April 12, 2019

Alcohol and other drugs in regional and remote areas

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A recent study has confirmed that alcohol consumption is significantly higher in regional and remote areas of Australia when compared to major cities.

The report, published by the Australian Institute of Health and Welfare, highlights that the use of alcohol and some drugs, as well as harms related to use and access to treatment, is very different for people living in non-urban areas.1,2

The impact of alcohol

Alcohol is the most commonly used drug in Australia, with consumption per capita and alcohol-related harms increasing with remoteness.2,5,6 People living in regional and remote areas are more likely to drink frequently or at levels that are harmful to their health.2,3,4

Various factors contribute to higher alcohol consumption within regional and remote areas including the social acceptability of alcohol and its role in community and social events.4 For example, cultural attitudes toward alcohol in regional and rural settings are more likely to normalise frequent or heavy alcohol consumption as acceptable or positive behaviour in comparison to attitudes in urban areas.4

One study found that these attitudes and beliefs are copied among adolescents and influenced by widespread supply of alcohol by parents to teenagers in regional and remote areas.6 As a result, adolescents living outside cities are up to 80% more likely to consume alcohol, particularly at levels that are harmful to their health.6,7

Some studies have also argued that there is a higher density of alcohol outlets in outer-urban, regional and rural areas, which can increase the likelihood of risky drinking, particularly among adolescents.8,9

Illicit drug use in regional and remote areas

Overall use of illicit drugs in regional and remote areas is similar to that in cities, however the type and frequency of drug use varies considerably. For example, people in remote and very remote areas are 2.5 times more likely to use meth/amphetamines as those in cities.5 Cannabis use is also more widespread and frequent in remote and very remote settings.2

While drug-induced deaths are more common in major cities, they are increasing more rapidly in regional and remote areas than in cities.2

Alcohol and drug use in regional and remote areas

Many individual - and community-level factors contribute to alcohol and drug use, dependency and related harms.10

These include education, employment, affordability and quality of housing, gender, age and socioeconomic status.11 These factors are influenced and exacerbated by proximity to major cities and services. The social isolation, rates of youth unemployment and lower educational attainment experienced by people in regional and remote areas are likely to have an impact on alcohol and drug use.2

Lack of access to primary and specialist health services for people living in regional and remote areas also impacts poor health outside cities.

While most people in major cities and regional areas live near services, people in remote and very remote areas travel an average of 1.5 hours or 102.7 kilometres to access treatment for alcohol or other drug dependency.2 This trend is compounded for Aboriginal and Torres Strait Islander people, who are more likely to live in very remote areas.2

Vulnerable groups

Some communities in regional and remote areas may be at heightened risk of harm from alcohol and other drugs, particularly those that experience poorer health and wellbeing in general.

It is well established that men are more likely than women to be using or dependent on alcohol or other drugs.2 This tendency is exacerbated in regional and remote communities.

Alcohol dependency is prevalent among fly-in-fly-out (FIFO) workers in Western Australia, Queensland and the Northern Territory, due to routine separation from families and support networks, long working hours and variability of living conditions.13,14

Aboriginal and Torres Strait Islander people also experience a disproportionate amount of harms from alcohol and drug use.15

Alcohol dependency is common among rural farmers, as a result of financial stressors, climatic challenges, restructuring of the sector and high prevalence of mental illnesses such as depression and anxiety.16

Access to help

People living remotely believe alcohol and drug issues are one of the top health priorities for their local community.17

Reducing inequalities and addressing alcohol and drug-related harms requires comprehensive town planning, interventions targeting licensed venues and expanding access to primary and specialist health services.18,19,20

If you or someone you know is experiencing alcohol or drug dependence, help is available.

