol use disorders were the leading cause of total burden among Aboriginal and Torres Strait Islander people aged 25-44 years (8.4% of total DALY) and the second leading cause among those aged 15-24 years (9.9% of total DALY).

[1] Never greater than four standard drinks in a single day in the past year [48574].

[2] The 2018-19 NATSIHS assessed a person’s alcohol consumption for single occasion and lifetime risk using the previous NHRMC’s 2009 guidelines [39231].

[3] Four or less standard drinks on a single day for both males and females [39231].

[4] No more than two standard drinks on any single day [39231].

[5] Estimate should be interpreted with caution due to the small sample size [48574].

[6] Data excludes NSW and SA [43321].

[7] Excluding remote Vic [42101].