Increasing alcohol restrictions and rates of serious injury in four remote Australian Indigenous communities

Stephen A Margolis, Valmae A Ypinazar, Reinhold Muller and Alan Clough
Med J Aust 2011; 194 (10): 503-506.


Objective: To document rates of serious injuries in relation to government alcohol restrictions in remote Australian Indigenous communities.

Design and setting: An ecological study using Royal Flying Doctor Service injury retrieval data, before and after changes in legal access to alcohol in four remote Australian Indigenous communities, Queensland, 1 January 1996 – 31 July 2010.

Main outcome measures: Changes in rates of aeromedical retrievals for serious injury, and proportion of retrievals for serious injury, before and after alcohol restrictions.

Results: After alcohol restrictions were introduced in 2002–2003, retrieval rates for serious injury dropped initially, and then increased in the 2 years before further restrictions in 2008 (average increase, 2.34 per 1000 per year). This trend reversed in the 2 years after the 2008 restrictions (average decrease, 7.97 per 1000 per year). There was a statistically significant decreasing time trend in serious-injury retrieval rates in each of the four communities for the period 2 years before the 2002–2003 restrictions, 2 years before the 2008 restrictions, and the final 2 years of observations (2009–2010) (P < 0.001 for all four communities combined). Overall, serious-injury retrieval rates dropped from 30 per 1000 in 2008 to 14 per 1000 in 2010, and the proportions of serious-injury retrievals decreased significantly for all four communities.

Conclusion: The absolute and the proportional rates of serious-injury retrievals fell significantly as government restrictions on legal access to alcohol increased; they are now at their lowest recorded level in 15 years.

  • Stephen A Margolis1
  • Valmae A Ypinazar2
  • Reinhold Muller2
  • Alan Clough2

  • 1 Education and Research Unit, Royal Flying Doctor Service (Queensland Section), Cairns, QLD.
  • 2 James Cook University, Townsville, QLD.



We thank the Royal Flying Doctor Service (Queensland Section) for providing access to their data.

Competing interests:

None identified.