  1. Miller PG, Coomber K, Staiger P, Zinkiewicz L, Toumbourou JW. Review of rural and regional alcohol research in Australia. Australian journal of rural health. 2010 Jun;18(3):110-7.
  2. Australian Institute of Health and Welfare 2019. Alcohol and other drug use in regional and remote Australia: consumption, harms and access to treatment, 2016–17. Cat. no. HSE 212. Canberra: AIHW.
  3. Roche A, Kostadinov V, Fischer J, Nicholas R, O'Rourke K, Pidd K, Trifonoff A. Addressing inequities in alcohol consumption and related harms. Health promotion international. 2015 Sep 1;30(suppl_2):ii20-35.
  4. Allan J, Clifford A, Ball P, Alston M, Meister P. ‘You're less complete if you haven't got a can in your hand’: alcohol consumption and related harmful effects in rural Australia: the role and influence of cultural capital. Alcohol and alcoholism. 2012 Sep 1;47(5):624-9.
  5. Australian Institute of Health and Welfare. National Drug Strategy Household Survey detailed report: 2013.Canberra:AIHW; 2014
  6. Chan GC, Leung J, Quinn C, Kelly AB, Connor JP, Weier M, Hall WD. Rural and urban differences in adolescent alcohol use, alcohol supply, and parental drinking. The Journal of Rural Health. 2016 Jun;32(3):280-6.
  7. Chan GC, Kelly AB, Connor JP, Hall W, Young RM, Toumbourou JW, Williams J. Regional versus urban differences in teenage alcohol use: Does parental disapproval account for these differences?. Australian journal of rural health. 2016 Feb;24(1):3-8.
  8. MacLean S, Ferris J, Livingston M. Drinking patterns and attitudes for young people in inner-urban Melbourne and outer-urban growth areas: Differences and similarities. Urban Policy and Research. 2013 Dec 1;31(4):417-34.
  9. Azar D, White V, Coomber K, Faulkner A, Livingston M, Chikritzhs T, Room R, Wakefield M. The association between alcohol outlet density and alcohol use among urban and regional Australian adolescents. Addiction. 2016 Jan;111(1):65-72.
  10. Breen C, Shakeshaft A, Sanson‐Fisher R, D'este C, Mattick RP, Gilmour S. Identifying individual‐and population‐level characteristics that influence rates of risky alcohol consumption in regional communities. Australian and New Zealand journal of public health. 2014 Feb;38(1):60-5.
  11. Loring B. Alcohol and inequities: guidance for addressing inequities in alcohol-related harm. Copenhagen, Denmark: World Health Organization; 2014.
  12. Roxburgh A, Miller P, Dunn M. Patterns of alcohol, tobacco and cannabis use and related harm in city, regional and remote areas of Australia. International Journal of Drug Policy. 2013 Sep 1;24(5):488-91.
  13. Tynan RJ, Considine R, Wiggers J, Lewin TJ, James C, Inder K, Kay-Lambkin F, Baker AL, Skehan J, Perkins D, Kelly BJ. Alcohol consumption in the Australian coal mining industry. Occup Environ Med. 2017 Apr 1;74(4):259-67.
  14. Joyce SJ, Tomlin SM, Somerford PJ, Weeramanthri TS. Health behaviours and outcomes associated with fly‐in fly‐out and shift workers in W estern A ustralia. Internal Medicine Journal. 2013 Apr;43(4):440-4.
  15. Gray D, Stearne A, Bonson M, Wilkes E, Butt J, Wilson M. Review of the Aboriginal and Torres Strait Islander alcohol, tobacco and other drugs treatment service sector: harnessing good intentions. National Drig Research Institute (NDRI), Curtin University; 2014.
  16. Brumby S, Kennedy A, Chandrasekara A. Alcohol consumption, obesity, and psychological distress in farming communities—An Australian study. The Journal of Rural Health. 2013 Jun;29(3):311-9.
  17. Bush asks for more doctors, mental health, and drug and alcohol services. Australia: Royal Flying Doctor Service; 2017 August 1 [cited: 2019 March 21].
  18. Roche A, Kostadinov V, Fischer J, Nicholas R, O'Rourke K, Pidd K, Trifonoff A. Addressing inequities in alcohol consumption and related harms. Health promotion international. 2015 Sep 1;30(suppl_2):ii20-35.
  19. THE EXTENT OF THE RURAL HEALTH DEFICIT . Australian Capital Territory: National Rural Health Alliance Inc.; 2016 May 13 [cited 2019 March 21].
  20. Australian Institute of Health and Welfare. Rural, Regional and Remote Health: Indicators of Health. Canberra: AIHW; 2005.

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