  • 1. Australian Bureau of Statistics and Australian Institute of Health and Welfare. The health and welfare of Australia’s Aboriginal and Torres Strait Islander peoples. Canberra: ABS / AIHW, 2008. (ABS Cat. No. 4704.0; AIHW Cat. No. IHW 30.)
  • 2. Calabria B, Doran CM, Vos T, et al. Epidemiology of alcohol-related burden of disease among Indigenous Australians. Aust N Z J Public Health 2010; 34 Suppl 1: S47-S51.
  • 3. Australian Institute of Health and Welfare. Australia’s health 2010. Canberra: AIHW, 2010. (AIHW Cat. No. AUS 122.)
  • 4. Australian Institute of Health and Welfare. Statistics on drug use in Australia 2002. Canberra: AIHW, 2003. (AIHW Cat. No. PHE 43; Drug Statistics Series No. 12.)
  • 5. Vos T, Barker B, Stanley L, Lopez A. The burden of disease and injury in Aboriginal and Torres Strait Islander peoples. Summary report. Brisbane: School of Population Health, University of Queensland, 2007. (accessed Apr 2011).
  • 6. Shakeshaft A, Clifford A, Shakeshaft M. Reducing alcohol related harm experienced by Indigenous Australians: identifying opportunities for Indigenous primary health care services. Aust N Z J Public Health 2010; 34 Suppl 1: S41-S45.
  • 7. Eber C. “Take my water”: liberation through prohibition in San Pedro Chenalho, Chiapas, Mexico. Soc Sci Med 2001; 53: 251-262.
  • 8. Landau TC. The prospects of a harm reduction approach among indigenous people in Canada. Drug Alcohol Rev 1996; 15: 393-401.
  • 9. Lonner TD. Village alcohol control: traditional methods and the Local Option Law. Circumpolar Health 1985; 84: 335-339.
  • 10. Seale JP, Seale JD, Alvarado M, et al. Prevalence of problem drinking in a Venezuelan Native American population. Alcohol Alcohol 2002; 37: 198-204.
  • 11. Queensland Government. Cape York Justice Study report. Brisbane: Qld Government, 2001. (accessed Apr 2011).
  • 12. Queensland Government Department of the Premier and Cabinet. Meeting challenges, making choices: the Queensland Government’s response to the Cape York Justice Study. Brisbane: Qld Government, 2002.
  • 13. Borges G, Cherpitel C, Orozco R, et al. Acute alcohol use and the risk of non-fatal injury in sixteen countries. Addiction 2006; 101: 993-1002.
  • 14. Cherpitel C, Ye Y, Bond J, et al. The effect of alcohol consumption on emergency department services use among injured patients: a cross-national emergency room study. J Stud Alcohol 2006; 67: 890-897.
  • 15. Macdonald S, Cherpitel C, DeSouza A, et al. Variations of alcohol impairment in different types, causes and contexts of injuries: results of emergency room studies from 16 countries. Accid Anal Prev 2006; 38: 1107-1112.
  • 16. Wundersitz J. Indigenous perpetrators of violence: prevalence and risk factors for offending. Canberra: Australian Institute of Criminology, 2010. (Research and Public Policy Series No. 105.) (accessed Apr 2011).
  • 17. Margolis SA, Ypinazar VA, Muller R. The impact of supply reduction through alcohol management plans on serious injury in remote indigenous communities in remote Australia: a ten-year analysis using data from the Royal Flying Doctor Service. Alcohol Alcohol 2008; 43: 104-110.
  • 18. Queensland Government. Meeting challenges, making choices. Evaluation. Brisbane: Qld Government, 2005.
  • 19. Queensland Government. Aboriginal and Torres Strait Islander Services. Alcohol reforms. (accessed Apr 2011).
  • 20. Margolis SA, Ypinazar VA. Aeromedical retrieval for critical clinical conditions: 12 years of experience with the Royal Flying Doctor Service, Queensland, Australia. J Emerg Med 2009; 36: 363-368.
  • 21. McLeod R, Stockwell T, Stevens M, Phillips M. The relationship between alcohol consumption patterns and injury. Addiction 1999; 94: 1719-1734.
  • 22. Macdonald S, Cherpitel CJ, Borges G, et al. The criteria for causation of alcohol in violent injuries based on emergency room data from six countries. Addict Behav 2005; 30: 103-113.
  • 23. Australian Bureau of Statistics [website]. Census data. July 2010. Canberra: ABS, 2010. (accessed Aug 2010).
  • 24. Queensland Government. Annual highlights report for Queensland’s discrete Indigenous communities. July 2009 – June 2010. Brisbane: Qld Government, 2010. (accessed Apr 2011).
  • 25. Saggers S, Gray D. Dealing with alcohol: indigenous usage in Australia, New Zealand and Canada. Melbourne: Cambridge University Press, 1998.
  • 26. Margolis SA, Ypinazar VA, Clough AR, Hunter E. Absence of alcohol withdrawal syndrome in a remote Indigenous community [letter]. Med J Aust 2008; 189: 596. <MJA full text>
  • 27. Barry S. Council wants more police to combat sly grogging. ABC News [website] 2009; 9 Jun. (accessed Apr 2011).
  • 28. Koch T. “Token fines” only for sly-grogging. The Australian 2010; 9 Feb. (accessed Apr 2011).
  • 29. Senior K, Chenhall R. Lukumbat marawana: a changing pattern of drug use by youth in a remote Aboriginal community. Aust J Rural Health 2008; 16: 75-79.
  • 30. McCalman J, Tsey K, Wenitong M, et al. Indigenous men’s support groups and social and emotional wellbeing: a meta-synthesis of the evidence. Aust J Prim Health 2010; 16: 159-166.
  • 31. Taylor K, Thompson S, Davis R. Delivering culturally appropriate residential rehabilitation for urban Indigenous Australians: a review of the challenges and opportunities. Aust N Z J Public Health 2010; 34 Suppl 1: S36-S40.
  • 32. Queensland Health. The health of Queenslanders 2010: third report of the Chief Health Officer Queensland. Brisbane: Qld Health, 2010. (accessed April 2011).


remove_circle_outline Delete Author
add_circle_outline Add Author

Do you have any competing interests to declare? *

I/we agree to assign copyright to the Medical Journal of Australia and agree to the Conditions of publication *
I/we agree to the Terms of use of the Medical Journal of Australia *
Email me when people comment on this article

Responses are now closed for this article.